Insurance companies continue to deny any type of injury claim to fatten their wallets

Author Subject: Insurance companies continue to deny any type of injury claim to fatten their wallets
Chris Posted At 15:14:59 05/16/2000


A $5,000,000 consumer class action complaint was filed on 8/20/99 in Oregon, in Multnomah County Circuit Court, by a policyholder against auto insurer Farmers Insurance Company of Oregon. The lawsuit alleges that Farmers systematically denied medical expense reimbursement to persons covered under the auto no-fault portion of the policy (Personal Injury Protection).

Persons injured in a car accident and insured with Farmers who did not have all of their medical expenses paid may be eligible to participate if the court certifies the class action. Policyholder Mark Strawn contends that Farmers wrongly refused to pay reasonable medical expenses usually charged by physicians and hospitals. Strawn received a head injury in an automobile accident in November, 1997, was briefly in a coma, and was diagnosis with brain damage.. He later learned that his auto insurer refused to pay reasonably incurred medical expenses.

“Consumers have been wrongfully required to pay a portion of their own medical expenses when their insurer was required to pay for all reasonable charges,” said Richard S. Yugler, the attorney who filed the class action case. “For example, when an injured person incurred a $110 emergency room bill, the insurer would improperly refuse to pay $7. It is uneconomical for one consumer to try to recover this amount. When the insurance company withholds small amounts from hundreds or thousands of Oregonians, it amounts to millions of dollars of improperly withheld health care benefits. To hold insurers accountable large groups of policyholders must join together.”

The lawsuit contends that consumers are entitled to reimbursement for all reasonable medical expenses and that no-fault claimants were not subject to cost containment limits. Cost containment procedures, similar to those imposed by HMO’s, prevent consumers from receiving medical and hospital treatment from the best and most highly qualified health professionals. The complaint alleges that consumers were promised reimbursement for all reasonable expenses, even if the fee charged was in the top 20% of fees usually billed by the best and qualified doctors and hospitals.

A similar class action lawsuit seeking $300 million was filed August 18, 1999 against auto insurers State Farm, Allstate and GEICO in Maryland. In 1998 a similar individual lawsuit alleging improper use of cost containment practices was settled for a confidential amount against State Farm after the Oregon Supreme Court determined that plaintiff Debbie Foltz was entitled to trial by jury on her claims. Foltz’s lawsuit was subject to recent court action as lawyers representing consumer groups sought to have court records unsealed and made public.

Interested persons should contact Richard S. Yugler at the law firm of Copeland, Landye, Bennett & Wolf LLP, Portland, Oregon, at (503) 224-4100

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