Torgerson v. State Farm Mutual Automobile Insurance Company

District Court, D. Nevada·Decided May 28, 2024·No. 3:21-cv-00452·Unknown

Opinion

* * *

ANGELA TORGERSON, an Individual, Case No. 3:21-cv-00452-LRH-CSD Plaintiff, ORDER v.

INSURANCE COMPANY, an Insurance Company, and Does I-X, inclusive,

Defendants.

Defendant State Farm Mutual Automobile Insurance Company (“Defendant” or “State Farm”) moves this Court to grant partial summary judgment in its favor on the second and third causes of action in a complaint brought by Plaintiff Angela Torgerson (“Plaintiff”). ECF No. 69. Plaintiff opposed (ECF No. 75) and Defendant replied (ECF No. 87).1 For the reasons contained within this Order, the Court denies Defendant’s motion for partial summary judgment (ECF No. 69). This matter involves Plaintiff’s insurance claim for underinsured motor vehicle (“UIM”) benefits denied by Defendant. On October 7, 2019, Plaintiff was involved in a motor vehicle collision while driving a 2013 Toyota Tacoma. ECF No. 69-3. According to the police report, the collision occurred in Elko, Nevada, on S. Street and involved a four-vehicle pile-up. ECF No. 69-

1 Originally, Defendant moved for summary judgment in its favor on each of the three causes of action in the complaint. ECF No. 69. When Plaintiff responded by requesting that the Court certify two questions of law to the Nevada Supreme Court, each of which pertained to Defendant’s arguments as to Plaintiff’s first cause of action, Defendant withdrew its arguments related to the requested certified questions and no longer moves for summary judgment on the first cause of T 4. The driver of the first vehicle looked down to open a can of chewing tobacco and did not realize the traffic on S. Street had begun slowing in front of him. Id. The driver was unable to brake to avoid hitting the first vehicle. Id. The first vehicle then hit the second vehicle; the second vehicle hit the third vehicle; and the third vehicle hit the fourth vehicle—Plaintiff’s Toyota Tacoma. Id. The estimates to repair the damage to Plaintiff’s vehicle were $623.31 and $1,172.81. ECF Nos. 69-5, 75-2. The driver of the second vehicle was transported to the hospital after complaining of neck and back pain. ECF No. 69-4. No other injuries were reported to law enforcement by other drivers or passengers at the scene of the accident. Id. In November 2019, State Farm notified Plaintiff that her “policy provides [m]edical [p]ayments [c]overage for reasonable expenses of necessary medical treatment resulting from injuries sustained in this accident . . . , [i]f it is determined that the other driver is not insured, or is underinsured, your [UIM] coverage may apply.” ECF No. 69-5 at 14. In December 2019, Plaintiff’s counsel requested that State Farm extend Plaintiff “whatever medical payments benefits are available under [her] policy” and notified State Farm that if the liable driver’s “insurance limits are not sufficient to fully compensate [Plaintiff], [she] will make a claim under the [UIM] provisions of [her] policy.” Id. at 17. State Farm reimbursed Plaintiff for all of the medical payment coverage available under her policy—$5,000. ECF No. 75-1 at ¶ 25. The liable driver’s insurer paid his bodily injury policy limit—$25,000—to settle Plaintiff’s claim against him. ECF No. 69-6. In October 2020, Plaintiff’s counsel notified State Farm of the settlement and Plaintiff’s plan to pursue a UIM claim. ECF No. 69-5. The case manager for Plaintiff’s counsel informed the State Farm claim specialist assigned to Plaintiff’s UIM claim that Plaintiff was undergoing surgery for her spine at the end of October 2020. Id. In March 2021, State Farm notified Plaintiff’s counsel that her UIM claim was denied “based upon [State Farm’s] medical expert’s medical records review as well as the mechanism of impact.” Id. In August 2021, Plaintiff commenced this action against Defendant. A. Plaintiff’s Medical History About one year before the subject accident, Plaintiff became an established patient with a her ability to “[e]xtended [c]omputer [u]se,” sleep, statically sit, and function. Id. Plaintiff reported previously receiving chiropractic care and experiencing discomfort in her neck, midback, and left shoulder. Id. On the day of the subject accident, Plaintiff presented at the chiropractor for her weekly treatment. Id. Plaintiff returned for her weekly chiropractic treatment the following week without reporting any change in symptoms since her last visit and continued to receive weekly spinal adjustments into March 2020. Id. In October 2019, Plaintiff reported to her physician, i.e., general practitioner, that she was experiencing intermittent pain in her thoracic and lumbar spine as well as numbness or tingling following the subject accident. ECF No. 69-8. While following up with her general practitioner in November 2019, Plaintiff reported continued back pain aggravated by working, bending, and lifting. Id. After Plaintiff’s physical examination resulted positive for back pain and negative for neck pain, the general practitioner referred her to obtain a lumbar and thoracic MRI scan. Id. In December 2019, Plaintiff presented at a neurosurgery organization where Christopher Demers, M.D., examined her. ECF No. 69-9. Dr. Demers reviewed the MRI scan and found the results pertaining to Plaintiff’s lumbar spine were normal and the results pertaining to her thoracic spine showed some mild disc bulges and minimal degenerative changes. Id. He did not find that Plaintiff needed surgical intervention or any restrictions at that time. Id. In February 2020, Plaintiff complained to her general practitioner of neck and midthoracic pain with tingling. ECF No. 69-8. She was subsequently scheduled for a cervical MRI scan. Id. After Plaintiff reported that her chiropractic treatment was not helping, she was referred to physical therapy. Id. Shortly thereafter, Plaintiff began physical therapy on a bi-weekly basis into July 2020. ECF No. 69-10. In February 2020, Plaintiff also returned to Dr. Demers, presenting with neck pain. ECF No. 69-9. He recommended that surgery not be considered until Plaintiff exhausted all nonoperative measures. Id. He advised that Plaintiff attend six physical therapy sessions before returning and, if needed, try steroid injections. Id. In April 2020, Plaintiff reported that her neck pain was significantly improved during a followed-up appointment with Dr. Demers. Id. Dr. Demers recommended continuing to manage her symptoms nonoperatively and a follow-up In June 2020, Plaintiff presented at a surgical consultation with James Rappaport, M.D. ECF No. 69-11. He reviewed Plaintiff’s cervical MRI scan, which occurred on February 5, 2020, and noted disc protrusion at the C5-6 and C6-7. Id. He concluded that, “[a]t the time, surgery is certainly not mandatory . . . , [s]he can continue with nonoperative treatment to include [physical therapy, and] [i]f her symptoms continue to improve, she may not require surgical intervention.” Id. In July 2020, Plaintiff received medical care at a hospital for injuries after she fell off a horse. ECF No. 69-12. According to medical records, Plaintiff reported pain in the back of her neck and lower back after she fell off of a horse and “hit the back of her head and lower back.” Id. In September 2020, Plaintiff presented at a follow-up surgical consultation with Dr. Rappaport. ECF No. 69-13. He recapped that, in June 2020, he told Plaintiff that, while surgery was not mandatory, “if her symptoms persisted or increased, then she would be a candidate for” surgery. Id. Plaintiff’s symptoms did persist, and on September 24, 2020, Dr. Rappaport opined:

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Torgerson v. State Farm Mutual Automobile Insurance Company, (D. Nev. 2024).

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