IMPORTANT UPDATE: On May 17, 2023, settlement checks were mailed to eligible claimants.
NOTICE OF A CLASS ACTION SETTLEMENT AND FINAL APPROVAL HEARING
IF (1) YOU ARE A FLORIDA HEALTH CARE PROVIDER WHO HOLDS AN ASSIGNMENT OF BENEFITS OF A GEICO INSURANCE POLICY FROM AN INDIVIDUAL INSURED BY ONE OF THE GEICO COMPANIES; AND,
(2) PURSUANT TO THAT ASSIGNMENT, YOU SUBMITTED A CLAIM FOR REIMBURSEMENT OF NO-FAULT BENEFITS TO ONE OF THE GEICO COMPANIES DURING THE CLASS PERIOD FOR A CHARGE IN AN AMOUNT LESS THAN THE SCHEDULE OF MAXIMUM CHARGES IN THE FLORIDA PIP STATUTE (SECTION 627.736(5)(a)1., FLORIDA STATUTES); AND,
(3) THE APPLICABLE GEICO COMPANY UTILIZED THE REASON CODE “BA” TO ISSUE PAYMENT ON YOUR EXPLANATION OF BENEFITS (EOB) OR EXPLANATION OF REVIEW (EOR); AND,
(4) THE GEICO COMPANIES PAID YOU 80% OF THE AMOUNT CHARGED FOR THE CLAIM,
( The “Policy” refers to the Florida Motor Vehicle Insurance policy underwritten by one of The GEICO Companies in Florida and which contains the No-Fault Policy Endorsement indicated by the acronyms, “FLPIP (01-13),” “FLPIP (07-15)” and “FLPIP (01-18)” and such later Endorsements containing the “BA” language. The “GEICO COMPANIES” means Defendants, GEICO General Insurance Company, GEICO Indemnity Company, Government Employees Insurance Company and GEICO Casualty Company. )
YOU COULD GET A PAYMENT
FROM A CLASS ACTION SETTLEMENT.
What is this Lawsuit about?
- The Lawsuit claims that The GEICO Companies misinterpreted the “Billed Amount” or “BA” policy language applicable to medical charges submitted by health care providers arising from treatment to persons insured under PIP or other No-fault coverages contained in motor vehicle insurance policies issued by The GEICO Companies in Florida.
- The Policies included in the Settlement are the Florida Motor Vehicle Insurance policy underwritten by one of The GEICO Companies in Florida and which contains the No-Fault Policy Endorsement indicated by the acronyms, “FLPIP (01-13),” “FLPIP (07-15)” and “FLPIP (01-18)” and such later Endorsements containing the “BA” language. The “Billed Amount” or “BA” language referred to is the following sentence in the Policy: “A charge submitted by a provider, for an amount less than the amount allowed above, shall be paid in the amount of the charge submitted.”
- In particular, the Lawsuit contends that The GEICO Companies misinterpreted the “Billed Amount” policy language when making payments in response to charges, resulting in underpayments to the charges. Plaintiff contends that based on the BA language in the Policy The GEICO Companies should have paid the full billed amounts (100% rather than 80% or more paid) on certain charges submitted by health care providers for medical charges arising from treatment to persons insured under PIP* or other No-fault coverages issued by The GEICO Companies in Florida. Plaintiff therefore asserts that The GEICO Companies underpaid PIP benefits for medical services by 20% by allegedly failing to properly pay the amount authorized under the “Billed Amount” or “BA” policy language.
- A health care provider may have submitted a bill or bills to one or more of The GEICO Companies at less than the schedule of maximum charges as defined by Section 627.736(5)(a)1, Florida Statutes, for medical charges arising from medical services provided to persons insured under PIP or other No-fault coverages provided in a Florida motor vehicle insurance policy issued by The GEICO Companies wherein The GEICO Companies utilized the code “BA” when issuing payment and paid 80% of the amount charged for the claim. “BA” is a reason code The GEICO Companies utilized, and when used, it would appear with reference to certain charge line items on the Explanation of Benefits (EOB) or Explanation of Review (EOR) that you were sent associated with your billed charges.
- The GEICO Companies contend that they complied with their obligations in interpreting the “Billed Amount” policy language and issuing payment for reasonable medical expenses submitted pursuant to the applicable insurance policy and the No-Fault Law. The Court has made no ruling on the merits of the claims or defenses asserted in the Lawsuit.
- The Lawsuit and Settlement concern only claims submitted for coverage under applicable insurance Policies identified above and as set forth in the definition of the Settlement Class contained in the Notice defined below.
- The Court has approved the Lawsuit to proceed as a class action against The GEICO Companies for settlement purposes only. If the Settlement is not finally approved, then the case will return to its prior status, and the case will proceed to trial on the merits of Plaintiff’s claims
( "PIP" refers to the personal injury protection insurance as defined by and required under Section 627.736, Florida Statutes.)
Who is covered by the Settlement?
You are a member of the Settlement Class covered by the Settlement if you fall within the following class definition adopted by the Court:
All health care providers who hold an assignment of benefits of the Policy from an individual insured by one of The GEICO Companies and, pursuant to that assignment, submitted a claim for reimbursement of no-fault benefits to one of The GEICO Companies during the Class Period for a charge in an amount less than the schedule of maximum charges as defined by Section 627.736(5)(a)1., Florida Statutes, where the applicable GEICO Company utilized the reason code “BA” to issue payment to the provider for 80% of the amount charged for the claim.
Excluded from the Settlement Class are: (1) The GEICO Companies, any entities in which The GEICO Companies have a controlling interest, and all of their legal representatives, heirs and successors; and (2) members of the judiciary for the United States District Courts of Florida.
The “Class Period” for each of the specific included GEICO COMPANIES means;
• GEICO Indemnity Company – June 15, 2017 through May 31, 2022.
• GEICO General Insurance Company – May 7, 2014 through May 31, 2022.
• GEICO Casualty Company – June 15, 2017 through May 31, 2022.
• Government Employees Insurance Company – June 15, 2017 through May 31, 2022.
How can I get a payment?
To qualify for Settlement Relief, you needed to timely submit a complete Settlement Claim Form via First Class Mail, postage prepaid or via the Settlement Website. The deadline was November 28, 2022 and has passed.