Cribari v. Allstate Fire and Casualty

Court of Appeals for the Tenth Circuit·Decided June 3, 2021·No. 19-1270·Unpublished

Opinion

FILED

United States Court of Appeals UNITED STATES COURT OF APPEALS Tenth Circuit

FOR THE TENTH CIRCUIT June 3, 2021

Christopher M. Wolpert

Clerk of Court

BEVERLY CRIBARI,

Plaintiff - Appellant/Cross -

Appellee, No. 19-1270

v. (D.C. No. 1:16-CV-02450-NRN)

(D. Colo.)

ALLSTATE FIRE & CASUALTY INSURANCE COMPANY,

Defendant - Appellee/Cross -

Appellant.

BEVERLY CRIBARI, Plaintiff - Appellee,

v. No. 19-1343 (D.C. No. 1:16-CV-02450-NRN)

ALLSTATE FIRE AND CASUALTY (D. Colo.) INSURANCE COMPANY,

Defendant - Appellant.

BEVERLY CRIBARI, Plaintiff - Appellee,

v. No. 19-1425 (D.C. No. 1:16-CV-02450-NRN)

ALLSTATE FIRE AND CASUALTY (D. Colo.) INSURANCE COMPANY,

Defendant - Appellant.

ORDER AND JUDGMENT*

Before MORITZ, BRISCOE, and CARSON, Circuit Judges.

Plaintiff Beverly Cribari sued her underinsured motorist insurance provider for breach of contract and bad faith. A jury found in Defendant Allstate Fire & Casualty Insurance Company’s favor on all counts. Plaintiff appealed the district court’s denial of her summary judgment motion as well as various pretrial and trial rulings— Case No. 19-1270. Post-trial, Defendant sought to claw back a payment it made under a reservation of rights. After Plaintiff refused to return the check and filed a notice of appeal, Defendant filed a motion for leave to amend its pleadings. The district court denied that motion and Defendant appealed that ruling—Case No. 19-1343. Finally, the Clerk of Court for the United States District Court for the District of Colorado entered a cost award for Defendant. After the Clerk declined to tax any expert costs beyond a forty dollar per day appearance fee, Defendant sought review of the Clerk’s award, which the district court denied. Defendant filed a second appeal on this issue—Case No. 19-1425.

Our jurisdiction arises under 28 U.S.C. § 1291. We affirm the district court’s decisions in Case Nos. 19-1270, 19-1343, and 19-1425.

*

This order and judgment is not binding precedent, except under the doctrines of law of the case, res judicata, and collateral estoppel. It may be cited, however, for its persuasive value consistent with Fed. R. App. P. 32.1 and 10th Cir. R. 32.1.

I.

An underinsured motorist ran a red light and struck Plaintiff’s vehicle.

Plaintiff suffered a wrist injury in the collision and settled with the underinsured motorist for his $100,000 policy limit. She later filed a claim with Defendant—her underinsured motorist (“UIM”) insurance provider. Her UIM policy placed obligations on Plaintiff to assist in an investigation of the claim—specifically the policy required her to attend a medical examination, provide a medical authorization, and cooperate with Defendant’s investigation.

Four months after Plaintiff’s filing of the UIM claim, Defendant asked Plaintiff’s counsel to return a signed medical authorization and list of Plaintiff’s treating providers. After not hearing from Plaintiff’s counsel, Defendant offered to resolve the claim for $35,000, noting that it did not have evidence of future treatment expenses. Defendant asked about Plaintiff’s surgical options, costs, and how long Plaintiff would need to miss work. Plaintiff’s counsel responded that Plaintiff required surgery. The parties met in person and agreed that Plaintiff would see her surgeon to discuss her impairment rating, future surgical options, a cost estimate for the potential future surgeries, and any resulting complications. Defendant again asked for a medical authorization and a wage loss authorization. After a third request, Plaintiff’s counsel provided the authorizations.

Plaintiff’s counsel provided Defendant with correspondence that purported to summarize Plaintiff’s surgeon’s review of Plaintiff’s condition. Although it listed two surgical possibilities, the correspondence lacked an impairment rating, surgical

cost estimate, or an estimate of how long Plaintiff would need to take off work. Defendant re-evaluated the claim and offered to resolve it for $100,000. The offer accompanied a note that Defendant still did not have the disability rating, cost estimates for future surgeries, or corresponding wage loss. Despite the earlier meeting, Plaintiff’s counsel responded that she did not anticipate Defendant needing that information. She asked whether Defendant would pay for another appointment to obtain that information. Defendant agreed. And Plaintiff’s counsel acknowledged she would schedule an examination “to obtain the information Allstate needs to evaluate her claim, including the impairment rating, the physician charges for the future surgery, and the amount of time she is likely to miss from work.”

Plaintiff retained a vocational rehabilitation forensic expert to develop a life care plan and analyze the cost and impact of Plaintiff’s future surgeries. She also retained a second expert to estimate her future medical expenses—a figure the expert calculated at $341,700. Plaintiff did not disclose these experts until litigation.

Plaintiff’s surgeon eventually sent Defendant a report that provided an impairment rating and suggested Plaintiff may require surgery, but it did not provide a cost estimate for any surgery or describe the potential complications and time Plaintiff would need to recuperate. The surgeon later testified he could have provided a cost estimate, but that Plaintiff’s counsel did not request one. Defendant reassessed the claim without the information it had requested and without knowing about the two expert reports. Defendant offered $115,000.

Plaintiff did not respond to the offer. Rather, Plaintiff believed Defendant refused to make her a reasonable offer for underinsured motorist benefits and sued Defendant in Colorado state court alleging, among other things, breach of contract and bad faith. Defendant removed the civil action to the United States District Court for the District of Colorado. In its Answer, Defendant asserted an affirmative defense to the breach of contract claim that Plaintiff failed to cooperate with Defendant’s investigation and comply with the policy’s terms. Defendant later explained in discovery that it raised a failure to cooperate affirmative defense because Plaintiff failed to provide it with a cost estimate for a possible future surgery and associated wage loss. Defendant’s Rule 30(b)(6) corporate representative also testified that Defendant suffered prejudice because it could not investigate the claim and incurred expenses to defend the claim in litigation.

After a year of litigation, the parties mediated the case. Before that mediation, one of Defendant’s claims adjusters made an entry in Defendant’s claim log. That entry examined the claim, analyzed potential liability and Plaintiff’s potential damages, referenced the mediation, and noted the policy limits of $250,000. That adjuster noted a “gross tort value” up to policy limits. The day of the mediation, one of Defendant’s managers authorized up to $250,000 to resolve the claim and noted that authorization in the claim log.

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