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Patients and care providers may qualify for payments under the terms of an Allstate class action settlement recently reached in a Washington state court.
In this Allstate class action lawsuit, plaintiff Folweiler Chiropractic alleges several Allstate defendants failed to properly pay claims for certain medical expense benefits under its policies issued in Washington state.
Folweiler claims Allstate improperly relied on a computerized bill review process to determine how much it should pay in response to certain claims for coverage under the PIP and Med Pay provisions of its Washington state health plans. Allstate allegedly underpaid these claims as a result of the use of these systems, Folweiler claims.
Under terms of this Allstate class action settlement, Allstate will make payments to insured persons and care providers that more than cover the amounts by which Allstate allegedly underpaid the claims at issue. Allstate will make these payments solely based on its own records.
Class Members must submit a claim to the settlement administrator to receive a payment. Settlement payments will not be sent out automatically.
The settlement also requires Allstate to pay all qualifying medical bills for three years from Feb. 1, 2017 to Feb. 1, 2020 if the reduction is up to $10 above the 85th percentile amount in the FAIR health database.
If the reduction is above that amount, Allstate reserves the right to take the full reduction. Nevertheless, Allstate is expected to pay the full bill if the amount billed is reasonable and consistent with Washington law.
Class Members who do not exclude themselves from the settlement Class will not be able to bring a Class or collective action against Allstate that challenges its payment of bills in accordance with this three-year plan. Class Members may, however, be able to sue Allstate under this plan on an individual basis.
Defendants named in this Allstate class action settlement include many different Allstate-related business entities, all of which are referred to generally as “Allstate.” The full list of defendants includes Allstate Fire & Casualty Insurance Company, Allstate Insurance Company, Allstate Indemnity Company, Allstate Property and Casualty Insurance Company, Allstate Vehicle and Property Insurance Company, Northbrook Indemnity Company, Allstate County Mutual Insurance Company, Deerbrook Insurance Company, Encompass Insurance Company, Encompass Insurance Company of America and Encompass Indemnity Company.
Who’s Eligible
This Allstate class action settlement benefits two Subclasses: an Insured/Claimant Subclass (which covers patients) and a Provider Subclass (which covers care providers).
The Insured/Claimant Subclass includes all persons who, between Oct. 15, 2011 and Jan. 31, 2017:
- were insured under an Allstate policy in Washington state;
- suffered a covered injury, for which they received covered treatment;
- submitted a claim for that treatment;
- received from Allstate a total amount for all covered treatment that was less than the applicable PIP or Med Pay limits stated in their policy;
- received from Allstate an amount for one covered treatment that was less than the amount billed for that treatment because of a determination, based on the use of a computerized bill reviewing system including the FAIR database that determined the amount billed for that treatment exceeded what was usual, customery and/ or reasonable; and
- whose applicable PIP or Med Pay policy limits had not been exhausted.
The Provider Subclass includes all persons who, between Oct. 15, 2011 and Jan. 31, 2017:
- provided covered treatment within the state of Washington to an Insured/Claimant Class Member for a covered injury;
- billed Allstate for that treatment under PIP or Med Pay coverage;
- received from Allstate an amount less than the amount billed, based on the use of a computerized bill reviewing system including the FAIR database that determined the amount billed for that treatment exceeded what was usual, customery and/ or reasonable; and for whom
- the applicable PIP or Med Pay policy limits had not been exhausted.
Potential Award
Varies
Generally, for each valid settlement claim submitted, Allstate will be required to pay 135 percent of the difference between the amount of the bill originally submitted and the amount Allstate paid for that bill.
If both an insured person and a care provider make valid claims over the same bill, Allstate will pay 67.5 percent of the difference to each of those claimants.
Proof of Purchase
No proof of purchase is necessary, but Class Members must submit a claim to the settlement administrator to receive payment.
Claim Form
Claim Form Deadline
7/13/2017
Case Name
Folweiler Chiropractic PS v. Allstate Fire & Casualty Ins. Co. and Allstate Ins. Co., Case No. 15-2-25375-1 SEA, in the Superior Court for King County, Washington
Final Hearing
4/14/2017
Settlement Website
www.FolweilerSettlement.com
Claims Administrator
Folweiler v. Allstate
c/o Epiq Systems Inc.
P.O. Box 3719
Portland, OR 97208-3719
1-844-299-6986
Class Counsel
David Breskin
Brendan Donckers
BRESKIN JOHNSON & TOWNSEND
Defense Counsel
Gavin W. Skok
Travis Dailey
RIDDELL WILLIAMS PS
Steven M. Levy
DENTONS US LLP
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4 thoughts onWashington Allstate PIP, Med Pay Coverage Class Action Settlement
I have something in the mail it shows on the usps inform delivery website i hope it a check
Did you receive your settlement check?
Never heard anything
Any updates available?