CLAYTON, Mo. (CN) – Group Health Plan illegally asserts liens against personal injury settlements, a man claims in a class action in St. Louis County Court. Jodie Nevils claims GHP “routinely engages in a widespread pattern and practice of unlawfully asserting reimbursement rights” that are paid through the Federal Employee Health Benefits Act.
The FEHBA provides federal employees and retirees and eligible family members with subsidized health-care benefits.
“For instance, occasionally an individual is injured in an auto accident and that individual’s health care benefits are covered through a FEHBA plan,” the complaint states. “If that individual pursues legal action against the tortfeasor for his/her injuries, the defendant unlawfully assert a lien for repayment of the health care benefits paid for such treatment.”
Nevils claims that Missouri law prohibits such reimbursement.
“Despite the fact that any reimbursement/subrogation rights are controlled by Missouri state law that prohibits such subrogation, defendant routinely asserts liens on personal injury recoveries of Missouri citizens and subrogate for repayment of health benefits paid out on personal injury claims on Missouri citizens,” the complaint states.
“Defendant pursues such course of conduct despite being informed repeatedly that they are not entitled to reimbursement of such funds under Missouri law.”
The class consists of all Missourians who received coverage through a FEHBA plan that is administered by GHP within the past 5 years, who have had a right to reimbursement asserted against a personal injury claim.
They want GHP enjoined from seeking such reimbursements, disgorgement, and damages for conversion, unjust enrichment and violation of the Missouri Merchandising Practices Act.
They are represented by John Campbell with The Simon Law Firm of St. Louis.