Healthcare Provider Sues Direct General Insurance Company Over PIP Payments

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Direct General Insurance Company is facing a proposed class action lawsuit alleging it improperly reimbursed a healthcare facility for providing services to a man injured in a motor vehicle accident whose treatment was covered under an insurance policy issued by the defendant. The plaintiff in the case, a Florida spinal care center, claims it provided the man services on eight occasions and should have been reimbursed $60.93 for each visit per his Personal Injury Protection (PIP) coverage. Instead, the suit alleges, the defendant only paid the plaintiff $59.71 for each treatment, a two percent deduction from its entitled repayment. The case argues that the difference is a result of the defendant’s “improper application” of a reduction that was only legally available to Medicare contractors.