Federici v. IDS Property Casualty Ins. Co. CA2/2

CourtCalifornia Court of Appeal
DecidedSeptember 28, 2016
DocketB262009
StatusUnpublished

This text of Federici v. IDS Property Casualty Ins. Co. CA2/2 (Federici v. IDS Property Casualty Ins. Co. CA2/2) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Federici v. IDS Property Casualty Ins. Co. CA2/2, (Cal. Ct. App. 2016).

Opinion

Filed 9/28/16 Federici v. IDS Property Casualty Ins. Co. CA2/2

NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA SECOND APPELLATE DISTRICT DIVISION TWO

MICHAEL FEDERICI, B262009

Plaintiff and Respondent, (Los Angeles County Super. Ct. No. BC502718) v.

IDS PROPERTY CASUALTY INSURANCE COMPANY,

Defendant and Appellant.

APPEAL from a judgment of the Superior Court of Los Angeles County. Michelle R. Rosenblatt, Judge. Affirmed.

Lewis Brisbois Bisgaard & Smith, Roy G. Weatherup and Allison A. Arabian; Woolls & Peer and H. Douglas Galt for Defendant and Appellant.

Reisman & Reisman and Daniel A. Reisman; Law Office of John J. Perlstein and John J. Perlstein for Plaintiff and Respondent. In this first party insurance bad faith action, defendant and appellant IDS Property Casualty Insurance Company (IDS) appeals from the judgment entered in favor of plaintiff and respondent Michael Federici (Federici) after a jury awarded Federici $335,000 in damages on his claim for unreasonable delay in payment of benefits under his automobile insurance policy for underinsured motorist (UIM) coverage. We affirm the judgment. BACKGROUND The accident and claim history On August 10, 2011, Federici was injured in an automobile accident with an underinsured driver. The front airbag in Federici’s vehicle did not deploy, and Federici complained of mouth pain at the scene of the accident. Federici had a six-tooth dental bridge secured in his mouth by two of his own teeth. Concerned about damage to the bridge, Federici went to his regular dentist, Douglas Oswell, two days after the accident. Dr. Oswell examined Federici and found that the bridge was not mobile. Two weeks later, Federici bit down on something and felt the bridge become loose. He went to see a different dentist, who confirmed that the bridge was loose and referred him to an oral surgeon. On September 29, 2011, the oral surgeon informed Federici that the two teeth securing the dental bridge were fractured and had to be removed. The oral surgeon advised Federici that he would need dental implants and a bone graft to secure a new bridge. The process could take a year and Federici would have to wear a temporary dental bridge in the interim. The oral surgeon removed the existing bridge, extracted the two fractured teeth, and provided Federici with a temporary bridge, which broke several times while Federici awaited IDS’s payment for the dental implants. At the time of the accident, Federici was an insured under a policy issued by IDS that provided a limit of $5,000 in medical payment coverage and a $250,000 per person limit for bodily injury caused by an underinsured motor vehicle. Federici tendered a

2 claim for his medical expenses, including approximately $50,000 in dental expenses. His medical payment coverage was soon exhausted. The other driver’s insurer did not dispute liability and paid its policy limit of $15,000. On October 31, 2011, Federici provided IDS with evidence he had received the at-fault driver’s $15,000 policy limit. In December 2011, Federici informed IDS that his medical expenses were increasing and demanded a settlement of $200,000. In February 2012, the IDS claims adjuster assigned to the case, Robert Cannon (Cannon), informed Federici that IDS was investigating his claim and that an independent medical examination (IME) would be necessary. IDS retained Dr. Richard Boudreau, an oral and maxillo-facial surgeon, to determine whether Federici’s dental problems were caused by the accident or were preexisting. Dr. Boudreau examined Federici in March 2012 and found that Federici had an exceedingly poor state of dental health that predisposed his teeth to fracture with minimal impact, a condition Dr. Boudreau described as “‘eggshell’ status.” Dr. Boudreau noted that Federici’s dentist had submitted a claim to replace the dental bridge in 2008 because of recurrent decay, but the work had never been performed. Dr. Boudreau was unable to determine whether the factures in Federici’s teeth were preexisting or whether they were caused by the accident. He concluded, however, that “[o]ptimum treatment involves dental implants to support the bridge.” On April 5, 2012, Federici demanded $100,000 as a “last effort to settlement” before retaining an attorney. IDS offered $37,000, which covered only one of Federici’s two fractured teeth and did not include any allowance for dental implants. Federici rejected the offer and retained counsel to represent him. In August 2012, Federici’s attorney demanded payment of the policy limit. IDS responded by increasing its settlement offer to $40,000. IDS then transferred responsibility for Federici’s claim from Cannon to litigation adjuster Dan Thompson. Thompson’s initial review of the file on August 28, 2012, led him to conclude that an arbitrator could award Federici in excess of $100,000, and he raised the reserve set for the claim to $80,000. At the time, Thompson erroneously believed that the policy limit

