Foraker v. USAA Casualty Insurance Company

Filing 315

Opinion and Order. The Court GRANTS Defendant's Motion 274 for Summary Judgment as to Plaintiff's First Cause of Action for Breach of Contract; DENIES Plaintiff's Motion 283 for Partial Summary Judgment on Breach of Contr act, Attorney Fees, Expert Costs, and Prejudgment Interest; and DENIES Plaintiff's request for a partial final judgment on Claim One pursuant to Federal Rule of Civil Procedure 54(b). Signed on 10/14/2016 by Judge Anna J. Brown. See attached 16 page Opinion and Order for full text. (bb)

Download PDF
IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF OREGON PEGGY FORAKER, 3:14-cv-00087-BR Plaintiff, v. USAA CASUALTY INSURANCE COMPANY, Defendant. HEATHER A. BRANN P.O. Box 11588 Portland, OR 97211 (503) 490-6563 STEPHEN C. HENDRICKS Hendricks Law Firm, PC 1425 S.W. 20th Avenue, Suite 201 Portland, OR 97201 (503) 241-5629 Attorneys for Plaintiff 1 - OPINION AND ORDER OPINION AND ORDER JOSHUA N. KASTAN ROBERT S. MCLAY Hayes Scott Bonino Ellingson & McLay, LLP 203 Redwood Shores Parkway, Suite 480 Redwood City, CA 94065 (650) 637-9100 MATTHEW C. CASEY Bullivant Houser Bailey, PC 300 Pioneer Tower 888 S.W. Fifth Avenue Portland, OR 97204 (503) 499-4478 Attorneys for Defendant BROWN, Judge. This matter comes before the Court on Defendant USAA Casualty Insurance Company's Motion (#274) for Summary Judgment as to Plaintiff's First Cause of Action for Breach of Contract and Plaintiff Peggy Foraker's Motion (#283) for Partial Summary Judgment on Breach of Contract, Attorney Fees, Expert Costs, and Prejudgment Interest, including for partial final judgment on Claim One pursuant to Federal Rule of Civil Procedure 54(b). For the reasons that follow, Motion (#274) the Court GRANTS Defendant's for Summary Judgment as to Plaintiff's First Cause of Action for Breach of Contract and DENIES Plaintiff's Motion (#283) for Partial Summary Judgment on Breach of Contract, Attorney Fees, Expert Costs, and Prejudgment Interest. 2 - OPINION AND ORDER BACKGROUND The following facts are undisputed and taken from the record on summary judgment: 1 I. Factual Background Plaintiff was injured in a two-car automobile collision on January 4, 2012, when Plaintiff's car was struck by the car that Adrian Neira, an uninsured motorist, was driving. At the time of the collision Neira was fleeing police and driving the wrong way down a one-way street. Defendant insured Plaintiff and her automobile under an insurance policy that provided $50,000 in "Additional Personal Injury Protection" (PIP), $100,000 on Medical Payments (MedPay), and $1,000,000 in Uninsured Motorist (UM) benefits. As noted, Neira was uninsured. On January 5, 2012, Plaintiff reported the accident to Defendant and made PIP and MedPay claims. Plaintiff later made a UM claim. Defendant accepted coverage under PIP and MedPay and between February 6, 2012, and February 20, 2013, Defendant paid 1 In her Opposition (#289) to Defendant's Motion for Summary Judgment Plaintiff moves to strike various exhibits and factual materials filed by Defendant on summary judgment on the basis that those materials are not relevant to the legal analysis as to Claim One. The mere fact that portions of the summary-judgment record may not be material to the ultimate legal analysis, however, is not a basis to strike those materials from the record. Instead the Court disregards or gives little weight to such material as described herein. Accordingly, the Court denies Plaintiff's Motion to Strike presented in her Opposition to Defendant's Motion for Summary Judgment. 