Progressive Insurance Co. Termination of PIP Benefits WA Class Action

Automobile insurance policies offer personal injury protection (PIP) benefits for persons who are injured in auto accidents, whether it’s the insured person or a third party. But the complaint for this class action alleges that Progressive Insurance Company terminated benefits unfairly for each of the plaintiffs because it claimed that they had reached the maximum medical improvement (MMI) for the injury in their claim.

The class for this action is all first-party insureds and third-party beneficiaries of automobile insurance policies issued by Progressive in Washington state, who filed a claim for PIP benefits, and Progressive ended or limited benefits or denied coverage for further treatment of injuries because Progressive believed that the person had reached MMI or that treatments were not essential in achieving MMI.

PIP benefits usually cover “reasonable and necessary” medical expenses for physical injuries. According to the complaint, in the state of Washington, PIP benefits can only be stopped for one of four reasons. These are that the treatment is not (1) reasonable, (2) necessary, (3) related to the accident, or (4) incurred within three years of the accident.

One of the plaintiffs in this case, Joel Stedman, was a third party who was injured in an accident on March 2, 2016. To treat his injuries, he received massage and physical therapy, paid for with PIP benefits. In August, Progressive requested that he have a medical examination to determine whether he had reached his MMI. The company then terminated his benefits as of August 31, even though Stedman believes he still needs treatment.

The other plaintiff, Karen Joyce was a first-person insured when she had an accident on August 26, 2014. She was injured in the accident and had physical therapy from August to November that same year. Progressive also asked her to undergo an examination. The company then terminated her benefits as of January 30, 2015, declaring that she had reached her MMI, even though she feels she still needs treatment.

The complaint claims that Progressive is not permitted to terminate PIP benefits based on the contention that the person has reached MMI. This is not one of the reasons for termination set forth in the state’s laws.

Progressive’s actions, the complaint says, are violations of Washington’s Insurance Fair Conduct Act. It also claims common law bad faith, breach of good faith and fair dealing, and violations of consumer protection acts. 

Article Type: Lawsuit
Topic: Consumer

Most Recent Case Event

Progressive Insurance Co. Termination of PIP Benefits WA Complaint

August 24, 2018

Automobile insurance policies offer personal injury protection (PIP) benefits for persons who are injured in auto accidents, whether it’s the insured person or a third party. But the complaint for this class action alleges that Progressive Insurance Company terminated benefits unfairly for each of the plaintiffs because it claimed that they had reached the maximum medical improvement (MMI) for the injury in their claim.

progressive_insurance_pip_complaint.pdf

Case Event History

Progressive Insurance Co. Termination of PIP Benefits WA Complaint

August 24, 2018

Automobile insurance policies offer personal injury protection (PIP) benefits for persons who are injured in auto accidents, whether it’s the insured person or a third party. But the complaint for this class action alleges that Progressive Insurance Company terminated benefits unfairly for each of the plaintiffs because it claimed that they had reached the maximum medical improvement (MMI) for the injury in their claim.

progressive_insurance_pip_complaint.pdf
Tags: Auto Insurance, Deceptive Insurance Practices, Incomplete payment of benefits due, Termination of Benefits