Hopkins v. Integon General Insurance Corporation

CourtDistrict Court, W.D. Washington
DecidedFebruary 16, 2021
Docket2:18-cv-01723
StatusUnknown

This text of Hopkins v. Integon General Insurance Corporation (Hopkins v. Integon General Insurance Corporation) is published on Counsel Stack Legal Research, covering District Court, W.D. Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hopkins v. Integon General Insurance Corporation, (W.D. Wash. 2021).

Opinion

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5 6 7 UNITED STATES DISTRICT COURT 8 WESTERN DISTRICT OF WASHINGTON AT SEATTLE 9 10 DANIEL HOPKINS, CASE NO. C18-1723 MJP 11 Plaintiff, ORDER DENYING IN PART GRANTING IN PART 12 v. DEFENDANT’S MOTION FOR JUDGMENT AS A MATTER OF 13 INTEGON GENERAL INSURANCE LAW AND LIMITATION OF UIM CORPORATION, VERDICT; 14 Defendant. DENYING IN PART GRANTING IN 15 PART PLAINTIFF’S MOTION FOR ATTORNEYS’ FEES AND 16 MOTION FOR JUDGMENT NOTWITHSTANDING THE 17 VERDICT 18 19 This matter comes before the Court upon Defendant’s Motion for Judgment as a Matter 20 of Law and Limitation of Verdict on Plaintiff’s UIM claim (Dkt. No. 95) and upon Plaintiff’s 21 Motion for Attorneys’ Fees and Motion for Judgment Notwithstanding the Verdict (Dkt. No. 96). 22 Having read the Motions, the Responses (Dkt. Nos. 98, 100), the Replies (Dkt. Nos. 102, 104), 23 the supplemental briefing (Dkt. Nos. 115, 116, 118), and the related record, the Court DENIES 24 1 in part GRANTS in part Defendant’s Motion and DENIES in part, GRANTS in part Plaintiff’s 2 Motion. 3 Background 4 Plaintiff, Daniel Hopkins, brought this case against his insurer, Defendant Integon

5 General Insurance Corporation, after he was rear-ended by another driver in 2016. The other 6 driver’s policy with Progressive Insurance Company was limited to $25,000, which Progressive 7 paid to Plaintiff for his injuries. (Dkt. No. 78 at 3.) But when Plaintiff began experiencing 8 severe vertigo shortly after the accident, exacerbated by a traumatic brain injury he sustained 9 from a previous car accident, he understood that he would require additional coverage from 10 Integon, who insured Plaintiff under an underinsured motorist (“UIM”) policy. 11 The severity of Plaintiff’s injury was contemplated by his neurologist, Dr. Carolyn 12 Taylor, who evaluated Plaintiff after the accident. Dr. Taylor noted “[t]he impact [of the 13 collision] did cause an inner ear disturbance resulting in new gravitational vertigo due to damage 14 to the inner ear utricle.” (Trial Ex. 6 at 2.) She concluded that Plaintiff suffered from

15 “[r]ecurrent post-concussive symptoms likely as a result of his brain’s inability to compensate as 16 well because of his fatigue from the vertigo, or he may actually have sustained another mild 17 concussion.” (Id.) 18 On March 26, 2018, Plaintiff submitted a request to Defendant for payment of his UIM 19 policy limit of $250,000. Integon’s claims’ adjustor, Mary Gordon, summarized her first 20 conversation with Plaintiff’s attorney in a note in Plaintiff’s claim file: “Main injury is vertigo, 21 which his attorney relates will not improve, according to his neurologist.” (Trial Ex. 1 at 28.) 22 Ms. Gordon understood that because of Plaintiff’s prior brain injury “he was a potential 23 eggshell,” or someone who is more susceptible to injury. (Dkt. No. 109 at 79:1-2.) In an email

24 1 to her supervisor on April 17th, 2018, Ms. Gordon wrote: “His attorney claims that he’ll never 2 return to his pre-collision status, and his neurologist said it may never resolve but hopes it will 3 continue to improve.” The following week, Ms. Gordon offered $17,340, telling Plaintiff’s 4 lawyer that Integon “was not considering any permanency.” (Dkt. No. 109 at 35:3-6; Trial Ex. 1

