Clegg v. Butler

3 Mass. L. Rptr. 278
CourtMassachusetts Superior Court
DecidedJanuary 24, 1995
DocketNo. 93-0640
StatusPublished
Cited by2 cases

This text of 3 Mass. L. Rptr. 278 (Clegg v. Butler) is published on Counsel Stack Legal Research, covering Massachusetts Superior Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Clegg v. Butler, 3 Mass. L. Rptr. 278 (Mass. Ct. App. 1995).

Opinion

Zobel, J.

I make the following findings by a preponderance of the credible evidence and the reasonable inferences to be drawn therefrom.

1. Plaintiff James Clegg was injured in an automobile accident (“the accident”) May 4, 1991 at Woburn, Massachusetts.

2. Plaintiff is, and at all material times was, married to Catherine; he is the father of two minor children, Erin and Rachael.

3. At the time of the accident plaintiff, 39, was employed by the Boston Edison Company and by White Hen Pantry. He had earned $40,259.93 in 1990 from the Boston Edison Company as a Grade A mechanic. He also earned $80.00 weekly from White Hen Pantry as a night manager one or two nights per week. On his 1990 federal income tax return he reported total earnings of about $41,000.00.

4. The accident occurred solely as a result of the negligence of defendant Jeffrey L. Butler, insured by defendant Utica Mutual Insurance Co. (“Utica”) with coverage of $250,000.00 per person/$500,000.00 per accident. Butler was also covered by an excess limits or “umbrella” policy issued by the Merrimack Mutual Insurance Company (“Merrimack”) providing indemnity up to $1,000,000.00.

5. Having investigated the circumstances of the accident immediately upon notification of the accident and plaintiffs claim, Utica determined in May 1991, that its insured was clearly liable. The Utica adjuster, Jerome Zeidman, and his supervisor, John Petrosius, shared this view. Although the record contains evidence to the contrary, I do not credit it.

6. At no time did Utica possess any credible information that indicated that plaintiff caused or contributed to the accident in any way. At no time did Utica consider the case to be anything but a so-called 100% liability case against its insured.

7. Plaintiff, as Utica knew no later than May 8, 1991, was represented by Attorney Marvin H. Green-berg of Woburn, Massachusetts.

8. Plaintiffs medical and hospital records abundantly document serious musculoskeletal and neurological injuries proximately caused by the accident.

9. Utica retained Dr. Robert Swiggert, Jr., an orthopedic specialist, to perform an independent medical examination (“IME”) on Plaintiff in June 1991. At that time, Dr. Swiggert lacked any medical information relating to plaintiffs care and treatment.

10. Petrosius considered the IME “nothelpful,” and, because Dr. Swiggert had no medical information to review, an inaccurate assessment of plaintiffs injuries.

11. In July 1991, Zeidman retained Peter Cavanaugh to perform an activity check and surveillance on plaintiff. Zeidman did not tell Cavanaugh that plaintiff was represented by an attorney.

12. Cavanaugh interviewed plaintiff, although Utica’s standards for investigation of claims proscribed interviewing a represented claimant. The investigation revealed plaintiff to have been severely injured. Cavanaugh reported to Utica that plaintiff might never return to work. He also reported that the injuries appeared severe, and suggested that Utica check its reserves, i.e., that it reevaluate the case.

13. At no time after June 1991, did Utica obtain another IME of plaintiff, although the evidence permits the inference, which I draw, and the finding, which I make, that neither plaintiff nor his counsel would have objected to one.

14. Utica considered a further IME of plaintiff on several occasions, but rejected the idea. The evidence permits the inference, which I draw, and the finding, which I make, that Utica reached this decision because it believed the results of the IME would be more likely to harm Utica’s interests than to help them.

15. On September 20, 1991, Mr. Greenberg sent Utica a written settlement demand of $200,000.00, together with additional medical records confirming medical information which Utica had previously received, viz., L-l radiculopathy, lumbar disc herniation, post-traumatic headaches, and bilateral lumbosacral root compressions, all resulting from the accident. Mr. Greenberg pointed out that plaintiff was still unemployed as a result of the accident.

16. Upon receiving the demand and medical package, Zeidman requested additional medical records concerning plaintiffs treatment for back injuries sustained in 1977. On October 1, 1991, Greenberg responded by providing the records for the period 1978-1983.

17. Utica made no settlement offer in 1991.

[279]*27918. In November 1991, Zeidman retained William B. (“Sam”) Gaughan to perform another activily check. Using false pretenses, Gaughan contacted plaintiff twice in November 1991, and confirmed that plaintiff was not working. Gaughan’s contacts with plaintiff were improper and violated Utica’s standards. Furthermore, Zeidman had not informed Gaughan that plaintiff was represented by an attorney.

19. On January 23, 1992, Mr. Greenberg made another written settlement proposal, this one for $750,000, including demands for relief under G.L.c. 93A and G.L.c. 176D. His proposal described plaintiffs injuries in detail, made appropriate statutory references (specifically noting the consequences of failure to respond within 30 days), and supplied additional documentary medical confirmation of plaintiffs injuries and damages: physical therapy notes, physician’s office notes, CT scans of the lumbar spine, a myelogram report on the lumbar spine, an MRI report on the cervical spine, photographs of the head injury, police reports and the defendant’s citation. The proposal documented the $37,544 wage loss with plaintiffs 1990 Form 1040 and W-2s from 1990.

20. The $750,000.00 demand was objectively reasonable.

21. Upon receiving the January 23, 1992 communication, Utica assigned the response to John Ryan, Esq. of Boston, a highly reputable attorney well versed in insurance-law matters. Neither Mr. Ryan nor Utica sought any further information from Mr. Green-berg before Mr. Ryan responded to Mr. Greenberg’s letter of January 23, 1992, which he did February 20, 1992.

22. Mr. Ryan’s response contained no settlement offer. Instead he asserted that Utica could not respond to the demand: he also maintained that Utica had violated neither G.L.c. 176D nor G.L.c. 93A. Mr. Ryan maintained that Mr. Greenberg had failed to provide information Utica had requested concerning a back injury which plaintiff had sustained in the 1970s. He did not suggest that Mr. Greenberg’s letter was insufficient in any other respect.

23. The only medical information Mr. Ryan requested was that which Mr. Greenberg had previously supplied in October 1991.

24. On February 24, 1992, Mr. Greenberg sent Mr. Ryan, for his consideration and review, a copy (with enclosures) of his previous letter to Zeidman.

25. Neither Mr. Ryan nor Utica asked Mr. Greenberg for additional information regarding the previous back treatment. Nor did either suggest that the information supplied was incomplete or inadequate for their purposes.

26. Utica gave plaintiffs medical records to a neurologist, Dr. Thomas Sciascia, for review. After receiving Dr. Sciascia’s response, Zeidman noted (Exhibit 13, March 24, 1992): “The bad news is that the doctor says that the injury sustained by the claimant on [sic] our accident of neck cervical disc herniation and the post-traumatic syndrome would appear to be from our accident. He sees nothing in the claimant’s prior history to [sic] show any of these injuries.”

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Related

Clegg v. Butler
8 Mass. L. Rptr. 262 (Massachusetts Superior Court, 1998)
Kapp v. Arbella Mutual Insurance
5 Mass. L. Rptr. 442 (Massachusetts Superior Court, 1996)

Cite This Page — Counsel Stack

Bluebook (online)
3 Mass. L. Rptr. 278, Counsel Stack Legal Research, https://law.counselstack.com/opinion/clegg-v-butler-masssuperct-1995.