UMR $20.25M Insurance Claim Denial Class Action Settlement

Insurance holders who were a participant or beneficiary of an employer-sponsored health plan administered by UMR Inc. and had a claim for an emergency room visit or urinary drug screening denied may qualify to claim a cash payment from a $20.25 million class action settlement.

UMR Inc. agreed to resolve a lawsuit brought by the U.S. Department of Labor alleging it improperly denied certain health benefit claims.

Who is eligible for a UMR payment?

Class members must meet the following criteria:

• They were a participant or beneficiary of an employer-sponsored health plan administered by UMR Inc.
• They or their beneficiary had a health benefit claim for an emergency room visit denied because it was determined they were not experiencing a medical emergency OR
• They or their beneficiary had a health benefit claim for a urinary drug screening denied because it was determined the screening was not medically necessary.

Class members may be eligible for one or both types of claims. They can check the settlement website to see if they have a covered UDS claim or covered ER claim that may be eligible for a baseline UDS payment, additional UDS payments or covered ER payment. 

How much can class members get?

• Covered emergency room claims: Eligible claimants can receive up to $353.22 per covered ER claim if they provide documentation showing they paid out-of-pocket for the denied claim.
• Covered urinary drug screening claims: All eligible class members automatically receive a baseline UDS payment of $68.85 for each covered UDS claim. No action is needed to receive this payment.
• Class members who paid more than $68.85 out-of-pocket for a covered UDS claim can submit documentation to receive an additional UDS payment of up to $103.27 per claim for a total of up to $172.12 per covered UDS claim.

Class members with multiple eligible claims can claim each one separately provided they submit the required documentation for each.

How to claim an ER or UDS class action rebate

Class members with a covered urinary drug screening claim should have already received a baseline UDS payment check, which they can cash without submitting a claim form. However, to receive an additional UDS payment or a proven emergency room payment, they must submit a claim form and documentation.

Class members can file a claim online or download, print and complete a PDF claim form to mail to the settlement administrator. There are separate PDF claim forms for ER claims and UDS claims. The claim deadline is Sept. 2, 2025.

Settlement administrator's mailing address: UMR UDS-ER Settlement, c/o JND Legal Administration, P.O. Box 91226, Seattle, WA 98111

Required proof and information

• To file a claim, all class members must provide the unique ID number and PIN located on the settlement notice they received.
• To receive a payment for a covered emergency room claim or an additional UDS payment, claimants must provide documentation showing they paid an out-of-pocket amount to their medical provider. Acceptable forms of proof include:
• Copies of canceled checks
• Credit card statements
• Bank account statements
• Receipts for payments
• Statements from a financial institution

Payout options

Payments will be issued by check and mailed to the address on file or provided on the claim form.

Important dates

• Claim deadline: Sept. 2, 2025

When is the UMR UDS-ER Settlement payout date?

Baseline UDS payment checks were mailed on June 17, 2025. Proven ER payments and additional UDS payments will be sent by Jan. 13, 2026.

Why was there a class action settlement?

The class action lawsuit alleged UMR Inc., as a third-party administrator of employer-sponsored health plans, improperly denied claims for emergency room visits and urinary drug screenings. The Department of Labor claimed UMR denied ER claims when it determined the patient was not experiencing a medical emergency and UDS claims when it deemed them not medically necessary.

UMR denied wrongdoing but agreed to settle to resolve the dispute and provide compensation to affected participants and beneficiaries.

Sources

1. Settlement consent order and judgement
2. Settlement FAQ