Attorneys Jeremy Sitcoff and Dan Caplis on Oct. 18 scored a seven-figure win for their client, when a jury ruled against insurer Cincinnati Casualty Company in Denver District Court. While the final amount is still being calculated, they expect an award of more than $3 million for breach of contract, bad faith and unreasonable delay or denial of benefits to plaintiff Alex Headley.
In Oct. 2013, Headley, an Aurora resident, was involved in a high-impact car crash on I-25 in Castle Rock while driving a vehicle owned by his employer, Patriot Plumbing. The company car was insured under a Cincinnati policy that provided $1 million in underinsured motorist coverage. Another driver, Kelsey Meyer, had fallen asleep at the wheel and was determined to be at fault in the multi-car collision. Meyer was covered for up to $1.25 million for bodily injury under policies from Allstate at the time of the accident.
After the accident, Headley was treated for back pain and other symptoms, first through physical therapy, injections and oral steroids and, eventually, he underwent three surgeries.
Headley made a bodily injury claim against Meyer soon after the accident and, while waiting for a settlement with Allstate, started talking with Cincinnati about a UIM claim in 2014. Headley later settled with Allstate for an amount within the limits of Meyer’s policies, but he continued to pursue the UIM claim with Cincinnati since his total losses — including medical bills and lost wages — exceeded $1.25 million. The dispute went unresolved and Headley filed a lawsuit against Cincinnati in February 2018, alleging breach of contract, bad faith breach of insurance contract and unreasonable delay or denial of benefits.
Although Sitcoff and Caplis said they didn’t get a chance to speak to any of the jurors after the eight-day trial, they had some ideas about what might have swayed them.
Caplis, founding partner at Dan Caplis Law, said he thinks one of the key points working in his client’s favor during the trial was the fact that Cincinnati put no value on the UIM claim, rather than offering some money, even if it was less than the full policy limit of $1 million Headley was seeking.
Sitcoff, a shareholder at Levin Sitcoff, agreed and said another important factor in their success was that, according to an evaluation by Cincinnati, the insurer relied on the word of an independent medical exam doctor who only saw Headley briefly in September 2017 to determine whether his medical costs and procedures were necessary.
“They completely relied on what that doctor said,” Sitcoff said, adding the company didn’t consider the opinions of Headley’s neurosurgeon, who had been treating him since 2014 and performed his three surgeries.
Caplis said the testimony by Headley’s treating neurosurgeon, his treating physiatrist and insurance industry expert Garth Allen were important to the case.
In its answer to Headley’s complaint filed in March 2018, Cincinnati claimed Headley’s injuries were at least partly the result of pre-existing conditions or intervening causes.
The insurer also said in the answer, “It is fairly debatable whether or not Plaintiff’s damages exceed Allstate’s underlying $1,250,000 liability insurance limits.” Additionally, the carrier claimed that Headley had breached his policy by “failing to provide prompt and full disclosure of his medical records and bills” to the company.
In April 2016, soon after Headley had hired counsel, his lawyers requested the insurer open a medical payments coverage claim, according to the lawsuit.
In response, Cincinnati requested wage loss documentation, doctor reports and other medical information. According to the complaint, as of February 2017, Headley had supplied documentation showing medical costs and assessments of lost wages exceeding $1.25 million and asked Cincinnati to pay the $1 million in UIM benefits available under the company’s policy.
The complaint said the insurer continued to request additional documentation, most of which had already been provided and served to delay evaluation of Headley’s claim. In its answer, Cincinnati denied receiving all the necessary documentation prior to December 2017.
“I think one overriding theme of ours in the trial that I think really was important in the end is: You should not have to hire a lawyer to get your insurance claim paid in full,” said Caplis, adding that Headley had been dealing with Cincinnati for two and a half years before he hired an attorney.
“Until he hired an attorney, they didn’t even request his medical records,” he said. “So, I think an important message that we were sending at trial — and the jury made its own very strong statement – is that you shouldn’t have to hire and pay a lawyer to get your insurance benefits paid.”
Sitcoff said the total amount of the award has yet to be finalized as they plan to file motions to cover attorney fees and costs, but because they prevailed on their claim under Colorado’s unreasonable delay/denial statute, Headley is entitled to “three times the $1 million in benefits the jury determined was denied or delayed [to him].”
“I think it’s accurate to say that it’s a judgment in excess of $3 million,” Sitcoff said.
In an e-mail, Colin Campbell, counsel for Cincinnati, said the insurance company “appreciates the court hearing Cincinnati’s case, and that Cincinnati respects the jury’s verdict.” Campbell, of Campbell Wagner Frazier and Dvorchak, said his client is “evaluating its next steps and is considering whether to take the process through an appeal.”
— Jessica Folker, [email protected]