Reyher v. State Farm Mutual Automobile Insurance Co.

230 P.3d 1244, 2009 Colo. App. LEXIS 1968, 2009 WL 4981898
CourtColorado Court of Appeals
DecidedDecember 24, 2009
Docket08CA2021, 09CA0080
StatusPublished
Cited by4 cases

This text of 230 P.3d 1244 (Reyher v. State Farm Mutual Automobile Insurance Co.) is published on Counsel Stack Legal Research, covering Colorado Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Reyher v. State Farm Mutual Automobile Insurance Co., 230 P.3d 1244, 2009 Colo. App. LEXIS 1968, 2009 WL 4981898 (Colo. Ct. App. 2009).

Opinion

Opinion by

Judge HAWTHORNE.

In this action concerning the payment of medical bills under the Colorado Automobile Accident Reparations Act (No-Fault Act), plaintiffs, Pauline Reyher and Dr. Wallace Brucker, appeal the trial court’s four separate orders (1) dismissing Reyher’s claims because she lacks standing, (2) denying plaintiffs’ motion for class certification, (3) denying plaintiffs’ motion to compel certain discovery and granting a protective order to defendant, State Farm Mutual Automobile Insurance Company, and (4) finding that Dr. Brucker spoliated evidence. We reverse the order dismissing Reyher’s claims for lack of standing, but remand for proceedings to determine Dr. Brucker’s standing. We also reverse the order denying plaintiffs’ motion for class certification, and we do not address the orders regarding discovery and spoliation.

I. Facts

In October 2001, Reyher was injured in an automobile accident and required medical treatment. At the time, she was insured under a no-fault insurance policy issued by State Farm. The policy was governed by section 10 — 4—706(l)(b) of the No-Fault Act, which required insurers to pay for their insured “all reasonable and necessary expenses for medical ... services” related to covered automobile accidents. Ch. 303, sec. 5, § 10-4 — 706(l)(fo), 1984 Colo. Sess. Laws 1071 (formerly codified as amended at § 10-4-706(l)(b); repealed effective July 1, 2003, ch. 189, sec. 2, § IOhI-726, 2002 Colo. Sess. Laws 649).

Shortly after her accident, State Farm notified-Reyher that “[t]o determine [the] reasonable and necessary amount [for the treatment], [it] would compare [her] provider’s charges to a Medicode database through the Sloans Lake AIM [Auto Injury Management] program.” According to State Farm, the database compared “charges for the same or like services in the specific geographical area where the service was performed” and “iden-tifie[d] those bills that exceed the 90th percentile of charges for similar services in the provider’s geographical area.”

Reyher subsequently received treatment from Dr. Brucker, a salaried independent contractor of the Arkansas Valley Regional Medical Center. Dr. Brucker submitted the bills for Reyher’s treatment to State Farm for reimbursement. State Farm sent the bills to Sloans Lake, which reviewed them using the database. On Sloans Lake’s recommendation, State Farm repriced eight bills, compensating Dr. Brucker only for the amount it deemed reasonable. In response, Dr. Brucker wrote State Farm asserting that he was the only orthopedic surgeon in his geographic location and requested one bill be reviewed further. State Farm did not change its position.

*1250 Dr. Brucker billed Reyher for, and she paid, the amount that State Farm refused to pay on two of the eight bills. Three years later, Dr. Brucker’s office reimbursed her due to an alleged clerical error.

Reyher and Dr. Brucker filed suit against State Farm and Sloans Lake, asserting claims for (1) declaratory relief; (2) breach of contract and violation of No-Fault statute; (3) breach of implied covenant of good faith and fair dealing; (4) statutory willful and wanton breach of contract; (5) statutory deceptive trade practice violation; and (6) civil conspiracy. They asserted the claims in their individual capacities and as representatives of insureds and providers similarly situated. They settled their claims against Sloans Lake.

