Paul Tassin  |  July 28, 2016

Category: Consumer News

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car-crash-accidentAllstate is unlawfully requiring Pennsylvania car insurers to submit to physical exams after auto accidents before paying for any medical bills, according to a recently filed proposed class action lawsuit.

Plaintiff Samantha Sayles alleges Allstate maintains a company-wide policy and procedure of compelling insureds to submit to a physical exam before paying claims for medical benefits related to injuries sustained in car accidents.

Sayles says she was told by Allstate that policyholders are legally required to submit to a physical exam and that the company could legally withhold benefit payments unless the claimant cooperated with the exam.

The plaintiff alleges that by demanding an exam, Allstate is violating the Pennsylvania Motor Vehicle Financial Responsibility Law. That law states that when a person’s mental or physical condition is material to a claim for benefits, a court may then order the person to submit to an exam.

The order can be issued only if “good cause” is shown, according to the lawsuit.

If the person fails to comply with the exam once the order is issued, the law states that the court may order the individual be denied benefits until they comply.

The Allstate class action lawsuit also raises claims for unjust enrichment, intentional misrepresentation, breach of the duty of good faith and fair dealing, as well as violations of the Pennsylvania Insurance Bad Faith Act and Unfair Trade Practices and Consumer Protection Law.

Allstate has already removed Sayles’ class action lawsuit to federal court. Although Sayles originally filed her claim in the Pennsylvania state court for Pike County, Allstate argues that her claims invoke federal court jurisdiction under the Class Action Fairness Act.

Allstate says based on Sayles’ allegations, the amount in controversy exceeds the $5 million federal jurisdictional minimum.

In her own case, Sayles says Allstate demanded she submit to an exam without showing good cause and without securing a court order. Sayles claims that she was injured in a car accident in December 2015 while covered by an Allstate policy that included medical benefits.

The plaintiffs says Allstate demanded that she submit to an insurance physical exam and refused to pay her medical expenses until the exam had been completed.

Sayles is proposing to represent a plaintiff Class consisting of all persons injured in a motor vehicle accident and insured by Allstate under a Pennsylvania policy that includes medical benefits, and in whose case Allstate:

  • Directed them to submit to a physical exam without first securing a court order
  • Told them they would not receive medical benefits until they submitted to such an exam
  • Failed to pay them medical benefits based on their failure to attend the exam
  • Subjected them to Allstate’s alleged exam procedure, then failed to pay them medical benefits

 

She seeks a court order certifying her proposed Class and appointing her as class representative and her attorney as class counsel. She also seeks a damage award including treble damages and punitive damages, plus interest, court costs and attorney’s fees.

Sayles is represented by Charles Kannebecker of Weinstein Schneider Kannebecker & Lokuta.

The Allstate Bad Faith Class Action Lawsuit is Samantha Sayles v. Allstate Insurance Co., Case No. 3:16-cv-01534, in the U.S. District Court for the Middle District of Pennsylvania.

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One thought on Allstate Class Action Says Forced Medical Exams Illegal

  1. Sharon kadroske says:

    I was in a accident in August of 2014 and had surgery to fix my neck but because I had prior back problems that did not interfere with my daily life but after the accident my back was pushed over the edge and their doctor even stated this and then they stopped my payments due to their doctor I live in Michigan and have Allstate insurance

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