Physicians Mutual Insurance Company Class Action

Result: $23 million for class representatives and class members residing in the states of Alabama, Mississippi, and Texas.Venue: Alabama, Mississippi, Texas

Named plaintiffs entered into insurance contracts with Physicians Mutual Insurance Company which contained a rider that provided certain outpatient sickness and accident benefits. The plaintiffs alleged that Physicians Mutual wrongfully failed to pay insurance claims for the plaintiffs and other class members.

Physicians Mutual is an insurance company based in Omaha, Nebraska that sells numerous types of insurance products throughout the United States. Beginning in 1993, Physicians Mutual began selling a supplemental insurance product in Alabama called the “Outpatient Plus Plan,” which is a supplemental insurance product comprised of a hospital indemnity policy and a combination of two or more riders. One of the riders attached to the hospital indemnity policy was the outpatient benefit rider, which pays a fixed benefit of $100.00 each time a policyholder makes a claim that meets the requirements of the rider. The Plaintiffs entered into insurance contracts with Physicians Mutual which contained a rider that provided certain outpatient sickness and accident benefits. In the lawsuit, the plaintiffs, individually and on behalf of all class members, alleged that Physicians Mutual wrongfully failed to pay insurance claims.Through the discovery process, the plaintiffs gathered significant documentation to support the allegations.

The result was that Physicians Mutual paid $23 million for class representatives and class members residing in the states of Alabama, Mississippi, and Texas.