Updated on: 10/30/2018
Starting in 1971, State Farm's tagline was "Like a good neighbor, State Farm is there." pitching itself as the company that stands by you when things go wrong. But in 2016 the company abandoned the "good neighbor" messaging and apparently shifted it's culture one step further in the "nasty neighbor" direction.
State Farm Refuses To Pay Underinsured Motorist Coverage Benefits AND Hires Medical ‘Experts’ To Refute Brain Injury
Davis Law Group, P.S. has filed an insurance bad faith lawsuit against State Farm on behalf of a Harley Davidson rider that suffered a traumatic brain injury in a motorcycle accident that was not his fault because the insurance company refused to pay underinsured motorist coverage benefits. State Farm has fraught back by trying to subject the accident victim to examinations that are not required by the insurance policy and which Washington State courts have previously ruled are inadmissible, unduly inflammatory and prejudicial.
Below is the complete story of the accident, injuries, insurance coverage, and lawsuit. The case is scheduled for trial in November of 2018.
The Motorcycle Accident Victim
The motorcycle rider, MM, is a 46 year-old man who had been married to his wife for over 17 years. Together they have 3 children. Employed in a high-level position as a Category Leader at Google. He lives with his family on Bainbridge Island.
In September 2015, MM was operating his 1995 Harley Davidson motorcycle and with is wife as a passenger. They were traveling east on Second Avenue in Seattle. They were proceeding through the intersection of Second Avenue and James Street on a solid green traffic light. The driver of a 2004 Kia Spectra was attempting to make a left turn on Second Avenue and failed to yield to the motorcycle which had the right-of-way on a solid green traffic light causing a collision. The driver of the Kia was solely at fault for the collision. The motorcycle driver sustained immediate injuries in this collision.
The Seattle Fire Department responded to the scene of the collision. Emergency medical technicians found MM lying in the roadway. He was experiencing pain on the entire left side of his body, with primary pain complaints in his left leg and lower back. Medics noted diminished grip in his left hand. He was placed on a backboard, with a c-collar, and was transported to Harborview Medical Center.
MM had complaints of left side pain, left hip, knee, ankle and foot pain, with radiating pain into the left lateral/dorsal foot. The pain was sharp and burning, and shoots rapidly into the foot randomly and with movement. He also had numbness and persistent foot drop in the left leg since the collision. He had soreness all over his body, including his neck and upper back sore and stiff.
MM suffered a traumatic brain injury which caused cognitive impairment, chronic headaches, blurred vision, dizziness, hearing loss, ringing in the ears, anxiety, depression, and sleep problems. He also suffered a peroneal nerve injury which caused him to have a dropped foot.
MM received treatment at Harborview Medical Center; his own primary care physician; and University of Washington Medical Center for neurological care, rehabilitation counseling and therapy, physical therapy and speech therapy resulting in tens of thousands in medical bills. He is expected to require ongoing medical treatment in the future.
The severity of his injuries required that MM go on medical from Google. He was unable to work more than a year and a half resulting in hundreds of thousands of dollars in lost wages.
MM’s total past and future special and general damages come to more than $600,000.
Both the at-driver of the Kia and the motorcycle had insurance policies with State Farm at the time of the accident.
The driver of the Kia had automobile insurance liability policy with State Farm with bodily injury coverage limits of $100,000 per person. State Farm paid its $100,000 limits to MM to settle all claims against the at-fault driver.
At the time of the collision motorcycle had automobile insurance through State Farm with underinsured motorist (UIM) coverage in the amount of $250,000.
State Farm Refuses To Pay UIM Benefits
Under the terms of his State Farm insurance policy, MM's entitled to recover benefits, including UIM benefits, for the damages he sustained in the collision. State Farm is contractually and legally obligated to pay MM his UIM $250,000 benefits. State Farm’s failure to pay UIM policy limits is a breach of the insurance contract.
Insurance Fair Conduct Act (IFCA) Lawsuit
The Insurance Fair Conduct Act (IFCA) was passed by the Legislature, singed by the Governor, and approved by Washington votes in 2007. IFCA was enacted to prevent insurers from unreasonably denying claims; it provides legal remedies for policyholders when an insurer engages in such unfair claims and settlement practices. State Farm violated RCW 48.30.015 when it unreasonably denied Plaintiffs’ claim for benefits by, among other things, refusing to pay the fair value of their claim.
In November 2017, Davis Law Group filed a complaint against State Farm for breach of contract of the policy terms for MM’s damages arising from the motorcycle collision in September 2015.
State Farm Fights Brain Injury Victim
State Farm is trying to build a case against MM so they will not have to live up to the terms of the underinsured motorist coverage outlined in the insurance policy. State Farm wants to paint MM as someone who is faking, feigning or malingering his brain injury symptoms. The company attempted to misue certain psychological tests which are unscientific and un reliable in order to discriminate against MM.
State Farm hired an otolaryngologist and a neurologist refute the diagnoses, options and prognoses made by MM’s own treating physicians. They also hired a neuropsychologist to refute MM’s neurocognitive injuries, brain injury, and disabilities. State Farm’s neuropsychologist intended to use the Minnesota Multiphasic Personality Inventory (MMPI) test. The test is a complex, controversial and oft-criticized psychological personality profile. It is used to test for personality traits such as depression, hysteria, psychopathic deviate; paranoia, masculinity/femininity, hypomania, social introversion, etc.
Under the terms of the insurance policy State Farm only a “physician”, not a psychologist, can examine MM. State Farm’s policy does not provide for psychological or neuropsychological testing.
DLG Victory: Protects Brain Injury Victim From Unfair Psychological Exam
Davis Law Group filed a protective order so MM would not be subjected to psychological or neuropsychological testing. State Farm also asked the courts to compel MM to undergo an examination by State Farm’s neuropsychologist and be subjected to the MMPI.
It is a well-settled law in the State of Washington that MMPI testing and the results/interpretation thereof are inadmissible if properly objected to. In one case the Washington Supreme Court ruled that evidence regarding MMPI testing and its opinions and/or conclusions are inadmissible on three separate grounds including that they are unduly inflammatory and prejudicial.
In addition, Davis Law Group enlisted the aid of an expert with decades of experience with the MMPI test---training mental health professionals how to administer and interpret the test. In his declaration he stated that using the MMPI in cases such as this are completely inappropriate.
The courts granted the protective order. State Farm filed a motion for reconsideration. The judge denied State Farm’s motion stating that MMPI tests are inadmissible under ER 803(a)(4) and that the test has a danger of unfair prejudice, confusion of issues and is misleading to a jury. The judge went on to say that opinion testimony from experts which directly serves to bolster or detract from the credibility of a witness (MM) invades the province of the jury who are the ultimate deciders of credibility matters.
The case is scheduled for trial in November of 2018.
DLG Case Number: 201167