Garcia v. Berkshire Life Insurance Co. of America

569 F.3d 1174, 2009 U.S. App. LEXIS 12503, 2009 WL 1609364
CourtCourt of Appeals for the Tenth Circuit
DecidedJune 10, 2009
Docket08-1022
StatusPublished
Cited by49 cases

This text of 569 F.3d 1174 (Garcia v. Berkshire Life Insurance Co. of America) is published on Counsel Stack Legal Research, covering Court of Appeals for the Tenth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Garcia v. Berkshire Life Insurance Co. of America, 569 F.3d 1174, 2009 U.S. App. LEXIS 12503, 2009 WL 1609364 (10th Cir. 2009).

Opinion

McCONNELL, Circuit Judge.

In 2004, Tina Garcia filed this action against her insurer, seeking payment of benefits under a disability policy. Over the course of the litigation, the district court concluded that Ms. Garcia “willfully, knowingly, [and] intentionally” fabricated a number of discovery documents in an effort to win her case. Mag. Op. 15; Dist. Ct. Op. 12-14. As a result, in addition to granting Berkshire’s motion for summary judgment on the merits, the district court separately and independently dismissed the action as a sanction for Ms. Garcia’s abusive litigation practices. Because we conclude that the district court did not abuse its discretion by dismissing Ms. Garcia’s action as a sanction for her improper actions, we affirm its judgment without reaching the merits of her claims.

I. Background

In 1991, Ms. Garcia purchased a disability policy from Berkshire, under which she would receive benefits if “due to injury or sickness [she was] unable to perform the material and substantial duties of [her own] occupation,” and she was “not engaged in any occupation in which [she] might reasonably be expected to engage with due regard for [her] education, training, experience, and prior economic status.” Aple. SuppApp. 305.

At the time that she purchased the policy, Ms. Garcia was the CEO of a real estate company called Special Properties, Inc. (“SPI”), which held a contract with the United States Department of Housing and Urban Development (“HUD”). In 1998, HUD undertook a criminal investigation of SPI and terminated its contract after finding billing irregularities and fraudulent invoices. The following year, SPI sued HUD in a matter ultimately dismissed without prejudice by stipulation of both parties.

*1177 At around this time, Ms. Garcia first filed for benefits under her policy, claiming that she was suffering from post-traumatic stress disorder and a chronic sleep disorder. She later argued that her disability was aggravated by two subsequent developments. First, the psychiatrist treating Ms. Garcia admitted to having sex with her. Second, Ms. Garcia suffered multiple injuries from a rear-end motor vehicle collision in September 2002. This accident allegedly resulted in cognitive impairment.

Berkshire eventually paid full benefits on Ms. Garcia’s claim through August 6, 2003, under a reservation of rights until its investigation of her claim could be completed. As of that date, however, Berkshire suspended payment of benefits, contending that Ms. Garcia had failed to comply with certain provisions of her policy requiring her to establish proof of her loss. See Aple. Supp.App. 281. Although Berkshire ultimately approved Ms. Garcia’s claim for total disability benefits as of February 1, 2007, it refused to pay benefits for the period between August 2003 and February 2007, primarily because of Ms. Garcia’s alleged “failure to comply with critical policy provisions.” Amongst other deficiencies, Berkshire claimed that Ms. Garcia had failed to submit to an independent medical examination until 2007, and withheld the authorization Berkshire required in order to get access to her medical records. See id. at 281-82.

These omissions were important because Berkshire questioned the legitimacy of Ms. Garcia’s disability claim before 2007. In particular, it noted that during the period before 2007 in which Ms. Garcia had claimed to be totally disabled due to cognitive defects, Ms. Garcia had obtained a Juris Doctor degree from the University of Denver College of Law, where she was named an “Outstanding Law Graduate,” and subsequently completed a Masters program. Moreover, Berkshire noted that it appeared that Ms. Garcia had operated a real estate business during 2002, three years after the time she had first claimed total disability. Berkshire concluded that because of Ms. Garcia’s alleged failure to comply with Berkshire’s requests for an independent medical examination and access to medical records during the 2003-2007 period, it could not meaningfully evaluate whether Ms. Garcia had been totally disabled within the meaning of the policy during that time.

After the dispute proceeded to litigation, both sides filed motions for summary judgment on the merits. In addition, Berkshire later filed a Motion for Sanctions, asserting that Ms. Garcia falsified or fabricated at least four documents submitted during discovery. The magistrate judge held a hearing on Berkshire’s Motion for Sanctions on November 14, 2007, at which Ms. Garcia testified concerning each of the allegedly fabricated documents. The magistrate judge found Ms. Garcia’s testimony at the Sanctions hearing to be “incredible,” and “refusefd] to rely on any of it.” Id. at 4. See also Mag. Op. 13 (stating that “plaintiffs willingness to lie knows no bounds”). The magistrate judge concluded that Ms. Garcia prepared fabricated evidence “willfully, knowingly, intentionally, after careful contemplation, for self-serving purposes, and with a full understanding of the impropriety involved.” Id. at 15.

The magistrate judge noted that at least two of the falsified documents were directly related to Ms. Garcia’s claims. First, Ms. Garcia submitted a letter, purportedly written by Earl Schoenborn, a former Berkshire claims adjuster, that appeared to be a smoking gun in support of her claims. In the letter, Mr. Schoenborn is alleged to have written:

I left [Berkshire] after Berkshire refused to honor disability claims of sev *1178 eral female policy holders. I was distressed and told [Ms. Garcia] so, to witness Berkshire’s denial of legitimate claims of disabled and dying women clients.
I can testify based on personal knowledge that Berkshire used unfair business practices contrary to policy provisions in order to delay or deny payment of valid claims. Berkshire’s tactics include ‘stall and starve’, delay pay (on the courthouse steps) and manipulate claimant’s attorney to advocate taking a settlement paying back benefit and lawyers without recovery for the financial damages.

Id. at 9. The letter went on to suggest that Mr. Schoenborn had contacted a current Berkshire employee and learned that Berkshire’s “only defense” was not a real defense under the policy. Id. at 9-10. But Mr. Schoenborn repudiated the letter in full, stating that he “[absolutely, completely, definitively, totally... did not write that letter,” and that “the letter contains false statements that [he did] not agree with and which should not be attributable [to him].” Id. at 10.

Likewise, the magistrate judge found that Ms. Garcia fabricated a document allegedly prepared by Patrick Renfro, Ms. Garcia’s vocational rehabilitation expert, and submitted to the Colorado Board of Law Examiners (“CBLE”) in support of Ms. Garcia’s application for special accommodation (double time) when taking the bar exam. While Mr. Renfro’s actual report described Ms. Garcia’s symptoms as occurring “secondary to a mild to moderate head injury or a post-concussive syndrome as well as stress, depression, chronic pain, and possible iatrogenic (medication) effects,” the report Ms.

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Cite This Page — Counsel Stack

Bluebook (online)
569 F.3d 1174, 2009 U.S. App. LEXIS 12503, 2009 WL 1609364, Counsel Stack Legal Research, https://law.counselstack.com/opinion/garcia-v-berkshire-life-insurance-co-of-america-ca10-2009.