Patricia Stephenson Eichenseer v. Reserve Life Insurance Company

894 F.2d 1414, 1990 U.S. App. LEXIS 2188, 1990 WL 10624
CourtCourt of Appeals for the Fifth Circuit
DecidedFebruary 9, 1990
Docket88-4421
StatusPublished
Cited by10 cases

This text of 894 F.2d 1414 (Patricia Stephenson Eichenseer v. Reserve Life Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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Patricia Stephenson Eichenseer v. Reserve Life Insurance Company, 894 F.2d 1414, 1990 U.S. App. LEXIS 2188, 1990 WL 10624 (5th Cir. 1990).

Opinion

ON PETITION FOR REHEARING AND SUGGESTION FOR REHEARING EN BANC

Petition for rehearing denied.

JONES, Circuit Judge,

dissenting from denial of rehearing en banc,

joined by GEE, JOLLY and SMITH, Circuit Judges.

A panel of our court held that assuming arguendo the applicability of the Due Process Clause to awards of punitive damages, no violation of due process can be found on the facts of this case. By their lights, the defendant Reserve Life was “provided with adequate notice of the type of conduct which would subject it to significant punitive damages,” and the district court’s award was within Mississippi’s “well-established guidelines for the imposition of punitive damages.” The panel thus affirmed a $500,000 punitive damage award for Reserve’s delay and belated payment of a $6,658.38 medical claim, amounting to a penalty 75 times the value of the claim.

Notwithstanding the decision of my brethren to the contrary, this case should be reheard en banc. Notwithstanding its demurrer on the due process issue, the rationale of the panel opinion sets no due process limit on awards of punitive damages for bad faith refusals to pay insurance claims governed by Mississippi law. 1 I am convinced that the panel’s reasoning and result are fundamentally in error. Mississippi’s bad faith refusal tort, a creature designed by the state supreme court, not the legislature, to punish and deter insurance companies when they fail to pay certain claims, mocks our notions of fundamental fairness embodied in the Due Process Clause of the fourteenth amendment. First, neither Reserve Life nor most of the dozens of other insurers who have been attacked by this new Mississippi tort have had adequate notice of the conduct that could result in punitive damage awards. Second, despite the panel’s incantation of Mississippi’s “well established standards,” the fact finder possesses unbridled discretion to punish, and punishment is meted out among defendants in radically varying amounts.

Yet another factor counsels rehearing en banc. A majority of the Supreme Court have questioned the constitutional propriety of punitive damage awards run amok. 2 As lower court judges, we should debate this issue for the benefit of the higher Court and the public. 3

Lacking the opportunity for that debate, but in hope of spurring it on, I shall shadow-box the panel opinion.

I. Mississippi Law

Commencing with Standard Life Ins. Co. v. Veal, 354 So.2d 239, 248 (Miss.1977) the Mississippi Supreme Court entered the vanguard of state courts that began to create torts from what were previously breach of contract actions against insur- *1416 anee companies for failure to pay a claim. The state supreme court has articulated the basis for imposing punitive damages as a two-step process: first, was there a legitimate and arguable reason for the insurance company to deny coverage; second, if no such reason appears, was the denial motivated by malice or recklessness. Ei-chenseer, 881 F.2d at 1360. If the jury finds the requisite state of mind, they are entitled to award punitive damages based upon multiple factors:

(1) Such amount as is necessary for the punishment of the wrongdoing of the defendant and deterring defendant from similar conduct in the future;
(2) such amount as is reasonably necessary to make an example of the defendant so that others may be deterred from the commission of similar offenses; and
(3) the pecuniary ability or financial worth of the defendant.

Bankers Life & Cas. Co. v. Crenshaw, 483 So.2d 254, 278 (Miss.1985) (citations omitted). It has been correctly observed that the standards for insurance practice effectively mandated by the Mississippi Supreme Court are evolving on a case-by-case basis. Eichenseer v. Reserve Life Ins. Co., 682 F.Supp. 1355, 1366 (N.D.Miss.1988).

The long march of the Mississippi Supreme Court toward “equitable” insurance claim handling practices is not without significance for this case. Surprisingly, however, this sequence of decisions is completely overlooked by our court’s opinion. Prior to the handling of Eichenseer’s claim, no Mississippi case had held that either failure to obtain “all relevant medical records” or egregious delay in processing a claim could fall within the purview of a bad faith refusal tort. The Mississippi cases before 1983 dealt with entirely different fact patterns: Veal, 354 So.2d at 247-48 (punitive damages for insurance company’s failure to honor credit insurance claim clearly within terms of policy); Travelers Indemnity Co. v. Wetherbee, 368 So.2d 829, 834-35 (Miss.1979) (payment withheld on homeowners’ policy in violation of its terms after arson investigation had terminated favorably for insureds); Reserve Life Ins. v. McGee, 444 So.2d 803, 805-06, 811 (Miss.1983) (post-claims underwriting, i.e. rescission of a medical policy, after insured made a covered claim, for a material misstatement of facts in the policy application when the insured provided sufficient information about past medical treatment that the company could have investigated before issuance of a policy). See also Richards v. Allstate Ins. Co., 693 F.2d 502 (5th Cir.1982) (company misled automobile policyholders to believe there was an exclusion to policy coverage, even though Mississippi law did not recognize such exclusion); Freeland & Freeland, Bad Faith Litigation: A Practical Analysis, 53 Miss.L.J. 237, 276 (1983) (“The lack of clarity in the case law has made it exceedingly difficult for either plaintiffs or defendants to evaluate the merits of a bad faith claim.”).

Not until after Eichenseer’s claim was denied by Reserve did the Mississippi Supreme Court begin to “punitize” in certain cases an insurer’s failure to obtain “all relevant medical records”, Crenshaw, 483 So.2d at 270, 272; and its failure to consult with a medical expert prior to denying a claim, Life Ins. Co. v. Allen, 518 So.2d 1189, 1193 (Miss.1987). Even then, the court’s pronouncements have not been uniform. In Blue Cross & Blue Shield v. Campbell, 466 So.2d 833, 840-41 (Miss.1984), predating Crenshaw, the court found as a matter of law that an insurance company could rely on ambiguous hospital records alone in denying a claim based on a pre-existing condition clause of the policy. Later Mississippi cases have continued to elaborate, ex post facto, upon acceptable claims handling policies. 4 Indeed, but for *1417 the rulings that already exist regarding the bad faith refusal tort, Mississippi’s Supreme Court has eschewed a definition of actionable conduct in favor of mere description of the justices’ goal:

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894 F.2d 1414, 1990 U.S. App. LEXIS 2188, 1990 WL 10624, Counsel Stack Legal Research, https://law.counselstack.com/opinion/patricia-stephenson-eichenseer-v-reserve-life-insurance-company-ca5-1990.