Falvo v. Safety Insurance

5 Mass. L. Rptr. 666
CourtMassachusetts Superior Court
DecidedJune 26, 1996
DocketNo. 921606
StatusPublished

This text of 5 Mass. L. Rptr. 666 (Falvo v. Safety Insurance) 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
Falvo v. Safety Insurance, 5 Mass. L. Rptr. 666 (Mass. Ct. App. 1996).

Opinion

Fecteau, J.

This is an action under the provisions of G.L.c. 176D, and c. 93A, in which the plaintiff alleges that the defendant insurer committed unfair and deceptive acts or practices in the manner in which it conducted its investigation, evaluation and negotiation of the underlying motor vehicle accident which had resulted in a personal injury having been caused to the plaintiff by its insured. The underlying claim for personal injury having been closed by the execution of a release and the litigation against the defendant’s insured having been closed by a stipulation of dismissal, this cause of action, the subject of an amendment to the original complaint for personal injury, comes for trial before the court on June 10, 1996, sitting without jury, having reserved the case on a nonjury basis by ruling on June 6, 1996.

Upon consideration of all the credible evidence, the court makes the following findings of fact and rulings of law.

FINDINGS OF FACT

1. The plaintiff, Cynthia Falvo (“Falvo”), was injured in a motor vehicle accident on September 1, 1990, in Marlboro, Massachusetts, when the car in which she was occupying as a passenger was rear-ended by an intoxicated driver, Richard Butts, an insured under a policy of motor vehicle liability insurance with the defendant Safety Insurance Company (“Safety”).

2. Safety was first notified of this claim for personal injuries on or about September 12, 1990, when it received a letter of representation from Falvo’s attorney, JohnF. Keenan (“Keenan”). (Ex. 1, 2.) It acknowledged receipt of this letter by letter dated September 13, 1990. (Ex. 3.) Although it had not made verbal contact with its insured by this time, an entry was made on its computer status program that liability was clear. (Ex. 1.) This entry was repeated on September 19, 1990.

3. The next contact of significance between Keenan and Safety occurred on January 23, 1991, at which time a telephone conversation took place and a confirmatory note was sent by the Safety claim representative. (Ex. 4, 5.) As a result, Keenan sent a letter dated January 24, 1991, in which he listed medical bills incurred to date by Falvo of which he was aware, which totalled approximately $4,000.00. He also enclosed copies of a report of Falvo’s treating neurologist, Dr. Naren Sodha dated October 8, 1990, and a report from Somerset Diagnostic Center indicating that a magnetic resonance imaging (MRI) study was performed on October 4, 1990. (Ex. 6.) Although Keenan believed that he enclosed copies of the medical bills referred to in his letter and that it would have been his practice to do so, the claim representative stated that she did not receive them. As Keenan’s handwritten notation [667]*667on the telephone message note from Safety’s telephone call of January 23, 1991, indicates “list bills and cc MRI + Dr. Sodha’s notes” (Ex. 4), I find that the copies of bills probably were not sent, but that Dr. Sodha’s handwritten office notes and the MRI report were sent. Thus, Safety was on notice of the possibility of disc involvement with radiation symptomology into the left shoulder and arm as well as of the scar injury she sustained over the left eye with supra-orbital nerve involvement. Safety received this letter with these enclosures on January 25, 1991. There were no calls or letters from Safety to Keenan requesting copies of bills not sent with this letter nor was his attention invited to this apparent oversight, if indeed it was.

4. Dr. Sodha’s report also noted a childhood accident whereby the plaintiff reportedly “fell down a flight of stairs and was ‘paralysed’ for one day.. . recovered 100% wore a back brace for one mo. had ‘neck spasm’ for 10 years and this completely resolved.”

5. For the next six and one-half months, neither parly initiated contact with the other. The next contact between the parties was Keenan’s letter to Safety, dated August 20, 1991, which enclosed a follow-up note of Dr. Sodha dated July 22, 1991. (Ex. 7.) Safety received this on August 21, 1991. He reported that the plaintiff stated that she had experienced “no material change since January 1991.” Good days and bad days were noted including a reference to “pain on the left side of the neck which spread to the left shoulder and radiates down the left upper arm up to the elbow,” sometimes with a “tingling numbness in the left hand.” He found diminished pin prick sensation in the first four digits of the left hand and mild decrease in the range of movement at the neck. Also noted was the plaintiffs unwillingness to use a TENS unit due to her work and her time constraints, and a willingness to learn to live with her discomfort.

6. The next contact between the parties occurred three and one-half months later when Safety called Keenan seeking a status as to the plaintiffs injuries and treatment, as well as for complete medical documentation, followed-up by a note to Keenan confirming its request. (Ex. 1, 27.) Keenan wrote to Safety by letter dated December 9, 1991, enclosing a report from the plaintiffs plastic surgeon, Dr. Ekstrom, dated September 18, 1991, and another copy of Dr. Sodha’s report dated July 22, 1991, which he had already sent them. (Ex. 8.) Keenan noted in his cover letter that his client has a “protuding disc which continues to cause symptoms”; additionally it should be noted that this letter refers to the medical expenses that he had “outlined” in his January 24, 1991, letter. Dr. Ekstrom’s report makes reference to a history as given by the plaintiff including being “hit by a drunk driver and suffering a cervical spine injury with a disk herniated in her neck (cared for by Dr. Sodha).” Safety received this December 4, 1991, letter with enclosures on December 10, 1991. However, this is not noted in the claim representative’s “note pad” entries. What is noted is that on February 13, 1992, there was a telephone call from Safety to Keenan looking for the plastic surgeon’s report; in addition, there is noted a December 5, 1991, telephone conversation wherein Keenan had advised that he was still waiting for the report from the plastic surgeon. I do not credit this February 13, 1992, entry, as I infer and so find that if such a call took place, that Keenan would have referred Safety to his December 9, 1991, letter.

7. Also not noted on the claims examiner’s “note pad,” nor recalled by the claims examiner was Keenan’s demand letter of February 18, 1992, in which he enclosed a photo of the plaintiffs face and made a settlement demand of $225,000.00, based on the plaintiffs permanent disfiguring scar and a ruptured cervical disc and a life expectancy of 45.4 years. He also made a demand under the newly-effective legislation for insurance policy coverage limits. (Ex. 9.)

8. On April 6, 1992, Keenan sent a demand letter to Safety under the provisions of G.L.c. 93A and G.L.c. 176D, §3 for its failure to effectuate a prompt settlement where liability had become reasonably clear. This letter was received by Safety and responded to on April 23, 1992. (Ex. 10, 11.) In his demand letter, Keenan made reference to his earlier demand letter of February 18, 1992, and in their response, Safety advised him that they had not received this letter. Safety disclosed their bodily injury coverage limits of $100,000.00 per claimant $300,000.00 per accident. Also noted in this response and for the first time in writing to Keenan is the observation that his January 24, 1991, letter did not enclose copies of bills, although acknowledging that the letter referred to $3,533.00 in bills incurred. Safety acknowledged the 2 cm.

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Bluebook (online)
5 Mass. L. Rptr. 666, Counsel Stack Legal Research, https://law.counselstack.com/opinion/falvo-v-safety-insurance-masssuperct-1996.