DeFrenza v. Progressive Express Ins. Co.

345 F. Supp. 3d 1243
CourtDistrict Court, E.D. California
DecidedNovember 14, 2017
DocketCase No. 1:16–CV–00736–AWI–JLT
StatusPublished
Cited by2 cases

This text of 345 F. Supp. 3d 1243 (DeFrenza v. Progressive Express Ins. Co.) is published on Counsel Stack Legal Research, covering District Court, E.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
DeFrenza v. Progressive Express Ins. Co., 345 F. Supp. 3d 1243 (E.D. Cal. 2017).

Opinion

Anthony W. Ishii, SENIOR DISTRICT JUDGE

Defendant Progressive Express Insurance Company ("Progressive" or "Defendant") submits to this Court a motion for summary judgment, or in the alternative, partial summary judgment (Doc. 16), on Plaintiff John Michael DeFrenza's ("DeFrenza" or "Plaintiff") single claim that Progressive acted in bad faith in resolving his uninsured motorist insurance claim. DeFrenza was in an accident on September 18, 2011 and did not receive a settlement from Progressive until April 2, 2015, almost 3 and a half years later. This matter is now fully briefed. For the reasons that follow, Progressive's motion for summary adjudication will be granted in part and denied in part.

FACTUAL BACKGROUND 1

DeFrenza was a "Rated Driver" under a Progressive Commercial Automobile Insurance Policy, Number 06764199-5 (the "Policy"), issued to DeFrenza's employer, Ross Fabrication and Welding Inc. ("Ross"), with a policy period of June 12, 2011 through December 12, 2011, and including Underinsured Motorist coverage with a combined single limit of $750,000. SUMF 1. DeFrenza had underinsured motorist coverage through his own carrier, AAA, with a limit of $250,000/500,000. SUMF 2. Coverage was pro-rated between the two carriers. SUMF 3.

On September 18, 2011, DeFrenza and a co-worker were driving a pickup truck owned by Ross to a jobsite, when it was struck by a 1999 Chevrolet Astro Van. SUMF 4. The driver of the Astro Van, who was at fault, struck DeFrenza's vehicle at 30 to 35 miles per hour while running a red light, and spun DeFrenza's vehicle clockwise. Doc. 20 at 6-7. The 2011 Ford F-150 pickup truck DeFrenza was driving, which was less than a year old, was totaled. Doc. 20 at 6.

On August 13, 2012, Progressive confirmed DeFrenza would present an Uninsured Motorist ("UIM") claim through his attorney, Brandon Holladay. SUMF 5. DeFrenza filed a first party UIM claim on or about October 10, 2012. Doc. 20 at 8. On October 10, 2012, after confirming DeFrenza's policy-limits settlement with the at-fault driver, Progressive opened the UIM claim. SUMF 6.

On October 12, 2012, three days after the claim was opened, Emy Liberty ("Liberty") confirmed UIM coverage was in order, with limits of $735,000 ($750,000 - 15,000), and documented the amount of coverage in the claim file. DSUF 7. While confirming coverage, Liberty noted initial *1247questions about DeFrenza's own UIM coverage and a possible offset for worker's compensation coverage. DSUF 8. On October 23, 2012, Rowena Pavlinac entered her own coverage statement again affirming the amount of UIM coverage and noting the need to rule out worker's compensation and whether DeFrenza had his own UIM coverage. Pavlinac documented the amount of UIM coverage in the claim file. DSUF 9.

