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In Miezejewski v. Infinity Auto Ins. Co., the insured was injured in an auto accident, and not only suffered physical injury, but alleged her physical condition deteriorated over time, causing her to be laid off.  She claim that the carrier’s claim evaluation was too low, and failed to consider lost wages.  The carrier sought partial summary judgment on the statutory bad faith claim.

The insured claimed the carrier’s investigation was done in bad faith; specifically in failing to review the first party medical file, not requesting permission to speak with the plaintiff, and not reviewing any of the pre-accident medical records. The court rejected these arguments.  The plaintiff failed to make any clear argument as to how review of those documents would have made any difference in the defendant’s valuation.

Plaintiffs had provided the defendant with extensive medical records related to the accident, and there was nothing before the court indicating that they even sought to have the first-party file reviewed; nor did they offer anything to show what was included in that file or how it would have affected the adjustors determination.

Quoting earlier Middle District case law, citing Pennsylvania’s Superior Court, previously summarized on this site: “A plaintiff in a bad faith claim must show that the outcome of the case would have been different if the insurer had done what the insured wanted done.”

The “record contained no evidence that the plaintiffs communicated this desire to the defendant or any indication of how those records would impact the valuation of the claim, this argument fails.”

Next, the court turned it attention to the argument that it is bad faith for the defendant not to request permission to speak with the plaintiffs.  However,  the defendant did speak with plaintiffs’ counsel and knew plaintiffs’ position via their attorney.  The insureds failed to articulate a reason or cite a case in support to explain how this failure demonstrates bad faith.

They were represented by counsel throughout the claim process and counsel regularly communicated with the defendant. If they wished to testify in support of their position that that the settlement offers were too low, there was nothing in the record indicating the carrier would have refused the request.

The court then added that the adjustor was in fact continually asking for additional information. And again, the plaintiffs failed to articulate how this would have altered the defendant’s evaluation or offer. “Failure to request permission to speak with the plaintiffs does not constitute bad faith in this case.”

As to the pre-accident medical records, there was abundant evidence the carrier requested this information from the plaintiffs, which were not provided; and even if reviewed would have only revealed the injured plaintiff’s pre-existing conditions. “As with the previous two allegations of an inadequate investigation, the failure to review pre-accident records that were requested by the defendant, but not provided by the plaintiffs, does not indicate bad faith.”

Even combining these three factors was not bad faith: “There is no legal requirement that insurance companies conduct perfect investigations. ‘An insurance company simply must show it conducted a review or investigation sufficiently thorough to yield a reasonable foundation for its action.’”

The final issue was the failure to include the wage loss claim. The plaintiffs claimed that the supervisor’s testimony conclusively established bad faith as “uncontroverted evidence” that plaintiff lost her job because of injuries stemming from her car accident. They also claimed that the insurer raised the settlement offer at the initiation of the suit with no change in facts.

The court observed a change in fact that could justify the later.  As to the former, there were other potential physical issues that could have affected the inability to work, and the carrier was deemed reasonable in investigating these issues to value the claim, and not simply concluding that the plaintiff’s deterioration and termination was solely from the accident.  Once re-evaluated, it was reasonable to raise the settlement offer.  In sum, there was no bad faith here either.
Date of Decision January 22, 2014

Miezejewski v. Infinity Auto Ins. Co., NO. 3:12-1000, 2014 U.S. Dist. LEXIS 7425 (M.D. Pa. January 22, 2014) (Mannion, J.)

This decision was affirmed on appeal.