Analysis of Ingalls v Paul Revere [Life Insurance Company]
In a matter of Bad Faith
Date: Sat, 29 Aug 1998 15:39:46 -0400
Subject: Ingalls v. Paul Revere - Part 1
Paul Revere - Analysis of Lee Ingalls Lawsuit v. Paul Revere Life
Insurance Company - you can read the full thing at
http://sc3.court.state.nd.us/COURT/OPINIONS/960145.htm
This case is just another example of the multitude of unbelievable
excuses these miscreants can come up with to delay a court finding.
(Miscreants according to Webster's collegiate destitute of conscience,
unscrupulous, villainous) This topic is also discussed in the next book
I will be reviewing "The Terrible Truth About Lawyers" by Mark
McCormick.
Filed 3/20/97 by Clerk of Supreme Court - North Dakota
Civil No. 960145
Attorney Randall J. Bakke of Smith, Bakke, Hovland & Oppefard, 418 E.
Broadway, Suite 240, Bismarck, ND 58501, for plaintiff and appellee.
Appearance by Scott K. Porsborg
This review is lengthy but not the complete story. However there were
so many high points that I wanted to share them with those who don't
have Internet Access.
"Paul Revere Life Insurance Company (Revere) has appealed a judgment
against it for breach of a disability insurance policy with its insured,
Lee Ingalls, that awarded past and continuing benefits, damages for
mental anguish, and exemplary damages. We affirm." That means the
Supreme Court upheld the verdict against Revere.
Ingalls was a railroad worker who also managed his own farm. He bought
disability insurance in Sept. 1990.
In December he had an accident at the railroad severing part of his
right foot and requiring multiple surgeries.
Revere paid his claim until 1992. Then they offered him a lump sum for
$15,600. He refused. They demanded to see his tax returns. After
analyzing his tax returns they determined that he "misrepresented his
income" for one of the years he was asked about. Revere rescinded his
contract Ingalls sued. Revere countersued seeking to be paid back for
the two years they had already paid him. The case went to trial and Mr.
Ingalls was awared his disability benefits, $500,000 for mental anguish,
$2,500,000 in exemplary damages, other costs of $54,060 and attorney's
fees of $242,981.
The details of the supposed misrepresentation are that on the
Application, the agent asked Ingalls for his income for the previous
three years. Ingalls gave his gross income (not knowing the
difference). Revere determined that since he had expenses and a net
deficit for that year that he had lied. In actuality, Ingalls has
UNDERESTIMATED his gross income anyway and did not have a deficit.
So Revere first challenged saying, still that they were justified in
rescinding the contract because of the misrepresentation. The court did
mention that "everyone has a duty to exercise ordinary care in
conducting his affairs and in doing so, to make reasonable sue of his
faculties to avoid damage to himself. If he fails to do so, he is
guilty of negligence."
[Comment: I too supplied to my agent/broker all the information she
asked for. I don't recall if she specifically asked for my tax forms or
just an estimate of my income. At any rate since she was insuring me
for a fixed amount, to me it seemed reasonable that an estimate would be
enough. Without her telling me I would have no way of knowing that by
estimating my income to her, the insurance company could later try to
accuse me of lying. In my case, they didn't rescind or question this
since they decided not to pay me anyway
Fortunately the jury found based on the facts that Ingalls did not
misrepresent his income.
"The application did not define 'amounts as Reportable for Federal Tax
purposes'or 'net earned income.' An insurer's failure to define what
precise income information it sought in an application form has been
held to preclude it from later rescinding a disability insurance policy
for income misrepresentation. See, e.g. Gonzalez-Marin V Equitable Life
Assur. Soc, 845 F 2d 1140, 1145 (1st Cir. 1988) (that insured's net
income was less than the policy minimum did not establish insured
misrepresented his income, where there was evidence for the trier of
fact to conclude that the insured reasonably understood the insurance
agent's question 'as a query concerning gross income, and that the
applicant answered truthfully to the best of his knowledge' "
"Ingalls testified that he did not know what 'amounts as reportable for
federal tax purposes' means.' He testified that he did not prepare his
own tax returns because he had 'no idea on how to fill them out.'
