Peggy Cedillo v. Farmers Ins Co of Idaho

CourtIdaho Supreme Court
DecidedNovember 29, 2017
Docket43890
StatusPublished

This text of Peggy Cedillo v. Farmers Ins Co of Idaho (Peggy Cedillo v. Farmers Ins Co of Idaho) is published on Counsel Stack Legal Research, covering Idaho Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Peggy Cedillo v. Farmers Ins Co of Idaho, (Idaho 2017).

Opinion

IN THE SUPREME COURT OF THE STATE OF IDAHO

Docket No. 43890

PEGGY CEDILLO, ) ) Boise, May 2017 Term Plaintiff-Appellant, ) ) 2017 Opinion No. 118 v. ) ) Filed: November 29, 2017 FARMERS INSURANCE COMPANY OF ) IDAHO, ) Karel A. Lehrman, Clerk ) Defendant-Respondent. ) _______________________________________ )

Appeal from the District Court of the Fourth Judicial District of the State of Idaho, Ada County. Hon. Lynn G. Norton, District Judge.

The judgment of the district court is affirmed.

Runft & Steele Law Offices, Boise, for appellant. Jon M. Steele argued.

Gjording Fouser, PLLC, Boise, for respondent. Bobbi K. Dominick argued.

_____________________

BRODY, Justice This is an insurance bad faith case arising out of a claim for underinsured motorist coverage. Ms. Cedillo claims the district court erred when it (1) granted summary judgment in favor of Farmers on her bad faith claim, (2) denied discovery of the entirety of Farmers’ claims file and certain electronic information, and (3) denied a motion to amend her complaint to include a claim for punitive damages. We affirm the judgment of the district court on the bad faith claim and do not reach the merits of Ms. Cedillo’s other claims. We deny Farmers’ request for attorney’s fees, but award costs on appeal. I. FACTUAL AND PROCEDURAL BACKGROUND In May 2008, Peggy Cedillo was injured in a collision while riding as a passenger on the back of a motorcycle. About a year after the collision, she settled her claim against the motorcycle driver for $105,000, the total amount available under his insurance policy. Ms. 1 Cedillo married the motorcycle driver about eight months after the collision, and he is her lawyer in this lawsuit and has been designated as one of her experts. In July 2009, about two months after settling her tort claim, Ms. Cedillo sent Farmers a letter seeking payment under the underinsured motorist portion (UIM) of her own auto policy. The UIM insuring clause stated: We will pay all sums which an insured person is legally entitled to recover as damages from the owner or operator of an UNDERinsured motor vehicle because of bodily injury sustained by the insured person.

Ms. Cedillo told Farmers that her medical bills totaled $53,048.62, and she demanded payment of policy limits of $500,000 and resolution of the claim within thirty days. Shortly after receiving Ms. Cedillo’s letter, Farmers requested that she sign a medical release authorizing the company to obtain her medical records. She signed the release, but limited it to medical information related to the motorcycle collision by adding the notation “(information pertaining to the accident/injury occurring 5-25-08 only).” On August 25, 2009, a few days before the thirty-day demand period was up, Farmers sent Ms. Cedillo a $25,000 check with a letter stating that the check represented their valuation of her UIM claim and took into account the $105,000 she received from the motorcycle driver’s insurance company. The policy also contained a provision allowing a reduction in the amount of UIM coverage based on third party liability payments: The amount of UNDERinsured Motorist Coverage we will pay shall be reduced by the amount of any other bodily injury coverage available to any party held to be liable for the accident.

Farmers stated that its valuation did not include lost wages because her letter did not support a wage claim and she had not requested lost wages. The letter stated she could submit any additional information she had to support her claim. There was no further contact between the parties for a period of about six months. On March 30, 2010, Ms. Cedillo sent Farmers another letter informing it that she needed surgery to remove or block the occipital nerves because of ongoing headaches and neck pain. She estimated the procedure to cost $25,000. She also stated that she may need another surgical procedure to cover numbness and tingling in her hands. She stated she did not have a cost estimate for that procedure. She again made a demand for policy limits of $500,000.

2 Farmers responded to Ms. Cedillo’s March 2010 demand approximately two weeks later by sending her a letter stating that it was not in a position to accept or deny the demand. Farmers stated that it needed to obtain the records pertaining to recent medical treatment and that it needed records for five years prior to the collision. Farmers noted in the letter that there may be relevant pre-accident records. Farmers also stated that it had not received any additional documentation regarding a wage claim. On May 7, 2010, Farmers sent Ms. Cedillo a letter advising her that it had obtained her medical records from the physician she said had recommended the nerve block/removal surgery. Farmers obtained the records using the limited release Ms. Cedillo had previously provided. Farmers stated that the doctor’s records did not document the need for surgery and asked her to provide any additional documentation that she might have. Farmers also stated that the records it had obtained did not support changing its evaluation of her claim and again requested that she sign a medical release so that it could request pre- and post-accident records. It also requested that she provide a list of her treatment providers. Ms. Cedillo provided the release on July 2, 2010, approximately two months later. On July 16, 2010, Farmers sent Ms. Cedillo another letter again requesting a list of treatment providers. On September 3, 2010, Ms. Cedillo sent Farmers another demand for policy limits. In her letter, she outlined her injuries, the impact those injuries had on her daily life, including her inability to work, and her medical bills to date (a little over $56,000) and the difficulties she was having paying those bills. She included adjusted gross wage information from past years (selected information from past tax returns) and provided a list of past treatment providers as well as new treatment providers. She stated that she had not received Farmers’ August 25, 2009, request for wage information. Farmers responded to Ms. Cedillo’s demand on September 24, 2010. It requested Ms. Cedillo’s complete tax returns so that it could evaluate her claim for lost wages. It also stated that it needed the medical records for new medical bills she had provided (it said it would request the records) and records documenting the need for surgery since the records they had obtained did not support her claim. Farmers also pointed out that the August 24, 2009 request for wage information was included with the $25,000 check which she had cashed. Farmers stated that it was not in a position to accept or deny the claim and told her that she would need to undergo an independent medical examination to determine the cause and extent of her injuries pre- and post

3 accident. Ms. Cedillo responded to Farmers about a month later, giving it updated information on a bill and telling it to let her know the date and location of the medical examination. In December 2010, Farmer’s attorney contacted Ms. Cedillo to set up the independent medical examination. Dr. Richard Wilson did the exam on April 19, 2011, and issued a report outlining his findings. He attributed her ongoing pain symptoms to stress rather than a nerve issue requiring surgery and apportioned the necessity of the neck fusion surgery she had undergone in 2008 after the collision equally between pre-existing conditions (she had been involved in two prior collisions) and the motorcycle accident at issue. Farmers advised Ms. Cedillo on May 5, 2011 that it was not changing its evaluation of her claim. The parties proceeded to arbitration. While the arbitration was pending, Ms. Cedillo underwent a second neck fusion surgery (a level above the original fusion) in February 2012.

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Peggy Cedillo v. Farmers Ins Co of Idaho, Counsel Stack Legal Research, https://law.counselstack.com/opinion/peggy-cedillo-v-farmers-ins-co-of-idaho-idaho-2017.