MILLER, P. J., RICKMAN and REESE, JJ.
MILLER, PRESIDING JUDGE.
Francis Clouthier was involved in a tractor-trailor accident,
The Medical Center of Central Georgia, Inc.
("MCCG") placed a lien on his causes of action. In
response, Clouthier filed a putative class action against
MCCG challenging the lien and raising numerous claims for
damages. Clouthier appeals from the trial court's order
granting MCCG's motion to dismiss his complaint, arguing
that he pled viable claims for fraud, negligent
misrepresentation, and violations of Georgia's
Racketeering Influenced and Corrupt Organizations
("RICO") Act. After a careful examination of
Clouthier's complaint, we determine that the trial court
erred in dismissing the complaint. Therefore, we reverse.
review a trial court's ruling on a motion to dismiss de
novo. Roberts v. JP Morgan Chase Bank, Nat.
Assn., 342 Ga.App. 73 (802 S.E.2d 880) (2017).
A trial court should not grant a motion to dismiss for
failure to state a claim upon which relief may be granted
unless: (1) the allegations of the complaint disclose with
certainty that the claimant would not be entitled to relief
under any state of provable facts asserted in support
thereof; and (2) the movant establishes that the claimant
could not possibly introduce evidence within the framework of
the complaint sufficient to warrant a grant of the relief
sought. In deciding a motion to dismiss, all pleadings are to
be construed most favorably to the party who filed them, and
all doubts regarding such pleadings must be resolved in the
filing party's favor. In other words, a motion to dismiss
for failure to state a claim should not be granted unless it
appears to a certainty that the plaintiff would be entitled
to no relief under any state of facts which could be proved
in support of his claim.
(Citation omitted.) Ikomoni v. Bank of America,
N.A., 330 Ga.App. 776, 776-777 (769 S.E.2d 527)
(2015). We emphasize that we are at the motion-to-dismiss
stage, prior to the completion of discovery, and we are not
considering whether Clouthier's claims will ultimately
prove meritorious or the likelihood that Clouthier will
indeed be able to introduce evidence to support his claims.
"If, within the framework of the complaint, evidence
may be introduced which will sustain a grant of
relief to the plaintiff, the complaint is sufficient.
(Citation omitted; emphasis supplied.) Id. at 777.
Thus, "it is the rare case in which a motion to dismiss
for failure to state a claim, as opposed to a motion for
summary judgment, will provide an appropriate procedural
device for securing summary adjudication of the issues raised
in a complaint . . . ." (Citation omitted.) Radio
Perry, Inc. v. Cox Communications, Inc., 323 Ga.App.
604, 611 (1) (b) (746 S.E.2d 670) (2013). Mindful of these
principles, we turn to Clouthier's complaint.
to his complaint, Clouthier was injured in a tractor-trailer
collision in August 2016, and an ambulance transported him to
MCCG's emergency room for treatment. After his discharge
from the hospital, MCCG became aware that Clouthier's
injuries were caused by third parties, and in November 2016,
MCCG filed a hospital lien against Clouthier's causes of
action, in the amount of $56, 856.89. Specifically, the lien
affidavit stated that MCCG "claims a lien upon any and
all causes of action accruing to [Clouthier] on account of
injuries giving rise to such causes of action and that
necessitated hospital care." The affidavit also stated
that the lien was claimed "as provided for in the
Official Code of Georgia Annotated, Section 44-14-470 et
reached a "confidential" settlement in his
collision case and then filed a complaint and petition for
class action against MCCG in the Bibb County State Court.