Ingalls submitted an exhibit showing he had $24,253 in income reported
for federal income taxes that Revere did not consider."
[Comment: Revere, like many insurance companies is engaging in what's
called Post-Claims Underwriting. This means they don't check for
mistakes and may even encourage misrepresentations at the time of sale
of the insurance. Then then collect the premiums as if it was a valid
contract. Only after a claim is filed do they go looking for excuses to
say the contract is invalid. They are more than happy to take your
premiums whether you lied, or misrepresented your application
accidentally, on purpose, or because your agent/broker misled you. Only
after you make a claim do they care if the contract is valid. I believe
this is generally illegal.]
So in this case the Supreme Court affirmed the lower court decision that
Ingalls did not misrepresent his income and Revere's decision to rescind
the contract was not "reasonable."
Then Revere want a NEW TRIAL based on some technicality I don't even
understanding regarding the agent that sold the policy. Fortunately the
N.D. Supreme Court didn't buy this either.
Then Revere objects to the fact that Ingalls used Revere's pleadings and
legal strategies (the frivolous motions, stonewalling, delays and
discovery abuses) as evidence of Bad Faith. There is a precedent for
this. "An insurer's unreasonable defense may evidence bad faith, and
whether an insurer has acted in bad faith in refusing to pay a claim is
a question for the trier of fact (the jury)" Corwin Chrysler-Plymouth,
Inc. V Westchester Fire Ins. Com, 279 NW 2d 638, 644 (N.D. 1979) In
Ingalls case the jury thought the evidence did indicate bad faith.
A few more frivolous and irrelevant objections by Revere
The Court re-iterates the definition of total disability:
"Total disability does not mean complete physical or mental incapacity
or utter helplessness."
'The existence of total disability depends largely on the occupation and
employment in which the insured was engaged at the time the policy was
issued and when the claim arose. Total disability is an inability on
the part of the insured to do all the substantial and material acts
necessary to carry on the insured's business or occupation or any other
business or occupation in a customary and usual manner." Other
employment open to the insured must approximate the same livelihood as
his former occupation in order for him not to be totally disabled."
In this case, the Supreme Court felt the jury acted appropriately in
determining that Ingalls was totally disabled.
Then the testimony of Ingall's doctors, a rehab counselor and a friend
who helps Engalls agreed he wouldn't be able to carry out the essential
functions of farming.
Revere, of course, said he could to one degree or another based largely
on evidence they took out of thin air.
The court stated "We conclude substantial evidence supported the jury's
disability findings. Indeed, that evidence verifies that Revere's
intransigent refusal to recognize the disabling nature of Ingall's
injury was as grievous as the jury believed."
Date: Sat, 29 Aug 1998 23:13:49 -0400
Subject: Ingalls Part 2 - mental anguish
Part 2
"The trial court instructed the jury that violation of this State's
Prohibited Practices in Insurance Business Act may be considered as
evidence of bad faith. Revere contends the issue should not have been
submitted to the jury because there are no evidence that Revere's acts
listed in the statute were performed with a frequency indicating a
general business practice.
[We won't have that problem if any of us can ever get UNUM into court
and parade 10 or 15 of us through the court telling our stories.]
"Barbara Paull, an independent insurance claims consultant, testified
Revere committed a number of acts that violated NDCC 26.1-04-03(9) and
that constituted bad faith in claims handling. Paull testified about a
1984 memorandum to Revere field representatives from C.D. Smith a Revere
executive:
The importance of this document is that it is telling the field
men they are going to be judged-their
performance is going to be judged, they are going to get raises,
they are going to keep their jobs if they
can close out or finalize 25 percent of the claims that are sent
to them in the field. And then it talks about
the particular types of things they can do to get that minumum
25 percent performance.
[Comment: Wouldn't it be nice if a document like this arrived
anonymously in my mailbox???]
