(last updated August 13, 2012)
IF YOU SUBMITTED PERSONAL INJURY PROTECTION (“PIP”) MEDICAL EXPENSE CLAIMS TO NATIONWIDE
IN DELAWARE BETWEEN SEPTEMBER 1, 2004 AND DECEMBER 31, 2007, YOU MAY BE ELIGIBLE
TO RECEIVE A PAYMENT FROM A PROPOSED CLASS ACTION SETTLEMENT.
PLEASE READ THIS CAREFULLY AS IT DESCRIBES A CLASS ACTION SETTLEMENT THAT MAY AFFECT
For more detailed information, please review the Notices, Claim Forms, and other
documents on the links to the left.
IMPORTANT DATES & DEADLINES
Submit Claim Forms to Receive Share of Settlement Proceeds:
This deadline has passed.
February 21, 2012
February 21, 2012
February 28, 2012 at 11:00 a.m.
What is the Lawsuit About?
The Lawsuit claims that Nationwide improperly reduced or denied insurance benefits
for medical services after submitting medical bills to a computer based bill review
audit. Specifically, the Lawsuit challenges reductions in payment for those services
based upon a reasonableness or usual and customary charge bill review administered
by Mitchell Medical. Among other things, the Lawsuit challenges Nationwide's right
to conduct such bill review under the applicable policies, the disclosure that such
bill review would be conducted, and the manner in which the bill review was conducted.
Nationwide denies any wrongdoing, and contends that review of medical bill pricing
protects against excessive charges and helps to preserve insurance benefits. The
Court has made no final rulings on the merits of the claims or defenses made in
The Court has preliminarily approved the claims to proceed as a class action for
settlement purposes only. If the settlement is not approved, the Court will have
to decide whether the Lawsuit should be treated as a class action for the purposes
of addressing the merits and trying the Lawsuit.
What are the Terms of the Settlement?
Payments (“Settlement Payments”) will be made to Settlement Class Members who timely
submit valid Claim Forms as explained below. The settlement also protects insureds
of Nationwide from certain claims and balance billing from their medical providers
as explained in the Release in Appendix A of the Notices.
Settlement Class Members who were insured by Nationwide are receiving a Claim Form
that provides for each of them the amount of recommended reduction(s) from which
his or her Settlement Payment may be estimated according to the formulas in the
Notice. This amount provided is based on electronic records, and may differ from
the actual reduction(s) applied by Nationwide. Settlement Payments will be based
on the actual, rather than recommended, reduction(s) applied.
Settlement Class Members who were medical providers for Nationwide insureds (“Provider
Settlement Class Members”) may request the above information for services provided
to Nationwide's insureds which have been identified from Nationwide's bill review
data as potentially qualifying as Covered Claims (as defined in the Notice) under
the settlement. The process for requesting such information is more fully described
in the Claim Form for Provider Settlement Class Members.
Who is Included in the Settlement Class?
You are a member of the “Settlement Class” and a “Settlement Class Member” covered
by the settlement if you fall within the following class definition adopted by the
All persons, and their medical providers or other assignees, who (a) submitted first-party
medical expense claims to Nationwide pursuant to Nationwide's Delaware automobile
insurance policy No-Fault coverage; (b) had their claim submitted by Nationwide
to computer pricing review during the period from September 1, 2004 through December
31, 2007; (c) received or were tendered payment but in an amount less than the submitted
medical charges based upon the pricing review of the charges; and (d) received or
were tendered an amount less than the stated policy limits.
Excluded from the Settlement Class is Nationwide, any entities in which Nationwide
has a controlling interest, and all of their legal representatives, heirs, and successors.
Also excluded are any claims resolved and/or discharged or released prior to the
date of the Preliminary Approval Order.
You should assume that you are a Settlement Class Member unless you can determine
without a doubt that you are not. All Settlement Class Members will be bound by
the settlement, unless they timely request exclusion.
How Can a Settlement Class Member Make a Claim Under the Terms of the Settlement?
To qualify for a Settlement Payment, you must send in a Claim Form. A Claim Form
may be found on the links to the left. If you have multiple claims, you may use
copies of the provided Claim Form. Read the instructions carefully, fill out the
form, include all the documents the form asks for, sign it, and mail it by the deadline
set forth below.
The first round of distribution checks have been mailed.
A more detailed description of this proposed settlement and your rights as a Settlement
Class Member is contained in the Notices and Frequently Asked Questions available
on this website. A complete description of the terms of the Settlement is contained
in the Stipulation of Class Action Settlement available on the link to the left.
If you have any questions, you may write to the Settlement Administrator at the
mailing address listed below.
If you change your address, you should immediately provide your correct address
to the Settlement Administrator at the mailing address listed below.
c/o Rust Consulting, Inc.
P.O. Box 24768
West Palm Beach, FL 33416