UnitedHealthcare agreed to a settlement with the North Carolina Department of Insurance (NCDOI) to resolve claims it failed to pay enough for out-of-network medical services.
The UnitedHealthcare settlement benefits members of UnitedHealthcare of North Carolina who received out-of-network medical services between Jan. 1, 2016, and Dec. 31, 2021, and paid more than their copayment, coinsurance or deductible for these services.
The NCDOI investigated UnitedHealthcare after a consumer complaint alleged the insurer failed to pay enough for out-of-network services. According to the investigation, some UnitedHealthcare members were billed by out-of-network providers for the difference between the providers’ billed charges and the amount UnitedHealthcare paid.
UnitedHealthcare is an insurance company that offers health, dental, vision and other types of insurance.
UnitedHealthcare has not admitted any wrongdoing but agreed to pay $3.4 million to resolve the NCDOI investigation.
Under the terms of the UnitedHealthcare settlement, UnitedHealthcare members can receive reimbursement for out-of-network services they paid for out of pocket. Members can be reimbursed for the amount they paid in excess of their copayment, coinsurance or deductible. Reimbursement will also include interest.
The deadline for exclusion and objection is Nov. 4, 2025.
To receive settlement benefits, UnitedHealthcare members must submit a valid claim form by Nov. 4, 2025.
Source: $3.4M UnitedHealthcare out-of-network services class action settlement