"Paull testified Michael O-Brien, a field claim representative of Revere
who attempted to get a 'compromise' settlement from Ingalls, used five
of the six listed methods to 'finalize' Ingalls's claim. Paull
testified there is no
way and insurance company can know that a certain percentage of their
claimants should have their benefits finalized. Paul testified she has
seem nothing suggesting Revere no longer attempts to finalize claims
through
acts described in this memorandum. Paull testified that the Smith
memorandum was 'evidence of bad faith on a continuing basis by Paul
Revere."
"Paull testified about one of O'Brien's acts she thought was
particularly improper;
To threaten to sue Mr. Ingalls if he didn't agree with the
position of rescission and he sought help from
an attorney was certainly improper. And in this case to
threaten to to it three times in the memo we've
read was definitely improper.
"O'Brien testified about the threat:
Q. Do you extend this type of treatment to all Paul Revere's
insureds when you cancel or rescind their
policy or benefits?
A. I want to make sure they understand the nature of the
rescission and the ramifications thereof.
Q. And so this wouldn't be unusual then for you to tell
someone three times you might sue them if they
go see a lawyer and try to pursue their rights under the
policy?
A. Right.
"We conclude there was evidence for the jury to find the unfair
settlement practices prohibited by NDCC 26.1-04-03(9) that Revere used
on Ingalls were 'performed with a frequency indicating a general
business practice,' and we
conclude the trial court did not err in submitting that issue to jury."
"The jury found that Revere acted in Bad Faith and awarded Ingalls
$500,000 in damages for mental anguish on the bad faith claim. Revere
contends the award must be reversed or substantially reduced because
there is no evidence
to support it."
"Because a primary consideration in purchasing insurance is peace of
mind and security it will provide, an insured
may recover for any emotional distress resulting from an insurere's bad
faith. Jarchow v. Transamerica Title Ins. Co., 122 Cal Rptr. 470, 486
(Cal. App. 1975). As we said in Fetch v. Quam 530 N.W, 2d 337, 341 (n.D
1995), quoting State Farm Fire & Cas. Co. v Signman, 508 N.W. 2d 323,
326 (N.D) 1993), ordinarily and 'insured pays premiums to receive
protection, not a lawsuit from its insurer.'"
[Come on UNUM, sue me for Libel]
"An insurer's bad faith breach of its duties to an insured is likely to
cause mental anguish; It is inconceivable that a
layman, unaccustomed to the courtroom and fearful of the entire judicial
process, who is also subjected to financial pressures from the refusal
of the insurer to discharge its commitments, will not be subjected to
stress the precise effects of which are difficult to measure in exact
terms but which, nevertheless, are present."
[Does blood pressure of 180/120, avoidance behavior and running red
lights, and nightmares of persecution by UNUM and by demons qualify? I
keep waking Mike up yelling in my sleep when I have these nightmares.]
"John Alan Appleman and Jean Appleman, Insurance Law and Practice
$8876.55 p 442 (rev. Vol. 1981). Thus, in a case of this kind, damages
for mental anguish may be 'general' damages -'damages for a harm so
frequently resulting from the tort that is the basis of the action that
the existence of the damages is normally to be anticipated
and hence need not be alleged in order to be proved.' Marily Minser et
al., Damages in Tort Actions $1.01930 (1996)........As the Minzer text
also explains at $3,01[3][b][, a claim for mental anguish is a classic
example of a noneconomic, intangible loss."
"'Traditionally, the jury had wide discretion in evaluating and awarding
these damages.' id. The only standard for evaluation of mental anguish
damages 'is the amount a reasonable person would estimate to be fair
compensation.' Id $ 3.01[1] 'The determination of damages for pain,
discomfort, and mental anguish largely is dependent upon the jury's
common knowledge, good sense, and practical judgment and mainly rests
within its sound discretion.' Reisenauer v Schaefer, 515 N.W. 2d 152,
157 (N.D 1994) The determination of damages for mental anguish i'is not
susceptible of an arithmetical calculation.' Dahlen v Landis, 314 N.W.
