USAA Unfair Practices Results in Class Action Law Suit!

Posted by Dr. Leslie Holcombe on October 27, 2010 04:19 AM

Don't be fooled, USAA Insurance Company will gladly  take your premium for medical coverage and they'll even give you a "Claim Number" for you to present to a doctor to get chiropractic and physical therapy treatments after your car accident. But when it comes to USAA paying for your accident related medical, chiropractic and physical therapy bills - it's like being involved in an auto accident all over again.

That's what happened to two loyal USAA policy holders. Amanda K. Horton and Keith Alstrin. On their own behalf and on behalf of other insureds or health care providers, who may have similar claims to theirs, filed a Class Action  Lawsuit against the Insurance giant.

The Plaintiffs, Horton and Alstrin,  alleges that, in some instances, USAA  failed to pay to or on behalf of insureds injured in covered automobile accidents or their health care provider assignees the amounts for covered benefits required under the First-Party medical expense benefits payments and personal injury protection coverage (called "Medpay" and/or "PIP") in the respective policies of automobile insurance.  This is the coverage that provides medical benefits to covered persons injured in an automobile accident. 

According to Plaintiffs, USAA routinely paid less than the submitted charges based on its payment of Medpay benefits, in whole or in part, on Audit recommendations made by the medical audit vendor, Auto Injury Solutions (AIS). The lawsuit alleges AIS improperly recommended a reduced payment of insureds' Medpay benefits based on the recommendation of an invalid statistical program used to determine a reasonable fee for the services rendered based on the geographic location of the service provider or amounts in excess of what the provider had agreed to accept pursuant to an applicable PPO or PPN agreement. To read more about this law suit go to

After 10 years of personal injury experience in the  Washington DC/ Arlington, VA /Alexandria, VA areas, I've learned a lot dealing directly with health insurances, attorney's, case workers and auto insurance claims adjusters. Namely, how to help you get the most of your coverage and get nearly  ALL your chiropractic and physical therapy bills PAID!

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