Harner v. USAA General Indemnity Company

District Court, S.D. California·Decided October 27, 2020·No. 3:18-cv-01993·Unknown

Opinion

PAUL HARNER, Case No.: 18-CV-1993 W (MDD)

Plaintiff, ORDER GRANTING IN PART AND v. DENYING IN PART DEFENDANT’S MOTION FOR SUMMARY JUDGMENT OR, IN THE COMPANY, ALTERNATIVE, PARTIAL Defendant. SUMMARY JUDGMENT [DOC. 14] Pending before the Court is Defendant USAA General Indemnity Co’s motion for summary judgment or, in the alternative, partial summary judgment. Plaintiff Paul Harner opposes. The Court decides the motion on the papers submitted, and without oral argument. See Civ.L.R. 7.1.d.1. For the reasons that follow, the Court GRANTS IN PART and DENIES IN PART Defendant’s motion [Doc. 14]. Plaintiff Paul Harner is suing his insurer, Defendant USAA General Indemnity Company, for breach of contract, breach of the implied covenant of good faith and fair dealing (i.e., “bad faith”), and intentional infliction of emotional distress. (See Compl. ) The lawsuit arises out of Harner’s claim under the underinsured motorist provision in his USAA automobile policy following a motorcycle accident in which he allegedly sustained serious injuries and other damages. A. The accident and Harner’s medical treatment. On August 20, 2014, Harner was riding his motorcycle northbound on Interstate 5 in San Diego when a vehicle driven by Daniel Galindo swerved into his lane. (Harner Decl. [Doc. 20-1] ¶ 2.) Harner collided into the back of the vehicle and was thrown from his motorcycle. (Id.) He landed on the back of the vehicle, smashing his head on the trunk and then falling to the pavement where he again hit his head. (Pl’s Ex. 4 [Doc. 20- 2] at 293.2) At the scene, Harner complained of dizziness and had to sit on the side of the road. (Id.) He also had abrasions to his right knee, elbow and hip. (Id.) Harner was driven from the scene of the accident to work. (Pl’s Ex. 4 at 293.) When he arrived at work, Harner could not focus and felt “foggy” so he immediately went to the hospital emergency room for treatment. (Id.) He was examined, prescribed pain medication and released. (Id.) On October 1, 2014, Harner was examined by Dr. Carrie Roeder at Roeder Chiropractic, Inc. (Pl’s Ex. 7 [Doc. 20-2] at 332.) Harner complained of low back pain, neck and upper back pain, as well as memory loss and difficulty concentrating. (Id.) Dr. Roeder treated Harner until November 14, then referred him to a neurologist, Dr. Kevin Yoo, because of continued complaints of memory loss and difficulty concentrating. (Id.)

1 The Complaint is attached to the Notice of Removal [Doc. 1] as Exhibit 1 [Doc. 1-2]. The Complaint also includes a conversion cause of action. However, Harner concedes that the cause of action was dismissed before USAA removed the case to this Court. (Opp’n [Doc. 20] 22:11–14.)

