USAA Personal Injury Protection Class Action Settlement (Washington State Only)
The Class consists of two Subclasses: the Provider Subclass and the Insured Subclass.
Provider Subclass: The Provider Subclass includes all Washington health care service providers and billing providers (1) who billed for and/or provided medical, health care, or rehabilitation services, or medication or equipment, to a Person who was insured under the Personal Injury Protection (“PIP”) coverage of a Washington automobile insurance policy issued by one of the USAA Entities and (2) who submitted or had submitted on their behalf to the USAA Entities bills for such services or products pursuant to the PIP coverage of that insurance policy, and (3) the USAA Entities paid less than the full amount of the charges billed, and (4) the bill was reduced by an RF-prefix, RF_1-prefix, or RF_2-prefix Reason Code from October 3, 2008 through May 29, 2015.
Insured Subclass: The Insured Subclass includes all Persons (1) who were insured under the Personal Injury Protection (“PIP”) coverage of a Washington automobile insurance policy issued by any of the USAA Entities; (2) who received medical, health care, or rehabilitation services, or medication or equipment, from one or more members of the Provider Subclass; (3) who made a claim under the PIP coverage of that policy; (4) who submitted (or whose health care provider submitted) to the USAA Entities a bill for such services or products; and (5) who had that bill reduced by an RF-prefix, RF_1-prefix, RF_2-prefix Reason Code from October 3, 2008 through May 29, 2015.
Proof of Purchase
MySpine, et al. v. USAA
Case No. 12-2-32635
Superior Court of the State of Washington, King County
According to the plaintiffs USAA utilized a computerized bill review process to determine the reasonableness of health care fees based on provider charges for the same treatment in the same geographic area. This resulted in failure to pay certain claims which should have been paid