RodaLaw has filed an insurance bad faith case arising from the defendant insurer’s handling of a claim for underinsured motorist (“UIM”) benefits.
UIM benefits are optional benefits that provide coverage when a person is injured in a motor vehicle accident that is the fault of another drover, but the at-fault driver does not have sufficient coverage to pay for all of the injured person’s losses. UIM benefits are provided by an insurance policy through which the injured person is insured.
In this case, the plaintiff was injured while in the course of doing his job, and while operating his employer’s vehicle, and the UIM benefits were provided by the employer’s automobile insurance policy.
In the accident, which was the fault of another driver, the plaintiff sustained injuries to his spine, which prevented him from working for most of the first year after the accident.
When his low back symptoms did not improve after a year, the plaintiff underwent a medical procedure in an attempt to resolve them, but he then developed new symptoms, with pain and radiation. Approximately six months after the procedure, it was discovered that the plaintiff’s lumbar discs and vertebrae had become infected as a result of the procedure.
The infection caused permanent damage to the plaintiff’s spine and rendered him unable to return to either his full-time job, which involved physical exertion, or a similar part-time job. As a result, he also lost his health insurance and other fringe benefits. His economic losses alone were valued in excess of $1 million. In addition, to this the plaintiff continued to have substantial pain and suffering, the plaintiff was limited in his ability to enjoy the things that he ordinarily enjoyed, and the plaintiff’s wife, who ordinarily relied on the plaintiff for household assistance, comfort, care, and companionship, had suffered a substantial claim for loss of consortium—all from which the plaintiff and his wife can expect to suffer for the rest of their lives.
The insurer of the automobile that the at-fault driver was operating paid the maximum coverage available under its policy, but that covered only a fraction of the damages suffered by the plaintiff and his wife.
The plaintiff thus made a UIM claim with his employer’s automobile insurer.
The bad faith lawsuit alleges that, in response to the plaintiff’s claim, instead of promptly and fairly evaluating the claim, the UIM insurer unreasonably:
- misrepresented the available UIM coverage;
- refused, upon request, to pay even the amount that it misrepresented was available, which was a fraction of the actual coverage;
- forced the plaintiff and his wife to go to arbitration to obtain the benefits owed to them;
- waited an unreasonable time to request an independent medical evaluation (“IME”) of the plaintiff;
- selected an IME doctor who spent an unreasonably limited time amount of time examining the plaintiff, yet issued an opinion that the plaintiff’s injuries were caused by something other than the motor vehicle accident and the plaintiff’s related medical care—an opinion that was in stark contrast to those of the doctors who had actually treated the plaintiff;
- waited an unreasonable amount of time, indeed, until the day after the arbitration hearing, to make its first and only offer;
- made an offer that was too low;
- said, months after receiving the claim and after numerous communications on it, that it had no record of the claim;
- said at one point that it had no medical documentation in its file, when extensive documentation had been provided to it a year earlier;
- told the plaintiff’s attorney, a year after consenting to the plaintiff’s settlement with the at-fault driver, that its files did not reflect such consent;
- questioned, more than a year of conducting an assets check to see if the at-fault driver had the ability to pay above the amount offered in insurance, whether that driver had additional insurance coverage;
- delayed in providing a copy of the insurance policy;
- repeatedly made promises—such as that it would work to resolve the claim as quickly as possible, would be in a position to discuss settlement, and would respond to the plaintiff’s settlement demand—that it did not keep;
- failed to conduct the proper investigation of the claim in a timely fashion;
- waited too long to request the plaintiff’s statement under oath; and
- argued in its arbitration submission that there was a question as to liability, when the at-fault driver had been found guilty of a motor vehicle violation, which violation caused the accident.
The lawsuit asserts that the UIM insurer took all of these unreasonable actions knowingly or in reckless disregard of the insurer’s lack of reasonable basis.