2d 63, 68 (N.D. 1981) 'In a case where the amount of damages may be hard
to prove, the amount of damages is to be left to the sound discretion of
the finder of facts.'' B.W.S. Investments v Mid-Am Restaurants, Inc.,
459 N.W. 2d 759, 764 (N.D. 1990). We explained in Hopkins v McBane, 427
N.w. 2d 85, 93 (N.D. 1988) 'Difficulty in measuring damages is an burden
that should be born by tortfeasors rather than their victims.'"
[This bears repeating DIFFICULTY IN MEASURING DAMAGES IS A BURDEN THAT
SHOULD BE BORN BY TORTFEASORS RATHER THAN THEIR VICTIMS --- AN EXCELLENT
ARGUMENT AGAINST ERISA
PRE-EMPTION AND MISINTERPRETATION TO PREVENT EMOTIONAL DAMAGES AND
PUNITIVE DAMAGES]
"After Ingalls suffered his disabling injury an dsubmitted a claim for
benefits, Revere began paying him policy benefits. Within two years,
Revere began a campaign to reduce or eliminate its liability under the
policy. The jury decided Revere engaged in a course of conduct
exhibiting bad faith and likely to produce mental anguish. Rever
engaged in a process of 'postclaim underwriting,' according to one
testifying expert, when, "instead of looking to pay the claim,' it began
to 'look for all the things in the application that [it]might be able to
dig up that would allow [it] to rescind the policy.' Revere rescinded
the policy for misrepresentation of income without first making a proper
investigation. revere alleged Ingalls had an actual intent to deceive
about his income, without a basis for such an allegation. Revere tried
to negotiate a compromise settlement with Ingalls while he was in the
hospital, was disabled, and had no reason to compromise. Revere gave
Ingalls only one day to accept or reject its proposed compromise
settlement. In that settlement discussion, revere threatened three
times to sue Ingalls if he sought help from an attorney . Revere relied
on a casual statement by Ingalls that he was only partially disabled
without making appropriate inquiries to determine his real condition.
revere discontinues paying benefits at ta time when ingalls was intitled
to benefits. Revere misrepresented policy provisions to Ingalls. Revere
unreasonably compelled Ingalls to sue to recover benefits due under the
policy."
"When Ingalls sued Revere, Revere answered and counterclaimed for fraud,
alleging among other things that Ingalls 'knowingly, willingly and
intentionally deceived Paul Revere regarding his True Income. Even at
trial, after Revere had withdrawn the intentional misrepresentation
claim, its attorney who drafted its answer and counterclaim testified,
among other things; he 'looked at the file...and concluded that this
person, Lee Ingalls, had intentionally misled [Revere] about his
income;' from looking through the Ingalls file, '[i]t was pretty clear
this guy was not telling the truth;' he reviewed the file and 'came to
the conclusion that Mr. Ingalls was a liar.'"
"Revere's actions and allegations were likely to cause mental anguish.
The jury was well justified in finding that Ingalls suffered mental
anguish from Revere's conduct. The appropriate amount of damages to
award was, of course, difficult to determine. As we have written in
several prior cases, Vanover v Kansas City Life Ins. Co, 553 N.W. 2d
192,199 (N.D. 1996) and Hopkins v McBane, 427 N.W. 2d 85, 95 (N.D.
1988), each quoting Schultz v Winston & Newell Co., 68 N.D. 674, 682,
283 N.W. 69, 73-4 (1938), from our review of this record, we are unable
to give a safe ground upon which we can say that the verdict is so
excessive as to justify our interference herewith."
Date: Sun, 30 Aug 1998 12:57:47 -0400
Subject: Ingalls - Part 3
Part 3
"The jury found that Ingalls proved by clear and convincing evidence
that Revere committed fraud and acted oppresively and maliciously, and
the jury awarded Ingalls exemplary damages of $2,500,000. Revere
contends
the exemplary award must be reversed because it is not supported by
evidence of oppression, fraud, or malice and is excessive."
a. evidence of oppression, fraud or malice
"At the time of Revere's actions in this case, part of NDCC 32-03.2-11
91) authorized;
In any action for the breach of an obligation, not arising from
contract, when the defendant has been guilty by clear and convincing
evidence of oppression, fraud, or malice, actual or presumed [presumed -
I like that word], the court or jury, in addition to the actual damages,
may give damages for the sake of EXAMPLE and by way OF PUNISHING THE
DEFENDANT" [Capitalization courtesy of Judydoc].