5 at 23.) Plaintiff rejected Integon’s offer and once again demanded the policy limits. 6 Integon then searched for a doctor who would conduct an independent review of 7 Plaintiff’s medical situation, asking for a recommendation from one of Integon’s defense 8 attorneys. (Dkt. No. 109 at 40:5-13.) According to the claims file, the defense attorney told Ms. 9 Gordon that in his experience doctors will not agree to review the records in a traumatic brain 10 injury case without meeting with the patient because “[r]ecords won’t show them what they need 11 in order to provide an opinion.” (Dkt. No. 109 at 57:10-58:1; 60:7-8.) When Ms. Gordon asked 12 the defense attorney “if there’s any downside to having an [in person medical exam], if that’s the 13 route we choose to go,” his response was “not really, other than if you do an [in person medical 14 exam], you’ll have to share it with [Plaintiff].” (Id. at 62:21-25.) On the other hand, Ms. Gordon

15 noted that if Integon only did a records review, “we don’t have to give it to [Plaintiff] or tell 16 [him] who we consulted with.” (Id. at 63:3-4.) Integon hired neurologist Dr. Roman Kutsy who 17 agreed to provide an opinion without evaluating Plaintiff in person. Dr. Kutsy concluded that 18 with physical therapy Plaintiff could recover from his injuries within three months. (Dkt. No. 19 109 at 74:15-19; Trial Ex. 1 at 13.) After receiving Dr. Kutsy’s report, Integon extended a 20 second offer to Plaintiff, this time for $40,000. (Dkt. No. 109 at 75:4-8.) 21 On October 16, 2018, Plaintiff filed suit in King County Superior Court. Defendant 22 removed the matter to this Court on November 30, 2018. Following a seven day jury trial 23 beginning on October 5, 2020, the jury returned a verdict in favor of Plaintiff on his claim for

24 1 benefits under his UIM policy in the amount of $751,491; his Consumer Protection Act (“CPA”) 2 claim in the amount of $16,931; and his claim that Defendant acted in bad faith in the amount of 3 $180,231. (See Dkt. Nos. 92-94.) The jury also found that Defendant did not violate the 4 Insurance Fair Conduct Act (“IFCA”) or act with negligence. (Id.)

5 Discussion 6 I. Defendant’s Motion for Judgment as a Matter of Law and Limitation of UIM 7 Verdict 8 A. Judgment as a Matter of Law 9 Defendant moves for judgment as a matter of law on Plaintiff’s CPA Claim, arguing that 10 the jury’s award of unpaid medical bills and expert witness fees was improper as neither 11 category is compensable under the CPA. (Dkt. No. 95.) 12 1. Medical Expenses 13 To begin, Plaintiff’s unpaid medical bills are compensable under the CPA, as the 14 Washington Supreme Court has held that “the deprivation of contracted-for insurance benefits is

15 an injury to ‘business or property’ regardless of the type of benefits secured by the policy.” 16 Peoples v. United Servs. Auto. Ass’n, 194 Wash. 2d 771, 779 (2019). While Integon argues that 17 the Peoples holding applies only to the PIP claims at issue in that case, the Court’s analysis 18 rooted the plaintiffs’ injuries in the insurer’s violation of their rights under the insurance 19 contract: 20 An insured, therefore, has a legally protected property interest in benefits due under the contract and a related right to insurance dealings free from bad faith. 21 Claims mishandling and wrongful denial of benefits invade this property interest, regardless of the type of event that triggers coverage. 22 Id. at 780. Defendant has failed to explain why Plaintiff’s UIM policy does not afford him the 23 same property interest in benefits due. 24 1 Integon also argues that Plaintiff cannot demonstrate that its denial of benefits is the “but 2 for” cause of Plaintiff’s medical expenses because these expenses were covered by the $25,000 3 from Progressive and $10,000 in PIP coverage from Integon. (Dkt. No. 116 at 5.) But Plaintiff 4 incurred the $931 in unreimbursed medical expenses after these payments were made. (See Dkt.

5 No. 118 at 5 (citing Dkt. No. 55, Ex. 1).) As determined by the jury, Integon’s offers in 6 combination with the Progressive payment and the PIP coverage were insufficient to compensate 7 Plaintiff for his injuries and medical expenses. There is nothing to indicate, therefore, that these 8 payments covered all future medical expenses. Plaintiff has established that Integon’s failure to 9 pay the UIM benefits caused his out-of-pocket medical expenses, which are compensable under 10 the CPA. See Peoples, 194 Wash.

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Hopkins v. Integon General Insurance Corporation, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hopkins-v-integon-general-insurance-corporation-wawd-2021.