PORTLAND, Ore. (CN) – USAA Casualty Insurance and affiliates target military veterans with a fraudulent file review system that deprives them of medical coverage for auto accidents, two vets claim in a class action in Multnomah County Court.
Lead plaintiffs Randi Byers and Rebecca Farris claim USAA Casualty Insurance and its affiliates refuse to cover medical expenses for car accidents involving active, reserve and former military personnel.
“When plaintiffs suffered injuries as a result of automobile accidents, they sought reasonable and necessary medical care which USAA promised to pay for,” the complaint states. “However, payment for plaintiffs’ medical treatment was then 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 its military insureds.”
Also named as defendants are the United States Automobile Association, USAA General Indemnity Co., USAA County Mutual Insurance Corp., Garrison Property and Casualty Insurance Co., and John Does 1-20.
The class claims that USAA hired (nonparty) Auto Injury Solutions to audit medical bills in insurance disputes and determine what is “medically necessary,” according to the complaint. The veterans say USAA relies solely on those reports to deny or reduce medical coverage for car accidents.
“The scheme employed by USAA categorically eliminates, abates, and/or reduces charges actually incurred when submitted in conjunction with what it perceives to be certain deficiencies in the medical documentation provided,” the complaint states.
The class claims USAA saved more than $1 million since 2006 by using the review process, but has not used the money to reduce insurance rates.
And they claim that despite this, USAA represents itself as a superior insurer for members of the military.
The class seeks compensatory and punitive damages for unjust enrichment, breach of contract, and fraud.
They are represented by Thane Tienson, with Landye Bennett & Blumstein.