Author: WorkCompAcademy

Darren Gilbert, who had lost part of his left leg and some toes on his right foot, relied on a prosthetic leg and wheelchair to get around. In August 2021, he pulled his wheelchair-accessible van into a 7-Eleven in Rio Linda, California.

The van-accessible parking spot was taken, so he parked in a regular space, climbed out on his prosthetic, and made his way across the lot. The curb ramp to the sidewalk was steep and uneven; he struggled to keep his balance and felt exhausted by the effort just to reach the door. Inside, he bought a few items and left.

Two months later, Gilbert sued 7-Eleven under the Americans with Disabilities Act (ADA) and California’s Unruh Civil Rights Act. He claimed the store’s parking lot and entryway violated federal accessibility standards and denied him equal access because of his disability. He wanted the barriers fixed and statutory damages under state law.

While the case was pending, 7-Eleven quietly remodeled the parking lot and entrance. By the time the case went to trial, the store had a fully compliant van-accessible stall, access aisle, curb ramp, and walkway.

The district judge ruled that the ADA claim for an injunction was now moot – there was nothing left to fix. But the violations had existed when Gilbert visited, and because any ADA violation automatically triggers liability under the Unruh Act, the judge awarded Gilbert $4,000 in statutory damages.

7-Eleven appealed, making three main arguments.First, it said Gilbert hadn’t proven that removing the barriers was “readily achievable” under the ADA – after all, he hadn’t submitted cost estimates or design plans. The Ninth Circuit disagreed. Yes, plaintiffs typically have to propose a plausible fix whose benefits seem to outweigh the costs. But 7-Eleven had already fixed everything voluntarily, without claiming it was burdensome. That alone proved removal was feasible. The company could not meet its own burden to show otherwise.

Secondly, 7-Eleven argued that Gilbert needed to prove his experience was worse than an able-bodied person’s – that the barriers affected him specifically because of his disability. The court rejected that argument also. If a physical barrier violates the ADA’s technical standards and relates to the plaintiff’s type of disability (here, mobility impairment), and the plaintiff personally encounters it, that’s discrimination. No side-by-side comparison is required.

Finally, 7-Eleven attacked Gilbert’s standing under the Unruh Act. The district judge had found that Gilbert’s real reason for visiting was to build a lawsuit – he’d filed about 70 similar cases – and that his purchase was just a pretext. 7-Eleven insisted that without a “bona fide” intent to be a genuine customer, he could not recover.

The Ninth Circuit Court of Appeals affirmed the district court’s award of statutory damages for Gilbert’s claim that 7-Eleven violated § 51(f) of the Unruh Act in the published case of Gilbert v. 7-Eleven, Inc. 23-4045 (October 2025).

California law is clear: if you walk (or roll) into a store, encounter discrimination, and transact business, you have been injured under the Unruh Act. Motivation to sue is irrelevant. The California Supreme Court had already said so in earlier cases: even “professional plaintiffs” who pay a discriminatory fee or face a real barrier have standing. And for construction-related accessibility claims like this one, state law spells out exactly what’s needed: personal encounter plus some difficulty, discomfort, or embarrassment. Intent to return or shop again is not on the list.

The court distinguished a recent California Supreme Court case involving online terms of service in White v. Square, Inc., 7 Cal.5th 1019 (2019) 250 Cal.Rptr.3d 770 446 P.3d 276, where intent did matter – because the plaintiff never transacted at all. Here, Gilbert bought something from the store at the time of his visit. That was enough.

Darren Gilbert passed away in July 2024, before the appeal was decided. His successors stepped in. The Ninth Circuit affirmed the $4,000 award in full and sent the case back only to sort out the substitution formalities.

In the end, a voluntary fix helped prove the violation, a completed purchase established standing, and a litigation motive changed nothing. The barriers were real, the injury was personal, and California law demanded accountability.

The Institute for Clinical and Economic Review (ICER) is an independent, non-profit research institute that conducts evidence-based reviews of health care interventions, including prescription drugs, other treatments, and diagnostic tests. In collaboration with patients, clinical experts, and other key stakeholders, ICER analyzes the available evidence on the benefits and risks of these interventions to measure their value and suggest fair prices. ICER also regularly reports on the barriers to care for patients and recommends solutions to ensure fair access to prescription drugs.

