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Denial of Benefits

Advocate Health Care Facility

The Advocate Health Care Network has a Disability Income Protection Plan that provides funds for employees who have a long- or short-term disability and are unable to work because of sickness or injury. The plan coordinates its own benefits with benefits paid by other parties, such as Social Security. However, complaint for this class action alleges that the Plan refuses to recognize the common fund doctrine, which allows participants to recover any legal or other expenses they incur in obtaining those benefits. 

ACCC Eagle Logo

ACCC Insurance Company issues policies in the states of Mississippi, Alabama, Arizona, Georgia, Louisiana, New Mexico, Texas, and Utah. All of these states require that auto policies provide uninsured/underinsured motorist (UM/UIM) coverage, but the complaint claims that ACCC’s policies do not.

State Farm Logo

This settlement resolves a class action claiming that State Farm Mutual Automobile Insurance Company improperly denied or limited personal injury protection (PIP) benefits. The complaint alleged that the company used a “maximum medical improvement” (MMI) standard that violated Washington state insurance laws.

Yellow Hardhat on Orange Safety Cone

This class action is brought against certain members of the Liberty Mutual Group of insurance companies and a Liberty Mutual subsidiary that provides their claims administration. The complaint alleges that the companies do not provide prompt payment of workers’ compensation claims nor an explanation of why the claims are disputed. 

Three Types of Pepperidge Farm Cookies

The complaint for this class action alleges that Pepperidge Farm, Inc. misclassified the plaintiffs in this action as independent contractors when they were actually employees. Although the rules aren’t hard and fast, the complaint details the ways in which the company had substantial control over the scheduling, policies, and work. It brings suit under Massachusetts laws.

Elephant Insurance Company Logo

When an insurance company pays the replacement cost of a vehicle that is a total loss, should that amount include sales tax and title/tag transfer fees? The complaint for this class action says yes, and it alleges that Elephant Insurance Company owes these amounts to its insureds who have had total losses. 

Building for Blue Cross Blue Shield of Minnesota

If a health insurance company believes it overpaid on previous benefits, can it reduce payments for current, unrelated benefits? The complaint for this class action says it can only if its plan authorizes it. The plan for Blue Cross Blue Shield of Minnesota (BCBSM) does not authorize it, the complaint says, and the reduced benefits paid are a violation of the Employee Retirement Income Security Act (ERISA). 

ConAgra Logo

The complaint for this class action notes that certain changes were made to ConAgra Brands Retirement Income Savings Plan in 2015, at the same time as the company laid off around 30% of its workforce. The changes disadvantaged terminated employees, and the complaint claims that ConAgra wanted to save money at their expense. It brings suit under the Employee Retirement Income Security Act (ERISA).

State Farm Logo

This class action is asking the court to declare parts of Florida law unconstitutional, although the defendant is not the state but a car insurance company. The complaint claims that State Farm Mutual Automobile Insurance Company has been “systematically and routinely denying” all Personal Injury Protection (PIP) claims when the person involved does not receive initial treatment without fourteen days of an accident. According to the complaint, State Farm’s denials are based on “the 2012 PIP amendments” to Florida law. 

Hands of PTSD Patient and Medical Person with Clipboard

The complaint for this class action claims that United HealthCare Insurance Co. (UHIC) and United Behavioral Health (UBH) impose reimbursement penalties on claims for coverage for psychotherapy services, which the complaint says is a violation of the Employee Retirement Income Security Act (ERISA) parity provisions and the Affordable Care Act (ACA).

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