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Hall v. Liberty Mutual Insurance Co.

United States District Court, D. Nevada

September 29, 2017

ROCK HALL, individually, Plaintiff,
v.
LIBERTY MUTUAL GENERAL INSURANCE COMPANY, DOES I-X, and ROES I-X, Defendants.

          ORDER, (DEF.'S MOTION FOR SUMMARY JUDGMENT - ECF, 20)

          MIRANDA M. DU UNITED STATES DISTRICT JUDGE

         I. SUMMARY

         Before the Court is Defendant Liberty Mutual General Insurance Company's (“LM General”) Motion for Summary Judgment (“Motion”) (ECF No. 20). The Court has reviewed Plaintiff Rock Hall's response (ECF No. 28) and LM General's reply (ECF No. 30). The Court grants in part and denies in part LM General's Motion for the reasons discussed below.

         II. BACKGROUND

         Hall was involved in a car accident on or about October 29, 2014, that left him with significant medical expenses and ongoing physical ailments. (ECF No. 10 at 2-3.) Hall received $100, 000 of insurance benefits on behalf of the other driver from the accident. (ECF No. 20 at 3.) Hall now seeks to recover additional benefits from his insurer, LM General, pursuant to his auto policy's underinsured/uninsured motorist (“UM”) clause. (ECF No. 10 at 3.) The UM clause obligates LM General to pay “compensatory damages which an ‘insured' is legally entitled to recover from the owner or operator of an ‘uninsured motor vehicle' because of ‘bodily injury.'” (ECF No. 20-2 at 12.)

         The policy requires Hall to comply with certain duties before LM General becomes obligated to provide coverage. (Id. at 17.) These duties include cooperating with LM General in the investigation, settlement, or defense of any claim. (Id.)

         LM General conducted an investigation of Hall's UM claim primarily through correspondence with Hall's counsel by mail. LM General made seven requests for information after the accident over the course of about a year (from October 31, 2014, to November 3, 2015) based on exhibits provided to the Court. Hall provided materials that were only partially responsive to these requests in a demand package sent to LM General on September 29, 2015. Hall's counsel provided unspecified additional medical records on May 4, 2016, but otherwise Hall's counsel apparently ignored LM General's requests. The correspondence between LM General and Hall's counsel is set out in detail below.

         LM General sent its first letter regarding the accident directly to Hall (asking him to forward all medical bills arising from the accident to LM General) a couple days after the accident, on October 31, 2014. (ECF No. 20-3 at 2.) Hall's counsel responded with a letter of representation about a month and a half later, on December 12, 2014 (ECF No. 20-4 at 2), and LM General began sending all correspondence regarding the accident to Hall's counsel (ECF No. 20 at 6-7).

         LM General sent a letter to Hall's counsel requesting itemized medical bills, medical records, and Hall's social security and Medicare numbers on January 9, 2015. (ECF No. 20-5 at 2.) Hall's counsel did not respond but months later sent a letter to LM General notifying it that Hall intended to make a UM claim, on May 21, 2015. (ECF No. 20-6 at 2.)

         LM General then sent a series of three letters to Hall's counsel over the course of four months requesting the following: medical records (ECF No. 20-7 at 2), a signed release for medical records (id. at 3-4), lost wage records (id. at 2), a signed release for lost wage records (id. at 5-6), an interview with Hall about the accident and his injuries (id. at 2), an update as to the status of Hall's medical care (including “diagnosis, prognosis, treatment, medical bills & wage loss incurred to date and anticipated release date”) (ECF No. 20-8 at 2), confirmation of the other driver's policy limit (id.), confirmation that the other driver was a named insured on her policy (id.), an affidavit from the other driver asserting that she has no other insurance (id.), a demand package with itemized bills and records (ECF No. 20-9 at 2), wage loss documentation and support of disability from Hall's treating physicians (id.), estimates of future medical care including costs (id.), a copy of the other driver's policy (id.), Hall's medical records for the five years preceding the accident (id.), and an affidavit from the other driver asserting that there is no other valid insurance available for Hall's loss (id.).

         Hall's counsel provided LM General with a demand letter purportedly directed to LM General[1] (ECF No. 28-10 at 2-4), medical records and itemized bills related to the accident (id. at 8-90), a signed release for medical records[2] (id. at 5), Hall's social security number (id.), profit and loss records for Hall's business since the accident (id. at 6-7), a copy of the demand Hall had made on the other driver's insurer (ECF No. 20-10 at 5-8), confirmation of the other driver's policy limit (id. at 4), and confirmation that the other driver was a named insured on her policy, all on September 29, 2015. (Id.) Hall's counsel also seems to have provided a “recommendation for future medical care.” (See ECF No. 20-11 at 2 (acknowledging receipt).) At least the following of LM General's requests apparently remained outstanding: Hall's Medicare number, a signed release for lost wage records, records of Hall's disability from his treating physicians, an interview with Hall about the accident and his injuries, Hall's prior five years of medical history, and /// an affidavit from the other driver that there is no other valid insurance available for Hall's loss.

         LM General acknowledged receipt of the September 29, 2015, records and requested the following additional materials on October 27, 2015: missing pages from certain medical records; lost wage records (including confirmation of dates of disability from Hall's physicians); and a list of providers, dates of services, and charges. (ECF No. 20-11 at 2.)

         LM General apparently discovered that Hall was planning to file a lawsuit against it in a telephone conversation with staff at the office of Hall's counsel on November 3, 2015. (See ECF No. 20-12 at 2.) LM General then sent a letter to Hall's counsel requesting a courtesy copy of the complaint; an independent medical examination of Hall prior to surgery; “copies of all medical records, bills, wage loss documents and support for the disability from Mr. Hall's treating physicians;” a description of Hall's occupation and job requirements; tax returns for the five years preceding the accident; and medical history for ten years preceding the accident, including prior diagnostic tests. (Id.) LM General provided unsigned releases for Hall to complete if he preferred LM General obtain the records itself. (Id.)

         Hall then filed suit against LM General alleging inter alia breach of contract, breach of implied covenant, and violation of the Unfair Claims Practices Act on November 18, 2015. (ECF No. 20 at 7.)

         Hall's counsel provided additional medical records on May 4, 2016.[3] (ECF No. 28-9 at 2.)

         III. LEGAL STANDARD

         Summary judgment is appropriate when the pleadings, the discovery and disclosure materials on file, and any affidavits “show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.” Celotex Corp. v. Catrett, 477 U.S. 317, 322 (1986). An issue is genuine “if the evidence is such that a reasonable jury could return a verdict for the nonmoving party, ” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986), and a dispute is material if it could affect the outcome of the suit under the governing law. Id.

         Summary judgment is not appropriate when “reasonable minds could differ as to the import of the evidence.” See Id. at 250-51. “The amount of evidence necessary to raise a genuine issue of material fact is [that which is] enough ‘to require a jury or judge to resolve the parties' differing versions of the truth at trial.'” Aydin Corp. v. Loral Corp., 718 F.2d 897, 902 (9th Cir. 1983) (quoting First Nat'l Bank of Ariz. v. Cities Serv. Co., 391 U.S. 253, 288-89 (1968)). Decisions granting or denying summary judgment are made in light of the purpose of summary judgment “to avoid ...


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