Linthicum v. Nationwide Life Insurance

723 P.2d 703, 150 Ariz. 354, 1985 Ariz. App. LEXIS 869
CourtCourt of Appeals of Arizona
DecidedDecember 31, 1985
Docket1 CA-CIV 7205
StatusPublished
Cited by8 cases

This text of 723 P.2d 703 (Linthicum v. Nationwide Life Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Linthicum v. Nationwide Life Insurance, 723 P.2d 703, 150 Ariz. 354, 1985 Ariz. App. LEXIS 869 (Ark. Ct. App. 1985).

Opinion

OPINION

BROOKS, Presiding Judge.

Plaintiff-appellee Mrs. Sandra Linthicum (Sandra) brought an action in the superior court against Nationwide Life Insurance Company (Nationwide) and its claims agency Dan R. Wagnon and Associates, Inc. (Wagnon) for breach of contract and for breach of the duty of good faith and fair dealing following Nationwide’s denial of benefits under a group health insurance policy. 1 The jury returned a verdict in favor of Sandra and awarded her $14,-951.13 in damages for breach of the contract of insurance, $150,000.00 in compensatory damages on the bad faith claim and $2,000,000.00 in punitive damages. The trial court entered judgment in accordance with the verdict and awarded Sandra attorney’s fees in the sum of $76,000.00 pursuant to A.R.S. § 12-341.01. 2 Nationwide appealed from this judgment, as well as from the trial court’s order denying its Motion for Judgment Notwithstanding the Verdict and Motion for New Trial.

The issues presented on appeal are as follows:

1. Whether the trial court erred in failing to direct a verdict in favor of Nationwide on the contract claim and in denying Nationwide’s post-trial motions on this issue.
2. Whether the trial court erred in failing to direct a verdict in favor of Nationwide on the issue of “bad faith” and in denying Nationwide’s post-trial motions on that issue.
3. Whether the trial court erred in permitting the jury to consider Sandra’s emotional distress as an element of damage on the “bad faith” claim.
4. Whether the trial court erred in submitting the issue of punitive damages to the jury and in refusing to grant Nationwide’s post-trial motions on this issue.
5. Whether the trial court erred in the admission of evidence and in its instructions to the jury.

On appeal from a judgment and order denying a motion for a new trial, we will consider all conflicting evidence in the light most favorable to the appellee and will take as true all competent evidence supporting the judgment. Home Indemnity Company v. Bush, 20 Ariz.App. 355, 513 P.2d 145 (1973). The facts, as well as the reasonable inferences to be drawn therefrom, are hereafter stated in a light most favorable to sustaining the verdict of the jury. Additional facts will be discussed as they become relevant to the issues presented.

FACTS

Sandra obtained medical insurance from Nationwide through a group insurance policy issued to her employer, Arizona Optical Company. 3 Sandra’s insurance became effective on April 1, 1980 and included her husband, Jerry, as a dependent. Sandra did not personally receive a certificate of insurance nor a brochure explaining the coverage under the policy. The group policy contained a limitation on payment of claims relating to certain preexisting illnesses:

Eligible expenses do not include any charges incurred ... (7) for an illness for which the Insured Person received medical care or treatment within the 90 days *358 preceding the effective date of his insurance hereunder.... The term “treatment” includes the taking of any drug prescribed by a physician.

In September, 1979, prior to the issuance of the policy, Jerry had become ill and was hospitalized under the care of his family physician, Dr. James Skinner. A tumor of one of the parathyroid glands was surgically removed from his throat by Dr. Robert A. Brock on September 28, 1979. 4 At that time, Jerry’s physicians, and the pathologists reviewing the tissue samples, concluded that the tumor was benign. Since the findings were not absolutely conclusive, however, samples were also sent to the Mayo Clinic in Rochester, Minnesota for review. The Mayo Clinic pathologist confirmed the diagnosis that the tumor was non-cancerous. Following the surgery, which was deemed to be totally successful, Jerry reported monthly to Dr. Skinner solely for the purpose of having his blood tested to monitor any surgically-induced hypocalcemia (low blood calcium) or any reexacerbation of his prior symptoms. Jerry returned to work shortly after the surgery, and resumed his active lifestyle.

During the relevant ninety day period before Sandra’s insurance coverage became effective, January through March, 1980, Jerry was seen by Dr. Skinner on three occasions for blood tests. On the third visit, Jerry’s blood pressure and blood calcium were slightly elevated, and a blood pressure medication was prescribed. 5 During this time period, Jerry also received treatment for a shoulder injury which was not healing properly.

In June, 1980, after the insurance coverage at issue became effective, Jerry became acutely ill and was hospitalized in Phoenix and then transferred to a Los Angeles hospital. Sandra presented the Nationwide policy number and wallet card to the hospitals as part of the insurance information requested.

On July 11, 1980, Dr. Leonard Rosoff performed surgery in Los Angeles and discovered an extensive metastatic carcinoma (cancer) of Jerry’s parathyroid glands. Dr. Rosoff removed the entire thyroid gland and the remaining three parathyroid glands. He was unable to remove the entire lesion, however, as it had spread throughout the neck and into the chest area.

Dr. Rosoff and Dr. Roger Terry, a Los Angeles pathologist, examined the records and tissues from Jerry’s 1979 surgery. These physicians disagreed with the previous diagnosis of a benign tumor and were of the opinion that the tumor discovered in 1979 was also malignant.

The claims for Jerry’s June and July, 1980 hospitalizations were submitted to Nationwide by the Phoenix and Los Angeles hospitals. Ms. Georgia Nihoff, Senior Claim Examiner, processed Jerry’s claim. Nihoff testified that in accordance with Nationwide’s ordinary procedure to be followed when new insureds submit claims, an investigation was initiated to determine if the claim was covered or if payment was excluded by the preexisting illness limitation in the policy.

Mr. Richard Schlade, claims examiner, testified that one of the first bills submitted to Nationwide indicated that the condition for which the bill was incurred may have preexisted the issuance of the policy. The bill, from a radiologist, contained a diagnosis which referred to Jerry’s 1979 surgery for “parathyroid adenoma” (a benign tumor). Schlade, communicating with the Linthicums through Arizona Optical, requested the names and addresses of all doctors that Jerry had seen since January 1, 1980, and requested that Jerry and Sandra sign an authorization for Nationwide to obtain medical information.

Upon receipt of the necessary authorization and identification of the treating physicians, Nihoff, Schlade, and other Nation *359

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Bluebook (online)
723 P.2d 703, 150 Ariz. 354, 1985 Ariz. App. LEXIS 869, Counsel Stack Legal Research, https://law.counselstack.com/opinion/linthicum-v-nationwide-life-insurance-arizctapp-1985.