Paul Tassin  |  March 14, 2017

Category: Consumer News

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state farm class action lawsuitPlaintiffs have won Class certification in a State Farm class action lawsuit over alleged wrongful denials of personal injury insurance coverage.

U.S. District Judge Richard A. Jones granted the motion for Class certification filed by plaintiff Brett Durant, finding Durant’s claims met all the requirements for certification laid out in federal court rules.

According to estimates provided by expert witnesses, the certified Class could include around 3,000 beneficiaries whose personal injury coverage was denied or limited by State Farm’s determination of maximum medical improvement.

In State Farm’s opposition to Class certification, the company argued that each potential Class Member would have a unique set of damages to prove, making class action treatment unsuitable.

Judge Jones rejected that argument. He noted that while damages may indeed be individualized in this case, treating the case as a class action is preferable to making the purported Class Members file multiple and duplicative individual claims.

Durant filed this State Farm class action lawsuit in April 2014. He says he opened a Personal Injury Protection Coverage (PIP) claim under his State Farm insurance policy following a July 2012 vehicle accident.

According to his policy, State Farm would cover “reasonable medical expenses incurred within three years of the date of the accident.” Covered expenses include, among other things, expenses necessary to achieving “maximum medical improvement” from the injury sustained in the accident.

In the spring of 2013, State Farm denied further coverage of Durant’s treatment, based on a statement by his chiropractor that he had reached maximum medical improvement.

Durant challenges this denial. He claims that while his injuries may have stabilized by that time, they still had not resolved. He says further treatment was necessary to avoid the risk of exacerbating his injuries.

Durant argues State Farm’s denial of his PIP claim violates a provision of the Washington Administrative Code. Under this provision, an insurance company can deny PIP coverage only if the claimed expenses are not reasonable, not necessary, not related to the accident, or not incurred within three years of the accident.

Despite this seemingly contrary code provision, State Farm points out that its policy terms have been reviewed and approved by the state insurance commissioner’s office.

In addition to granting Class certification, Judge Jones also solicited briefing from the parties as to whether he should certify questions to the state supreme court about the interpretation and application of the Washington Administrative Code provisions at issue here.

As certified by the court, Durant’s plaintiff Class will represent all insureds and third-party beneficiaries under any State Farm policy issued in Washington State, with respect to whom State Farm terminated or limited benefits based on a determination of maximum medical improvement or that such benefits were not essential to achieve such improvement.

Representing Durant and the plaintiff Class are attorneys Tyler K. Firkins of Van Siclen Stocks & Firkins and David A. Nauheim of Nauheim Law Office.

The State Farm Personal Injury Protection Wrongful Denial Class Action Lawsuit is Brett Durant v. State Farm Mutual Automobile Insurance Co., Case No. 2:15-cv-01710, in the U.S. District Court for the Western District of Washington.

UPDATE: On Oct. 11, 2018, State Farm policyholders were able to secure an $18.5 million settlement in a class action lawsuit alleging the insurance provider wrongfully denies personal injury claims.

UPDATE 2: March 2019, the Washington State Farm personal injury denial class action settlement is now open. Click here to file a claim. 

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4 thoughts onState Farm Policyholders Win Class Cert. in PIP Coverage Lawsuit

  1. JD Hodge says:

    My Attorney kept telling me that state farm was going to pay me anymore money because of s1,2 L1-5, sciatica nerve problem in my left leg. Because I have 50k insured/uninsured motorists, but my Attorney Ramin, kept lying to me about my case. Ramin’s firm, seemed to calling me while heavily medicated on muscle relaxers, and RFA Shots, and Toradol Shots, and kept telling me that Statefarm isn’t going to pay anymore, now Ramin’s management called me and wanted to settle, for 3k and that’s it. I told him don’t you ever call me again, I’m on a walker cause I can’t walk or drive and you want to give me 3k. You have Ramin call me. I believe that my Attorney and his firm took advantage of my medical state of mind, and took advantage of a disabled man. What I found out was Ramin told me while on meds and stated state farm is sending you only 5k, but I’m waving my fee, I want to settle your case. State Farm sent Ramin 15k I have the paper to prove it! So you can add my name to that list, because I was lied too, and taken advantage of a disabled man.

    1. JD Hodge says:

      My case was just settled a few months ago

  2. Tina Rozelle says:

    08/2007 auto claim stopped paying on my injuries. Fractured back and neck
    TINA Rozelle

  3. Crystal vincent says:

    State Farm did me wrong I had a 2009 Infiniti story I crushed it 1st they said yes I had full coverage two days later they said no.there is a lot more to the story.

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