Court of Appeals affirms more than $150,000 dollars in fees and costs where State Farm unreasonably denied PIP benefits to head-injured insured
In Morales v. State Farm, a panel of the Court of Appeals unanimously approved a jury verdict awarding more than $300,000.00 in PIP benefits to the head-injured plaintiff. It also approved substantial fees and costs imposed by the the trial court, after the judge found that the PIP benefits had been "unreasonably denied". State Farm had argued that Morales' disability and medical needs were unrelated to a 2002 motor vehicle collision in which he suffered a closed head injury.
While State Farm had consulted with physicians, it did not call as a witness the IME doctor who had suggested that Morales did not suffer a head injury. It did call a cardiologist as an expert witness--and he claimed to see no evidence of head injury; however, this doctor acknowledged he was not a specialist in head injuries and would defer to such a specialist.
State Farm argued unsuccessfully that its claims procedure was not properly admitted into evidence, and that this evidence was "more prejudicial than probative". The Court of Appeals disagreed on both counts, and one might say that State Farm was "hoisted by its own petard".