UnitedHealthcare of North Carolina Out-Of-Network Settlement

UnitedHealthcare members in North Carolina who received medical services from an out-of-network provider between Jan. 1, 2016, and Dec. 31, 2021, and paid more than their copayment, coinsurance or deductible may qualify to claim reimbursement for the excess amount from a class action settlement.

UnitedHealthcare of North Carolina Inc. and UnitedHealthcare Insurance Co. agreed to resolve a North Carolina Department of Insurance investigation following member complaints stating they paid more than required for out-of-network medical services.

Who can file a claim?

Class members must meet the following criteria :

• They were a UnitedHealthcare member in North Carolina.
• They received medical services from a provider who was not in UnitedHealthcare’s network at the time of service.
• They paid the provider an amount above their required copayment, coinsurance or deductible for those services.
• The services occurred between Jan. 1, 2016, and Dec. 31, 2021, or the last renewal date for policies in effect on Dec. 31, 2021.

On Aug. 6, 2025, UnitedHealthcare mailed letters to potentially affected members. The letter included a list of out-of-network services, a claim form and a prepaid envelope. Those who did not receive a letter but believe they are eligible should contact the settlement administrator to verify their eligibility.

Additional important details:

• Individuals can fie claims on behalf of deceased, incapacitated or minor members with proper documentation.
• If a provider is pursuing collection of a class member's outstanding bill, they should contact the settlement administrator immediately at 888-857-4845 or info@UHCNCVoluntarySettlement.com

How much is the UnitedHealthcare payout?

Eligible class members can receive reimbursement for the amount they paid to out-of-network providers above their copayment, coinsurance or deductible plus interest. The reimbursable amount is the difference between what they paid and what their benefit plan required for the covered service.

How to claim a settlement payment

Class members can file an online claim form or download, print, complete and mail PDF claim form to the settlement administrator. The claim deadline is Nov. 4, 2025.

Settlement administrator's mailing address: UnitedHealthcare of NC DOI Settlement c/o Epiq, P.O. Box 2312 Portland, OR 97208-2312

Class members who paid for multiple out-of-network services may submit claims for each provided they include the required documentation for every service.

What proof or documentation is required to submit a claim?

• To file an online claim, class members must provide the unique ID and PIN from their settlement notice.
• All claimants must provide:
• An itemized bill from the provider showing the patient, service codes or descriptions, dates of service and amounts charged
• Proof of payment, such as a canceled check, bank or credit card statement, provider receipt or letter, or other verifiable documentation
• Any communications between themselves and the provider regarding the bill

• If filing on behalf of a deceased, incapacitated or minor member, the claimant must provide legal documentation showing authority to act on their behalf (e.g., death certificate, letters testamentary, birth certificate, etc.)

Important dates

• Deadline to file a claim: Nov. 4, 2025

When is the UnitedHealthcare North Carolina settlement payout date?

The settlement administrator will begin reimbursements for eligible claims around Dec. 4, 2025.

Why did this class action settlement happen?

The North Carolina Department of Insurance initiated an investigation after receiving consumer complaints. The investigation allegedly found that some UnitedHealthcare members paid more than required for out-of-network services.

The examination covered claims and grievances from Jan. 1, 2016, through Dec. 31, 2021, and led to a corrective action proposal and this settlement.

Sources

1. Settlement notice
2. Claim form
3. Settlement FAQ