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from our blog
February 16, 2014
Hospitals all over the country are starting to come across a problem they didn’t even know they had: pneumonia caused by poor oral hygiene. It has been known for a long time that patients on ventilators are at a drastically increased risk of pneumonia, and as such, hospitals are legally required to watch for signs […]
Well that’s what two of their insurance policy holders think. Here is an example of the type of insurance bad faith claim I routinely handle. The case involves Nationwide Insurance and highlights the poor treatment that two insurance policy holders received from them…
“At the beginning of a long awaited family trip to Idaho in September of 2006, a Nationwide Insurance policy holder and her mother were the victims of a high-speed, hit-and-run collision. Both were forced to file an uninsured motorist claim with their insurance company, Nationwide Insurance Company of America / Allied Insurance Company. Based upon their experience, it was their opinion that the advertising slogan of “Nationwide on Your Side” may be an effective marketing campaign with no substance when a valid claim is attempted to be resolved by those who pay premiums to Nationwide Insurance Company.
Just a few miles from the Phoenix, Arizona (Sky Harbor) airport, a vehicle traveling approximately 90-95 miles per hour smashed into the back of their vehicle, and fled the scene of the collision. The vehicle suffered over $10,000.00 in property damage and both were injured. Because this family trip had been planned for several months and was extremely important for not only them, but their family (The injured mother had two daughters taking the trip besides her injured daughter) as well, they attempted to continue on with the family trip as planned. Shortly after arriving in Idaho, because the pain became so severe, they sought treatment at an Idaho Urgent Care facility. At that time, the daughter’s main problem was noted as neck and low back pain. Her mother suffered from pain in her neck, back, and right shoulder. The Urgent Care doctor prescribed anti-inflammatory and pain medication for both of them and instructed them to follow up with their primary care physician when they returned home to Arizona. Both followed up with their primary care physician at the Mayo Clinic and Hospital. The injured mother suffered from severe low back pain for over two years and tried multiple rehabilitative efforts including therapy, modalities, manual techniques, exercise instruction, and SI joint injections. She, to this day, continues to suffer from severe low back pain which at times radiates down her right side. She incurred approximately $6,000 in medical expenses because of treatment related to this incident.
Prior to this collision, she was an extremely healthy, active, and independent 82-year old mother, grandmother, and great-grandmother. Sadly, she not only lost her health and activity, but her independence. She regularly volunteered at a local elementary school and assisted one of the first grade teachers. This volunteer work was incredibly important to not only her, but also to all the children. Following the collision, she tried to assist with her first-grade class but was unable to do so because of the severe back pain.
The daughter suffered from cervical pain, pain in the mid to low thoracic area, and increasing pain and instability to her left knee. She had extensive treatment including prescription medication, physical therapy, and two surgeries on her left knee. She incurred approximately $38,000.00 in medical expenses because of the treatment related to this incident.
Nationwide Insurance Company assigned adjuster Courtney Martin to handle the uninsured motorist claim. Nationwide refused to consider the injuries to the daughter’s knee as part of the claim. Nationwide also refused to explain the factual or legal basis for its position and during the claim, Ms. Martin misrepresented conversations she had with both insureds.
On November 28, 2007, Nationwide offered the daughter $8,190.00 to settle the personal injury claim and $6,194.00 to settle the mother’s personal injury claim. Ms. Martin represented that these offers were based, at least in part, on Nationwide’s use of a nurse practitioner evaluation. Despite multiple requests, Nationwide refused to put the factual and legal basis for its evaluations in writing and refused to disclose the nurse practitioner report upon which it apparently relied. Instead, on February 26, 2008, Nationwide increased the offers to $12,660.36 for the daughter and $9,471.46 for the mother respectively. Again, Nationwide refused to disclose to its insureds the basis for these offers and its change in position. Thus, Nationwide Insurance Company’s insureds were forced to request arbitration pursuant to their insurance contract with Nationwide Insurance Company.
Nationwide Insurance Company’s insureds requested arbitration on March 12, 2008, but Nationwide did not provide the name of its attorney until June 9, 2008 or its arbitrator until June 16, 2008. As part of the arbitration process, Nationwide hired a well-known defense medical examiner, Dr. Ronald Lampert, to examine and issue a negative report against the daughter. Dr. Lampert issued his standard report calling the daughter a “symptom exaggerator.” Dr. Lampert testified on behalf of Nationwide during the arbitration hearing. Dr. Lampert claimed to have performed testing on her that the arbitrators determined did not take place during his examination. Luckily, the examination was videotaped.
Interestingly, a couple days prior to the scheduled arbitration hearing on October 23, 2008, Nationwide presented, once again without any explanation as to the change in its evaluation, an offer that was nearly twice what it had previously offered on these claims. The arbitration was completed on October 23, 2008.
Nationwide’s Insured (the injured mother) was awarded $106,000.00.
Nationwide’s Insured (the injured daughter) was awarded $163,000.00.
In addition, Nationwide Insurance Company paid $30,000.00 and $55,000.00 respectively for extra-contractual, insurance bad faith damages.”
Warning: Case decisions are often subject to further review by other courts and thus may be affirmed, overturned, or modified in later proceedings; therefore the reader should exercise caution in the reading and interpretation of these cases as the current status of case law and/or statutory law may have changed by the time you read this. Please consult with a licensed attorney in the proper jurisdiction before you take any action based on what you read on this or any other website.