3 - OPINION AND ORDER $159,329.76 to Plaintiff for covered medical expenses under the PIP and MedPay portions of the policy. On February 20, 2013, Defendant advised Plaintiff and her medical providers that Defendant's payments exhausted the limits of Plaintiff's MedPay and PIP coverages. On April 8, 2013, Plaintiff made a policy-limits demand for $1,000,000.00, the full amount of the UM coverage, and the parties engaged in extensive negotiations regarding the UM claim. On May 30, 2013, the parties agreed to an open extension of the time limit by which Defendant was required to respond to Plaintiff's policy-limits demand for UM coverage. On November 14, 2013, Defendant offered to resolve Plaintiff's UM claim by paying $250,000.00, but Plaintiff did not accept this offer. As noted below, Plaintiff initiated this litigation approximately four weeks later. II. Procedural Background Plaintiff filed this action in Multnomah County Circuit Court on December 16, 2013, and Defendant removed it to this Court on January 16, 2014. In her original Complaint, against Defendant: Plaintiff asserted three claims Plaintiff alleges Defendant breached the insurance contract by refusing to make payments under the UM coverage (Claim One); Plaintiff alleges Defendant's refusal to pay UM benefits violated the Elderly Persons and Person with 4 - OPINION AND ORDER Disabilities Abuse Prevention Act, Oregon Revised Statutes § 124.005, et seq. (Claim Two); and Plaintiff alleges Defendant's actions in denying benefits under the UM coverage breached Defendant's contractual implied covenant of good faith and fair· dealing (Claim Three). On April 23, 2014, the Court dismissed without prejudice Claim Two as premature and with leave to amend if and when the amount of money that Defendant owes to Plaintiff is actually determined. On August 28, 2014, the Court bifurcated the proceedings to allow the parties to litigate Plaintiff's Claim One to conclusion before litigating Claim Three. After an eight-day bench trial the Court found the negligence of Neira, the uninsured driver of the other vehicle, caused Plaintiff personal injuries. In particular, the Court found Plaintiff incurred economic damages in the amount of $1,172,338.04 and noneconomic damages in the amount of $750,000.00 as a result of Neira's negligence. On February 19, 2016, Defendant paid to Plaintiff the $1,000,000.00 UM policy limit. STANDARD Summary judgment is appropriate when there is not a "genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." 5 - OPINION AND ORDER Fed. R. Civ. P. 56(a). The moving party must show the absence of a genuine dispute of a material Rivera v. Philip Morris, Inc., fact. Cir. 2005). 395 F.3d 1142, 1146 (9th See also Emeldi v. Univ. of Or., 673 F.3d 1218, 1223 (9th Cir. 2012). In response to a properly-supported motion for summary judgment, the nonmoving party must go beyond the pleadings and point to "specific facts demonstrating the existence of general issues for trial." Litig., 627 F.3d 376, 387 light one . In re Oracle Corp. Sec. "This burden is not a (9th Cir. 2010). The non-moving party must do more than show there is some 'metaphysical doubt' as to the material facts at issue." Id. (citation omitted). A dispute as to a material fact is genuine "if the evidence is such that a reasonable jury could return a verdict for the nonmoving party." 497 Nigro v. Sears, Roebuck & Co., 784 F.3d 495, (9th Cir. 2015) (quoting Anderson v. Liberty Lobby, Inc., U.S. 242, 248 (1986)). The court must draw all reasonable inferences in favor of the nonmoving party. Inc., 606 F.3d 584, 587 477 (9th Cir. 2010). inferences may be drawn from the facts, Sluimer v. Verity, "If conflicting the case must go to the jury" and summary judgment cannot be granted. Torres v. City of Los Angeles, 548 F.3d 1197, 1206 (9th Cir. 2008) (quoting LaLonde v. County of Riverside, 204 F.3d 947, 959 (9th Cir.2000)). A "mere disagreement or bald assertion" that a genuine dispute as to a material fact exists "will not preclude the grant 6 - OPINION AND ORDER of summary judgment." Deering v. Lassen Cmty. Coll. Dist., No. 2:07-CV-1521-JAM-DAD, 2011 WL 202797, at *2 2011) (citing Harper v. Wallingford, 1989)). 