Hellard v. Mid Century Insurance Company

District Court, N.D. Oklahoma·Decided November 10, 2020·No. 4:19-cv-00043·Unknown

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF OKLAHOMA

DUSTIN HELLARD, ) ) Plaintiff, ) ) v. ) Case No. 19-CV-00043-GKF-CDL ) MID CENTURY INSURANCE COMPANY ) d/b/a FARMERS INSURANCE, ) ) Defendant. ) OPINION AND ORDER This matter comes before the court on the Motion for Summary Judgment [Doc. 90] of defendant Mid-Century Insurance Company d/b/a Farmers Insurance (Mid-Century). For the reasons set forth below, the motion is denied. I. Factual Background The following facts are undisputed for purposes of the summary judgment determination. Mid-Century issued an Artisan Contractor Premier Policy to Gilley Ventures LLC (Gilley), designated policy no. 60184-20-49 and effective for the period from August 1, 2016 to August 1, 2017. [Doc. 90, p. 6, ¶ 1; Doc. 119, p. 8, ¶ 1]. The Policy included an Oklahoma Uninsured Motorists Coverage – Non-Stacked Endorsement, [Doc. 90-1, pp. 19-22], which stated, in part, as follows: We will pay, in accordance with Title 36, Oklahoma Statutes, all sums the “insured” is legally entitled to recover as compensatory damages from the owner or driver of an “uninsured motor vehicle”. The damages must result from “bodily injury” sustained by the “insured” caused by an “accident”. The owner’s or driver’s liability for these damages must result from the ownership, maintenance or use of the “uninsured motor vehicle”.

[Doc. 90-1, p. 19]. On August 15, 2016, plaintiff Dustin Hellard was driving a Gilley-owned vehicle while in the course and scope of his employment with Gilley when a vehicle operated by an employee of Tulsa Public Schools (TPS) struck Hellard’s vehicle. [Doc. 90, pp. 6-7, ¶ 2; Doc. 119, pp. 8-9, ¶ 2; Doc. 26, p. 2; Doc. 90-2]. Thereafter, Hellard presented at Hillcrest Medical Center with right-

sided lower back pain and pain when he lifted his leg. [Doc. 116-1, pp. 44-45]. Hellard was diagnosed with a lumbar back sprain, given Valium and Norco, and discharged. [Id.]. Hellard was subsequently evaluated by Dr. Randall Hendricks of Central States Orthopedic, who initially recommended treatment with anti-inflammatories, muscle relaxants, and physical therapy [Doc. 116-1, pp. 53-54], but later, on September 21, 2016, recommended surgery. [Doc. 116-1, p. 59]. Dr. Hendricks considered Hellard temporarily and totally disabled. [Doc. 116-1, pp. 54, 59]. On October 13, 2016, Hellard underwent fusion of the L4-L5 and L5-S1 levels. [Doc. 116- 2, pp. 82-84]. During the procedure, Hellard sustained a small dural tear. [Id.]. Although Hellard was discharged, he was readmitted to the hospital on October 17, 2016 and diagnosed with a dural

leak with headache and right leg pain. [Doc. 116-2, pp. 87-88]. On October 18, 2016, Hellard underwent a partial disassembly then reassembly of the orthopedic hardware, revision laminectomy of L4 and L5 right, and dural repair. [Doc. 116-2, pp. 88-89]. On October 21, 2016, Hellard underwent another surgery that involved removal of crosslink, L5-S1 instrumentation, exploration with identification of persistent dural tear, and repair of the dural tear. [Doc. 116-2, p. 90-91]. Several months later, on March 24, 2017, Dr. Hendricks released Hellard to return to work with restrictions as of that date, and without restrictions on May 8, 2017. [Doc. 90, p. 7, ¶ 5; Doc. 119, p. 8, ¶ 1]. Hellard filed a workers’ compensation proceeding against Gilley as a result of the accident. [Doc. 90, p. 7, ¶ 4; Doc. 119, p. 8, ¶ 1]. Hellard retained attorneys now associated with Smolen Law, PLLC to represent him with respect to his workers compensation claim.1 See generally [Doc. 116-4]. Over the course of the workers compensation proceedings, Hellard was deposed twice.