Clouthier alleged that MCCG's lien and charges were for
the "full chargemaster rate" or "sticker
price" of his medical procedures, "which [did] not
represent a reasonable charge for the treatment
received." Clouthier claimed that MCCG knew that the
lien amount was not reasonable, and he raised claims of
fraud, negligent misrepresentation, and violations of the
RICO Act. Clouthier further requested punitive
damages, an award of attorney fees, and class certification
as to all similarly situated plaintiffs.
filed a motion to dismiss the complaint for failure to state
a claim. MCCG contended that the Bibb County State Court
lacked subject matter jurisdiction over Clouthier's
complaint because Clouthier's lawsuit was essentially a
request for equitable relief. MCCG also argued that the lien
did not convey any false information.
a hearing, the trial court granted MCCG's motion to
dismiss. The trial court first determined that it had
jurisdiction because Clouthier sought an award of damages.
Regarding Clouthier's claims for fraud, negligent
misrepresentation, and violations of the RICO Act, the trial
court found that they all required a "false
swearing" or "negligent misrepresentation" by
MCCG as to the reasonableness of its charges. The trial court
reasoned that the language of the lien affidavit did not show
that MCCG ever swore that the lien amount was reasonable and
that MCCG therefore never made a false
statement. After the trial court issued a certificate
of immediate review, this Court granted Clouthier's
application for interlocutory appeal, and this appeal
First, Clouthier contends that the trial court erred in
dismissing his claims for fraud and negligent
misrepresentation on the basis that MCCG never made a false
statement or negligent misrepresentation. We agree.
law gives a hospital a lien for the reasonable charges for
its care and treatment of an injured person against all
causes of action accruing to that person on account of [his]
injuries, and establishes a process for the hospital to
perfect its lien for the amount claimed to be due."
Bowden v. Med. Center, Inc., 297 Ga. 285 (773 S.E.2d
692) (2015). See OCGA § 44-14-470 (b) (explaining that
the hospital "shall have a lien for the reasonable
charges"). In order to perfect the lien, the hospital
must provide written notice to the patient, and must also
file "a verified statement" setting forth "the
amount claimed to be due" for the hospital. OCGA §
44-14-471 (a) (1) -(2).
Turning to Clouthier's fraud claim, "fraud requires
five essential elements: a false representation, scienter,
inducement, reliance, and injury resulting from reliance on
the false representation." (Citation and punctuation
omitted.) Cox v. Bank of America, N. A., 321 Ga.App.
806, 807 (2) (742 S.E.2d 147) (2013). "Fraud, though,
does not have to be committed solely by wil[l]ful
misrepresentation." E-Z Serve Convenience Stores,
Inc. v. Crowell, 244 Ga.App. 43, 46 (1) (b) (535 S.E.2d
16) (2000). By its very nature, fraud "is subtle and can
be accomplished in an infinite number of ways including signs
and tricks and even, in some instances, by silence."
(Citation omitted.) Id. See Woodall v. Orkin
Exterminating Co., 175 Ga.App. 83, 84 (332 S.E.2d 173)
(1985) (explaining that it is "impossible to state any
general rule by which particular frauds are to be
identified" because fraud is "exceedingly
subtle" in nature and "almost, if not quite,
impossible" to classify). Indeed, fraud may be
consummated by "any . . . unfair way used to
cheat another." (Emphasis supplied.) OCGA §
23-2-56. Further, even "slight circumstances may be
sufficient to carry conviction of [fraud's]
existence." (Citation omitted.) Fed. Ins. Co. v.
Westside Supply Co., 264 Ga.App. 240, 242 (1)
(590 S.E.2d 224) (2003). Thus, MCCG need not have overtly and
falsely sworn that its claimed lien amount was reasonable in
order for Clouthier to have pleaded a fraud claim, and the
trial court erred in ruling otherwise.
explained above, MCCG is only allowed a hospital lien for
"reasonable charges, " but MCCG stated in the lien
affidavit that its lien was claimed "as provided
for" in the hospital lien statutes. Clouthier alleged
that MCCG filed a lien using the hospital lien statutes
knowing that the claimed amount of the lien was excessive and
unreasonable and that MCCG did so with the intent to collect
more than a reasonable charge for the services rendered to
Clouthier. Conceivably, evidence may be introduced that MCCG
did the above while knowing that it would not actually be
able to recover on the lien in the amount claimed and also