NOTICE: This website summarizes the proposed Settlement, but does not purport to be a comprehensive description of the Action, the allegations related thereto, or the terms of the Settlement Agreement. More details are in the Settlement Agreement, which is on file and may be reviewed at the Court or can be viewed at the Important Documents page. You can write to the Claims Administrator at Florida All X-Ray Settlement, c/o JND Legal Administration, PO Box 91067, Seattle, WA 98111, call at 1-877-753-2762, or email at info@flallxraysettlement.com.

IF (1) YOU ARE A FLORIDA HEALTH CARE PROVIDER WHO HOLDS AN ASSIGNMENT OF BENEFITS OF A GEICO INSURANCE POLICY FROM AN INDIVIDUAL INSURED BY ONE OF THE GEICO COMPANIES; AND,

(2) PURSUANT TO THAT ASSIGNMENT, YOU SUBMITTED A CLAIM FOR REIMBURSEMENT OF NO-FAULT BENEFITS TO ONE OF THE GEICO COMPANIES DURING THE CLASS PERIOD; AND

(3) THE GEICO COMPANIES ALLOWED AN AMOUNT THAT IS LESS THAN THE HIGHEST ALLOWABLE AMOUNT UNDER MEDICARE PART B FOR 2007 (DEFINED BELOW) AND ISSUED PAYMENT BASED THEREON;

YOU COULD GET A PAYMENT FROM A PROPOSED CLASS ACTION SETTLEMENT.

What is the Action about?

The Action claims that the GEICO Companies misinterpreted Florida No-Fault Law regarding the manner of calculating reimbursements to be made pursuant thereto, and in response to medical charges submitted by health care providers arising from treatment to persons insured under PIP or other No-fault coverages contained in motor vehicle insurance policies issued by the GEICO Companies in Florida.  (“PIP” refers to the personal injury protection insurance as defined by and required pursuant to Section 627.736, Florida Statutes.)  

In particular, the Action contends that the GEICO Companies failed to utilize the highest allowable amount under Medicare Part B for 2007 when issuing payment, which Plaintiff contends results in a violation of § 627.736(5)(a)(2), Fla. Stat.  Plaintiff further contends that the GEICO Companies improperly included a budget neutrality reduction applicable only on actual Medicare claims in calculating the allowable amount under the applicable schedule of Medicare Part B for 2007. The “Highest Allowable Amount Under Medicare Part B for 2007” is defined to mean the greater of 200% of the 2007 non-facility OPPS amount or 200% of the non-facility limiting charge with neither including the budget neutrality adjustment (BNA) applied to the work RVU.

Plaintiffs therefore assert that the GEICO Companies underpaid PIP benefits for medical services by allegedly failing to properly base its payment on the greater of 200% of the 2007 non-facility OPPS amount or 200% of the non-facility limiting charge, and by further including the budget neutrality adjustment (BNA) applied to the work RVU when issuing payment.

If you received the Notice, it is because the GEICO Companies’ records indicate that you or a health care provider with which you have been affiliated may have submitted a bill or bills to the GEICO Companies for medical charges arising from treatment to persons insured under PIP or other No-fault coverages provided in a Florida motor vehicle insurance policy issued by the GEICO Companies wherein the GEICO Companies failed to base its payment in response to the bill on the greater of 200% of the 2007 non-facility OPPS amount or 200% of the non-facility limiting charge, and further included the budget neutrality adjustment (BNA) applied to the work RVU when issuing payment.

The GEICO Companies contend that it complied with its obligations in issuing payment for reasonable medical expenses submitted pursuant to the applicable insurance policy and the No-Fault Law.  The Court has made no ruling on the merits of the claims or defenses asserted in the Action.

The Action and Settlement concern only claims submitted for coverage under applicable insurance policies set forth in the definition of the Settlement Class contained in the Notice.  

The Court has approved the Action to proceed as a class action for settlement purposes only.  If the Settlement is not finally approved, then the case will return to its prior status, and the case will proceed to trial on the merits of Plaintiff’s claims.

Who is covered by the Settlement?

You are member of the “Settlement Class” covered by the Settlement if you fall within the following class definition adopted by the Court:

All Florida healthcare providers who are/were the assigns or assignees of covered insureds under an automobile insurance policy issued by the GEICO Companies as described in s. 627.736, Fla. Stat., who at any time during the Class Period submitted bills to the GEICO Companies for payment of PIP benefits for all services, supplies or care described by the assigned CPT code for which the GEICO Companies allowed an amount that is less than the Highest Allowable Amount Under Medicare Part B for 2007 and issued payment based thereon. The “Highest Allowable Amount Under Medicare Part B for 2007” is defined to mean the greater of 200% of the 2007 non-facility OPPS amount or 200% of the non-facility limiting charge with neither including the budget neutrality adjustment (BNA) applied to the work RVU.

Excluded from the Settlement Class are persons and/or entities who timely opt-out of the Settlement Class using the correct protocol for opting-out that will be formally established by the Court; the GEICO Companies; any subsidiary or affiliate of the GEICO Companies; the directors, officers and employees of the GEICO Companies or their subsidiaries or affiliates; any entity in which any excluded person or entity has a controlling interest; the legal representatives, heirs, successors and assigns of any excluded person or entity; and the judge assigned to this case along with any persons within the third degree of consanguinity to such judge.

The “Class Period” for each entity comprising the GEICO Companies is defined as September 18, 2015 through August 12, 2024.  

The following claims of Settlement Class Members shall be outside of the scope of the Settlement Agreement and the Released Claims, but shall not otherwise affect membership in the Settlement Class:   

(1) any claims resolved by separate settlement, dismissal with prejudice, or full payment in response to a demand letter; (2) any claims that are the subject of a lawsuit that has been filed and remains pending as of the Court’s Preliminary Approval Order; (3) any claims where insurance benefits exhausted prior to the Effective Date or the date a timely Settlement Claim Form is deemed submitted, whichever is later; and (4) any claims that are denied during the settlement claims process on coverage or other  grounds not related to the Litigated Issues.  When a PIP or other No-fault claim includes both medical services within the scope of the Settlement Agreement and others outside the scope of the Settlement Agreement, the Settlement Agreement and Release will apply, but only to those medical services within the scope of the Settlement Agreement.

Members of the Settlement Class are referred to as “Class Members” or “Settlement Class Members.”  A search of The GEICO Companies’ records identified you as potentially a member of the Settlement Class.  If you are a member of the Settlement Class, unless you exclude yourself from the Settlement Class, you will be deemed to be a Settlement Class Member and a participant in the Settlement.

How can I get a payment?

To qualify for Settlement Benefits, you must timely submit a complete Settlement Claim Form via First Class Mail, postage prepaid, or via the Settlement Website. Your Settlement Claim Form must either be postmarked, or uploaded if using the Settlement Website portal, no later than 150 days from the Class Notice Mailing Date (September 26, 2024). The deadline is February 24, 2025.