Koch v. Mutual of Enumclaw Ins. Co.

31 P.3d 698
CourtCourt of Appeals of Washington
DecidedSeptember 12, 2001
Docket46747-6-I
StatusPublished
Cited by7 cases

This text of 31 P.3d 698 (Koch v. Mutual of Enumclaw Ins. Co.) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Koch v. Mutual of Enumclaw Ins. Co., 31 P.3d 698 (Wash. Ct. App. 2001).

Opinion

31 P.3d 698 (2001)

Alberta L. KOCH, Appellant,
v.
MUTUAL OF ENUMCLAW INSURANCE COMPANY and John E. McDermott, Respondents.

No. 46747-6-I.

Court of Appeals of Washington, Division 1.

August 13, 2001.
Publication Ordered September 12, 2001.

*699 Morris H. Rosenberg, Mussehl & Rosenberg, Seattle, for Appellant.

James M. Beecher, Theodore H. Millan, Hacket, Beecher & Hart, Seattle, for Respondents.

PER CURIAM.

At the request of Mutual of Enumclaw (MOE), appellant Alberta Koch's insurer, respondent Dr. John McDermott conducted an independent review of Koch's medical records. Based on Dr. McDermott's report, MOE declined to make payments under Koch's personal injury protection (PIP) coverage for several months. Because Koch failed to establish a genuine factual issue as to whether Dr. McDermott's opinion was dishonest or offered in bad faith, the trial court properly granted summary judgment and dismissed Koch's claims for tortious interference with a contract and violation of the Consumer Protection Act (CPA). We also affirm the trial court's award of attorney fees for a frivolous action, but reverse that portion of the award compensating Dr. McDermott for his time as a litigant.

*700 Facts

Appellant Alberta Koch is an insured under an automobile insurance policy issued by Mutual of Enumclaw. She was injured in a Port of Seattle bus accident on August 17, 1996, and sought treatment from Dr. Martin Tullus. During the following two years, MOE paid $7,900.75 in medical billings under Koch's personal injury protection coverage.

Because Koch's left shoulder pain was not responding to treatment, Dr. Tullus suspected a possible rotator cuff tear and performed exploratory surgery in July 1998. After the operation, MOE contracted with Objective Medical Assurance Corporation and respondent Dr. John McDermott, an orthopedic surgeon, for an independent review of Koch's medical records, including an "assessment whether the treatments are reasonable and necessary and that surgery was warranted and appropriate."

In his report dated August 12, 1998, Dr. McDermott noted that the exploratory surgery had not revealed the suspected rotator cuff tear or labral tear, but that Dr. Tullus had trimmed a prominent acromion,[1] which Dr. McDermott characterized as an "anatomic variant":

With respect to the left shoulder, the patient has an arc type impingement syndrome that was present prior to the accident and subsequently has been managed. At recent surgery only the anatomic variant and bursa were found. There was no evidence of rotator cuff tear or labral tear as had been earlier suspected. The concerns over rotator cuff tear were not borne out in the surgical procedure. Thus, her surgery would represent management of a preexisting problem.

(Emphasis ours.)

After receiving Dr. McDermott's report, MOE advised Koch that it would not release the remaining $2,099.25 in PIP benefits. When Koch threatened a lawsuit, MOE asked Dr. McDermott to review his report. On October 7, 1998, Dr. McDermott provided a supplemental report:

The records document the patient's history, that of tardy presentation for multiple complaints. The patient had complaints to the knees, neck, feet, ankles, low back, and left shoulder. The original concern focused over possible post traumatic patellar femoral syndrome and strain of the foot and ankle. Dr. Tullus does note that the patient had "painful arc" and he initially did not feel that special studies were needed. Subsequently, the patient had an MRI performed which raised the question of anterior [labral] tear.
As noted in my report, the patient at surgery was not found to have a [labral] tear, but rather a congenital variant.
In answering the questions posed at the time of the record review, the concern of possible aggravation of an also-diagnosed "impingement syndrome" was not asked nor addressed. Impingement syndrome is a degenerative change in the acromion that causes rotator cuff compromise and then shoulder symptoms.
It is my belief that the patient on a more probable than not basis could have aggravated or "lit up" the impingement syndrome in the accident as described. This scenario I do not believe was addressed by Dr. Tullus in reviewed records and therefore not commented on.

Based on Dr. McDermott's supplemental report, MOE issued a check for $2,099.25, the balance of Koch's PIP coverage, on October 21, 1998. Koch filed a "Complaint for Breach of Contract, Bad Faith, Violation of the Consumer Protection Act, Misrepresentation, and Tortuous [sic] Interference" against MOE and Dr. McDermott on November 5, 1998.[2]

Koch dismissed her action against MOE on March 12, 1999, after MOE waived most of its subrogation interest in Koch's tort claim *701 against the Port of Seattle, leaving the claims against Dr. McDermott for tortious interference with a contract and for violation of the CPA. Dr. McDermott moved for summary judgment, arguing that his reports to MOE were protected by the qualified "advisor's privilege" set forth in the Restatement (Second) of Torts § 772.

On March 3, 2000, the trial court granted the motion for summary judgment and dismissed Koch's claims. The trial court also found that Koch's action was frivolous and awarded Dr. McDermott $23,782 in attorney fees and expenses under RCW 4.84.185.

Decision

On appeal, Koch contends material factual issues preclude summary judgment dismissal of her claim that Dr. McDermott tortiously interfered with a contractual right. This court reviews an order of summary judgment de novo and determines whether the materials before the trial court, viewed in the light most favorable to the nonmoving party, demonstrate "that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law."[3]

The elements of tortious interference with a contract or expectancy are: (1) the existence of a valid contractual relationship or business expectancy; (2) the defendant's knowledge of that relationship; (3) an intentional interference inducing or causing a breach or termination of the relationship or expectancy; (4) the defendant's interference for an improper purpose or by improper means; and (5) resulting damage.[4] Koch concedes that in order to establish the fourth element, improper interference, she was required to demonstrate that Dr. McDermott's conclusions were dishonest or offered in bad faith.

Restatement (Second) of Torts § 772 provides:

One who intentionally causes a third person not to perform a contract or not to enter into a prospective contractual relation with another does not interfere improperly with the other's contractual relation, by giving the third person

(a) truthful information, or

(b) honest advice within the scope of a request for the advice.

The court applied this rule in Havsy v. Flynn,[5] although it declined to decide whether § 772 constituted a qualified privilege or described a "specific application of the fourth element of the tort of intentional interference."[6]

In Havsy,

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Shantanu Neravetla Md v. Virginia Mason Medical Center
705 F. App'x 520 (Ninth Circuit, 2017)
Richard Azpitarte v. Daniel Spino
Court of Appeals of Washington, 2015
BUILDING INDUSTRY ASS'N v. McCarthy
218 P.3d 196 (Court of Appeals of Washington, 2009)
Nelson v. Glass & Associates, Inc.
141 F. App'x 558 (Ninth Circuit, 2005)
Manteufel v. Safeco Insurance Co. of America
68 P.3d 1093 (Court of Appeals of Washington, 2003)

Cite This Page — Counsel Stack

Bluebook (online)
31 P.3d 698, Counsel Stack Legal Research, https://law.counselstack.com/opinion/koch-v-mutual-of-enumclaw-ins-co-washctapp-2001.