RodaLaw Files Insurance Bad Faith Case Over Nursing Care Coverage

Roda Law has filed an insurance bad faith case against an insurance company that unreasonably refused to send a letter that another insurance company needed in order to cover the plaintiff’s visiting nursing care.

The plaintiff was badly hurt in a car accident, with multiple fractures requiring two surgeries and nearly two weeks in the hospital. The bill for the hospital stay alone was nearly $200,000.

When the plaintiff was discharged from the hospital, she needed visiting home nurse care. She could not walk without assistance, had an open wound that required regular dressing changes, was in severe pain, on prescription narcotics, and needed home nursing care.

The medical benefits under the plaintiff’s automobile policy were only $5,000. After that, her cost of care would shift to her health insurer. Before the health insurer would assume the cost of her visiting home nurse care, it needed a letter from the automobile insurer confirming that the latter’s limits had been exhausted. When the automobile insurer was asked to issue that letter, it refused, saying that it would not issue the letter until the bills, which it acknowledged it had, were actually paid, that it did not have to pay those bills until thirty days after receipt, and that it wanted to hold onto its money, to earn interest, as long as it could.

The plaintiff had not asked the insurer to pay the bills any earlier than it ordinarily would, but only to confirm that her benefits would be exhausted. Even after the insurer paid the bills, it took another follow-up request and six more days before it issued the letter.

As a result, the plaintiff was forced to forego the home nursing care that she needed and had substantial difficultly controlling her pain and regulating her pain medication.

The lawsuit seeks remedies available under Pennsylvania’s bad faith insurance law, including punitive damages, attorneys’ fees, costs of suit, and interest at the prime rate plus three percent.