State Farm moved for summary judgment, arguing that plaintiffs could not legally prevail on their claims because the Colorado Division of Insurance (DOI) had found that by using the database to consider the medical bills’ reasonableness, State Farm did not presumptively violate a DOI regulation relating to the Unfair Competition — Deceptive Practices Act (UCDPA), § 10 — 3—1104(l)(h)(III)— (IV), C.R.S.2009. The trial court granted the motion and entered judgment for State Farm.

Plaintiffs appealed, and in Reyher v. State Farm Mutual Automobile Insurance Co., 171 P.3d 1263 (Colo.App.2007), a division of this court reversed the summary judgment. The division reasoned that the DOI’s finding was, at most, binding only as to the issue it actually decided, namely, that by using the database to consider the medical bills’ reasonableness State Farm did not presumptively violate a DOI regulation. The DOI did not decide whether the database recommendations conclusively determined the “reasonable” amount of medical expenses in all cases, or whether State Farm’s reliance on those recommendations was sufficient to discharge its statutory, contractual, and common law duties. Additionally, factual issues remained as to whether State Farm paid all reasonable medical bills of Reyher and Dr. Brucker or the other putative class members.

On remand, plaintiffs moved for an order compelling State Farm to answer a second set of interrogatories and honor their requests for production. State Farm moved for a protective order relieving it from responding to the discovery requests. After determining the requests were untimely and overly broad, the trial court granted State Farm’s motion and denied plaintiffs’.

Plaintiffs subsequently moved for class certification. While the parties were briefing the certification issue, State Farm filed a motion to dismiss Reyher’s claims because she lacked standing and a motion for sanctions against Dr. Brucker for spoliating evidence. The court granted both motions.

Regarding the standing motion, the court concluded that State Farm’s actions caused Reyher no injury because Dr. Brucker reimbursed the money she paid to cover the difference between the amount Dr. Brucker billed and the amount State Farm paid him. The court thus dismissed Reyher’s claims. As to the spoliation motion, the court found that when Dr. Brucker sold his practice, he failed to preserve various documents. As a sanction, the court granted all adverse inferences requested by State Farm.

Several months later, the court denied plaintiffs’ class certification motion, concluding that no class certification requirement under C.R.C.P. 23 had been satisfied.

The court then certified the class certification order and the dismissal order as final orders pursuant to C.R.C.P. 54(b). Plaintiffs appealed those orders, as well as the discovery and spoliation orders. The appeals were consolidated.

II. Analysis

A. Reyher’s Standing

Plaintiffs contend that the trial court erred in dismissing Reyher’s claims because she lacks standing. We agree.

Whether a plaintiff has standing is a legal question we review de novo. Barber v. Ritter, 196 P.3d 238, 245 (Colo.2008).

In Colorado, plaintiffs benefit from a relatively broad definition of standing that has traditionally been relatively easy to satisfy. Ainscough v. Owens, 90 P.3d 851, 855-56 *1251 (Colo.2004). They have standing if they suffer an injury in fact to a legally protected interest. Wimberly v. Ettenberg, 194 Colo. 163, 168, 570 P.2d 535, 538 (1977).

A legally protected interest is any right arising from a constitution, statute, common law, contract, rule, or regulation. Ainscough) 90 P.3d at 856.

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Related

Reyher v. State Farm Mutual Automobile Insurance Co.
2012 COA 58 (Colorado Court of Appeals, 2012)
State Farm Mutual Automobile Insurance Co. v. Reyher
266 P.3d 383 (Supreme Court of Colorado, 2011)
Ivar v. Elk River Partners, LLC
705 F. Supp. 2d 1220 (D. Colorado, 2010)

Cite This Page — Counsel Stack

Bluebook (online)
230 P.3d 1244, 2009 Colo. App. LEXIS 1968, 2009 WL 4981898, Counsel Stack Legal Research, https://law.counselstack.com/opinion/reyher-v-state-farm-mutual-automobile-insurance-co-coloctapp-2009.