Court upholds $90,000.00 fee award against Farm Bureau for unreasonable delay in paying benefits
Daniel Bamm was injured in a motor vehicle collision. All three of his treating doctors agreed that his newly-identifed herniated discs were caused by the accident, however Farm Bureau refused to pay the related Personal Injury Protection (PIP) benefits, claiming that his back problems predated the collision. Ultimately, the jury found that the back problems were related to the collision, and the trial judge hit Farm Bureau with $90,000.00 in attorney fees, finding that it "unreasonably delayed payment" of benefits. The Court of Appeals upheld this award.
The Court rejected Farm Bureau's claim that it was reasonable to delay payment because there was a factual uncertainty about the origin or etiology of Bamm's back problems. The Court noted, however, that Farm Bureau delayed in ordering Bamm's medical records, then refused to accept the opinions of his doctors, and then delayed unreasonbly in securing a defense medical examination by its own doctors. The opinion also noted that the "IME" when performed, was ambiguous and did not really contradict the treaters: rather it rejected medical causation based on the Defense doctor's assessment of the credibility of Bamm's medical history.
Given the statutory obligation to pay benefits within 30 days of receiving reasonable proof, the Court of Appeals concluded that the No Fault fee statute applied and it was appropriate to make Farm Bureau pay the injury victim's attorney.