Progressive Looks to Consolidate Class Action Lawsuit over Medical Short Pay

Progressive Select Insurance Co. (Progressive) has recently been in Florida’s federal courtroom over a class action lawsuit, which could have implications for the auto glass industry, led by MRI provider Clearview Imaging LLC (Clearview).

The lawsuit centers on medical providers seeking damages, totaling as much as $10 million, for Progressive’s copayment reductions, or short payments. Earlier this month Progressive argued, in court documents, that providers should “take it up with their patients instead.” Now both parties have filed a joint document asking the Federal Court to consolidate this class action with another lawsuit currently pending, because both are similar in nature.

Prior to the motion to consolidate, Progressive sought to have the case dismissed. The insurance company stated the reduced payments the patients owed were not covered by its medical insurance policies.

“By this lawsuit, Clearview seeks to inflate the amount paid by its patients as co-payments for medical bills,” Progressive said in a portion of court documents.

According to court documents, Clearview acknowledged the fact that Progressive is entitled to adjust the billed amount of its charges. In court documents, Progressive stated the lawsuit would lead to an inflated process for patients if it continued.

Progressive also stated, in court documents, that Clearview’s allegations were baseless due to reasons that include:

  • Clearview improperly attempting to sue Progressive for the inflated co-payment amounts. (which are co-payments that are not covered under the patients’ Progressive auto policies) Any attempt to address the extra-contractual payments must be directed at the patients.
  • The patients are necessary parties to any litigation over their payments.
  • Clearview’s theory as to why it may recover the co-payments from Progressive is inconsistent with the language of the applicable policies, the Florida PIP Statute, precedent, and basic common sense.

The lawsuit, originally filed in April 2019, acknowledges the fact that Progressive is allowed to reduce reimbursements using a “schedule of maximum charges,” but it also claims the reductions could not be applied to copays charged to patients. According to court documents, the case represents Florida health care providers who previously billed Progressive insurance policyholders and had rate reductions applied to its copay portion.

According to Progressive, if it applied the schedule of maximum charges to reduce the billable amount, it would reduce a patient’s copay by about $55. Providers however, are seeking an effective copay reduction across all applicable cases, which could translate to more than $10 million in damages across roughly 800,000 bills, according to Progressive’s estimate included in court documents.

Look to glassBYTEs.com for more updates about this case, as information becomes available.

This entry was posted in glassBYTEs Original Story and tagged , , , , , . Bookmark the permalink.

Leave a Reply

Your email address will not be published. Required fields are marked *