Confidential
Settlement – $75,000Judge
Court
Orange Superior
Attorneys
Plaintiff
Facts
The plaintiff was injured in an accident in the City of Santa Ana, when the vehicle in which she was a passenger was hit in an intersection by a third party (underinsured motorist) who had entered the intersection against a red traffic signal. The claim against the third-party motorist was settled for the full policy limit of $25,000. After the resolution of the third party claim, the plaintiff began further discussions with her UIM carrier for the portion of her coverage above $25,000, up to and including her policy limits of $100,000. Her UIM carrier assigned and reassigned the claim file to a series of seven adjusters. The plaintiff's initial claim letter included a demand package with detailed health care provider information and employment information and requested a list of all other information her carrier required in order to review the UIM claim. Each adjuster requested supplementary information before they, too, abandoned the file to the next-in-line adjuster. On Aug. 18, 2003, the UIM carrier offered $15,000 new money to settle the plaintiff's claim despite the fact that the plaintiff had incurred and submitted $54,358 in medical bills as well as documented wage loss of $16,608. The plaintiff's UIM carrier refused to comply with specific written requests to tender payment of the undisputed portion of the plaintiff's claim in accordance with California Code of Regulations (Fair Claims Settlement Practices Regulations, Standards for Prompt, Fair and Equitable Settlements), Title 10, Chapter 5, Subchapter 7.5, Section 2695.7 (h). The plaintiff's UIM carrier never tendered the undisputed portion of the claim. The defendant ultimately referred the matter to defense counsel to initiate binding arbitration of the UIM claim. Before a demand for arbitration was served, the UIM carrier tendered an offer for the full policy limits of $75,000. The offer was accepted, without waiver of the plaintiff's claim for breach of contract or extra contractual damages.
Specials in Evidence
$54,358 $16,608
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