2010). (E.D. Cal., Jan. 20, 877 F.2d 728, 731 (9th Cir. See also Moore v. Potter, 701 F. Supp. 2d 1171 (D. Or. When the nonmoving party's claims are factually implausible, that party must "come forward with more persuasive evidence than otherwise would be necessary." v. Brekka, 581 F.3d 1127, 1137 LVRC Holdings LLC (9th Cir. 2009) (citing Blue Ridge Ins. Co. v. Stanewich, 142 F.3d 1145, 1149 (9th Cir. 1998)). The substantive law governing a claim or a defense determines whether a fact is material. Prod., Inc., 454 F.3d 975, 987 Miller v. Glenn Miller (9th Cir. 2006). If the resolution of a factual dispute would not affect the outcome of the claim, the court may grant summary judgment. Id. DISCUSSION As noted, the parties have filed Cross-Motions for Summary Judgment on Claim One in which they each contend the Court must issue summary judgment in their favor as a result of the Court's Verdict ( #237) . Defendant asserts the undisputed factual record requires the Court to find Defendant did not breach the insurance contract because Defendant did not deny Plaintiff's UM claim and because it paid the $1,000,000.00 policy limit shortly after the Court 7 - OPINION AND ORDER determined Plaintiff suffered damages in excess of that limit. In addition, Defendant contends because the insurance contract specifically contemplated the adjudication of any disagreement between the insurer and the insured regarding the amount of damages and because the parties' disagreement about the nature and extent of Plaintiff's damages was not resolved until the Court returned its Verdict, Defendant did not breach the contract when it waited until after the Court's Verdict to pay the full amount of the policy limit. Defendant, therefore, contends it did not breach the insurance contract and, therefore, it is entitled to summary judgment on Claim One. Plaintiff, on the other hand, contends Defendant's failure to accept Plaintiff's UM claim and to pay the $1,000,000.00 policy limit before Plaintiff filed this action constitutes a breach of the insurance contract. As a result, Plaintiff contends she is entitled to summary judgment on Claim One; a declaration that Defendant breached the insurance contract; prejudgment interest in the amount of $258,169.26, plus $63.65 per day from February 19, 2016; attorneys' Oregon Revised Statute § fees pursuant to 742.061; and an award of expert costs. Plaintiff also seeks a partial, "final" judgment on Claim One pursuant to Federal Rule of Civil Procedure 54(b). I. Breach-of-Contract Claim The UM policy provides Defendant: 8 - OPINION AND ORDER will pay compensatory damages which [Plaintiff] is legally entitled to recover from the owner or operator of an uninsured motor vehicle because of: 1. Bodily injury sustained by [Plaintiff] and caused by an auto accident; and 2. [Property damage] caused by an accident if the Declarations indicates that [property damage] UM Coverage applies. Statement of Agreed Material Facts (#272), Ex. A at 24. The only portion of the UM policy that relates to resolving disagreements among the parties as to UM coverage or the amount of damages provides: If [Defendant] and [Plaintiff] disagree as to: 1. Whether the covered person is legally entitled to recover damages from the owner or operator of an uninsured motor vehicle; or 2. The amount of damages that the covered person is legally entitled to collect from that owner; then, that disagreement may be arbitrated, provided both parties so agree to the arbitration and agree to be bound by the results of the arbitration. However, disagreements concerning coverage under this Part may not be arbitrated. Statement of Agreed Material Facts (#272), Ex. A at 26. "[U]nder well-established principles of contract law, a contract action cannot be maintained . been breached." 296 (1996). . until the contract has Vega v. Farmers Ins. Co. of Oregon, 323 Or. 291, An insurer breaches the insurance contract "when the insurer denies a claim for UM/UIM benefits, thereby refusing to honor a promise to pay such benefits." 9 - OPINION AND ORDER Id. See also Pritchard v. Regence Bluecross Blueshield of Oregon, 225 Or. App. 455, 460 (2009). As noted, the UM policy in this case imparts on Defendant the duty to pay Plaintiff's UM claim in the event Plaintiff would be entitled to recover from an uninsured motorist compensatory damages caused by an automobile accident. Thus, under Vega if Defendant breached its duty to pay Plaintiff's UM claim as she asserts, that breach could only occur when Defendant denied Plaintiff's UM claim in whole or in part. As noted, it is undisputed that on May 30, 2013, the parties agreed to an open extension of time in which Defendant was required to respond to Plaintiff's policy-limits demand