Ingenix Antitrust Class Actions

          Two class actions have been filed by Scott+Scott LLP on behalf of people that received insufficient reimbursement from their health insurance companies for out-of-network services. The individual members of the class were cheated, according to the allegations, out of full, fair and proper coverage for out-of-network medical services. Specifically, the class actions are on behalf of people who paid excessive out-of-network charges since January 1, 2004 to any of the following insurance companies:

 • UnitedHealth Group, Inc.    • Oxford Health Plans
 • Cigna Corporation  • Empire Bluecross Blueshield
 • Humana Inc  • Group Health Insurance, Inc.
 • Health Insurance Plan Of New York        • Health Net, Inc.


          The complaints allege that the above insurance companies required consumers to pay inflated out-of-pocket expenses by working together to conspire to fix the reimbursement rates for out-of-network expenses. To calculate the reimbursement rates, these insurance companies used a database created by Ingenix, Inc. –- which is wholly owned by UnitedHealth Group. Under the health plans of these insurance companies, individuals paid a higher premium for the right to use out-of-network doctors. In exchange, the insurance companies promised to cover up to 80% of the bill or of the reasonable and customary rate depending upon which ever was cheaper. However, a recent New York Attorney General investigation uncovered that the so-called “reasonable and customary” rates produced by Ingenix were considerably lower than the actual cost of typical medical expenses. Indeed, by manipulating the reasonable and customary rates, these insurance companies were able to keep their reimbursements artificially low and force their customers to absorb a higher share of the costs for out-of-network services, i.e., increase patients’ out-of-pocket expenses.

          If you have used one of the above listed insurance companies within the last five years and have paid out-of-network costs, and would like further information about these lawsuits, please contact Scott+Scott at or call (800)404-7770 or (860)537-5537.