September 23, 2022
  • September 23, 2022

Miami court finds data withheld by IDS property insurance on PIP cases

By on December 29, 2021 0

In a class-action lawsuit that could affect no-fault auto insurance companies across the country, a Miami judge has fined an insurer for deliberately failing to hand over data that could show it was improperly transferring costs to Medicare .

The automobile insurer in the case, IDS Property Casualty Insurance Co., uses the same software, Compass Claims Systems, that many other insurers use to determine and report who should be the primary payor in no-fault automobile cases or protection from injury, according to court records and news reports.

In MSPA Claims 1 vs. IDS Miami-Dade Circuit Judge David Miller said up to a million records were missing from the information provided by the insurer to the court. A sample of records provided by IDS, however, showed that the carrier correctly reported primary payer information to Medicare less than 2% of the time, Miller said.

The IDS data also differed significantly from the limited information provided by the Office of Insurance Services, a subsidiary of Verisk Analytics, the judge noted.

“The Court finds that the IDS failed to produce all relevant data from all databases available to it and in doing so violated the court order,” the order reads. “This data, as established by the plaintiffs, is necessary for the defendant to comply with its legal responsibility to comply with federal and state laws in having to report and pay the claims as primary payor.”

Ruiz

Plaintiffs in the case, representing Medicare Advantage health plans, allege that failure to report shifted costs to health plans and to Medicare, costing the plans and taxpayers millions of dollars. One of the lead plaintiffs’ attorneys in the case is Miami attorney and entrepreneur John Ruiz, who founded MSP Recovery, which specializes in collecting Medicare secondary payments.

A Florida insurance group said the case was another round in a long-running battle between insurers and Ruiz, whose company essentially became his own client, and the amounts Medicare paid in many cases were not significant.

“If you look at who is made whole in all of this, this guy is made whole and a half,” said William Stander, director of the Florida Property and Casualty Association.

Ruiz said each of the 37 claimants in the Medicare Advantage plans could now be awarded damages of up to $10,000 each, according to the Daily Business Review, a South Florida news publication. But the total amount of damage could reach millions. Ruiz could not be reached by the Insurance Journal on Wednesday, but in court filings, the plaintiffs said they had notified more than 638,000 potential class members.

IDS, now part of Ameriprise Financial, and its attorneys in the case also could not be reached on Wednesday. But in response to the MSPA’s contempt motion, filed last summer, IDS lawyers said the company had in fact complied in good faith with the court’s demands. Finding more records would mean manually digging through the claims.

A Florida appeals court has already denied class-action certification in similar cases, and the MSPA lacks standing to compel the data, IDS argued.

The judge, Miller, disagreed and imposed penalties on IDS. He also certified the case as a class action and ruled in favor of the plaintiffs. He said he would later determine the dollar amount of damages, court costs and attorney’s fees that IDS should pay.

The decision will likely be appealed. Insurers and insurance defense attorneys have long complained that Miller, known for his outspokenness on the bench, has been biased against insurers’ interests and has been seen as too “plaintiff friendly” in many cases. many cases. In 2018, a member of one of Florida’s largest insurance defense companies ran against Miller but lost in a contentious election.

The Florida 3rd The District Court of Appeals has struck down Miller in a number of property insurance cases in recent years. In a case similar to IDS, Ocean Harbor Casualty Insurance v. MSPA Claims 1, the appeals court in 2018 overturned Miller’s class action certification. Earlier this month, the court overturned Miller in a dispute between a landlord and People’s Trust Insurance.

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