If you were a UnitedHealthcare member in North Carolina between 2016 and 2021, you may be owed money back for out-of-network medical bills you shouldn’t have had to pay. Thanks to a $3.4 million settlement with the North Carolina Department of Insurance (NCDOI), eligible members can now claim reimbursement — plus interest — for those extra payments.
Why is there a lawsuit?
The NCDOI investigated UnitedHealthcare after a consumer complaint revealed that:
Some members were billed by non-contracted (out-of-network) providers.
Members paid more than their copay, coinsurance, or deductible — covering part of the gap between the provider’s charges and what United paid.
To fix this, UnitedHealthcare agreed to a voluntary settlement. While not admitting wrongdoing, the insurer will now reimburse eligible members for those overpayments.
Who qualifies?
You may qualify if you:
Were a UnitedHealthcare of North Carolina member,
Received out-of-network medical services between Jan. 1, 2016, and Dec. 31, 2021, and
Paid more than your copay, coinsurance, or deductible for those services.
Even if you didn’t get a settlement notice, you may still be eligible. You can contact the settlement administrator to confirm.
How much can people get?
Reimbursement for the extra amount you paid beyond your copay/coinsurance/deductible.
Interest included on top of your refund.
Award amounts vary depending on your out-of-pocket costs.
What Are Your Options?
| Option | What It Means | Deadline |
|---|---|---|
| Submit a Claim | Request reimbursement (with interest) | November 4, 2025 |
| Exclude Yourself | Keep the right to sue separately | November 4, 2025 |
| Object | Tell the court you disagree with the settlement | November 4, 2025 |
| Do Nothing | No reimbursement, no separate lawsuit rights | N/A |
How to File a Claim
If you paid out-of-pocket for out-of-network services with UnitedHealthcare in NC between 2016 and 2021, you could get money back.
Complete a claim form (online or by mail). Provide documentation of out-of-network payments. Submit by November 4, 2025.
Online claim form: Submit Your Claim Here
Mail claim form to:
UnitedHealthcare of NC DOI Settlement Administrator
c/o Epiq
P.O. Box 2312
Portland, OR 97208-2312
Questions? Call 888-857-4845 or email [email protected].
