Hansen v. State Farm Mutual Automobile Insurance Co.

957 P.2d 1380, 1998 Colo. J. C.A.R. 2387, 1998 Colo. LEXIS 393, 1998 WL 251443
CourtSupreme Court of Colorado
DecidedMay 18, 1998
Docket96SC716
StatusPublished
Cited by187 cases

This text of 957 P.2d 1380 (Hansen v. State Farm Mutual Automobile Insurance Co.) is published on Counsel Stack Legal Research, covering Supreme Court of Colorado primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hansen v. State Farm Mutual Automobile Insurance Co., 957 P.2d 1380, 1998 Colo. J. C.A.R. 2387, 1998 Colo. LEXIS 393, 1998 WL 251443 (Colo. 1998).

Opinion

Justice KOURLIS

delivered the Opinion of the Court.

This appeal arises out of a jury verdict for Petitioner, Linda Hansen, on her claims against State Farm Mutual Automobile Insurance Company (State Farm) for breach of contract for failing to pay Personal Injury Protection (PIP) benefits and for bad faith. One of the principal issues at trial was whether State Farm’s request that Hansen submit to an examination by physicians of its choosing was reasonable, and whether Hansen’s failure to do so defeated her request for coverage and her assertion of bad faith. The court of appeals reversed the trial court *1382 judgment and remanded for a new trial based upon jury instruction error. See Hansen v. State Farm Mut. Auto. Ins. Co., 936 P.2d 584 (Colo.App.1996).

We granted review of the court of appeals’ rulings on the claimed instructional errors. 1 We now hold that the trial court satisfied its obligation to instruct the jury, both with respect to its decision not to give the tendered independent medical examination (IME) instruction and with respect to the inducement instruction as given. For these reasons, we reverse the judgment of the court of appeals.

I. FACTUAL AND PROCEDURAL BACKGROUND

Hansen was involved in two automobile accidents, on August 31, 1991 and April 25, 1992 respectively. She sustained multiple injuries in both accidents. At the times of the accidents, Hansen was insured with State Farm and claimed benefits under the no-fault provision of her policy. State Farm initially paid certain benefits under the policy and later declined to do so. Hansen filed suit for breach of contract and bad faith.

Hansen’s policy with State Farm provided, in pertinent part:

REPORTING A CLAIM — INSURED’S DUTIES

4. Other Duties Under No-Fault, Uninsured Motor Vehicle and Death, Dismemberment and Loss of Sight Coverages.
The person making the claim also shall:
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b. be examined by physicians chosen and paid by us [State Farm] as often as we reasonably may require....
2. Suit Against Us.

There is no right of action against us:

a. until all the terms of this policy have been met....

(Emphasis in original.)

State Farm was concerned that Hansen’s requests for medical expenses were not reasonable or necessary. At State Farm’s request, Hansen underwent one IME in November of 1991 with a chiropractic orthopedist and another IME in April of 1992 with an ophthalmologist. In May of 1992, State Farm notified Hansen that she would need to attend another IME with an orthopedic surgeon. Hansen arrived at the doctor’s office for the scheduled appointment with the orthopedic surgeon, but refused to be examined unless a nurse observer was also present. State Farm’s surgeon would not agree to proceed with the examination in the presence of a third person, hence, no orthopedic examination took place. In September 1992, State Farm notified Hansen that she would be required to attend a psychiatric IME. Through counsel, Hansen requested a resume of State Farm’s psychiatrist’s qualifications and permission to have a nurse observer attend the exam. State Farm did not respond to the requests; hence, the psychiatric IME also never occurred.

The matter was tried to a jury in July 1994. At trial, State Farm took the position that Hansen had failed to satisfy a condition precedent to her coverage by not attending the orthopedic and psychiatric IMEs. According to State Farm, Hansen’s conduct defeated her right to recovery on both the breach of contract and bad faith claims. In support of this position, State Farm tendered a jury instruction modeled after Jensen v. American Family Mutual Insurance Co., 683 P.2d 1212 (Colo.App.1984), which provided:

Compliance with the physical examination requirements of the State Farm insurance policy is a condition precedent to plaintiffs recovery of benefits under the policy. If you find that State Farm’s request that *1383 plaintiff attend examinations by Dr. Barry Lindenbaum [State Farm’s orthopedic surgeon] and/or Dr. I. Gene Schwarz [State Farm’s psychiatrist] was reasonable under the circumstances of this case and that plaintiff failed to be examined by Dr. Lindenbaum or Dr. Schwarz, then plaintiff is not entitled to recover benefits under her policy of no-fault insurance and your verdict must be in favor of defendant and against plaintiff. On the other hand, if you find that State Farm’s request for plaintiff to be examined by Dr. Lindenbaum and Dr. Schwarz was not reasonable under the circumstances, or that plaintiff complied with State Farm’s request to submit to these examinations, then you may consider whether plaintiff is entitled to recover benefits under her policy of no-fault insurance.

On the morning of the last day of trial, the court conferred with counsel about jury instructions. Hansen objected to the above instruction on two grounds: (1) because it focused on the reasonableness of the requests that Hansen undergo additional IMEs, without reference to the reasonableness of the terms and conditions of those IMEs; and (2) because it characterized the IME examination question as the sole issue of the case, dispositive of both the breach of contract and bad faith claims. Hansen argued in part that evidence of bad faith preceded the IME controversy, and would not in any event be defeated by Hansen’s failure to undergo the IMEs. State Farm maintained that Hansen’s failure to submit to the IMEs was a failure to satisfy a condition precedent under the insurance contract, which relieved State Farm of any duty to pay benefits.

At the jury instruction conference, the trial judge agreed with Hansen that the tendered instruction was “not a successful attempt to explain this area of the law” and suggested that State Farm’s counsel tender a revised instruction. At that point, the following dialogue ensued:

State Farm’s counsel: At this point in time, I really don’t have time to redraft this, so I guess this is the instruction that I’m submitting.
Court: Okay. So, if this is what you want to stand on, the Court will reject this instruction for the reasons I indicated.

Counsel did not request additional time to correct the tendered instruction nor did counsel request any further clarification of what the court would have required. The court marked its rejection on the face of the tendered instruction with a note that read: “Court would have (1) accepted a statement of the contract term and (2) the holding in Jensen [v. American Family Mutual Insurance Co., 683 P.2d 1212 (Colo.App.1984) ]. Defendant chose not to submit such an instruction.”

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Bluebook (online)
957 P.2d 1380, 1998 Colo. J. C.A.R. 2387, 1998 Colo. LEXIS 393, 1998 WL 251443, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hansen-v-state-farm-mutual-automobile-insurance-co-colo-1998.