Nichols v. Geico Insurance Company

CourtDistrict Court, W.D. Washington
DecidedApril 28, 2021
Docket2:18-cv-01253
StatusUnknown

This text of Nichols v. Geico Insurance Company (Nichols v. Geico Insurance Company) is published on Counsel Stack Legal Research, covering District Court, W.D. Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Nichols v. Geico Insurance Company, (W.D. Wash. 2021).

Opinion

1 HONORABLE RICHARD A. JONES

8 UNITED STATES DISTRICT COURT 9 WESTERN DISTRICT OF WASHINGTON AT SEATTLE 10 MERLE NICHOLS, on behalf of himself and 11 all others similarly situated,

12 Plaintiff, Case No. 2:18-cv-01253-RAJ

13 v. ORDER

14 GEICO GENERAL INSURANCE 15 COMPANY, a foreign automobile insurance company, 16 Defendant. 17 18 I. INTRODUCTION 19 Several motions are before the Court: Defendant’s Motion for Summary Judgment 20 (Dkt. # 73), Defendant’s Motion to Deny Class Certification (Dkt. # 77), Plaintiff’s 21 Motion to Certify Class (Dkt. # 94), Second Joint Statement Regarding Filing Documents 22 Under Seal (Dkt. # 123), and Third Joint Statement Regarding Filing Documents Under 23 Seal (Dkt. # 130). Having considered the submissions of the parties, the relevant portions 24 of the record, and the applicable law, the Court finds that oral argument is unnecessary. 25 For the reasons below, Defendant’s motions for summary judgment (Dkt. # 73) and to 26 deny class certification (Dkt. # 77) are DENIED, Plaintiff’s motion to certify class (Dkt. 27 # 94) is GRANTED, and the parties’ joint statements are ADOPTED (Dkt. ## 123, 130). 1 II. BACKGROUND 2 On January 15, 2015, Plaintiff Merle Nichols was injured in an automobile 3 accident. Dkt. # 78 ¶ 9; Dkt. # 78-1 at 72. He then sought personal injury protection 4 (“PIP”) coverage from Defendant GEICO General Insurance Company (“GEICO”), 5 which insured the vehicle that injured him. Dkt. # 78 ¶ 9. GEICO initially paid some 6 benefits. Id. ¶ 11. 7 Later, GEICO asked Mr. Nichols to undergo an independent medical examination 8 (“IME”) conducted by a GEICO-hired chiropractor. Id. ¶¶ 11, 14; Dkt. # 125-2 at 56-68. 9 The goal of the IME was “to determine the medical necessity and relatedness of the 10 treatment to the accident.” Dkt. # 78-1 at 53. Mr. Nichols attended the IME, and the 11 chiropractor issued his report. Dkt. # 125-2 at 56-68. Soon after, on August 21, 2015, 12 GEICO sent Mr. Nichols a letter terminating his coverage: 13 According to Dr. Jerry Torrence, “There were no objective findings today to support this patient’s subjective findings,” and “Merle Nichols has 14 reached maximum medical improvement effective on this date.” Therefore, 15 we are suspending all medical payments for treatment your client receives after 8/11/2015. As the treatment up to that date is reasonable and related 16 we will be issuing payments for billing received for dates of service on or 17 before 8/11/2015. 18 Dkt. # 95-11 at 2 (emphasis added). In response, Mr. Nichols’s counsel informed GEICO 19 that maximum medical improvement (“MMI”) could not “be the basis of discontinuation 20 of PIP benefits” under WAC 284-30-395. Dkt. # 95-12. 21 On August 24, 2018, Mr. Nichols sued GEICO in King County Superior Court. 22 Dkt. # 1-2. The same day, GEICO removed the action to this Court. Dkt. # 1. 23 Based on his Second Amended Complaint, Mr. Nichols alleges that GEICO 24 violated WAC 284-30-395. Dkt. # 16 ¶¶ 1.1-1.2. According to Mr. Nichols, under that 25 regulation, PIP benefits may be terminated only “if treatment is not (1) reasonable, (2) 26 necessary, (3) related to the accident, or (4) incurred within three years of the accident.” 27 Id. GEICO violated the regulation, he says, when it terminated his PIP benefits on the 1 basis that he had achieved “maximum medical improvement,” a basis not permitted by 2 the regulation. Id. ¶¶ 1.1-1.2, 5.1-5.16. Because Mr. Nichols alleges that GEICO had a 3 “systematic practice” of doing this to other insureds beyond Mr. Nichols, he is hoping to 4 bring this suit on behalf of a class. Id. ¶¶ 3.1-3.10. He asserts claims for declaratory 5 relief, violation of the Insurance Fairness Conduct Act (“IFCA”), violation of 6 Washington’s Consumer Protection Act (“CPA”), common law bad faith, and breach of 7 the implied covenant of good faith and fair dealing. Id. ¶¶ 6.1-10.4. 8 Since bringing this action, Mr. Nichols has moved for class certification. Dkt. 9 # 94. He has defined the class as: 10 All insured, as defined within GEICO’s Automobile Policy, and all third- party beneficiaries of such coverage, under any GEICO insurance policy 11 effective in the state of Washington between July 24, 2012 and the present, 12 for whom GEICO limited or terminated benefits, or denied coverage based, even in part, upon its determination that its insured or beneficiary had 13 reached “maximum medical improvement” or that such benefits were not 14 “essential in achieving maximum medical improvement for bodily injury.” 15 Id. at 9. GEICO moved to deny class certification.1 Dkt. # 77. GEICO has also moved 16 for summary judgment, arguing that collateral estoppel bars Mr. Nichols’s claims. Dkt. 17 # 73. All motions are now ripe for review. 18 III. LEGAL STANDARD 19 A. Summary Judgment 20 Summary judgment is appropriate if there is no genuine dispute as to any material 21 fact and the moving party is entitled to judgment as a matter of law. Fed. R. Civ. P. 22 56(a). The moving party bears the initial burden of demonstrating the absence of a 23 genuine issue of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323 (1986). 24 Where the moving party will have the burden of proof at trial, it must affirmatively 25