On October 25, 2012, Holladay's office told Pavlinac they had no medical records for DeFrenza but would send them when they became available. SUMF 10. On November 20, 2012, Pavlinac wrote and left a voicemail message for Holladay following up on her requests for information. SUMF 11. On January 24, 2013, Pavlinac again spoke with Holladay, who represented that he would provide medical authorizations and confirmation of DeFrenza's personal UIM coverage. SUMF 12. On February 4, 2013, Holladay sent a demand letter for the policy limits of $735,000. SUMF 13. On February 4, 2013, Holladay represented that DeFrenza had no personal UIM coverage. SUMF 14. On February 4, 2013, Holladay stated that DeFrenza was anticipated to undergo two additional surgeries. SUMF 15. On February 4, 2013, Holladay did not return the medical authorizations. SUMF 16. On February 4, 2013, Holladay provided 365 pages of medical records relating to DeFrenza's treatment, along with wage information. SUMF 17. On or about February 8, 2013,2 DeFrenza made a demand to Progressive to pay the underlying UIM policy limits of $735,000. Doc. 20 at 8.

On February 15, 2013, Pavlinac told Holladay she required all of DeFrenza's prior Kaiser records, not just the surgery records. SUMF 18. On March 8, 2013, at Progressive's request, Holladay provided what he represented were DeFrenza's medical records for three years prior to the accident. SUMF 19. On April 10, 2013, Pavlinac sent Holladay a letter requesting the promised medical authorizations and AAA declarations page. SUMF 20. On April 10, 2013, after speaking with Holladay and explaining the medical records provided were incomplete, Pavlinac again asked for complete medical records and billings. SUMF 21. Holladay never returned the signed medical authorizations. SUMF 22.

On April 29, 2013, Holladay asked for Progressive's settlement position, Pavlinac advised Holladay that she needed to review specific coverage issues, including whether worker's compensation applied, and possible additional UMBI coverage through DeFrenza's policy with AAA, which up to that date had not been notified of a potential claim. SUMF 23. On June 14, 2013, Holladay-while continuing to demand policy limits-asked that Progressive make an offer of the "undisputed value" of DeFrenza's injuries "even if they are keeping believe [sic] that a reduction should be taken against the worker's compensation benefit." SUMF 24.

On July 31, 2013, Pavlinac advised Holladay that Progressive would "not be able to make any payments ... until we reach an agreement for the full amount of the claim." SUMF 25. On August 2, 2013, Pavlinac informed Holladay that Progressive still had not received DeFrenza's post-operative reports and requested updated medical records and billing. Holladay said he was unaware that Progressive did not have the updated medical records. SUMF 26. On August 13, 2013, Pavlinac advised Holladay that Progressive would not assert a workers' compensation offset and renewed her request for updated medical records. SUMF 27. August 26, 2013, Pavlinac *1248received the updated Kaiser records and began her evaluation of DeFrenza's injury and medical records and billings. SUMF 28.

On August 27, 2013, assuming pro-rata coverage with AAA, Pavlinac arrived at a settlement range of $219,942-294,742 as Progressive's 88% share. SUMF 29. On September 4, 2013, using, inter alia , a different loss of earnings component, Pavlinac's manager reached a settlement range of $152,791-327,791. SUMF 30. On September 10, 2013, Holladay made a formal arbitration demand. SUMF 31. On September 17, 2013, Progressive offered the low end of its evaluation, $152,791 (as its pro-rated share), to settle DeFrenza's entire claim. SUMF 32.

On September 17, 2013, while making her offer of settlement, Pavlinac advised Holladay that the medical records he provided were neither numbered nor Bates-stamped, and that they made references to numerous procedures for which there were no corresponding records. SUMF 33. On September 17, 2013, Holladay told Progressive that it could obtain any additional necessary records via subpoena. SUMF 34. In a letter dated September 17, 2013, Holladay rejected the $152,791 offer, asserted that it constituted an "undisputed amount," and demanded immediate advance payment "while we move forward with the demanded arbitration." SUMF 35.

The basis for Holladay's demand for immediate payment of the settlement offer was language from the implementing regulations of the Fair Claims Practices Act found at Cal. Code.Regs. tit. 10 § 2695.7(h). SUMF 36. Progressive referred the arbitration defense to Richard Phillips ("Phillips"). SUMF 37.

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345 F. Supp. 3d 1243, Counsel Stack Legal Research, https://law.counselstack.com/opinion/defrenza-v-progressive-express-ins-co-caed-2017.