This case stemmed out of a motor vehicle accident on March 20, 2010, when Plaintiff and several companions were returning to their California college from New Orleans. A drunk driver going the wrong way on a California highway hit them head-on. The drunk driver fled the scene on foot but was later caught. Plaintiff was in the back seat sleeping, but was seat-belted. The force of the collision caused significant internal injuries. The injuries were immediately life-threatening and he developed a hematoma at the sight of the abdominal wall rupture that grew from softball to watermelon size. Emergency surgery included pulling his abdominal contents out and searching inch by inch for tears or no-viable tissue. The surgeons removed large sections of the upper and lower intestines and bowels.
Plaintiff settled his claim against the drunk driver for policy limits of $100,000 and then made a demand for underinsured motorist (UIM) insurance benefits under an insurance policy issued by State Farm to his parents. That policy had $1,000,000 in limits. A demand for policy limits was made 3 months before the Statute of Limitations expired. State Farm requested additional information which was not provided prior to suit. The information was provided within 90 days after filing suit. State Farm evaluated and offered $113,000 to resolve the claim. After a failed mediation, State Farm advanced the $113,000. State Farm informed the jury it had evaluated the claim in the range of $113,000-160,000 in addition to the BI limits previously received.
Just prior to the expiration of the Statute of Limitations, Plaintiff filed suit for UIM benefits, and alleging unreasonable delay, bad faith and (later) punitive damages.
State Farm admitted Plaintiff sustained serious, life-threatening injuries, but claimed he had made a remarkable recovery and had not sought treatment for anything since August, 2011. In fact, he traveled to South America, living and working there for 6 months in 2011-12. He had worked two lengthy stints in the backcountry for national parks in the Northwest, creating/restoring trails and removing invasive species, which work involved heavy manual labor. Further, he completed a 1,500 mile bike trip from Oregon to Mexico. State Farm denied he had ongoing or future medical expenses or income loss.
As to the extra-contractual claims, State Farm alleged any delays were caused by plaintiff, through his lawyer-agents. State Farm alleged that coverage for additional damages was voided due to failure to cooperate, and material misrepresentations made in correspondence about plaintiff’s ongoing treatment. Plaintiff, through his lawyer-agents, failed over 3 years to return a signed medical authorization as requested under the policy, and failed to respond to requests for related medical information. (Plaintiff claimed the other records were minor compared to the uncontested injuries, for which plaintiff counsel supplied the records.) In addition, State Farm asserted material misrepresentations voided coverage because plaintiff counsel asserted that plaintiff had treatment in 2012 when treatment had actually ended in 2011.
DIRECTED VERDICTS: Defendant’s Motion for Directed Verdict was granted on plaintiff’s claims for future income loss ($660,000) and future medical expense ($440,000).
Plaintiff called Dave Torres as a Claims Handling expert. Following voir dire, the court determined Mr. Torres lacked qualifications to provide an expert opinion.
The jury returned a verdict for Defendant State Farm on Verdict Form A – Plaintiff failed to cooperate, voiding any additional coverage. As a result, the jury did not address the remaining claims of UIM damages, unreasonable delay, bad faith or punitive damages.