Now Your Insurance Has To Pay You Piecemeal Benefits if Need Be (A Way They Hate the Most)

Now Your Insurance Has To Pay You Piecemeal Benefits if Need Be (A Way They Hate the Most)

 Posted by:    May 26, 2015  


uim-car-insuranceThe uninsured/underinsured motorist statute found in our Colorado State laws at C.R.S. § 10-4-609, mandates that an insurance company must evaluate their insured’s loss and pay the claim when due. Furthermore, C.R.S. § 10-3-1115/1116 provides for a penalty against an insurance company if that company unreasonably delays or denies a covered benefit when due. Nonetheless, whether an insurance company had an obligation to pay piecemeal benefits remained unsettled until May 7, 2015 when the Colorado Court of Appeals issued its decision in Fisher v. State Farm Automobile Insurance Company, 13 CA 2361. Insurance companies hate the idea of paying part of a claim, and then having to pay more when more damages/losses are incurred or substantiated. They prefer the leverage associated with holding undisputed money ransom until a policyholder capitulates and accepts less to resolve an entire claim forever. Therefore, the Fisher case is groundbreaking.

In February of 2010, Dale Fisher was injured in a motor vehicle collision. The person who caused the auto accident with Mr. Fisher had only a $25,000 automobile insurance policy. Fortunately, Mr. Fisher had underinsured motorist coverage under several automobile insurance policies, all with State Farm, for a combined value of $400,000. In September of 2010, Fisher presented his claim to State Farm for uninsured benefits totaling $1.35 Million of damages, which he claimed were incurred as a result of the motor vehicle collision. In February of 2011, State Farm offered to settle Fisher’s UIM claim against it for only $59,572.10. In July of 2011 Fisher filed a Complaint against State Farm alleging, that State Farm had not paid him any uninsured motorist benefits and that it was an unreasonable delay or denial for them not to have paid benefits in violation of C.R.S. § 10-3-1115. At the end of trial, the jury returned a verdict for Fisher and against State Farm in the amount of $780,572. However, the jury also found that State Farm was unreasonable in delaying payment to Fisher for medical expenses totaling $61,125.16. The trial court entered a judgment for Fisher and against State Farm for the $400,000 uninsured motorist limits plus $122,250.32, constituting the statutory penalty doubling the $61,125.16 in medical benefits that the jury found to have been unreasonably delayed.

underinsured motorist accident lawyer

On May 7, 2015, the Colorado Court of Appeals rejected State Farm’s argument that its failure to pay Fisher’s medical benefits cannot have been unreasonable because State Farm was not legally required to pay Fisher’s UIM claim on a piecemeal basis. The court ruled that neither the statute nor their policy requires that all the claims be established beyond reasonable dispute before a duty to pay some of the claim that is not reasonably in dispute arises. The court further found that it was undisputed that Fisher’s medical expenses for injuries he incurred from the accident were a “covered benefit” under the UIM policy, and notwithstanding the fact that the remainder of Fisher’s UIM claim was for damages other than medical expenses, the court found that under the plain language of C.R.S. § 10-1-1115, State Farm had a duty to not unreasonably delay or deny payment of Fisher’s medical expenses. The court ultimately reasoned that State Farm was legally obligated to not unreasonably delay or deny payment of Fisher’s medical expenses notwithstanding that other components of his UIM claim that may have been subject to reasonable dispute.

The Fisher decision means that in first party claims against your own insurance company, the insurance company has a duty to evaluate any undisputed portion of your claim and pay, if need be, piecemeal. How this is manifestly better for consumers than before the Fisher case is that oftentimes people suffer great financial losses during the pendency of their personal injury claims. It has often been the case that severely injured people take less in settlement value because it is abundantly clear that if they do not, the insurance company will utilize additional delay tactics that can result in financial ruin for the injured insureds. As made clear in Fisher, these stall tactics will no longer be tolerated. Furthermore, Fisher provides support for the standard that insurance companies should promptly resolve and pay on undisputed portions of claims, and then pay the remaining benefits following the submission of additional documentation. The court specifically found that the piecemeal payment of policies in these circumstances was not only warranted, but it would be an unreasonable delay of benefits to not do so.

The Fisher case is groundbreaking on a number of fronts, but the erosion of the insurance company’s virtual chokehold on what has been considered legally mandated delay tactics have been put in checkmate by the Fisher v. State Farm decision.

CONCLUSION:
At Anderson, Hemmat & McQuinn we know that it is important to understand complex legal issues such as UM/UIM coverage. Not understanding UM and UIM coverage can potentially cost you thousands if you are making a claim for injuries. If you have been injured in a car crash and you have questions about your UM/UIM coverage and how that coverage can compensate you, please call and speak with one of our Denver underinsured accident injury attorneys today.









Current Post Comments


Quick & Easy Contact

Are You a Robot? - Help

Review Us Online

Review Anderson Hemmat & McQuinn on Google Plus
Review Anderson Hemmat & McQuinn on Facebook
Review Anderson Hemmat & McQuinn on Lawyers.com
Review Anderson Hemmat & McQuinn on Yelp
Review Anderson Hemmat & McQuinn on AVVO
Talk to Anderson Hemmat & McQuinn Past Clients

Firm Associations

  • Featured in Super Lawyer Magazine
    Featured in Super Lawyers
  • AV Preeminent Rating 2017
    AV Peer Review Rated
  • Colorado Supreme Court
    Colorado Supreme Court
  • AVVO Rated Law Firm
    AVVO 10.0 Rated Law Firm
  • Colorado Trial Lawyers Association
    Colorado Trial Lawyers Association
  • Colorado Bar Association
    Colorado Bar Association
  • National Trial Lawyers
    National Trial Lawyers Association
  • American Association for Justice
    American Association for Justice
  • American Institute of Legal Counsel
    American Institute of Legal Counsel
  • Find Law
    Featured on Find Law
  • ASLA
    American Society of Legal Advocates
  • CATL
    Class Action Trial Lawyers Association
  • Rue Rated Attorneys
    Rue Rated Attorneys
  • Justia
    Justia Member
  • Million Dollar Advocates Forums
    Million Dollar Advocates Forums
  • lawyers.com
    Featured on www.lawyers.com
  • NAOPIA
    National Academy of P.I. Attorneys
  • NOLO
    NOLO
  • hg.org
    Featured on www.hg.org
  • Top American Lawyers Association
    Top American Lawyers Association
  • Best Law Firms of America
    Best Law Firms of America
  • Trial Masters
    Trial Masters Member

Blog Post Archive

INJURY LAW UPDATES

Captcha Image
Anderson, Hemmat & McQuinn
5613 DTC Pkwy #150 Greenwood Village , CO 80111
Phone: (303) 782-9999

The information on this website is for general information purposes only. Nothing on this should be taken as legal advice for any individual case or situation. This information on this website is not intended to create, and receipt or viewing of this information does not constitute, an attorney-client relationship.

Copyright © Anderson, Hemmat & McQuinn | By +Chad Hemmat | Denver Accident Injury Attorneys | Personal Injury Blog | About Anderson, Hemmat & McQuinn | Privacy

Anderson Hemmat Logo

Secure Client Area Login




Lost your password? Click here to reset it...

Anderson Hemmat Logo

Reset Your Password