"As we explained in Corwin Chrysler-Plymouth, Inc v. Westerchester Fire
Ins. Co., 279 N.W. 2d 638, 646 (N.D) 1979) quoting Silberg v. California
Life Ins. Co. 521 P. 2d 1103, 1110 (Cal. 1974), an insurer who violates
its duty of good faith and fair dealing with its insured may fact
exemplary damages if it acted 'with the intent to vex, injure or annoy,
or with a conscious disregard of the plaintiff's rights.'"
The trial court instructed the jury:
If you find the [Ingalls] is entitled to an award of actual or
compensatory damages, and you further find that in
doing the act complained of, [Revere] acted fraudulently,
maliciously or oppresively, you may in your discretion
award [Ingalls] exemplary damages in such a sum as would in your
opinion, punish [Revere] for the unlawful act
and deter the defendant AND OTHERS from committing the acts in the
future.
[Comment : This case was filed in 3/20/97. As we know UNUM, Provident,
Paul Revere, and Standard, among others are continuing their fraudulent,
malicious, oppressive behavior to innocent victims all over the country.
Obviously a $2.5 Million dollar punitive damages award is NOT ENOUGH to
deter insurance companies from engaging in this behavior, as I'm sure
they are well aware of this judgement.]
However, exemplary damages cannot be allowed against [Revere] unless
you find that [Revere] committed fraud,
oppression or malice as defined in these instructions by clear and
convincing evidence.
The court instructed the jury on fraud and on malice and oppression:
The term 'malice' and 'maliciously' import a wish to vex, annoy, or
injure another person, or an intent to do a
wrongful act, established either by proof or presumption of law...
For the purposes of exemplary damages, the term 'oppression' is
defined as an act of cruelty, severity, unlawful
exaction, or excessive use of authority. It is an act of
subjecting to cruel and unjust hardship, or an act of
domination."
[Is being forced to learn enough about a complicated area of law in
order to represent myself hardship enough to fit this criteria, in
addition to all the other crap they put me through?]
"Paull testified about a number of unreasonable and unfair actions in
bad faith by Revere for the jury to have inferred fraud, malice or
oppression from: Revere did not do a proper investigation before
rescinding; Revere improperly sought a compromise settlement when
Ingalls was disabled and had no reason to compromise; Revere alleged
Ingalls had an actual intent to deceive about his income when there was
nothing in their file on Ingalls to suggest he had such an intent; Rever
relied on Ingall's isolated statement he was only partially disabled
without
properly determining his condition with an independent evaluation;
O'Brien talked to Ingalls about a settlement when Ingalls was in the
hospital and under medication; O'Brien threatened three times to sue if
Ingalls sought help from an attorney; O'Brien gave Ingalls's benefits
while it investigated whether to rescind for income misrepresentation
when it knew he was totally disabled from his railroad job; and Revere
engaged in 'postclaim underwriting' as Paull, one testifying expert,
described it, when 'instead of looking to pay the claim and provide a
basis for paying the claim, you look for all the things in the
application that you might be able to dig up that would allow you to
rescind the policy.' Paull testified that Revere acted in bad faith.
She testified that of the 600-650 previous bad faith claims she was
consulted on, '[t]his is definitely in the top ten percent. I would say
probably one of the worst cases I have seen of bad faith. [Comment: I
guess they don't have UNUM in North Dakota]. Paull testified that
Revere's bad faith conduct was intentional and malicious."
"We conclude there was evidence for the jury to find Revere guilty 'by
clear and convincing evidence of oppression, fraud, or malice,' which is
what NDCC 32-03.2-11(1) requires for an award of exemplary damages."
