Case details
Carrier: Insured submitted an overstated storm damage claim
SUMMARY
$0
Amount
Verdict-Defendant
Result type
Not present
Ruling
KEYWORDS
emotional distress, mental, psychological
FACTS
On Feb. 18, 2010, July 15, 2010, and Oct. 5, 2010, plaintiff Julio Avina, 31, an Arizona resident, allegedly sustained storm damage to his Arizona home. He subsequently filed claims with his insurance carrier, Pacific Specialty Insurance Co., regarding the damage, seeking to recover the cost of repair to the insured dwelling, the cost of replacement of the entire original roof of the 35-year-old home, and the living expenses needed during the repairs. However, Avina claimed that Pacific Specialty unjustifiably refused to pay the estimate of repairs submitted to it by his public adjuster. Avina sued Pacific Specialty Insurance Co. He alleged that Pacific Specialty breached the contract of insurance, and breached the covenant of good faith and fair dealing by failing to pay the amounts due under the policy of insurance arising out of the storm damage claims. Pacific Specialty claimed that it timely paid Avina the amounts due under the policy, but that it denied the claim submitted to replace the entire roof system because it was not covered. Thus, it denied any bad faith or breach of the insurance contract. Pacific Specialty further claimed that Avina failed to notify the insurer in compliance with the contractual requirements, breached the covenant of good faith and fair dealing, and submitted an overstated claim., Avina sought recovery of damages based on the alleged unjust refusal of Pacific Specialty to pay the estimate of repairs in the amount of $87,096.12. He also sought recovery of damages for his emotional distress. Avina alleged that Pacific Specialty resorted to fraud, malice and oppression, and acted with an evil mind to evade its obligation under the policy of insurance. Thus, he claimed Pacific Specialty should be subjected to punitive damages. Defense counsel disputed Avina’s emotional distress claim and contended Pacific Specialty timely paid Avina the amounts due based on what was covered under the policy. Thus, counsel denied there was any fraud, malice and oppression.
COURT
Superior Court of San Mateo County, San Mateo, CA
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INJURIES:
- anxiety
- brain
- brain damage
- brain injury
- cognition
- depression
- epidural
- extradural hematoma
- face
- facial bone
- fracture
- head
- headaches
- hearing
- impairment
- insomnia
- loss of
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- psychological
- scapula
- sensory
- shoulder
- skull
- speech
- subdural hematoma
- tinnitus
- traumatic brain injury
- vision
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