26 1 “Rule 23 does not preclude a defendant from bringing a ‘preemptive’ motion to deny certification.” Vinole v. Countrywide Home Loans, Inc., 571 F.3d 935, 939 (9th Cir. 27 2009). 1 demonstrate that no reasonable trier of fact could find other than for the moving party. 2 Soremekun v. Thrifty Payless, Inc., 509 F.3d 978, 984 (9th Cir. 2007). On an issue where 3 the nonmoving party will bear the burden of proof at trial, the moving party can prevail 4 merely by pointing out to the district court that there is an absence of evidence to support 5 the non-moving party’s case. Celotex Corp., 477 U.S. at 325. If the moving party meets 6 the initial burden, the opposing party must set forth specific facts showing that there is a 7 genuine issue of fact for trial to defeat the motion. Anderson v. Liberty Lobby, Inc., 477 8 U.S. 242, 250 (1986). The court must view the evidence in the light most favorable to 9 the nonmoving party and draw all reasonable inferences in that party’s favor. Reeves v. 10 Sanderson Plumbing Prods., 530 U.S. 133, 150-51 (2000). 11 B. Class Certification 12 A court’s decision to certify a class is discretionary. Vinole v. Countrywide Home 13 Loans, Inc., 571 F.3d 935, 944 (9th Cir. 2009). Federal Rule of Civil Procedure 23 14 guides the court’s exercise of discretion. A plaintiff “bears the burden of demonstrating 15 that he has met each of the four requirements of Rule 23(a) and at least one of the [three 16 alternative] requirements of Rule 23(b).” Lozano v. AT&T Wireless Servs., Inc., 504 F.3d 17 718, 724 (9th Cir. 2007). Rule 23(a) requires a plaintiff to demonstrate that (1) the 18 proposed class is sufficiently numerous (“numerosity”); (2) it presents common issues of 19 fact or law (“commonality”); (3) it will be led by one or more class representatives with 20 claims typical of the class (“typicality”); and (4) the class representative will adequately 21 represent the interests of the class (“adequacy”). Gen. Tel. Co. of the S.W. v. Falcon, 457 22 U.S.

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