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UIM Claim Results in Bad Faith Punitive Damages Verdict (PA)

February 18, 2016

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The case of <em><a href="http://blog.wcmlaw.com/wp-content/uploads/2016/02/Clemens-v.-NYCM-Verdict-PDF.pdf" rel="">Bernie Clemens and Nichole Clemens v. New York Central Mutual Fire Insurance Co</a></em> began on August 26, 2009 when Bernie Clemens sustained back and neck injuries as a passenger in a car rear-ended by an underinsured motorist.  He settled with the tortfeasor for her $15,000 policy limit and sought coverage from the UIM carrier for the vehicle in which he had been riding.
The accident occurred in Mount Pocono, Pennsylvania.  The insurer, New York Central Mutual Fire Insurance Co. was located in Liberty, New York.  Although the UIM coverage was $50,000, under New York law, only $35,000 was available above to Clemens above the amount he had received from the tortfeasor.  New York Central Mutual initially offered Clemens $7,000 based upon information that Clemens was not wearing a seat belt at the time of the accident.  The insurer justified this on the basis of a New York law that this failure was evidence of comparative negligence.
As the claim progressed, various conflicts arose between Clemens and the carrier. While the carrier wanted Clemens to travel to its offices 80 miles away from his home to give a statement, Clemens insisted that the adjuster come to him in Pennsylvania.  Additionally, Clemens balked at giving HIPAAs for records that he had provided to the insurer.
Clemens filed suit against New York Central in federal court.  While the UIM claim ultimately settled for $25,000, the claim for bad faith claim proceeded to a five day trial. Clemens alleged that in the process of handling the UIM claim, New York Central committed bad faith in a number of ways, including pressuring claims adjusters to pay less on valid claims, requesting signed authorizations without actually making specific requests, and demanding that Clemens travel to New York Central offices to make a statement under oath. Clemens relied upon an insurance expert who was allowed to testify as to the ultimate issue in the case, i.e. New York Central committed bad faith in its handling of the claim.
For its part, New York Central argued that Clemens committed bad faith in refusing to travel to their offices to make a statement, and further claimed that Clemens was deliberately trying to set up New York Central for the bad faith claim. After four hours of deliberation, the jury awarded Clemens $100,000 in punitive damages.
Thanks to Melanie Brothers for her contribution.
For more information contact Denise Fontana Ricci at <a href="mailto:dricci@wcmlaw.com">dricci@wcmlaw.com</a>.
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