Insured loses fight with State Farm over head injury medical expenses
Adia Blacksher and McLaren Hospital sued Blacksher's auto insurer, State Farm, after State Farm refused to pay PIP benefits arising out of Blacksher's head injury. Blacksher was invovled in two car accidents, in February and April of 2007, and claimed to have continuing head injury issues. Her doctors agreed and provided what they deemed to be appropriate care. State Farm rejected payment of the bills, however, and hired "Independent" Medical Consultant doctors to perform examinations of Blacksher and her records. Not surprisingly, the doctors trusted by State Farm for an "independent" examination, came to the anticipated opinion that Blacksher's symptoms were magnified and not auto-related.
The case went to trial and resulted in a verdict for the insurer, with the jury reimbursing Blacksher only $8,000.00 of medical expense. The attorneys for Blacksher appealed, arguing that the result was against the great weight of the evidence. The Court of Appeals reviewed the testimony and concluded that there was sufficient evidence from the IME doctors and the medical charting to support the jury's conclusion that the bulk of Blacksher's treatment was not "reasonably and necessarily" related to the car accidents.
The Court held that the jury could have accepted the insurance IME doctors' opinions that Blackher's head injury symptoms should have disappeared within weeks. It also held that a damage verdict need not comport, precisely, with the exact expenses or billings incurred. The Court also held that State Farm was properly denied sanctions even though Blacksher was awarded far less money than she sought: given the testimony of her doctors, there was ample grounds for the claims Blacksher made.