State Farm Accused of Denying Auto Benefits to Accident Victims

Heather Hack, Gregory Hack and Skylar Hack, became the first individuals to file a class action lawsuit against State Farm Fire and Casualty Insurance Co. (State Farm) for allegedly withholding thousands of dollars in policyholder’s personal injury benefits. The group’s complaint alleges the insurance company used “an inadequate claims review process to deny or reduce personal injury benefits to policyholders who required medical treatment after car accidents.”

The complaint highlights what the Hacks believe to be violations against Kentucky’s Motor Vehicle Reparations Act (MVRA). The Act mandates speedy compensation for car accident victims in routine cases, according to the complaint.

The Hacks were involved in a car accident in 2013 and were denied claims for treatment based on a utilization review that found their treatments were unnecessary, according to the complaint.

“The reviews were obvious cut and paste jobs,” Hack said in the complaint, while noting the reviewing chiropractor in her case forgot to change the name of a previous patient to hers. The so-called utilization reviews State Farm based its denials and reductions on were conducted by experts who concluded treatments were unnecessary without ever seeing the patients in question, according to Hack.

“State Farm has contracted with vendors in the past which have retained utilization reviewers who have opined on the reasonableness and necessity of medical treatment without the reviewers ever actually seeing or reviewing the insured claimants’ medical records,” a portion of the complaint reads.

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