Nichols v. Geico Insurance Company

District Court, W.D. Washington·Decided April 28, 2021·No. 2:18-cv-01253·Unknown

Opinion

HONORABLE RICHARD A. JONES

UNITED STATES DISTRICT COURT AT SEATTLE MERLE NICHOLS, on behalf of himself and all others similarly situated,

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

v. ORDER

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

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