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Jury punishes family that was sloppy in documenting attendant care expenses

This week, the Court of Appeals decided to publish its prior opinion in Ramona Thomas v. State Farm Mutual Automobile Insurance Company, most likely at State Farm's request.  It is likely that State Farm wanted to secure maximum public attention to the decision, in order to deter or intimidate other families with significant, long-term PIP claims.

The case arises out of horrific injuries suffered by Ramona Thomas' son, John Gentris, who was struck by a car.  Gentris was left with an "essentially dysfunctional" left side, a severe head injury requiring 24-hour supervision and the need to wear various orthotic devices to support the joints of his left arm and leg.  State Farm did not dispute Gentris' injuries or his need for 24 hour care.  It argued, however, that the family did not always provide the care it alleged in monthly reports.  It paid an investigator to surveil the family and documents several days when the parents who billed for supervision were not with John. 

The mother, Ramona, explained that she filled out her monthly reports based on her normal routine and that there were occasions when she did not recall variations in routine.  It also appears that she often relied upon other persons to provide the supervision and care for John, without designating them as providers in State Farm's forms.  There were also several quite prejudicial facts associated with the Thomas' absence that came into evidence.

In any event the jury did not award the family any attendant care benefits; the jury either concludied that the Thomases did not provide the care they alleged, or that they had not documented their care sufficiently to meet their burden of proof.  State Farm then asked the Court to award it over $100,000.00 in attorney fees and $50,000.00 in costs under the Judge's discretionary power to award fees where fraudulent or unreasonably excessive no fault PIP claims have been pursued by an injured claimant.

The trial judge rejected the fee request, finding that it was not merited because there was no dispute over John's need for the services.  He also refused to award costs, finding that State Farm had not complied with the Court Rule governing the award of costs.  On appeal, the Court of Appeals reversed the lower court ruling.  It send the case back for the Court to reconsider.  The appellate panel held that the lower court judge needed to consider not only whether services were justified, but also whether Ramona's claim was "fraudulent or excessive."  It also held that while some $33,000.00 worth of costs sought by State Farm were excessive and illegal, the Court needed to consider the request for the remaining $17,000.00 in costs.


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