Rhodes v. AIG Domestic Claims, Inc.

937 N.E.2d 471, 78 Mass. App. Ct. 299
CourtMassachusetts Appeals Court
DecidedNovember 23, 2010
DocketNo. 09-P-619
StatusPublished
Cited by4 cases

This text of 937 N.E.2d 471 (Rhodes v. AIG Domestic Claims, Inc.) is published on Counsel Stack Legal Research, covering Massachusetts Appeals Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Rhodes v. AIG Domestic Claims, Inc., 937 N.E.2d 471, 78 Mass. App. Ct. 299 (Mass. Ct. App. 2010).

Opinions

Cypher, J.

On January 9, 2002, plaintiff Marcia Rhodes (Marcia),3 then forty-six years old, stopped her car, as directed by a police officer conducting traffic around a tree service crew, whereupon she was hit from behind by an eighteen-wheel trailer truck, leaving her instantly and permanently paralyzed. Marcia, along with her husband, Harold, and their daughter, Rebecca (collectively, the plaintiffs), are claimants under policies of insurance issued by the defendants for Building Materials Corp. of America (GAF),4 to whom the truck driver was assigned at the time of the accident. The plaintiffs brought this action against the defendant insurers, under G. L. c. 176D, § 3(9)(f), and c. 93A, §§ 2 and 9, for failure to effectuate prompt, fair, and equitable settlements of the plaintiffs’ tort claims. Principal among the issues on appeal are the plaintiffs’ burden to prove that their damages were caused by a recalcitrant insurer, and the amount to be multiplied for the insurer’s wilful and knowing violations of c. 93A.

We recount the facts relevant to this appeal from the trial judge’s comprehensive June 3, 2008, “Findings of Fact, Conclusions of Law, and Order,” summarized here and detailed further, as needed, in our discussion. Marcia was severely injured in 2002, when a truck struck her car from behind on Route 109 in Medway. At the time she was hit, she had been stopped by a patrolman at the site of tree service work being conducted by Jerry MacMillian’s Professional Tree Service (Professional Tree Service). The driver of the trailer truck, Carlo Zalewski, was employed by Driver Logistics Services (DLS), and was assigned to drive the truck for GAF. GAF leased the truck from Penske Truck Leasing Corp. (Penske). GAF carried a $2 million primary [301]*301automobile insurance policy with Zurich American Insurance Company (Zurich), and a $50 million excess umbrella policy with National Union Fire Insurance Company of Pittsburgh, PA (National Union). AIG Domestic Claims, Inc. (AIGDC), formerly known as AIG Technical Services, Inc., was the claims administrator for National Union.5

GAF and Zurich used Crawford & Company (Crawford), as a third-party administrator for GAF’s claims. Crawford received notice of the claim regarding Marcia on January 9, 2002, the day of the accident. Crawford characterized the claim as “catastrophic” and deemed it reportable to both GAF and Zurich. A Crawford report dated January 30, 2002, sent to GAF, Zurich, and AIGDC, described the accident and indicated both that Marcia was paralyzed and remained hospitalized in life-threatening condition, and that the claim would carry a high value. A second correspondence from Crawford to GAF, Zurich, and AIGDC on April 8, 2002, reported that Zalewski, the driver of the truck, was clearly liable for the accident, and that there was the potential for contribution from Penske, Professional Tree Service, and the town of Medway. Crawford recommended that Zurich put the $2 million policy limits in reserve.

On April 16, 2002, Marcia returned home for the first time since the accident, where she was confined to a wheelchair, only to be hospitalized in May for emergency surgery. She again returned home in June, 2002. On July 12, 2002, the plaintiffs filed a civil complaint against Zalewski, DLS, Penske, and GAF (the tort action), Marcia seeking damages for her injuries, and Harold and Rebecca seeking damages for loss of consortium.6 On November 21, 2002, Zalewski admitted to sufficient facts to support a finding of guilt as to criminal charges stemming from the accident.

