BOCA RATON, FL (Boca Post) (Copyright © 2026) — West Boca Medical Center, Inc., doing business as West Boca Medical Center, has filed a civil complaint against Best Roofing Services, LLC in Palm Beach County Circuit Court, alleging the company’s employee health plan underpaid a hospital claim for inpatient services.
The case is West Boca Medical Center, Inc. d/b/a West Boca Medical Center v. Best Roofing Services, LLC, Case No. 502026CA002352XXXAMB, filed Feb. 27, 2026, in the Circuit Court of the 15th Judicial Circuit in and for Palm Beach County, Florida (Civil Division).
The hospital is represented by the Law Offices of Lorne S. Cabinsky, P.A. of Fort Lauderdale, according to the complaint. A defense law firm is not identified in the filing.
In the complaint, the hospital alleges it provided “medically necessary inpatient hospital services for labor and delivery” to a participant or beneficiary of Best Roofing Services’ employee health benefit plan during a hospitalization dated July 13, 2022 through July 18, 2022. The patient is referenced in the filing by initials, and the hospital states it is using that limited identifier for privacy reasons.
The lawsuit describes Best Roofing Services as the plan sponsor and alleges the plan is a self-funded employee welfare benefit plan governed by the federal Employee Retirement Income Security Act of 1974, commonly referred to as ERISA. The filing also states that EVHC served as the plan’s third-party administrator.
According to the complaint, the hospital submitted a claim for payment under the plan and the plan issued an explanation of benefits that acknowledged coverage but paid $11,767.96, with $500 applied to patient responsibility. The hospital alleges that patient-responsibility amount was paid, and it claims an unpaid balance of $94,443.62 remains. The hospital states the total billed charges for the hospitalization were $106,711.58, and it alleges the remaining amount was reduced as an “adjustment” reflected on the explanation of benefits.
The complaint further alleges that, at the time of admission, the patient executed a written consent and assignment of benefits in favor of the hospital. The hospital claims that assignment transferred plan benefits and related rights to the hospital, including the right to pursue appeals and legal remedies for alleged nonpayment or underpayment of covered benefits.
The hospital alleges it appealed the underpayment through the plan’s internal review process, but the plan upheld the payment determination and did not remit additional benefits. The complaint states that administrative remedies required under the plan were exhausted or deemed exhausted before the lawsuit was filed.
The filing asserts two counts. In Count I, the hospital brings a claim for benefits under ERISA §502(a)(1)(B), alleging Best Roofing Services is obligated to pay benefits due for covered inpatient hospital services and failed to pay the full amount allegedly owed under the plan’s terms. In Count II, pleaded in the alternative, the hospital seeks equitable relief under ERISA §502(a)(3), alleging equitable remedies may be appropriate if relief under the benefits provision is deemed unavailable or inadequate.
In its demand for relief, the hospital seeks $94,443.62 in alleged unpaid benefits, along with prejudgment interest, and attorneys’ fees and costs under ERISA, plus any other relief the court deems proper.
The original complaint, West Boca Medical Center, Inc., d/b/a West Boca Medical Center v. Best Roofing Services, LLC, Case No. 502026CA002352XXXAMB, as filed Feb. 27, 2026, with the Palm Beach County Clerk of Court, can be viewed here.
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