ICER just released its new 118 page “Launch Price and Access Report,” finding that drug launch prices continue to rise at a rate that exceeds inflation, gross domestic product (GDP) growth, and overall healthcare costs.

ICER’s analysis focused on “net price,” or the actual price paid after rebates and discounts, offering crucial information to policymakers, given that most previous analyses of drug pricing trends focus on the publicly available “list price,” which does not always reflect the actual price paid.

The report, using net prices, found that the inflation-adjusted median annual launch price of drugs increased by 51% from 2022 to 2024, while the annual list price increased 24% during the same period. Even after accounting for the differences in the mix of drugs approved each year (by holding certain characteristics constant, like the number of gene therapies approved), the annual net launch price increased by 33% per year.

ICER also conducted an in-depth review of the 23 drugs in scope that had been previously reviewed by ICER. The analysis indicated that aligning the prices of these therapies with ICER’s Health Benefit Price Benchmark (HBPB) could have saved approximately $1.3 to $1.5 billion in the first year post-approval alone – savings that could have been redirected to higher-value drugs and services.

To evaluate the patient access barriers to newly launched drugs, ICER focused on the novel drugs approved in 2024. For the majority of these drugs, insurance coverage policies were not publicly available, even up to one year after approval, and the majority of commercial first-time prescriptions for newly approved drugs were rejected. Non-coverage of the drug was the most common reason for rejection.

“The results of ICER’s independent analysis on trends in launch pricing and patient access highlight the critical moment facing the U.S. health care system,” stated ICER’s President and CEO Sarah K. Emond, MPP. “Launch prices are going up, patient access is going down, and in many cases, we are overpaying for treatments. As Americans confront rising health insurance premiums and risk losing health insurance altogether, it has never been more critical to move towards a system that pays for value. When we price treatments based on the benefits they deliver to patients, we ensure Americans have access to affordable, high-quality treatments, all while continuing to reward the hallmark innovation of the U.S. pharmaceutical industry.”  

A Marin County resident was sentenced October 20 in Superior Court to 180 days in Marin County Jail and potentially additional prison time after pleading guilty to felony insurance fraud.

The Marin County District Attorney’s Office filed multiple insurance fraud charges against Marilyn Gibson, 46, on February 13, 2025. On July 28, Gibson pled guilty to a felony violation of Penal Code section 550(a)(4), Filing a False Insurance Claim, and admitted several enhancements related to her prior criminal history, which included multiple prior fraud-related convictions.

At the conclusion of the October 20 sentencing hearing, Gibson was remanded into custody to serve 180 days in jail. Judge Kelly Simmons imposed a three-year prison term that is stayed pending Gibson’s successful completion of probation. Gibson is on a two-year grant of supervised probation during which she must pay a penal fine of $1,000, complete 40 hours of community service, and complete a theft awareness class. Should Gibson fail to comply with the terms of her probation, she will be required to serve the three-year prison sentence.

On September 15, 2021, Gibson rear-ended another car, causing significant damage to the hood of her car. The following day, Gibson called an insurance company and obtained a policy without disclosing the accident she had caused.

Eight days later, Gibson submitted a false claim under the recently acquired policy, asserting her car was parked near Carlotta Circle in unincorporated Strawberry when it was struck by another car that fled the scene. That claim was denied due to lack of proper collision coverage, and the policy later was canceled for nonpayment.

Six weeks later, Gibson obtained a second insurance policy with a different insurance carrier effective December 8, 2021. After waiting one month, on January 8, 2022, Gibson submitted a false claim under this second policy, asserting that her recently parked car was struck by another car that fled the scene. Gibson submitted the same photos showing damage to the hood of her car that she had submitted in support of the September 23, 2021, false claim.

An investigator for the second insurance company determined that Gibson had made the same claim to the first insurance company and confronted her in a telephone interview. Gibson denied making the first claim and insisted that she bought the car in September 2021 and had not experienced any accidents whatsoever. The DA’s Office filed charges following a detailed review and analysis of the case.

The DA’s Office would like to remind the public that reporting false information to an auto insurance carrier when making an insurance claim constitutes insurance fraud. A person still can be prosecuted for fraud even if the claim is denied and no money is obtained from the insurance company. Auto insurance fraud is a felony that can result in a maximum punishment of five years in prison and a $50,000 fine.