for UM coverage. It is also undisputed that on November 14, 2013, Defendant offered to resolve Plaintiff's UM claim by paying $250,000.00, but Plaintiff did not accept that offer and instead filed this action on December 16, 2013. Moreover, the parties did not invoke the arbitration provision in the UM policy. Plaintiff, however, does not point to any portion of the record that establishes either as a matter of undisputed fact or creates a genuine issue of material fact as to whether Defendant actually denied Plaintiff's UM claim in whole or in part in violation of the policy terms. Instead the record indicates Plaintiff and Defendant were actively engaged in negotiating Plaintiff's UM claim from April 8, 2013, until December 16, 2013, when Plaintiff filed this action. 10 - OPINION AND ORDER In particular, because Plaintiff and Defendant agreed to an open-ended extension of time for Defendant to respond to Plaintiff's policy-limits UM demand, Plaintiff fails to establish as a matter of fact or law that Defendant denied her UM policy-limits claim when it failed to pay the policy limit before Plaintiff filed this action. Instead, by filing this action in December 2013, the Court concludes Plaintiff effectively short-circuited the claims process before the expiration of the open-ended time extension for Defendant to state a final position on Plaintiff's policy-limits demand for UM coverage. In its February 3, 2016, Verdict, the Court resolved the disputed issues arising from the unresolved claims in that process by finding the damages caused by Neira exceeded the policy limit. That Verdict, however, did not establish any breach of the insurance contract. Accordingly, although the parties now agree Defendant was required to pay the full limit of the UM claim upon receiving the Court's Verdict, Defendant did not breach the contract because it did not deny Plaintiff's UM claim in whole or part and because Defendant has now paid the $1,000,000.00 UM policy limit. On this record, therefore, the Court grants Defendant's Motion for Summary Judgment as to liability on Claim One and denies Plaintiff's Motion for Summary Judgment as to liability on Claim One. For the same reasons, the Court denies Plaintiff's 11 - OPINION AND ORDER request for a partial final judgment as to Claim One under Rule 54 (b) . II. Prejudgment Interest Plaintiff moves for an order granting prejudgment interest in the amount of $258,169.26, plus $63.65 per day from February 19, 2016. Defendant, on the other hand, contends Plaintiff is not entitled to prejudgment interest because Defendant did not breach the contract; the insurance policy does not provide for the payment of any prejudgment interest; and, in any event, prejudgment interest is inappropriate under Oregon law because the exact amount and the time from which interest would accrue are not "ascertained or easily ascertainable." Precision Seed Cleaners v. Country Mut. 1228, 1257 Ins. Co., See, e.g., 976 F. Supp. 2d (D. Or. 2013) (citing Farhang v. Kariminaser, 230 Or. App. 554, 556 (2009)). Plaintiff is not entitled to prejudgment interest under the breach-of-contract theory underlying Plaintiff's Claim One because, as noted, the Court has determined Defendant is entitled to summary judgment as to Claim One. In any event, there is not any authority in the UM policy that authorizes an award of prejudgment interest when the Court has granted summary judgment as to Claim One in favor of Defendant. Accordingly, on this record the Court concludes Plaintiff is not entitled t.o prejudgment interest as to Claim One. 12 - OPINION AND ORDER III. Attorneys' Fees The parties agree Plaintiff is entitled to attorneys' fees pursuant to Oregon Revised Statute § 742.061. The parties disagree, however, regarding the extent of attorney services for which Plaintiff may recover attorneys' fees under § 742.061 for her Claim One. The Court concludes the parties' dispute in this respect is premature. Although the parties are correct that attorneys' fees pursuant to § 742.061 apply only to the litigation of Claim One, the Court concludes the issue of attorneys' fees as to Claim One is likely to overlap with similar issues