Mr. Andres Rene Gonzalez, Private Law Practice

Andres Gonzalez was born in Queens, New York, and has lived in South Florida since 1976. In April 1991, he earned his Bachelor of Arts degree with high honors at Florida International University, pursuing a double major in Finance and International Business. Because of his undergraduate academic achievements, he was selected for the Phi Kappa Phi National Honor Society. In 1993, Mr. Gonzalez attended the University of Denver College of Law, on an academic scholarship, where he was selected to the Order of St. Ives at the University of Denver College of Law for his outstanding academic scholarship. He earned his Juris Doctor degree with honors in 1996, graduating sixth in his class and top 10 percent and was admitted to the Florida Bar in 1997.

Upon graduation in 1997, Mr. Gonzalez joined the Firm as an associate. Since joining the Firm, he has concentrated his practice in the area of managed care and health law and long-term and short-term disability law. He represents managed care clients in disputes involving direct negligence allegations based on the administration of managed care benefits, utilization management decisions, network provider credentialing, quality assurance, and medical malpractice. He also represents managed care clients in vicarious liability claims based on theories of agency, apparent agency, respondent superior, joint venture and non-delegable duty for the alleged actions of contracted network health care providers.

Mr. Gonzalez is also highly experienced in the removal of claims from state court to federal court based on federal question jurisdiction pursuant to ERISA preemption or removal to federal court based on diversity jurisdiction. He is expert in defending claims against managed care clients instituted in state courts under numerous theories but which are preempted by ERISA pursuant to §§ 1132 and 1144. He also has expertise in ERISA litigation with emphasis on claims based on § 1132 of ERISA to recover benefits or enforce rights of coverage, on § 1109 for breach of fiduciary duty and on violation of disclosure requirements under §§ 1021 through 1027. He is also highly experienced in defending clients in federal and state court in claims for long-term and short-term disability benefits, with expertise in administrative record and standard of review defenses.

His practice also involves representing clients in commercial disputes, involving reimbursement for services rendered by contracted and non-contracted providers, with issues concerning procedure coding, Medicare reimbursement, Medicaid reimbursement, usual and customary charges, balance billing, technical component of services, professional component of services, hospital based physicians, and payment of emergency services under Florida law. He also represents clients in commercial disputes in arbitration proceedings before the American Arbitration Association.

Mr. Gonzalez also performs risk assessment for many clients, including review and assessment of service contracts, provider contracts, member contracts, group contracts, marketing materials, department policies and procedures, organizational policies and procedures, and organizational guidelines. He has also been intricately involved in assisting the Firm's founding partner, Steven M. Ziegler, Esquire with the drafting of the HMO reform language, which the Florida Legislature ultimately enacted.

Some of Mr. Gonzalez's notable results include defense summary final judgments in federal court on claims based on wrongful termination of contract, breach of fiduciary duty and violation of COBRA. He obtained a defense summary final judgment in federal court on claims by an acupuncture provider against a managed care client for payment of services, which decision was used in defense of multi-district litigation. He assisted in obtaining a defense summary final judgment in state court on claims based on agency, apparent agency and non-delegable duty and affirmance on appeal of the judgment, obtaining dismissal with prejudice of the breach of fiduciary claims, the breach of privacy claims and the conversion claims, and obtaining and assisting in obtaining decisions granting removal to federal court under ERISA of medical malpractice claims against managed care organizations.

In addition to practicing in Florida's trial and appellate courts and the Florida Supreme Court, Mr. Gonzalez also practices in federal court, as well as in the arbitration forum. He is admitted to practice in the U.S. District Court for the Southern District of Florida and the U.S. District Court for the Middle District of Florida. He is a member of the Florida Bar (Health Law and Trial Lawyers Sections), the American Bar Association (Health Law Section and Managed Care and Insurance Interest Group) and the Phi Kappa Phi Honor Society.

Mr. Gonzalez is married with two children. He also gives his time pro bono in family law matters, commercial disputes and benefit disputes. In addition to coaching his son's soccer team for the last 4 years and daughter's soccer team for last year, he also plays soccer, softball and basketball, and also enjoys diving/snorkeling, and fishing. He is fluent in Spanish.