Thank you for sharing!

Your article was successfully shared with the contacts you provided.
Click here for the full text of this decision FACTS:Pat Forth’s daughter was injured in an auto accident. When Forth filed claims for her daughter’s medical expenses with her personal-injury protection insurer, Allstate Indemnity Co. paid only a portion. Forth filed a class action on behalf of herself and other PIP claimants protesting Allstate’s use of an 85th-percentile method for deciding how much of a claimant’s medical expenses it will cover. Forth said that Allstate should pay “reasonable” medical expenses as determined by an independent evaluation, not an computerized assessments. Though Forth first asked for damages, she later removed those claims, asking instead for declaratory and injunctive relief. Forth sought retrospective relief requiring Allstate to reevaluate the past claims of her and other putative class members outside its computerized Medical Bill Review System. She also sought prospective relief in the form of an injunction against Allstate from using the MBRS and 85th-percentile standard on future claims. Once Forth dropped her claim for damages, the trial court dismissed her claims for lack of standing. Forth, who has since dropped Allstate as her insurer, now appeals. HOLDING:Affirmed in part; vacated and remanded in part. The court considers Allstate’s argument that Forth does not have standing since she no longer is an Allstate customer and finds that this argument addresses only one portion of Forth’s claims � the prospective relief � but not the claims asking for retrospective relief. When Forth conceded she was no longer an Allstate insured, she effectively removed herself from among those who could potentially sustain future harm resulting from Allstate’s ongoing claims review process. Because Forth is no longer insured by Allstate, she cannot be injured or threatened with injury by any of Allstate’s future practices and thus would have no personal stake in any litigation that might arise from them. On the other hand, Forth does have standing to ask that Allstate review her previously processed claims. If she can prove her allegations � that she suffered a distinct injury from Allstate’s conduct � a real controversy exists between the parties, and the controversy will be actually determined by the judicial remedies sought. The court also finds the existence of a justiciable issue, as Forth is not seeking a numerical sum for damages; she is only asking for the difference between what she was originally paid and whatever sum Allstate comes up once it uses the alternate evaluation method Forth proposes. The court adds that facts in this case � such as that Forth did not have any out-of-pocket expenses and that the applicable statute of limitations now likely bars Forth’s healthcare providers from collecting from Forth the portion of her expenses left unpaid � do not change Allstate’s possible obligation to reevaluate Forth’s claims so as to pay her a reasonable expense, as is required by the underlying insurance policy. OPINION:Morriss, C.J.; Morriss, C.J., Ross and Carter, JJ.

Want to continue reading?
Become a Free ALM Digital Reader.

Benefits of a Digital Membership:

  • Free access to 1 article* every 30 days
  • Access to the entire ALM network of websites
  • Unlimited access to the ALM suite of newsletters
  • Build custom alerts on any search topic of your choosing
  • Search by a wide range of topics

*May exclude premium content
Already have an account?

Reprints & Licensing
Mentioned in a Law.com story?

License our industry-leading legal content to extend your thought leadership and build your brand.


ALM Legal Publication Newsletters

Sign Up Today and Never Miss Another Story.

As part of your digital membership, you can sign up for an unlimited number of a wide range of complimentary newsletters. Visit your My Account page to make your selections. Get the timely legal news and critical analysis you cannot afford to miss. Tailored just for you. In your inbox. Every day.

Copyright © 2021 ALM Media Properties, LLC. All Rights Reserved.