Therapists' appeal of $56,000.00 attorney fee award to State Farm is substantially rejected; IME testimony renders treatment "unreasonable."
State Farm refused to pay for about $60,000.00 in physical therapy provided to a no fault insured named Roger Bonds. The therapists filed their own PIP claim against State Farm; jurors held that although Bonds was hurt in the wreck, the therapy wasn't reasonably necessary for treatment of his car wreck injuries between August of 2010 and March of 2012 (after State Farm stopped paying). The therapists argued that doctors had ordered the therapy, and that there was no finding that treatment was "excessive" or without foundation, but the Court awarded approximately $56,000.00 to the insurer as attorneys' fees for pursuing a claim that lacked "reasonable foundation." The Court concluded that the testimony of two IME doctors employed by State Farm so out-weighed the treating doctors' testimony that the trial judge did not err in awarding fees. The appellate court also held that it was sufficient for the judge to announce that the therapists' treatment "seemed" unnecessary without further explanation. This is an interesting outcome, given that prior cases had held that merely relying on an IME opinion--when rejected by jurors--was sufficient to protect the insurer from a claim of unreasonableness.