Moore v. Dudley

64 P.3d 429, 31 Kan. App. 2d 184, 2002 Kan. App. LEXIS 1208
CourtCourt of Appeals of Kansas
DecidedJuly 19, 2002
DocketNo. 87,512
StatusPublished
Cited by1 cases

This text of 64 P.3d 429 (Moore v. Dudley) is published on Counsel Stack Legal Research, covering Court of Appeals of Kansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Moore v. Dudley, 64 P.3d 429, 31 Kan. App. 2d 184, 2002 Kan. App. LEXIS 1208 (kanctapp 2002).

Opinion

Pierron, J.:

This case involves the failure of Farm Bureau Mutual Insurance Company, Inc. (Farm Bureau) to pay all of the personal injury protection (PIP) benefits to Maureen Moore following an automobile accident. The trial court ruled that Farm Bureau did not unreasonably refuse to pay PIP benefits and that no attorney fees would be allowed for the judgment recovered. We affirm.

Moore was a passenger in a vehicle when it was rear-ended by a Chevrolet Suburban in 1997. Moore filed a personal injury action against the driver of the Suburban for damages and also against Farm Bureau for PIP benefits arising out of the accident. The trial [185]*185court bifurcated Moore’s claims for PIP benefits from the rest of the personal injury action. In doing so, Farm Bureau consented to be bound by the jury’s verdict as to the amount of past medical bills that were reasonably necessary and arose out of the accident.

In January 2000, Moore’s personal injury action was tried to a jury. Judge William Rustin presided over the trial. Liability was admitted and the only issue was Moore’s damages. The jury awarded damages to Moore in the amount of $4,000 — $1,687.52 for noneconomic damages and $2,312.48 for medical expenses.

Moore filed a motion for attorney fees. She stated that following the accident, she filed for PIP coverage under her insurance policy with Farm Bureau. Farm Bureau paid $723 in PIP benefits toward the chiropractic charges of Moore’s treating doctor, Dr. Brad Swanson, and denied the balance of her claims — $1,370.43. Farm Bureau denied the balance of Moore’s claims based upon the report of Dr. Dan B. Futch, a chiropractor from Madison, Wisconsin. Dr. Futch opined that Moore sustained only minor and self-limiting injuries from the accident and justified chiropractic treatment for a 4-to 6-week period only. Dr. Futch concluded the medically necessary services totaled $485.

After considering all the evidence, Judge Karl Friedel, who decided the case after Judge Rustin retired, held that Moore was not entitled to attorney fees under K.S.A. 40-3111(b). The court found that Farm Bureau’s refusal to pay additional medical expenses after receiving Dr. Futch’s correspondence was not without just cause and excuse.

Moore raises two arguments concerning attorney fees under K.S.A. 40-3111(b). She first argues the trial court erred in not automatically awarding attorney fees after the juiy found Farm Bureau liable for refusing to pay her medical bills. Similarly, Moore argues the court erred in not awarding attorney fees for Farm Bureau’s failure to pay for her treatment by Dr. Abay.

Moore argues this court has a de novo standard of review, but she fails to cite any relevant authority to support her position. The court in DiBassie v. American Standard Ins. Co. of Wisconsin, 8 Kan. App. 2d 515, Syl. ¶ 8, 661 P. 2d 812 (1983), directly addressed [186]*186the analysis for determining an award or denial of attorney fees under K.S.A. 40-3111(b):

“Whether the refusal of an insurance company to pay is without just cause or excuse under this statute is to be determined on the facts and circumstances of each case. The circumstances confronting the insurer when payment of loss is denied determines the question, and the circumstances are to be judged as they would appear to a reasonably prudent man having a duty to investigate in good faith and to determine the true facts of the controversy. Whether there was just cause to refuse payment, and therefore justification for denial of attorney fees, is in the trial court’s sound discretion.”

The district court’s ability to award attorney fees in a PIP benefits case is governed by K.S.A. 40-3111(b):

“An attorney is entitled to a reasonable fee for advising and representing a claimant in an action for personal injury protection benefits which are overdue. The attorney’s fee shall be a charge against tire insurer or self-insurer in addition to the benefits recovered, if the court finds that the insurer or self-insurer unreasonably refused to pay the claim or unreasonably delayed in making proper payment.”

In determining whether an insurer or self-insurer should be penalized under K.S.A. 40-3111(b) for withholding PIP benefits, the courts examine whether the refusal was without just cause or excuse similar to cases examining the awarding of attorney fees under the general provisions of the Kansas Insurance Code, K.S.A. 40-256. The court in Miner v. Farm Bur. Mut. Inc. Co., Inc., 17 Kan. App. 2d 598, 620, 841 P.2d 1093 (1992), rev. denied 252 Kan.1092 (1993), stated:

“In refusing to pay a claim, an insurance company has a duty to make a good faith investigation of the facts surrounding the claim. Brown v. Combined Ins. Co. of America, 226 Kan. 223, 227, 597 P.2d 1080 (1979). If there is a bona fide and reasonable factual ground for contesting the insured’s claim, there is no failure to pay without just cause or excuse. Koch, Administratrix v. Prudential Ins. Co., 205 Kan. 561, 565, 470 P.2d 756 (1970). Whether an insurance company’s refusal to pay is without just cause or excuse is determined on the facts and circumstances in each case. Smith v. Blackwell, 14 Kan. App. 2d 158, 165, 791 P.2d 1343 (1989), rev. denied 246 Kan. 769 (1990).”

Whether there has been a delay in payment “without just cause or excuse” to support an award of attorney fees is a matter committed to the trial court’s discretion. The issue is primarily one of [187]*187fact, to be determined by the trial court on the basis of the facts and circumstances of each case. See Farm Bureau Mutual Ins. Co. v. Carr, 215 Kan. 591, 598-99, 528 P.2d 134 (1974); Knuth v. State Farm Mut. Auto. Ins. Co., 30 Kan. App. 2d 184, 41 P.3d 287 (2000). Judicial discretion is abused only when the action is arbitrary or unreasonable. See Saucedo v. Winger, 252 Kan. 718, 729-31, 850 P.2d 908 (1993).

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Cite This Page — Counsel Stack

Bluebook (online)
64 P.3d 429, 31 Kan. App. 2d 184, 2002 Kan. App. LEXIS 1208, Counsel Stack Legal Research, https://law.counselstack.com/opinion/moore-v-dudley-kanctapp-2002.