Settlement Structure: Claims Made
Active: OpenCase Summary:
This settlement resolves two lawsuits against United Services Automobile Association (USAA), USAA Casualty Insurance Company, USAA General Indemnity Company, and Garrison Property and Casualty Insurance Company. The complaints for both cases allege that the companies did not pay the full amounts of bills for health care under the Personal Injury Protection (PIP) coverages of auto insurance policies in Washington. Instead, the complaints alleged that the amounts were reduced through the use of a computerized review process meant to determine whether fees were reasonable for the geographic area. These “reasonable fee” deduction are displayed on the Explanation of Reimbursement (EOR) form sent to providers or insureds; the Reason Codes at issue have an RF prefix, including CR104, NR260, and NR263.Docket Number:
17-2-26885-2 SEA and 18-2-16812-1 SEA
Company: United Services Automobile Association (USAA)
Filing Deadline: August 11, 2021
Class Period: September 1, 2015 to July 5, 2018
Objection Deadline: April 23, 2021
Exclusion Deadline: April 23, 2021
Final Approval Hearing: May 13, 2021Proof of Purchase:
You do not have to provide proof. Presumably, company records will be used for verification. However, note that there are two claim forms, one for providers and one for insureds.Eligibility:
You may be eligible if you are Washington insured who, between September 1, 2015 and July 5, 2018, had your PIP claim for reimbursement for health care expenses reduced by one of the USAA companies based only on an Explanation of Reimbursement form saying that the bill exceeded “a reasonable amount for the service provided.”
Note that there are two subclasses in this case, the Provider Subclass and the Insured Subclass, and that each has a different claim form.Typical Settlement Amount:
Benefits: 140% of the RF reduction on each charge, as long as claims are not exhausted (i.e., as long as there is enough coverage left to pay them). The settlement will make only one payment per RF reduction. If an insured and a provider, or more than one provider, make claims on the same RF reduction item, a neutral evaluator will decide who will get the payment. No payments will be made for claims that were settled or resolved through other means before the preliminary approval in this case.
Total Settlement Amount: UnknownClass Representative Proposed Incentive Fee:
Breskin Johnson & Townsend
Washington Injury Lawyers, PLLC
Case Name: Eastside Physical Therapy, Inc., P.S. and Krista Peoples v. United Services Automobile Association, et al. and Krista Peoples v. United Services Automobile Association, et al.
Settlement Website: USAA Insurance PIP Claims Settlement Website
Rust Consulting, Inc.
Eastside v. USAA Claims Administrator – 7179
P.O. Box 44
Minneapolis, MN 55440-0044