Derenski v. USAA General Indemnity Company

CourtDistrict Court, W.D. Washington
DecidedDecember 10, 2024
Docket2:23-cv-00676
StatusUnknown

This text of Derenski v. USAA General Indemnity Company (Derenski v. USAA General Indemnity Company) is published on Counsel Stack Legal Research, covering District Court, W.D. Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Derenski v. USAA General Indemnity Company, (W.D. Wash. 2024).

Opinion

1 2

3 4 5 6 7 UNITED STATES DISTRICT COURT WESTERN DISTRICT OF WASHINGTON 8 AT SEATTLE

9 10 HEATHER DERENSKI, CASE NO. C23-0676JLR 11 Plaintiff, ORDER v. 12 USAA GENERAL INDEMNITY 13 COMPANY, 14 Defendant. 15 I. INTRODUCTION 16 Before the court is Defendant USAA General Indemnity Company’s (“USAA”) 17 motion for partial summary judgment on Plaintiff Heather Derenski’s extra-contractual 18 claims.1 (MSJ (Dkt. # 27); Reply (Dkt. # 42).) Ms. Derenski opposes the motion. (Resp. 19 (Dkt. # 35).) The court has considered the parties’ submissions, the relevant portions of 20

21 1 USAA and Ms. Derenski each filed a motion to exclude expert testimony. (See Dkt. ## 29, 31).) Because the experts’ testimony is not relevant to the issues raised in the instant 22 motion, the court addresses the motions to exclude in a separate order. 1 the record, and the governing law. Being fully advised,2 the court GRANTS in part and 2 DENIES in part USAA’s motion.

3 II. BACKGROUND 4 On March 20, 2018, Ms. Derenski suffered injuries in a three-car collision in 5 which an underinsured motorist (“UIM”) was at fault. (Compl. (Dkt. # 1-3) ¶¶ 2.1-2.5.) 6 Ms. Derenski was insured by USAA under a personal automobile policy having a 7 personal injury protection (“PIP”) coverage limit of $25,000 per person and a UIM 8 coverage limit of $300,000 per person or $500,000 per accident. (Tredway MSJ Decl.

9 (Dkt. # 28) ¶ 2, Ex. 1 at 6.3) On April 9, 2018, Ms. Derenski reported the accident to 10 USAA, which assigned a PIP medical adjuster to her claim. (Id. ¶ 3, Ex. 2 (“Claim 11 Notes”) at 4-54; see also id. ¶ 4, Ex. 3 (April 11, 2018 letter from USAA to Ms. 12 Derenski).) 13 Ms. Derenski submitted her claim to USAA on April 17, 2018. (Claim Notes at

14 6.) She advised that the at-fault driver’s insurance was “taking care of [her] vehicle 15 damage,” and reported that she had seen her primary care provider and received physical 16 therapy and a prescription for massage. (See id.) The PIP adjuster contacted Ms. 17 Derenski the following day to request additional information about her injuries and 18

19 2 Neither party requests oral argument, and the court concludes oral argument would not assist it in its resolution of the motion. See Local Rules W.D. Wash. LCR 7(b)(4). 20 3 The court refers to the page numbers in the CM/ECF header when citing exhibits to Ms. Tredway’s declaration. 21 4 Although USAA refers to pages of the Claim Notes by Bates number, it did not organize the pages in its exhibit by Bates number. Therefore, the court refers to the page 22 numbers in the CM/ECF header for ease of reference. 1 treatment, and USAA began making payments on April 19, 2018. (Claim Notes at 7, 2.) 2 On May 10, 2018, Ms. Derenski reported she had suffered whiplash; a possible

3 concussion; pain in her right hip, low back, and neck; a contusion on her abdomen from 4 her seatbelt; and gastrointestinal issues due to pain. (Id. at 8-9.) 5 In April 2019, after Ms. Derenski complained of denied medical payments, USAA 6 obtained an independent medical record review. (See Claim Notes at 3; Tredway MSJ 7 Decl. ¶ 6, Ex. 5 (email to Ms. Derenski).) The reviewer opined that the treatment Ms. 8 Derenski had been receiving since January 2, 2019, was “not related to the motor vehicle

9 accident” and was “not reasonable or medically necessary[.]” (Tredway MSJ Decl. ¶ 7, 10 Ex. 6 at 7.) At some point, however, USAA reversed its denial of medical payments. 11 (See id. ¶ 8, Ex. 7 (listing PIP payments).) In total, USAA paid Ms. Derenski $11,407.96 12 in PIP benefits. (See id. at 9.) 13 In a letter dated January 26, 2021, Ms. Derenski’s attorney advised USAA that the

