Dydek v. Dydek

2012 NMCA 88, 2012 NMCA 088, 2 N.M. 389
CourtNew Mexico Court of Appeals
DecidedJuly 9, 2012
DocketDocket 30,775 & 30,804
StatusPublished
Cited by13 cases

This text of 2012 NMCA 88 (Dydek v. Dydek) is published on Counsel Stack Legal Research, covering New Mexico Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Dydek v. Dydek, 2012 NMCA 88, 2012 NMCA 088, 2 N.M. 389 (N.M. Ct. App. 2012).

Opinion

OPINION

BUSTAMANTE, Judge.

{1} This is an insurance bad faith action brought by Joseph Gant (Receiver) on behalf of Lowell Dydek (Husband). Following a bench trial, the district court ruled that “USAA breached its contract with [Husband] by failing to act in good faith to make a timely policy limits settlement offer to Mary Dydek [Wife] and causing a Judgment in the amount of 2.8 million dollars to be entered against [Husband].” The district court concluded that “USAA knowingly failed to in good faith effectuate a prompt, fair, and equitable settlement of [Wife’s] liability claim ... in violation of [NMSA 1978, Sections] 59A-16-20 and 59A-16-30.” Although Receiver prevailed, the district court ruled that Wife’s agreement not to execute the judgment against Husband’s personal assets precluded the award of the excess judgment as damages. Instead, the court awarded $100 as nominal damages.

{2} The district court also concluded “that USAA wantonly and recklessly breached its contract with [Husband], and violated [Sections] 59A-16-20 and [-30].” As a consequence of this ruling, the district court granted Receiver attorney fees and costs incurred in pursuing the bad faith claim against USAA as well as punitive damages in the amount of $300,000. In addition, the district court awarded Receiver “compensatory damages for attorneyf] fees and costs expended in the Texas litigation.” The district court’s ruling that USAA acted recklessly and wantonly was based in part on its conclusion that “USAA’s actions ... in the Texas litigation show the culpable conduct of USAA regarding [Husband].”

{3} Receiver appeals the district court’s refusal to award the full amount of the excess liability judgment entered against Husband. We reverse that portion of the district court’s judgment. USAA cross-appeals arguing that (1) the district court erred in finding that USAA acted in bad faith; and (2) Receiver was not properly appointed and, therefore, the bad faith claim was not prosecuted by the real party in interest. We affirm the district court as to all matters raised in the cross-appeal.

I. BACKGROUND

{4} The factual background undergirding the district court’s decision is detailed in its comprehensive “Decision, Findings of Fact, Conclusions of Law, and Order.” The parties do not challenge the facts as found by the district court — USAA agrees that they are “largely based on undisputed evidence” — and we therefore accept them as accurate and controlling. The background facts organize themselves rather neatly into three areas: (1) the three-month period following the collision and ending with Wife’s filing of her tort action against Husband in October 2003, (2) the facts surrounding the so-called “Texas litigation” starting in April 2005, and (3) the process leading to the appointment of Receiver. We will provide a synopsis of the post-collision events and the Texas litigation here because they both have a direct impact on the finding of bad faith — which we will examine first. We will provide a summary of the facts regarding the Receiver’s appointment as part of our analysis of that issue.

A. Collision and Claims Handling

{5} On July 21,2003, Husband was driving a vehicle in which Wife was a passenger. The couple was headed to a neurologist appointment to assess what was later determined to be Husband’s early onset of Alzheimer’s disease. Husband attempted to pass on a blind curve and collided head-on with another vehicle. Wife was severely injured and within weeks of the collision incurred hundreds of thousands of dollars in medical bills. [RP 2395, 2421 FOF 25; Def. Exh. #17] Wife’s injuries included: (1) complex facial fractures, (2) a fractured jaw, (3) facial lacerations, (4) acute respiratory failure requiring a tracheotomy, (5) bilateral rib fractures, (6) fractured wrist, (7) fractured spine, (8) bladder rupture, (9) fractured pelvis, (10) fractured and lacerated knees and knee ligament displacement, (11) fractured/dislocated right ankle, (12) fractured left leg, and (13) a puncture wound to the right foot. As of July 25, 2003, Wife was in intensive care, had undergone “an open reduction of internal fixation [ORIF] surgery on her legs and was scheduled for spinal/back surgery.” USAA admitted during discovery that by July 25, it was aware of Wife’s general condition and impending surgery. Though the record does not reflect exactly when Wife was discharged from the hospital, it is clear that she went home sometime in late August with severe injuries after multiple surgical interventions and medical bills in excess of $300,000.

{6} USAA confirmed Husband’s coverage and opened a claim file on July 23, 2003. From that point on each of USAA’s claim handling activities “were reviewed by management, ratified and found to be satisfactory to USAA and constituted a general business practice of USAA.”

{7} On July 25, USAA determined that Husband was “100% at fault for the collision and crash injuries” to Wife. USAA had enough knowledge of the type and extent of the injuries Wife had incurred to classify her injuries and make a “Serious Injury Referral” to the home office. By July 25, USAA knew where Wife was hospitalized and her general condition, knew the identity of the financial case manager for the hospital, and had received a call from the hospital providing updated billing information for Wife’s treatment.

{8} Taylor Stott was the bodily injury adjuster assigned to the file. Stott knew as soon as he reviewed the file on July 25 that Wife’s “injuries and claim had a value in excess of the amount of [Husb and ’ s] liab ility coverage.” On July 25, USAA set a reserve for Wife’s bodily injury claim at the policy limit of $100,000. Soon after, however, USAA reduced the reserve to $25,000, relying on a provision in its policy that limited coverage for family members to $25,000. USAA relied on this provision “to justify its initial delay in paying [Wife’s] liability insurance benefits.” USAA was aware at the time it reduced the reserve that the family coverage limit had been declared invalid in New Mexico for at least eighteen years. USAA had a provision in its internal operating procedures that said the family coverage limit was invalid in New Mexico.

{9} Eventually, Wife began discussions with USAA to obtain insurance proceeds to help defray her medical costs. Though USAA knew within days that Husband was entirely at fault and that Wife’s damages would exceed the $100,000 policy limit — and after paying the $5000 limit for medical expenses — it made no settlement offers or payments to Wife until October 22, 2003. Instead, on August 20, USAA instructed Wife to forward any additional charges to her health insurer. Similarly, on August 27, USAA sent Wife copies of letters it had sent to various of her medical care providers refusing to pay them on their claims and referring them to Wife’s “health carrier.”

{10} On September 12, Wife started to correspond with USAA by faxed letter. Each of the letters she sent contained a variation of the same theme, including a recitation of severe injuries, the amount of the medical bills to date, attached copies of medical bills, requests for information, and requests for payment. USAA’s file did not reflect any written response to these communications prior to September 26.

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Cite This Page — Counsel Stack

Bluebook (online)
2012 NMCA 88, 2012 NMCA 088, 2 N.M. 389, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dydek-v-dydek-nmctapp-2012.