Latoi Adams v. Allstate County Mutual Insurance Company

CourtCourt of Appeals of Texas
DecidedJuly 20, 2006
Docket01-05-00744-CV
StatusPublished

This text of Latoi Adams v. Allstate County Mutual Insurance Company (Latoi Adams v. Allstate County Mutual Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Latoi Adams v. Allstate County Mutual Insurance Company, (Tex. Ct. App. 2006).

Opinion

Opinion to: SJR TGT SN TJ EVK ERA GCH LCH JB

Opinion Issued July 20, 2006




In The

Court of Appeals

For The

First District of Texas


NO. 01-05-00744-CV


LATOI ADAMS, Appellant

V.

ALLSTATE COUNTY MUTUAL INSURANCE COMPANY, Appellee


On Appeal from County Civil Court at Law No. 2

Harris County, Texas

Trial Court Cause No. 782897



O P I N I O N

          Appellant Latoi Adams sued Allstate County Mutual Insurance Company (“Allstate”) for violating former Texas Insurance Code Article 21.55 by failing to pay certain medical expenses under her personal injury protection policy.  Based upon the jury’s findings, the trial court entered a take-nothing judgment in favor of Allstate.  On appeal, Adams contends the trial court erred in (1) entering judgment against her because the court misinterpreted the jury’s verdict and (2) striking the affidavit of Joe Kimble as a sanction for discovery abuse.  We conclude that the trial court properly entered judgment on the verdict and did not abuse its discretion in striking the affidavit.  We therefore affirm.

Background

          In June 2001, Adams was involved in a car accident.  At the time, Adams had a personal injury protection policy with Allstate for $2,500 per person per accident, which covered “reasonable expenses incurred for necessary medical services.”  Allstate paid $710 under the policy for chiropractic treatment Adams received immediately after the accident.  In May 2002, Adams had a single visit with another chiropractor, Dr. Funderburk, during which Funderburk’s assistant, Joe Kimble, performed a “sensory nerve conduction threshold test,” or “black box test,” on Adams.  Adams submitted a bill to Allstate for the services provided by Kimble and Dr. Funderburk in the amount of $1,855, of which Allstate paid $175.  Thus, Allstate paid Adams $885 for her chiropractic treatments after the accident, including $175 for her visit to Dr. Funderburk during which she received the testing from Kimble.  When Allstate did not pay the balance, Adams sued Allstate for violating former Texas Insurance Code Article 21.55. 

Adams argued at trial that Allstate violated former Article 21.55, section 3(f) by failing to pay $1,855 for services rendered to Adams by Kimble and Dr. Funderburk.  The parties stipulated that Allstate had paid Adams $885—$710 for all of the previous office visits and $175 for Dr. Funderburk’s office visit.  At the close of the evidence, the first question submitted to the jury, labeled “Question No. 1,” asks “[w]hat sum of money, if any, do you find to be reasonable and necessary, and as a result of LATOI ADAMS’S injuries, if any, from her June 2, 2001 automobile accident?”  The jury answered “$1,110—$885 for previous office visits and $125 office visit for Dr. Funderburk.”   Because the trial court concluded that the jury’s answer was ambiguous as to whether Allstate owed Adams for additional amounts for her visit to Dr. Funderburk and treatment by Kimble, the trial court submitted Question No. 1a to the jury.  Question 1a is identical in content to Question 1, except that it instructs the jury to answer “only as to medical bills associated with the sensory nerve conduction threshold test performed by JOE KIMBLE.”  The jury answered $0 to Question 1a.  The trial court then entered a take-nothing judgment against Adams.

Reconciling the Verdict

          In her first issue, Adams contends the trial court erred in interpreting the jury’s verdict, thus entering a judgment in favor of Allstate that fails to assess penalties and attorney’s fees under the Insurance Code.  Allstate responds that the trial court properly entered judgment because the jury specifically found that Allstate owed nothing to Adams for the procedure Kimble performed, and the parties stipulated at trial that Allstate had paid all other charges.

Former Insurance Code Article 21.55, section 3(f) provides that “if an insurer delays payment of a claim . . . for more than 60 days, the insurer shall pay damages and other items as provided for in Section 6 of this Article.”  Act of May 27, 1991, 72nd Leg., R.S., ch. 242, § 11.03, 1991 Tex. Gen. Laws 939, 1045 (repealed and recodified 2003) (current version at Tex. Ins. Code Ann. § 542.052 (Vernon Supp. 2005)).  Former Article 21.55, section 6 provides that

[i]n all cases where a claim is made pursuant to a policy of insurance and the insurer liable therefor is not in compliance with the requirements of this article, such insurer shall be liable to pay the holder of the policy . . . in addition to the amount of the claim, 18 percent per annum of the amount of such claim as damages, together with reasonable attorney fees as may be determined by the trier of fact.

Act of May 27, 1991, 72nd Leg., R.S., ch. 242, §11.03, 1991 Tex. Gen. Laws 939, 1045 (repealed and recodified 2003) (current version at Tex. Ins. Code Ann. § 542.055 (Vernon Supp. 2005)).   

          Adams argues that Allstate violated former Article 21.55, section 3(f) by failing to pay $1,855 for Kimble’s services.  The parties stipulated at trial that Allstate had paid Adams $885—$710 for previous office visits and $175 for Dr. Funderburk’s office visit.  The dispute thus centers on the charge for Kimble’s test. 

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Latoi Adams v. Allstate County Mutual Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/latoi-adams-v-allstate-county-mutual-insurance-com-texapp-2006.