UnitedHealthcare agreed to a settlement with the North Carolina Department of Insurance (NCDOI) to resolve claims it failed to pay enough for out-of-network medical services.
The UnitedHealthcare settlement benefits members of UnitedHealthcare of North Carolina who received out-of-network medical services between Jan. 1, 2016, and Dec. 31, 2021, and paid more than their copayment, coinsurance or deductible for these services.
The NCDOI investigated UnitedHealthcare after a consumer complaint alleged the insurer failed to pay enough for out-of-network services. According to the investigation, some UnitedHealthcare members were billed by out-of-network providers for the difference between the providers’ billed charges and the amount UnitedHealthcare paid.
UnitedHealthcare is an insurance company that offers health, dental, vision and other types of insurance.
UnitedHealthcare has not admitted any wrongdoing but agreed to pay $3.4 million to resolve the NCDOI investigation.
Under the terms of the UnitedHealthcare settlement, UnitedHealthcare members can receive reimbursement for out-of-network services they paid for out of pocket. Members can be reimbursed for the amount they paid in excess of their copayment, coinsurance or deductible. Reimbursement will also include interest.
The deadline for exclusion and objection is Nov. 4, 2025.
To receive settlement benefits, UnitedHealthcare members must submit a valid claim form by Nov. 4, 2025.
Who’s Eligible
The settlement benefits UnitedHealthcare members who received medical services from non-contracted providers between Jan. 1, 2016, and Dec. 31, 2021, who may not have accepted UnitedHealthcare’s payment as full compensation for the services provided. UnitedHealthcare members who did not receive a settlement notice but believe they are eligible can contact the settlement administrator to verify their eligibility.
Potential Award
If you’re eligible, you may get money back — plus interest — for medical bills you paid above your copay, coinsurance, or deductible when you visited doctors or providers who were not in United’s network at the time.
Proof of Purchase
Claim form and documentation of out-of-network services
Claim Form
NOTE: If you do not qualify for this settlement do NOT file a claim.
Remember: you are submitting your claim under penalty of perjury. You are also harming other eligible Class Members by submitting a fraudulent claim. If you’re unsure if you qualify, please read the FAQ section of the Settlement Administrator’s website to ensure you meet all standards (Top Class Actions is not a Settlement Administrator). If you don’t qualify for this settlement, check out our database of other open class action settlements you may be eligible for.
Claim Form Deadline
11/04/2025
Case Name
In the Matter of UnitedHealthcare of North Carolina Inc. and UnitedHealthcare Insurance Company
Final Hearing
N/A
Settlement Website
Claims Administrator
UnitedHealthcare of NC DOI Settlement Administrator
c/o Epiq
P.O. Box 2312
Portland, OR 97208-2312
[email protected]
888-857-4845
Class Counsel
N/A
Defense Counsel
N/A
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