[Doc. 90, p. 7, ¶ 4; Doc. 119, p. 8, ¶ 1; Doc. 90-16]. Attorneys associated with the Smolen Firm also represented Hellard with respect to the insurance claim that is the subject of this lawsuit. All of Hellard’s communications with Mid- Century during the insurance claim were through the Smolen Firm. [Doc. 90, p. 8, ¶ 7; Doc. 119, p. 8, ¶ 1]. On July 13, 2017, Hellard first notified Mid-Century of his accident via a phone call from the Smolen Firm. [Doc. 90-9, p. 19]. On July 17, 2017, the Smolen Firm faxed a letter to Mid- Century advising that Hellard would be making a claim under the UM provisions of the Policy, and requesting a copy of the Policy. [Doc. 90-11, p. 2]. The next day, on July 18, 2017, the Smolen Firm notified TPS of Hellard’s intent to pursue a negligence claim against it. [Doc. 90-

12]. On July 18, 2017, Mid-Century adjuster Laila Doroudian (née Oliver) telephoned the Smolen Firm regarding Hellard’s claim. [Doc. 90-9, p. 11]. On July 26, 2017, Doroudian emailed the Smolen Firm a copy of the Policy and requested information as to Hellard’s injury and treatment status, as well as claim information once Hellard had opened a claim with the third-party administrator for TPS. The Smolen Firm responded that Hellard was still treating and that they

1 In 2017 and 2018, Laura Hamilton and Don Smolen represented Hellard as members of the law firm Smolen, Smolen & Roytman, PLLC and from 2019 to present, Mr. Smolen and Ms. Hamilton represented Hellard as a member of the law firm Smolen Law, PLLC. See generally [Doc. 116- 4]. For ease of reference, the court refers to plaintiff’s attorneys as the “Smolen Firm.” were in the process of collecting medical records. Doroudian then informed the Smolen Firm that she had the TPS adjuster’s contact number, provided it, and asked for information regarding the nature of Hellard’s injuries and whether he had surgery. On July 27, 2017, the Smolen Firm responded “[t]he body parts we know of are neck, back, hips and head” and “he’s had back

surgery.” See [Doc. 90-13]. Over the next several months, Doroudian attempted to contact the Smolen Firm. [Doc. 90- 14; Doc. 90-9, p. 5]. During a January 12, 2018 contact, the Smolen Firm advised Doroudian that Hellard was receiving treatment for his neck, back, and hips, but she did not know the nature of the treatment. [Doc. 90-9, p. 5]. Doroudian also contacted the third-party administrator for TPS, who stated that he saw a note about a $825,000 TPS policy limit but he “[wasn’t] certain it was accurate.” [Doc. 90-9, p. 17]. Hellard’s claim was subsequently reassigned to Mid-Century adjuster Dawn Kavanaugh. [Doc. 119, p. 46]. Between January 17, 2018 and January 30, 2018, Kavanaugh contacted Gilley, Gilley’s workers compensation carrier, the Smolen Firm, and TPS’s third-party administrator for information regarding Hellard’s claim. [Doc. 90-9, pp. 1, 8-10, 12-

13, 15-16]. On January 23, 2018, Hellard filed a lawsuit against TPS related to the August 15, 2016 motor vehicle accident. [Doc. 90-20]. Neither Hellard nor his counsel informed Mid-Century of the lawsuit. On February 6, 2018, Kavanaugh sent a letter to the Smolen Firm confirming a workers’ compensation lien of approximately $93,000, and requesting any declarations pages, offers, demands, and any medical records available. [Doc. 90-21]. On May 3, 2018, Hellard’s workers’ compensation proceeding resolved. [Doc. 90-6, p. 2]. On May 24, 2018, Kavanaugh called the Smolen Firm regarding Hellard’s insurance claim and spoke with Susan Graves who indicated she had just been transferred the file and would email Kavanaugh after she had reviewed it. [Doc. 90-9, p. 6]. That same day, Kavanaugh sent the Smolen Firm a letter, directed to Graves, requesting the status of Hellard’s injury claim and

whether or not Hellard had made a demand to the insurer for TPS. [Doc. 90-23].

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