Clark v. State Farm Mutual Automobile Insurance

292 F. Supp. 2d 1252, 2003 U.S. Dist. LEXIS 22986, 2003 WL 22997267
CourtDistrict Court, D. Colorado
DecidedDecember 19, 2003
DocketCIV.A. 00B1841PAC
StatusPublished
Cited by13 cases

This text of 292 F. Supp. 2d 1252 (Clark v. State Farm Mutual Automobile Insurance) is published on Counsel Stack Legal Research, covering District Court, D. Colorado primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Clark v. State Farm Mutual Automobile Insurance, 292 F. Supp. 2d 1252, 2003 U.S. Dist. LEXIS 22986, 2003 WL 22997267 (D. Colo. 2003).

Opinion

FINDINGS OF FACT, CONCLUSIONS OF LAW AND ORDER

BABCOCK, Chief Judge.

Plaintiff Ricky Eugene Clark brings claims for reformation of contract, breach of contract-failure to pay PIP benefits, breach of the duty of good faith and fair dealing, and willful and wanton breach of contract against Defendant State Farm Mutual Automobile Insurance Company (“State Farm”). The claims revolve around a July 18, 1996 incident in which Mr. Clark, a pedestrian, was struck by a car driven by Monica Madrid. The car was owned and insured by Monica Madrid’s grandmother, Hortencia Madrid (“Mrs. Madrid”).

On June 19, 2001, I granted State Farm’s motion to dismiss, reasoning that Brennan v. Farmers Alliance Mut. Ins. Co., 961 P.2d 550 (Colo.Ct.App.1998) did not allow Mr. Clark’s reformation of contract claim to proceed because Brennan did not apply retroactively. The Tenth Circuit reversed and remanded with direction to “determine, through the exercise of [the Court’s] equitable powers, the effective date of reformation,” Clark v. State Farm Mut. Auto. Ins. Co., 319 F.3d 1234, 1242-43 (10th Cir.2003) and to “determine the amount of extended PIP benefits, if any, to which Clark is entitled.” Id. at 1241. Pursuant to that remand a three day hearing was held November 3-5, 2003. Significant evidence was developed during that hearing sufficient to determine the amount of extended benefits to which Mr. Clark is entitled. I hold that the date of reformation is the date of this Order and that Mr. Clark is entitled to the difference between the personal injury protection (“PIP”) benefits he has received and the statutory aggregate $200,000 limit provided by the policy.

I. Procedural Background

Mr. Clark bi'ought claims in Pueblo, Colorado District Court for reformation of contract, breach of contract for failure to pay PIP benefits, breach of the duty of good faith and fair dealing, willful and wanton breach of contract, and deceptive trade practices pursuant to Colo.Rev.Stat. § 6 — 1—105(1)(e) and (g) against Defendant State Farm. State Farm removed the case to this Court on September 19, 2000.

In his complaint, Mr. Clark alleged that the coverage made available to him through Mrs. Madrid’s insurance did not conform to Colorado law. He alleged that under Brennan v. Farmers Alliance Mutual Insurance Co., 961 P.2d 550 (Colo.Ct. App.1998) he is entitled to unlimited medical and rehabilitative benefits, in addition to 100 percent of his lost income for an unlimited time.

State Farm moved ,To dismiss, contending that Brennan did not apply retroactively to allow.' reformation of the Madrid policy. I granted the motion, reasoning that the Colorado Court of Appeals’ rule in Brennan could not be applied retroactively and, therefore, could not apply to Mr. Clark’s requested contract reformation because he was injured over a year before Brennan was decided. Also, because Mr. Clark’s other claims were predicated on the theory that State Farm had an obligation to inform Mrs. Madrid of Brennan’s effect, I reasoned, those claims likewise failed to state a claim upon which relief *1255 could be granted. I granted State Farm’s motion and dismissed all of Mr. Clark’s claims.

On appeal, the Tenth Circuit concluded that Brennan’s rule must be applied not only prospectively, but also retroactively. Clark v. State Farm Mut. Auto. Ins. Co., 319 F.3d 1234, 1242 (10th Cir.2003). Accordingly, the Tenth Circuit concluded,

holdings in Brennan and Thompson [v. Budget Rent-A-Car Systems, Inc., 940 P.2d 987 (Colo.Ct.App.1996) ] mandate that the Madrid policy be reformed to include extended PIP benefits and that pedestrians, like Clark, must be included in the class of beneficiaries eligible to receive those benefits. The Brennan court, however, also concluded that the trial court has the discretion to ascertain the date of reformation because reformation is an equitable remedy.

Id. (internal citations omitted). Clark thus directed that “the district court ... determine, through the exercise of its equitable powers, the effective date of reformation.” Id. at 1242-43. The Court also affirmed the dismissal of Mr. Clark’s deceptive trade practice claim under the Colorado Consumer Protection Act. Id. at 1244. With respect to Mr. Clark’s breach of contract, breach of the duty of good faith and fair dealing, and willful and wanton breach of contract claims," the Court noted that those claims “will remain viable only if the district court ... determines that reformation should occur as of a date preceding its order of reformation. Only under those circumstances would there be an extant contract, tort, or statutory duty to be breached.” Id.

These findings of fact and conclusions of law follow the hearing held from November 3 through November 5, 2003. Given the somewhat unique nature of this proceeding, questions of law and fact are often mixed.

II. Findings of Fact

A. The 1996 Accident Involving Mr. Clark and Monica Madrid

On July 18, 1996, Mr. Clark was a pedestrian at the intersection of Highway 50 and Bonforte Boulevard in Pueblo, Colorado, when he was struck by a 1995 Subaru Impreza driven by Monica Madrid. The Impreza was owned by Monica Madrid’s grandmother, Hortencia Madrid, who insured the vehicle with State Farm’s basic “PI” level Personal Injury Protection (“PIP”) coverage. Pursuant to that coverage, Mr. Clark received PIP payments for medical expenses, essential services, and 52 weeks of wage losses. For the reasons stated in Section IV D.2 infra, Mrs. Madrid’s PTP coverage contains an aggregate limit of $200,000.

The State Farm PIP adjuster determined that Mr. Clark’s pre-injury average weekly wage was $400 and under the “PI” calculation, calculated his wage loss compensation at $302.50 per week. State Farm timely paid those claims for 52 weeks until, pursuant to “PI” level limitations, it discontinued those benefits. The company closed Mr. Clark’s wage loss file thereafter in July 1997. State Farm then marked the last payment as “final” and notified Mr. Clark that he was entitled to no more wage loss benefits. State Farm designated Mr. Clark’s file as inactive in early 1998, having paid Mr. Clark wage loss benefits of $15,730, expenses of $48,617.48, and $3,376.50 for essential services. Essential services under the Madrid policy are “reasonable expenses incurred ... during the insured’s lifetime for ordinary and needed services the insured

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Bluebook (online)
292 F. Supp. 2d 1252, 2003 U.S. Dist. LEXIS 22986, 2003 WL 22997267, Counsel Stack Legal Research, https://law.counselstack.com/opinion/clark-v-state-farm-mutual-automobile-insurance-cod-2003.