3 was $100,000. He subsequently learned that the per accident limit on Federici’s policy was $250,000, and not $100,000. Thompson noted that Federici was missing his front teeth, that the front airbag in Federici’s car did not deploy during the accident and that “it is not inconceivable he hit his mouth in this impact.” Thompson then sent the file to outside counsel for review. In early October 2012, IDS’s counsel advised IDS that Federici’s claim could be valued at $170,000. On December 11, 2012, Thompson contacted Federici’s counsel and offered $120,000. The claim settled for $140,000 shortly thereafter. The instant bad faith action Federici commenced this action against IDS in March 2013 for breach of the implied covenant of good faith and fair dealing. The matter proceeded to a jury trial. At the conclusion of the trial, the jury returned a special verdict finding that IDS had unreasonably delayed payment of policy benefits and awarded Federici $35,000 in economic damages and $300,000 in noneconomic damages. The trial court denied IDS’s motion for a new trial, and this appeal followed. IDS’s CONTENTIONS IDS contends Federici’s settlement of his UIM claim precluded him from pursuing a bad faith action; that it had no obligation to settle Federici’s claim until the value of the claim was determined either by agreement or by the arbitrator; and that the existence of a genuine dispute regarding the cause of Federici’s injury precluded any bad faith liability. IDS further contends the trial court erred by excluding certain expert testimony and by failing to instruct the jury on the applicable law and measure of damages. Finally, IDS claims the damages award is excessive as a matter of law. DISCUSSION I. Bad faith claim A. Applicable law and standard of review The law implies in every insurance contract a covenant of good faith and fair dealing that “‘requires each contracting party to refrain from doing anything to injure the right of the other to receive the agreement’s benefits. To fulfill its implied obligation, an

4 insurer must give at least as much consideration to the interests of the insured as it gives to its own interests.’” (Wilson v. 21st Century Ins. Co. (2007) 42 Cal.4th 713, 720 (Wilson).) An insurer that unreasonably delays payment of benefits due under a policy may be held liable in tort for breach of the implied covenant. (Maslo v. Ameriprise Auto & Home Ins. (2014) 227 Cal.App.4th 626, 633 (Maslo); Brehm v. 21st Century Ins. Co.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Zhang v. Superior Court
304 P.3d 163 (California Supreme Court, 2013)
Seffert v. Los Angeles Transit Lines
364 P.2d 337 (California Supreme Court, 1961)
Brandt v. Superior Court
693 P.2d 796 (California Supreme Court, 1985)
Moradi-Shalal v. Fireman's Fund Ins. Companies
758 P.2d 58 (California Supreme Court, 1988)
Royal Globe Insurance v. Superior Court
592 P.2d 329 (California Supreme Court, 1979)
Fleming v. Safeco Insurance
160 Cal. App. 3d 31 (California Court of Appeal, 1984)
Zephyr Park, Ltd. v. Superior Court
213 Cal. App. 3d 833 (California Court of Appeal, 1989)
Interinsurance Exchange v. Superior Court
213 Cal. App. 3d 1439 (California Court of Appeal, 1989)
Bosetti v. United States Life Ins. Co. in City of New York
175 Cal. App. 4th 1208 (California Court of Appeal, 2009)
Brehm v. 21st Century Insurance
166 Cal. App. 4th 1225 (California Court of Appeal, 2008)
Major v. Western Home Insurance
169 Cal. App. 4th 1197 (California Court of Appeal, 2009)
CHATEAU CHAMBERAY HOA v. Associated Internat. Ins. Co.
108 Cal. Rptr. 2d 776 (California Court of Appeal, 2001)
Jordan v. Allstate Insurance
56 Cal. Rptr. 3d 312 (California Court of Appeal, 2007)
Shade Foods, Inc. v. Innovative Products Sales & Marketing, Inc.
93 Cal. Rptr. 2d 364 (California Court of Appeal, 2000)
Hightower v. Farmers Insurance Exchange
38 Cal. App. 4th 853 (California Court of Appeal, 1995)
Westphal v. Wal-Mart Stores, Inc.
81 Cal. Rptr. 2d 46 (California Court of Appeal, 1998)
Century Surety Co. v. Polisso
43 Cal. Rptr. 3d 468 (California Court of Appeal, 2006)
Cassim v. Allstate Insurance
94 P.3d 513 (California Supreme Court, 2004)
Wilson v. 21st Century Insurance
171 P.3d 1082 (California Supreme Court, 2007)
Maslo v. Ameriprise Auto & Home Insurance
227 Cal. App. 4th 626 (California Court of Appeal, 2014)

Cite This Page — Counsel Stack

Bluebook (online)
Federici v. IDS Property Casualty Ins. Co. CA2/2, Counsel Stack Legal Research, https://law.counselstack.com/opinion/federici-v-ids-property-casualty-ins-co-ca22-calctapp-2016.