McLelland v. United Wisconsin Life Insurance

1999 NMCA 055, 980 P.2d 86, 127 N.M. 303
CourtNew Mexico Court of Appeals
DecidedMarch 26, 1999
Docket18,811, 18,837
StatusPublished
Cited by21 cases

This text of 1999 NMCA 055 (McLelland v. United Wisconsin Life Insurance) is published on Counsel Stack Legal Research, covering New Mexico Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
McLelland v. United Wisconsin Life Insurance, 1999 NMCA 055, 980 P.2d 86, 127 N.M. 303 (N.M. Ct. App. 1999).

Opinion

OPINION

HARTZ, Judge.

, {1} United Wisconsin Life Insurance Company (United Wisconsin) appeals a $250,000 punitive damages award entered against it for willfully engaging in an unfair trade practice, in violation of the Unfair Practices Act, NMSA 1978, §§ 57-12-1 to 57-12-22 (1967, as amended through 1995) (the UPA). It does not challenge the award of $9169.84 in compensatory damages. Its two contentions on appeal are: (1) The UPA does not permit a jury to award punitive damages; it only permits a judge to award up to treble damages for a willful violation of the Act. (2) The punitive damages award is excessive under constitutional and common-law standards. Plaintiff, Elizabeth McLelland, denies that the award is excessive and argues that United Wisconsin is precluded from raising the first contention because it approved a special verdict form that asked the jury to assess punitive damages for a willful UPA violation. We agree with United Wisconsin’s first contention and therefore reverse and remand for the district court to decide whether to award treble damages. We need not reach United Wisconsin’s second contention, because it does not argue that treble damages would be excessive. BACKGROUND

{2} McLelland bought health insurance from United Wisconsin to cover hospital and physician expenses in case a medical emergency prevented her from giving birth at home with a midwife’s assistance. The United Wisconsin brochure listed “Complications of Pregnancy” as a covered expense. The insurance agent selling the policy circled this language in the brochure and, according to McLelland’s testimony, assured McLelland that Caesarian sections were covered by the policy. The brochure advised the reader to refer to the certificate of coverage “for a more detailed list of benefits.” But at the time McLelland purchased the policy, the agent did not show McLelland a copy of the certificate; indeed, he had never seen one. Although the insurance company mailed McLelland the certificate several weeks later, she did not read it. On page twenty-one of the thirty-seven page document. Caesarian section delivery was excluded from the definition of complications of pregnancy.

{3} McLelland required an emergency Caesarian section. The hospital and physician expenses totaled about $7000. United Wisconsin denied coverage. After fruitless telephone and mail correspondence. McLelland sued the company on four theories of recovery: (1) breach of contract; (2) violation of the duty of good faith under the insurance contract (referred to by the parties as the “insurance bad faith” claim); (3) commission of an unfair claims practice prohibited by the New Mexico Insurance Code, NMSA 1978, § 59A-16-20 (1997); and (4) violation of the UPA.

{4} On at least two occasions during trial the district court discussed with counsel the availability of punitive damages. The first occasion was when counsel were debating the admissibility of testimony by McLelland’s expert witness. Although the discussion did not focus on this particular point, MeLelland’s position apparently was that the only possible punitive damages awards would be a jury award under her claims for insurance bad faith or unfair claims practices, or a court award of up to treble damages under the UPA claim. Later, during the hearing on United Wisconsin’s motion for a directed verdict, United Wisconsin stated that the only punitive damages that could be recovered would be those awarded by the jury for insurance bad faith or treble damages awarded by the court under the UPA. McLelland did not dispute that proposition in her argument against United Wisconsin’s motion.

{5} In its instructions to the jury after the close of evidence, the district court indicated that the jury could award punitive damages only if McLelland proved her bad faith claim. The damages instruction stated:

If you should decide in favor of McLelland on the question of liability, you must then fix the amount of money which will reasonably and fairly compensate her for any of the following elements of damages proved' by McLelland to have been proximately caused by United Wisconsin’s wrongful conduct as claimed:
1. The amount payable by United Wisconsin under the terms of the certificate of insurance.
2. The amount of any incidental or consequential loss to McLelland. Any damages found by you for this loss must be damages which United Wisconsin and McLelland could reasonably have expected to be a consequence of United Wisconsin’s failure to perform its obligations under the insurance policy.
3. If you find that McLelland should recover compensatory damages for the bad faith actions of United Wisconsin, then you may award punitive damages.
Punitive damages are awarded for the limited purposes of punishment and to deter others from the commission of like offenses.
The amount of punitive damages must be based on reason and justice, taking into account all the circumstances, including the nature of the wrong and such aggravating and mitigating circumstance's as may be shown. The amount awarded, if any, must be reasonably related to the compensatory damages and injury.
Whether any of these elements of damages have been proved by the evidence is for you to determine. Your verdict must be based upon proof and not upon speculation, guess and conjecture.
Further, sympathy for a person, or prejudice against any party, should not affect your verdict and is not a proper basis for determining damages.

{6} The principal issue on appeal arose after the district court had instructed the jury and the jury had retired to deliberate. The court showed counsel a verdict form it had drafted and asked them to respond “immediately” if they had any suggested changes. Both counsel approved the form.

{7} The present controversy concerns the instructions regarding Question 7 on the special verdict form, which permitted the jury to award an uncapped amount of punitive damages for violation of the UPA. The questions and the jury’s answers can be summarized as follows:

Question 1: Did United Wisconsin breach its contract with McLelland?
Answer: Yes.
Question 2: Was such breach of contract committed in bad faith?
Answer: No.
Because it answered “no” to Question 2, the jury was directed to skip Question 2A, which asked whether punitive damages should be awarded against United Wisconsin for “frivolous and unfounded denial of McLelland’s claim.”
Question 3: Did United Wisconsin violate the Insurance Code?
Answer: Yes.
Question 4: Did United Wisconsin violate the Unfair Practices Act?
Answer: Yes

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Cite This Page — Counsel Stack

Bluebook (online)
1999 NMCA 055, 980 P.2d 86, 127 N.M. 303, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mclelland-v-united-wisconsin-life-insurance-nmctapp-1999.