Roper v. State Farm Mutual Automobile Insurance

958 P.2d 1145, 131 Idaho 459, 1998 Ida. LEXIS 62
CourtIdaho Supreme Court
DecidedMay 28, 1998
Docket23415
StatusPublished
Cited by8 cases

This text of 958 P.2d 1145 (Roper v. State Farm Mutual Automobile Insurance) 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
Roper v. State Farm Mutual Automobile Insurance, 958 P.2d 1145, 131 Idaho 459, 1998 Ida. LEXIS 62 (Idaho 1998).

Opinions

[460]*460SILAK, Justice.

This case involves an appeal from two orders granting partial summary judgment dismissing causes of action for bad faith and intentional infliction of emotional distress against an insurance company by the insurance claimant. We affirm the order dismissing the bad faith claims, but vacate the order dismissing the claim for intentional infliction of emotional distress and remand for further proceedings. Appellant also appeals an order granting a motion in limine for the respondent. We decline to rule on that issue as it is not properly before this Court.

I.

FACTS AND PROCEDURAL BACKGROUND

On June 29, 1991, appellant Charles E. Roper (Roper) was injured in an automobile accident when his ear was struck by another ear which had run a red light. Respondent State Farm Insurance Company (State Farm) carried the automobile insurance for Roper’s vehicle and the vehicle of the other driver. Roper’s coverage included medical coverage for reasonable and necessary medical expenses for bodily injuries caused by an accident. Two different insurance agents were assigned to the claim, since State Farm insured both parties involved in the accident. Scott Bengoechea (Bengoechea) was assigned to Roper’s claim (first party claim) and Loretta Hailing (Hailing) was assigned to the tortfeasor’s claim (third party claim).

Prior to the accident, Roper suffered from extensive medical conditions including back pain, headaches and blurred vision from a prior surgery to remove an epidermoid pituitary tumor, depression and gastrointestinal ailments, which included gall bladder surgery, stomach surgery and hernia surgery. Roper’s alleged injuries from the accident include neck and shoulder injuries, back pain and aggravation of his gastrointestinal ailments and depression.

In processing the claim, State Farm requested a medical release from Roper. Roper signed the release and wrote on the bottom of the release “[t]his is for my insurance claim only- — this information is not for the girl’s ins that hit me — AKA—the other party involved.” Roper had also signed a medical release for the third party claim. On February 26, 1992, Bengoechea noted that Hailing was having trouble settling the third party claim with Roper. Shortly thereafter, Bengoechea provided Hailing with a copy of all of Roper’s medical records in the file. When asked by Roper’s counsel if any of the files had been shared, Bengoechea stated that they had not.

After the accident, Roper attended physical therapy intermittently, although there was little to no improvement in his condition. During this time, Roper saw several physicians who determined various causes for Roper’s existing condition. After November 1992, State Farm stopped paying any of Roper’s medical bills. A review of Roper’s medical records was completed by a medical records review service (CMR) on February 3, 1993, This review concluded that the accident had aggravated prior medical conditions and that the aggravation would require 45 to 60 days to heal.

On January 6, 1993, Roper’s counsel was contacted and informed that State Farm wanted to schedule an Independent Medical Examination (IME). The IME was not scheduled until March of 1994. On April 26, 1994, the IME Panel conducted an evaluation and concluded that the conditions were no more than a temporary aggravation of preexisting conditions. The panel suggested that treatment incurred up to one year following the accident should be paid. Following the IME, State Farm paid all bills incurred up to one year following the accident and denied all others. Four bills were not paid. Ultimately, State Farm paid a total of $7,816.73 for Roper’s medical bills and denied payment of $2,918.27. Denial was based on a determination by State Farm that the expenses were unnecessary or unrelated to the automobile accident.

Roper filed suit against State Farm on September 20, 1993 for: (1) breach of contract; (2) bad faith; (3) intentional infliction of emotional distress; (4) breach of fiduciary duty; (5) negligent bad faith; and (6) intentional interference with a property interest.

[461]*461On September 28, 1995, the district court granted a motion for partial summary judgment dismissing the bad faith claims, holding that the medical claims were “fairly debatable.” Subsequently, the court reversed itself on two of the bills, thereby reinstating the bad faith claims for two of the four medical bills. On February 1, 1996, the court granted another partial summary judgment dismissing all claims except the claims for breach of contract and bad faith on the two remaining bills.

The district court then granted State Farm’s motion in limine preventing Roper from introducing any information regarding the sharing of medical information by the two insurance agents. The district court granted the motion finding that the evidence was not relevant and its probative value was outweighed by its prejudicial effect. Roper then voluntarily dismissed the remaining breach of contract and bad faith claims under I.R.C.P. 41(a)(2), so he could directly appeal the granting of summary judgment on the bad faith and intentional infliction of emotional distress claims and the granting of the motion in limine. The claims were dismissed without prejudice.

On December 19, 1996, this Court entered an order remanding the case for entry of a judgment as to counts three through six. The district court dismissed counts three through six “with prejudice” on December 27,1996.

II.

ISSUES ON APPEAL

The following issues are raised on appeal:

(1) Whether the district court erred in granting the motion for summary judgment as to the bad faith claims.
(2) Whether the district court erred in dismissing Roper’s cause of action for intentional infliction of emotional distress.
(3) Whether the district court erred in granting a motion in limine preventing the introduction of evidence of State Farm’s bad conduct.

hi.

STANDARD OF REVIEW

On appeal from a summary judgment this Court reviews the pleadings, depositions, affidavits, and admissions on” file. Thompson v. Pike, 125 Idaho 897, 899, 876 P.2d 595, 597 (1994). The evidence must be construed in the light most favorable to the party opposing the motion. Id. If the evidence reveals no disputed issues of material fact, then the motion was properly granted. Id. at 900, 876 P.2d at 598.

IV.

ANALYSIS

A. The District Court Did Not Err In Granting The Motion For Summary Judgment Dismissing The Claims For Bad Faith.

The district court originally granted State Farm’s motion for partial summary judgment and dismissed the bad faith claims on all four of the outstanding medical bills. Subsequently, the district court reversed itself on two of the bad faith claims, reinstating these claims. Roper then voluntarily dismissed the two reinstated bad faith claims. Therefore, we are reviewing the dismissal of the bad faith claims as to the two outstanding medical bills which were dismissed by summary judgment. Roper alleges that since there was conflicting medical evidence, there was a factual dispute as to whether the bills were fairly debatable and that therefore, summary judgment was inappropriate.

In White v. Unigard Mut. Ins. Co.,

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Cite This Page — Counsel Stack

Bluebook (online)
958 P.2d 1145, 131 Idaho 459, 1998 Ida. LEXIS 62, Counsel Stack Legal Research, https://law.counselstack.com/opinion/roper-v-state-farm-mutual-automobile-insurance-idaho-1998.