2 Plaintiff’s exhibits 4 through 31 are attached to Vanessa Pena’s declaration. (See Pena Decl. [Doc. 20- 2] ¶¶ 4–21, 24, 26, 28, 35–40, 43.) Generally, page references are to the number at the end of the bates Beginning in December 2014, Harner was seen by Dr. Yoo at SD Neurosurgery. (Pl’s Ex. 8 [Doc. 20-2] at 347.) An MRI of Harner’s brain suggested he suffered a traumatic brain injury (“TBI”). (Id. at 345.) Dr. Yoo referred Harner to Scripps Encinitas Rehabilitation Center (“Scripps”) for treatment. (Id.) In approximately July 2016, Harner began outpatient treatment at Scripps. (See Pl’s Ex. 9 [Doc. 20-2].) On February 29, 2016, Harner had a follow-up visit with Dr. Yoo, who reiterated his belief that Harner suffered a TBI. (Pl’s Ex. 8 at 351.) Dr. Yoo also indicated that although Harner continued to complain of memory issues, he made slow improvement and “has been able to modify his life to be able to continue running his business.” (Id. at 351–52.) Dr. Yoo also stated that Harner “will more likely than not continue to have memory issues which he may suffer for the rest of his life given the fact that he continues to deal with these issues a year and a half after his accident.” (Id.) B. Harner’s UIM claim. The Traffic Collision Report found Daniel Galindo, the driver of the automobile, at-fault for the accident. (Pl’s Ex. 5 [Doc. 20-2] at 218.) On February 2, 2016, Harner’s attorney, Vanessa Pena, made a policy limits demand to Galindo’s insurance carrier, State Farm. (Pena Decl. ¶ 3.) On February 22, 2016, State Farm tendered the full policy limits of $100,000. (Id.) On March 9, 2016, Pena made a written policy limits demand to Harner’s insurer, USAA, under the underinsured motorist (“UIM”) provision in his policy. (Pena Decl. [Doc. 20-2] ¶ 4, Ex. 4.) Pena detailed the collision, Harner’s claimed injuries and damages, and included supporting medical and billing records. (See Pl’s Exs. 4–12 [Docs. 20-2, 20-3].) She stated that 4 months after first seeing Dr. Yoo, Harner continued to complain that “memory loss was still a traumatic issue in his life, he was having trouble running his business and maintaining his day to day rituals. Mr. Harner was severely depressed, felt lost, had terrible headaches and had trouble dealing with life.” (Ex. 4 at 294.) Harner’s subsequent evaluation at Scripps found he “had a decreased processing speed, impaired short term and working memories, impaired executive functioning and impaired divided attention,” among other cognitive impairments. (Id.) Although Scripps recommended Harner be admitted for inpatient therapy due to the severity of his issues, Harner opted for outpatient therapy because of his financial constraints. (Id.) Pena also stated Harner underwent a speech pathology evaluation, which found he had problems “getting his words out, especially late in the day’ [and] the overall evaluation impression indicated ‘moderate attention, memory, reasoning, and reading comprehension deficits with reduced speed processing skills and Acalculia.” (Id.) Finally, Pena provided USAA with financial and payroll records showing the effect of Harner’s cognitive injury on his business and income. (Id.) On March 31, 2016, Pena had a telephone conversation with Michelle Hutto, the USAA adjuster handling the claim. (Pena Decl. ¶ 13.) During the call, Hutto stated that Harner’s claim was not worth the policy limits and requested additional records from the speech rehabilitation clinic. (Id.) The same day, Pena sent a letter to USAA with additional information regarding Harner’s treatment and care. (Pl’s Ex. 13 [Doc. 20-3].) The information included dates Harner was seen at the clinic, and information related to his cognitive defects. (Id. at 468–70.) On April 7, Hutto sent Pena a letter confirming a $75,000 settlement offer based on “the supporting documents received to date.” (Pl’s Ex. 14 [Doc. 20-3] at 500.) Hutto also stated she would “re-evaluate the claim should additional loss of earnings supports be presented” and “any additional medical treatment supports and prior records should you present such evidence.” (Id.) On April 19, Pena sent Hutto a letter enclosing additional records. (Pl’s Ex. 15 [Doc. 20-3] at 563.) There were no documents responsive to USAA’s request for medical records dating back five years before the accident because, according to Pena, Harner was “unaware/unable to recall seeing a physician in the five years prior to the accident. * * * Up to the date of the accident, Mr. Harner has been and was in perfect health.” (Id.) She asserted USAA’s settlement offer undervalued Harner’s claim because he was “experiencing severe memory loss, severe headaches, depression, mood swings, and an inability to run his business and function in social settings.” (Id.) Pena stated Dr. Yoo opined that Harner’s injury was “a permanent brain injury and he will suffer from the memory loss for the rest of his life.” (Id. at 564.) She further asserted that as a result of his injury, Harner suffered a substantial loss of income, lost new accounts because he “either forgot to follow up with documents requested, forgot meetings, showed up to meetings on [the] wrong day, could not properly explain himself in meetings, etc.” (Id.) Finally, Pena contended Harner’

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Harner v. USAA General Indemnity Company, (S.D. Cal. 2020).

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