14 at-fault driver had only $25,000 in liability coverage; that Ms. Derenski intended to settle 15 with the at-fault driver for policy limits; and that Ms. Derenski intended to pursue a UIM 16 claim. (Tredway MSJ Decl. ¶ 9, Ex. 8.) In response, USAA opened a UIM claim, 17 assigned a UIM adjuster, and waived its subrogation rights. (Id. ¶ 10, Ex. 9.) It asked 18 counsel to provide information about Ms. Derenski’s injuries and treatment and noted

19 that it did not possess any recorded statements, vehicle damage repair estimates, or 20 accident reconstruction reports. (Id.) Between March 3 and October 5, 2021, USAA sent 21 nine letters to Ms. Derenski’s attorney following up on its request for information about 22 Ms. Derenski’s injuries and treatment. (See generally id. ¶ 16, Ex. 15.) Although 1 counsel contacted USAA on April 30, 2021, to inform it that Ms. Derenski was receiving 2 injections and physical therapy, he did not respond to USAA’s requests for medical bills

3 and records. (Id. ¶ 16.) 4 On October 26, 2021, Ms. Derenski’s attorney sent a UIM demand package to 5 USAA. (Tredway MSJ Decl. ¶ 17, Ex. 16 (“Demand”).) The demand letter described 6 Ms. Derenski’s injuries, recounted her treatment through June 2020, and discussed the 7 ways her injuries had caused her to suffer ongoing pain, loss of enjoyment of life, and 8 harm to her relationships with her husband and three young children. (Id. at 3-9.) The

9 package also included copies of medical records and bills totaling $13,458.44, along with 10 a request for reimbursement of $10,339.32 in out-of-pocket expenses Ms. Derenski 11 asserted were necessary to accommodate her injuries. (Id. at 7, see also id. Exs. 2-11.) 12 The demand letter did not include a settlement proposal. (Id. at 2-10.) 13 On November 10, 2021, USAA responded with a settlement offer of $5,000.

14 (Tredway MSJ Decl. ¶ 19, Ex. 18; see also Yager MSJ Decl. (Dkt. # 36) ¶ 7, Ex. 4 15 (“11/10/21 Claim Eval.”).) Although USAA did not challenge Ms. Derenski’s request 16 for additional medical expenses, it concluded that her out-of-pocket expenses “were not 17 supported by medical documentation or need for the items/services.” (11/10/21 Claim 18 Eval. at 3.)

19 Ms. Derenski responded through counsel on December 6, 2021. (Tredway MSJ 20 Decl. ¶ 21, Ex. 20.) Her attorney asked USAA to “provide a clear explanation under the 21 facts, the law, and the policy, as to why USAA believes $5,000 is sufficient to make Ms. 22 Derenski whole in this case.” (Id.) He granted permission for USAA to reach out to Ms. 1 Derenski’s care providers, offered to have Ms. Derenski provide a statement under oath, 2 and proposed an independent medical examination (“IME”). (Id. at 2.)

3 On December 29, 2021, USAA responded that it considered $13,459 “for 4 reasonably related medical bills” and “$16,541 in non-economic damages” in developing 5 its settlement offer. (Tredway MSJ Decl. ¶ 22, Ex. 21.) It did not, however, explain how 6 it determined the value of Ms. Derenski’s noneconomic damages. (See id.) USAA 7 requested a telephone conference with Ms. Derenski and her husband, the repair estimate 8 for Ms. Derenski’s vehicle, and any medical bills or records postdating June 3, 2020, but

9 it rejected Ms. Derenski’s offer to conduct an IME. (Id.) In January 2022, having not 10 received a repair estimate from Ms. Derenski, USAA obtained that information from the 11 at-fault driver’s insurer. (See Claim Notes at 15.) 12 USAA interviewed Ms. Derenski on March 30, 2022. (Yager MSJ Decl. ¶ 9, Ex. 13 6 (summary of interview).) Shortly thereafter, USAA raised its claim value estimate to

14 between $25,000 and $35,000 and increased its settlement offer to $25,000, “based on the 15 $13,459 in submitted medical bills and $36,459 in non economic damages.” (Tredway 16 MSJ Decl. ¶ 31, Ex. 30); see also Yager MSJ Decl. ¶ 8, Ex. 5 (“4/6/22 Claim Eval.”).) 17 USAA again did not explain how it valued the noneconomic damages. (Tredway MSJ 18 Decl. Ex. 30.) Between April 20, 2022 and December 13, 2022, USAA sent 11 letters to

19 Ms. Derenski’s attorney seeking a response to the outstanding settlement offer, but 20 counsel never wrote back.

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Derenski v. USAA General Indemnity Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/derenski-v-usaa-general-indemnity-company-wawd-2024.