Amica Mutual Medicare Advantage Accident Claims Class Action

This class action against Amica Mutual Insurance Company in its role as a Medicare Advantage insurer. The complaint alleges that Amica has refused to pay accident-related medical expenses, despite their role as primary payers for those enrolled under Medicare Advantage (MA) plans. This leaves Medicare, which was supposed to be the secondary payer, to pay  Read more

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Travelers Insurance Claims for Coronavirus Closing Losses Class Action

The coronavirus pandemic has caused disruptions to businesses because of mandatory closings or customers staying home. In this class action, the complaint alleges that Travelers Casualty Insurance of America should pay certain losses of a dentist office required to close by the state governor’s order. Interestingly, the complaint has been filed before the dentist has  Read more

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Shelter Mutual Conditioning of Auto Insurance Benefits Class Action

On what bases can insurance companies delay payment of claims? In this class action, the complaint alleges Shelter Mutual Insurance Company refused to pay personal injury protection (PIP) or other medical benefits to insureds until the insureds provided information showing whether they are entitled to Medicare or Medicaid or not.  Read more

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Consumers County Mutual Insurance PIP Claims Settlement

Consumers County Mutual Insurance is settling a class action alleging that it unfairly refused to pay certain PIP (personal injury protection) claims. The complaint claimed that the company violated Texas state law by improperly denying payment of all or some of PIP claims on the basis that a third-party insurance company paid all or some  Read more

No Payment, No Explanation for Workers’ Comp Claims Class Action

This class action is brought against certain members of the Liberty Mutual Group of insurance companies and a Liberty Mutual subsidiary that provides their claims administration. The complaint alleges that the companies do not provide prompt payment of workers’ compensation claims nor an explanation of why the claims are disputed.   Read more

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CareFirst Comprehensive Lactation Support Settlement

This settlement resolves a class action against CareFirst, Inc., Group Hospitalization and Medical Services, Inc., CareFirst of Maryland, Inc., and CareFirst BlueChoice, Inc. The complaint alleged that health plans of these companies did not properly cover comprehensive lactation support and counseling services (CLS) as required by the Affordable Care Act (ACA). In particular, the complaint  Read more

Geico General Auto Insurance PIP Payout Calculation Class Action

This class action, against Geico General Insurance Company is similar to another recently filed against a different automobile insurer, alleging that the company miscalculated what it owed under its personal injury protection (PIP) coverage to the provider of treatment for injuries sustained during an auto accident.   Read more

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Hamilton Township Board of Education Retirees Prescription Drug Benefit Settlement

The Hamilton Board of Education is making available $17 million to settle a lawsuit alleging that it breached its obligations to retirees, and in some cases to their dependents. The complaint alleges that collective bargaining agreements specified that retirees would be given a yearly cash payment in lieu of prescription drug coverage, but that the  Read more