in the event that Plaintiff prevails on the remaining claims. The Court, therefore, concludes Plaintiff's current claim for attorneys' fees should be resolved in the ordinary course after entry of a final judgment that resolves all of the issues in this litigation. IV. Expert-Witness Fees In a Request for Admissions Plaintiff requested Defendant admit the automobile accident that gave rise to this case caused 41 different medical conditions. Plaintiff moves for expert- witness fees under Federal Rule of Civil Procedure 37(c) (2) on the basis that Defendant's failure to admit any medical conditions were caused by the automobile accident required Plaintiff to call expert witnesses at trial in order to establish 13 - OPINION AND ORDER causation. Rule 37 (c) (2) provides: (2) Failure to Admit. If a party fails to admit what is requested under Rule 36 and if the requesting party later proves a document to be genuine or the matter true, the requesting party may move that the party who failed to admit pay the reasonable expenses, including attorney's fees, incurred in making that proof. The court must so order unless: (A) the request was held objectionable under Rule 36(a); (B) the admission sought was of no substantial importance; (C) the party failing to admit had a reasonable ground to believe that it might prevail on the matter; or (D) there was other good reason for the failure to admit. At trial the Court heard a significant amount of contested medical testimony from both sides regarding the many medical conditions that Plaintiff alleged were caused by the automobile accident, including significant disputed evidence as to a hydrocephalus condition that caused the majority of Plaintiff's damages and a cervical-spine injury that required significant treatment, including surgery. Indeed, of the $372,338.04 that the Court found Plaintiff incurred in past medical expenses, $307,600.20 were incurred to treat Plaintiff's hydrocephalus and cervical-spine injury. Although the Court ultimately concluded Plaintiff had proven causati6n and damages in the amounts included in the Verdict, 14 - OPINION AND ORDER that finding was made only by a preponderance of the evidence and in the face of credible evidence to the contrary presented by Defendant. In fact, the Court noted at the end of trial: Literally, this record is capable of variety of factual conclusions; none of which could be overturned by an appellate court because there is factual support for the theories both sides are advancing. I'm not saying that as a threat or as an incentive but an observation. Tr. of Proceedings (#262) at 12. Thus, as to Plaintiff's hydrocephalus and cervical-spine injury, the Court concludes Defendant "had a reasonable ground to believe that it might prevail on the matter." See Fed. R. Civ. P. 37(c) (2) (C). To the extent that Plaintiff seeks expert-witness fees as a result of Defendant's refusal to admit the accident caused the other 39 conditions, the Court declines to issue such fees because the vast majority (if not all) of the expert testimony at trial related to Plaintiff's hydrocephalus and cervical-spine injury and, therefore, "the admission[s] sought was of no substantial importance." See Fed. R. Civ. P. 37 (c) (2) (B). Accordingly, on this record the Court denies Plaintiff's request for expert-witness fees. CONCLUSION For these reasons, the Court GRANTS Defendant's Motion (#274) for Summary Judgment as to Plaintiff's First Cause of Action for Breach of Contract; DENIES Plaintiff's Motion (#283) 15 - OPINION AND ORDER for Partial Summary Judgment on Breach of Contract, Attorney Fees, Expert Costs, and Prejudgment Interest; and DENIES Plaintiff's request for a partial final judgment on Claim One pursuant to Federal Rule of Civil Procedure 54(b). IT IS SO ORDERED. DATED this 14th day of October, 2016. United States District Judge 16 - OPINION AND ORDER

Disclaimer: Justia Dockets & Filings provides public litigation records from the federal appellate and district courts. These filings and docket sheets should not be considered findings of fact or liability, nor do they necessarily reflect the view of Justia.


Why Is My Information Online?