If you are a Washington healthcare provider who from July 8, 2012 through December 23, 2019, submitted medical bills for payment, under the terms of an insured’s Personal Injury Protection or Medical Payments coverage, to American Family Insurance Company or American Family Mutual Insurance Company and had your bills reduced based on an explanation code P0041, as set out in the Explanation of Remittance form you received, a class action settlement may affect you.
In the class action lawsuit referenced above, Dr. David Folweiler sued American Family Insurance Company and American Family Mutual Insurance Company (“Defendants”) alleging that, in connection with paying benefits under an insured’s Personal Injury Protection (“PIP”) or Medical Payments (“MedPay”) coverage, Defendants improperly reduced provider charges exceeding the 85th percentile of charges contained in a medical charge database.
Defendants have denied all of Plaintiff’s allegations and any other wrongdoing.
After several years of litigation, the parties have agreed to settle the class action. You may be entitled to share in the cash settlement if you were a Washington healthcare provider who from July 8, 2012 through December 23, 2019 submitted medical bills for payment, under the terms of an insured’s Personal Injury Protection or MedPay coverage, to Defendants and had your bills reduced based on an explanation code P0041 (“Reason Code 41”) as set out in the Explanation of Remittance form you received.
If you are a member of this class, you can submit a claim form to recover the amount of charges that were reduced between July 8, 2012 and December 23, 2019 for explanation Reason Code 41 if you have not already been reimbursed for those charges from another source and the insured’s limits of coverage have not already been exhausted.
The court granted final approval of the Settlement on February 19, 2020.