Case details

Defense claimed insurance company did not act in bad faith

SUMMARY

$0

Amount

Verdict-Defendant

Result type

Not present

Ruling
KEYWORDS
neck, ot injuries
FACTS
On June 18, 2012, plaintiff Brenda Woods, 38, a respiratory therapist, was stopped for a red light at the intersection of Trower Avenue and St. Helena Highway (also known as State Route 29), in Napa, when her Nissan Roque was rear-ended by an F-150 pickup truck. Her vehicle sustained moderate rear-end damage, and Woods claimed neck and other from the accident. In 2013, Woods filed suit against the driver of the truck that hit her. Her husband, plaintiff Carlos Rodriguez, also filed suit for loss of consortium. About 18 months after the accident, Woods settled her claim for the driver’s $100,000 policy limits. Woods and Rodriguez then sought further recovery of the remaining $150,000 in damages via the supplementary-underinsured-motorist provision of their own insurance policy, which was administered by Mid-Century Insurance Co. Woods, who was represented by the same lawyer as the suit against the driver, had initially requested that Mid-Century settle the underinsured-motorist claim before settlement with the driver, asking them to essentially fund a potential excess verdict against the driver who was related to a prominent Napa Valley wine grower. At that time, Woods’ attorney sent 3 CDs of information to Mid-Century, which included a computer-aided copy of an MRI that showed congenital stenosis and pre-existing degenerative changes along with two probable herniated discs at C4 through C6. Some of the material from the CDs, including the program that allows the viewing of the MRI did not get uploaded into the insurer’s electronic file system, and the CDs were ultimately destroyed. Mid-Century declined to fund the litigation against the driver, and the settlement against the underinsured driver concluded in January 2014, at which time Woods and Rodriguez made the underinsured-motorist policy-limits demand for the $150,000. Mid-Century countered with a $10,000 new money offer, later increased to $15,000 when plaintiffs’ counsel produced a medical record that indicated that a local orthopedic surgeon had seen Woods in December 2013 and discussed a possible artificial disc replacement (ADR) surgery. It thereafter requested a defense medical examination with a local orthopedic surgeon, who felt that, under the circumstances, conservative treatment was the best course, but he did not have a copy of the actual MRI or the most recent records of the treating orthopedic surgeon. As a result, plaintiffs’ counsel provided the additional records, including a new record indicating that the treating surgeon was now recommending an ADR surgery. After reviewing the records, the independent medical examiner advised that his opinion had not substantially changed, but he did concede that if the orthopedic surgeon were to proceed with the ADR surgery, he would consider such surgery appropriate. As a result, Mid-Century increased its offer to reflect the recommended additional conservative treatment, after which a demand for arbitration was made along with a statutory offer for the underinsured-motorist policy limits less the medical payment offsets. During the pendency of the statutory offer, Mid-Century learned that Woods had scheduled the ADR surgery and, based on this new information, Mid-Century elected to pay the policy limits and waived its right to medical payment offsets. Thereafter, Woods and Rodriguez sued Mid-Century, alleging bad faith. Plaintiffs’ counsel contended that Mid-Century should have paid policy limits within 30 days of the initial demand in January 2014, claiming that the need for surgery was evident from the outset. In addition to alleging that the settlement offers were unreasonably low, plaintiffs’ counsel argued that Mid-Century failed to adequately investigate the medical issues and had destroyed evidence favorable to the insured. The plaintiffs’ claims handling expert testified that it was the custom and practice in the industry to pay undisputed amounts in underinsured-motorist claims and that it was unreasonable for Mid-Century not to advance-pay its offers and to defer disputed amounts for arbitration. Defense counsel contended that the eight Mid-Century claims-handling witnesses that were called by plaintiffs’ counsel all acted appropriately and that they were faced with a challenging and complex medical issue. Counsel argued that while some mistakes may have been made — like the failure of Mid-Century’s national records center to upload all the documents that had been initially submitted by plaintiffs’ counsel — the mistakes were of no consequence and not done in bad faith and that the claim was timely resolved in about six months. The defense’s claims handling expert and Mid-Century’s claims personnel all testified that it was not the custom and practice to pay undisputed amounts in underinsured-motorist claims, and the court instructed that insurance carriers are not required to do so., Woods and Rodriguez sought recovery of Brandt fees and costs. Woods also claimed that because Mid-Century failed to pay earlier, she had to delay her surgery, causing increased post-surgical neurologic deficits, such as numbness and tingling in her arms and hands. Thus, Woods and Rodriguez sought recovery of approximately $50,000 in attorney fees and costs, as well as recovery of non-economic damages for their emotional distress and general damages from the alleged delay in Woods’ surgery. They also sought recovery of damages for Mid-Century’s alleged intentional infliction of emotional distress, as well as sought recovery of punitive damages. However, the court granted defense counsel’s motions for non-suit regarding the cause of action for intentional infliction of emotional distress and the claim for punitive damages. Defense counsel argued that all of the attorney fees and costs were incidental to the handling of the underinsured motorist claim, and not incurred as a result of any bad faith conduct by Mid-Century. Counsel also argued that any delay in scheduling cervical surgery was caused by Woods’ own failure to follow medical advice and because of Blue Shield, Woods’ medical insurer, which initially denied coverage for the surgery, but later paid for it.
COURT
Superior Court of Napa County, Napa, CA

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