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USAA Claim Denial Class Action Lawsuit
By Mike Holter
A federal class action lawsuit claims USAA insurance cheats military families out of medical treatment for auto-accident injuries, even though it promises to pay for this type of coverage.
“USAA represented to U.S. service men and women that USAA would pay for reasonable and necessary medical expenses in the event of an automobile injury, thereby inducing Plaintiffs and other U.S. service men and women, into contracting with USAA for first-party insurance,” states the USAA class action lawsuit.
However, when military personnel suffered injuries and sought “reasonable and necessary medical care which USAA promised to pay for,” their medical treatment was “wrongfully denied by USAA on the basis of fraudulent file reviews in order to deprive plaintiffs, and those like them, of their medical treatment and thereby save USAA money at the expense of servicemen and women, and their families.”
According to the USAA class action lawsuit: “USAA contracted with an apparent third-party provider, Auto Injury Solutions, Inc., to assist USAA in implementing and carrying out its fraudulent cost containment program under the guise of AIS providing ‘independent’ and impartial medical review services. In reality, AIS serves at the direction of USAA, and/or as the alter ego of USAA, in that AIS’s services are not rendered independently and are focused on generating false and misleading reports in order to save USAA millions of dollars at the expense of military personnel and their family members who have been injured in automobile collisions and whose bills were reasonable and necessarily incurred.”
The USAA military insurance class action lawsuit is brought on behalf of active members of the military, honorably discharged veterans, and their families, including:
(1) All persons who, within applicable statutory limitations periods, were injured in automobile accidents while a driver or passenger in an automobile insured by USAA, or who were members/insureds of USAA and whose policy covered them; and
(2) The insurance policy provided by USAA covered MedPay, PIP, First Party Benefits, Medical Expense Benefits, Automobile Death and Disability, or any other first-party medical coverage; and Who submitted claims for MedPay benefits within January 1,2005, through the present, and
(3) Who had bills for health care expenses submitted to review by Auto Injury Solutions, or its parents, subsidiaries or affiliates, which recommended denial of payment and/or partial denial of payment, based upon: (a) A written AIS “Physician Review,” and (b) USAA denied payment of all, or a portion, of benefits based upon AIS’ s recommendation.
The proposed class action lawsuit is seeking class certification, an award for actual damages suffered by class members, and other relief.
A copy of the USAA Military Insurance Class Action Lawsuit can be read here.
Updated May 18th, 2011
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14 thoughts onUSAA Claim Denial Class Action Lawsuit
9/17/21 rear ended by woman who did not apply brakes while we were stopped at a red light. AIS denied cervical and cerebral CT(s) because Drs. clinical notes not legible. AIS is exhibiting bad faith. what is the next step.
Neurologist fought for a MRI due to persistent symptoms. MRI showed a TBI. Still under Neurologist’s case. Dr. RX for PT for cervical pain and lack of R.O.M. “approved for 12 visits by USAA”, PT booked and taken. R.O.M. increase however shooting pain down my left arm, 2,3,4 fingers numb when move head to my shoulder or when I sit for about 1.5hrs. E.O.R. notified me today PT denied. NOW WHAT DO I DO
Timeframe? I had USAA full auto coverage on a new car in Mn. My car was stolen. My brand new car when returned by WI police, was totaled. Even in the phone interviews by USAA, it was recorded as to their bullying tactics. The TV ads are shown with football state they won’t leave us behind, they speak of respect, how they have our backs for what we all paid in serving the country. My father served 42 years in the Navy and Army. USAA was to be a safe place for us. My parents were with USAA for over 50 years and me for over 35 years. I was bullied, verbally abused. An ex-Pastor took on the case and they repeatedly lied to him and myself. The Hubbard County Attorney office they lied to on several occasions. The perpetrator still had the alarm FOB and yet they would not pay for keys. At any time he could take my car again. USAA said, sorry we don’t allow that. Even with police reports and even with the perpetrator charged USAA still refused to buy that my car was stolen. At one point they accused me of having a relationship with him. I was victimized by the perpetrator and almost equally by USAA. I was laid off my job also, so I couldn’t pay to repair. The key & alarm charge was over $650. New tires, missing satellite radio, a navigation system, hole punched through the floor, beige carpet stained red, beige ceiling with black stains, are some damages. The garage had to use a crowbar to open the trunk and again remember this was a brand new car a few months old. USAA only nickel and dimed me in tiny payments, but never replaced a 2x totaled estimate claim. I was hung up on by agent Baptiste, verbally abused by him & those that interviewed me. I paid and put my trust into USAA so advertised being military only to be left behind, and being in such a vulnerable position, they in bad faith continued to victimize me, knowingly. Even with supporting law enforcement documents, photos dated, 2x estimations thëy denied me. I had to use what money the perpetrator didn’t steal from me as they also found he had stolen from Bloomington Lincoln Dealership, my USAA bank statements. They also found that the Dealership hired him knowing that he had a federal record. He was hired with no accountability or supervision in place. It gave him full access to their Dealership, software and all abilities to do fake sales. Having been laid off I went to the dealership to buy an older car and instead, walked into a scam. My whole life was destroyed and USAA held a huge part in it as well as losing my new car. Lastly my attorney suddenly died. Shame on you USAA you do not follow the code. The good ole boys club is about it. You may have gotten by in robbing me, but each of you involved will meet Karma on your own.
Get ahold of the Federal Insurance Commissioner. If they can not help you, I will still be praying for you