LAWSUITS NEWS & LEGAL INFORMATION
Settlement Proposed in Nationwide Insurance Class Action
This is a settlement for the Bad Faith Insurance lawsuit.
Washington, DC: A federal court has preliminarily approved a settlement with Nationwide Insurance that resolves allegations brought in a federal class action lawsuit, that the insurer improperly reduced or denied insurance benefits to residents in Delaware.
If you submitted personal injury protection ("PIP") medical expense claims to Nationwide in Delaware between 2004 and 2007, you may be eligible to receive a cash payment. The Nationwide Insurance settlement also includes medical providers whose claims were reduced or denied.
The Lawsuit claims that Nationwide improperly reduced or denied insurance benefits for medical services after submitting medical bills to a computer based bill review audit. Specifically, the Lawsuit challenges reductions in payment for those services based upon a reasonableness or usual and customary charge bill review administered by Mitchell Medical. Among other things, the Lawsuit challenges Nationwide's right to conduct such bill review under the applicable policies, the disclosure that such bill review would be conducted, and the manner in which the bill review was conducted. Nationwide denies any wrongdoing, and contends that review of medical bill pricing protects against excessive charges and helps to preserve insurance benefits. The Court has made no final rulings on the merits of the claims or defenses made in the Lawsuit.
The Court has preliminarily approved the claims to proceed as a class action for settlement purposes only. If the settlement is not approved, the Court will have to decide whether the Lawsuit should be treated as a class action for the purposes of addressing the merits and trying the Lawsuit.
Settlement Class Members who were insured by Nationwide are receiving a Claim Form that provides for each of them the amount of recommended reduction(s) from which his or her Settlement Payment may be estimated according to the formulas in the Notice. This amount provided is based on electronic records, and may differ from the actual reduction(s) applied by Nationwide. Settlement Payments will be based on the actual, rather than recommended, reduction(s) applied.
Settlement Class Members who were medical providers for Nationwide insureds ("Provider Settlement Class Members") may request the above information for services provided to Nationwide's insureds which have been identified from Nationwide's bill review data as potentially qualifying as Covered Claims (as defined in the Notice) under the settlement. The process for requesting such information is more fully described in the Claim Form for Provider Settlement Class Members.
Who is Included in the Settlement Class?
You are a member of the "ettlement Class"and a "ettlement Class Member"covered by the settlement if you fall within the following class definition adopted by the Court:
All persons, and their medical providers or other assignees, who (a) submitted first-party medical expense claims to Nationwide pursuant to Nationwide's Delaware automobile insurance policy No-Fault coverage; (b) had their claim submitted by Nationwide to computer pricing review during the period from September 1, 2004 through December 31, 2007; (c) received or were tendered payment but in an amount less than the submitted medical charges based upon the pricing review of the charges; and (d) received or were tendered an amount less than the stated policy limits.
To qualify for a Settlement Payment, you must send in a Claim Form. A Claim Form and further information on important dates, and where to send completed claim forms can be found at hartsettlement.com.
Published on Jan-10-12
If you submitted personal injury protection ("PIP") medical expense claims to Nationwide in Delaware between 2004 and 2007, you may be eligible to receive a cash payment. The Nationwide Insurance settlement also includes medical providers whose claims were reduced or denied.
The Lawsuit claims that Nationwide improperly reduced or denied insurance benefits for medical services after submitting medical bills to a computer based bill review audit. Specifically, the Lawsuit challenges reductions in payment for those services based upon a reasonableness or usual and customary charge bill review administered by Mitchell Medical. Among other things, the Lawsuit challenges Nationwide's right to conduct such bill review under the applicable policies, the disclosure that such bill review would be conducted, and the manner in which the bill review was conducted. Nationwide denies any wrongdoing, and contends that review of medical bill pricing protects against excessive charges and helps to preserve insurance benefits. The Court has made no final rulings on the merits of the claims or defenses made in the Lawsuit.
The Court has preliminarily approved the claims to proceed as a class action for settlement purposes only. If the settlement is not approved, the Court will have to decide whether the Lawsuit should be treated as a class action for the purposes of addressing the merits and trying the Lawsuit.
Settlement Class Members who were insured by Nationwide are receiving a Claim Form that provides for each of them the amount of recommended reduction(s) from which his or her Settlement Payment may be estimated according to the formulas in the Notice. This amount provided is based on electronic records, and may differ from the actual reduction(s) applied by Nationwide. Settlement Payments will be based on the actual, rather than recommended, reduction(s) applied.
Settlement Class Members who were medical providers for Nationwide insureds ("Provider Settlement Class Members") may request the above information for services provided to Nationwide's insureds which have been identified from Nationwide's bill review data as potentially qualifying as Covered Claims (as defined in the Notice) under the settlement. The process for requesting such information is more fully described in the Claim Form for Provider Settlement Class Members.
Who is Included in the Settlement Class?
You are a member of the "ettlement Class"and a "ettlement Class Member"covered by the settlement if you fall within the following class definition adopted by the Court:
All persons, and their medical providers or other assignees, who (a) submitted first-party medical expense claims to Nationwide pursuant to Nationwide's Delaware automobile insurance policy No-Fault coverage; (b) had their claim submitted by Nationwide to computer pricing review during the period from September 1, 2004 through December 31, 2007; (c) received or were tendered payment but in an amount less than the submitted medical charges based upon the pricing review of the charges; and (d) received or were tendered an amount less than the stated policy limits.
To qualify for a Settlement Payment, you must send in a Claim Form. A Claim Form and further information on important dates, and where to send completed claim forms can be found at hartsettlement.com.
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