In September, 2002, and May, 2003, Crawford provided Zurich and AIGDC with an estimate for the plaintiffs’ case of between $5 million and $10 million. On August 13, 2003, the plaintiffs sent to GAF’s counsel a “day in the life” videotape, chronicling a typical day for Marcia, now a paraplegic, and a [302]*302written demand for $16.5 million, which included summarized medical expenses of $413,977.68, present value of future medical costs of $2,027,078, loss of household services of $292,379, and out-of-pocket expenses of $83,984.74.

On September 11, 2003, Crawford sent Zurich a copy of the plaintiffs’ written demand and accompanying documentation, including medical records and expenses, and the videotape. Zurich then set about to verify the claims, developing its own life care plan and conferring with GAF’s defense counsel concerning the claims, defenses, and value of the plaintiffs’ damages. On a November 19, 2003, conference call, a Zurich claims director told GAF’s counsel, along with Crawford and AIGDC, that she would seek authority to tender Zurich’s policy limit of $2 million. GAF’s counsel recommended that a $5 million settlement offer be made to the plaintiffs, but AIGDC’s claims director refused, claiming he was new to the case and that he wanted to hire additional counsel to represent GAF and AIGDC.

Following the conference call, Zurich’s claims director began compiling the necessary information for a report that was required by Zurich to obtain authorization for the $2 million tender to AIGDC. On December 19, 2003, she submitted the report, estimating the value of the claim in excess of $10 million. The individual to whom she submitted the report was leaving Zurich’s employ at the end of the year, and the request for authority was forwarded to her replacement. Approval came on January 22, 2004, and on January 23, 2004, Zurich verbally tendered its policy limits to AIGDC, which indicated that it would not accept a verbal tender and needed it in writing.

In the meantime, the plaintiffs’ August 13, 2003, settlement demand went unanswered. AIGDC, for its part, refused to make a settlement offer prior to mediation and claimed more discovery was needed. On March 18, 2004, GAF’s counsel sent a letter to AIGDC, stating that its failure to tender settlement constituted a violation of c. 176D, § 3(9)(/), and c. 93A. AIGDC continued to drag its feet, however, wrangling with Zurich over defense obligations and refusing to accept Zurich’s tender of its primary policy limits (conduct described by the trial judge here as “spurious”). At the end of March, 2004, GAF’s counsel offered [303]*303the plaintiffs Zurich’s policy limit of $2 million to settle the case, which the plaintiffs rejected.

In mid-April, 2004, the plaintiffs agreed to mediation, but AIGDC refused to proceed, claiming the need for more discovery, including depositions of Marcia and Rebecca, even though the discovery period had closed in September, 2003. Again, AIGDC stalled, waiting until July 20, 2004, to conduct an independent medical examination of Marcia and eventually forgoing the deposition of Rebecca altogether before mediation. As the trial date of September 7, 2004, loomed, AIGDC finally agreed to schedule mediation for August 11, 2004. AIGDC’s claims director recommended that authority be given to make a settlement offer at mediation of $6 million, but AIGDC’s claims supervisor overruled him and authorized a settlement of only $4.75 million, which included $2 million from Zurich plus $1 million from Professional Tree Service (the limits of its coverage, which AIGDC assumed it would be willing to pay; as it turned out, Professional Tree Service ultimately settled for $550,000).

At the mediation on August 11, 2004, the plaintiffs sought $15 million to settle the case. AIGDC offered $3.5 million. Harold testified at trial that he would not have accepted a settlement offer of less than $8 million at the mediation.

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Related

Rhodes v. AIG Domestic Claims, Inc.
961 N.E.2d 1067 (Massachusetts Supreme Judicial Court, 2012)

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Bluebook (online)
937 N.E.2d 471, 78 Mass. App. Ct. 299, Counsel Stack Legal Research, https://law.counselstack.com/opinion/rhodes-v-aig-domestic-claims-inc-massappct-2010.