[Comment - Haven't any of these people ever heard of the word
Extortion?? This is not a lay term. It is a legal term that exactly
fits the conduct described in this case and others. The punitive damages
probably would have been
10 times more if the jury had been properly instructed on what Extortion
is.]
b. amount of exemplary damages
"Revere contends the amount of exemplary damages awarded is grossly
excessive. 'The reason for awarding punitive damages is to punish the
wrongdoer in order to deter him, and other, from repetition of the
wrongful conduct.' Delzer v United Bank, 1997 N.D. 3, quoting Dahlen v
Landis, 314 N.W. 2d 63, 68 (N.D 1981). As we also explained in Delzer
(quoting Dewey v. Lutz, 462 N.W. 2d 435, 443 (N.D. 1990) "punitive
damages are excessive when the amount of the award is so great that it
indicates passion or prejudice on the part of the jury.'"
"In ruling on Revere's post-trial motions, the trial court generally
assessed the qualifications of the jurors;
In this case, however, we had an educated and intelligent jury
well-qualified to comprehend the issues and
the law. For instance, this case involved financial, tax and
contract matters. We had two accountants on the
jury. The case involved insurance and we had a person
experienced in an insurance agency. Others on the
jury were qualified to understand the injury and disability
issues involved. Finally, most of them had enough
farm background to judge the effect of a physical disability on
a farmer's ability to do his work. In short,
this was a jury not easily misled or one proven to make
emotional judgements. They deliberated for a
reasonable time without asking any questions. There is no
justification for jumping to the conclusion that
this admittedly large verdict was somehow the product of emotion
or prejudice rather than thoughtful
deliberation by nine qualified individuals."
[ I think I'm going to move to North Dakota where the lawyers, the
judges and the juries make sense.]
On the amount of punitive damages awarded, the trial court ruled:
"This was a good jury which gave a thoughtful consideration to the
award based on the acts of [Revere] and the factors on which they were
instructed. It is a large verdict, but it has adequate support in the
evidence. The wealth of [Revere] is a consideration and the verdict is
proportional to that wealth and [Revere's] actions regarding its
handling on this policy claim."
"As we reasoned in Delzer...'the trial court observed the witnesses and
the jury and was in a better position than we were to determine if the
jury's punitive damages award resulted from passion or prejudice.' We
are unable to conclude that the amount of this punitive damages award is
so great that it proved passion or prejudice on the part of the jury.
We conclude, therefore, the punitive damages award is not excessive, and
it is a reasonable amount in
light of its purposes of punishment and deterrence."
[As I noted previously, it obvious was far to little to accomplish the
purpose of deterrence.]
"Relying on BMW of North America v Gore, 116 S. Ct. 1589 (1996), Revere
contends it 'should not be punished, certainly not to the extent of $2.5
Million, for rescinding an insurance policy based upon well established
legal principles, i.e. for conduct lawful in other jurisdictions.' The
jury did not award exemplary damages to punish Revere for 'rescinding an
insurance policy based upon well established legal principles.' We are
NOT persuaded that the conduct impelling the jury to award exemplary
damages here was lawful conduct anywhere." [CAPS MINE]
"The statute authorizing exemplary damages, NDCC 21-03.2-11940, was
amended in 1993 to limit them to 'two times the amount of compensatory
damages or two hundred fifty thousand dollars, whichever is greater.'
See 1993 N.D. Laws Ch. 324 $3 Relying on State v Cummings, 386 N.W. 2d
468 (ND. 1986), revere contends that this new limitation on exemplary
damages applies to this case because it tool effect before this lawsuit
was commenced. 'A statute is employed retroactively when it is applied
to a cause of action that arose prior to the effective date of the
statute.' Id at 471 The statute considered in Cummings reduced the
mandatory minimun sentence for driving with a suspended license. This
court held that, while statutes are not retroactive unless expressly
declared so by the Legislature,' an exception should be made to this
general rule in the case of ameliroating penal legislation.' Id at 472
Cummings was 'a narrow exception ot the general urle' of
nonretroactivity....Revere has not overcome the presumption against
retroactivity here.'
"Revere argues 'the legislature's passage of the punitive damages cap is
persuasive evidence that the award here is excessive.' The fact that
the Legislature has chosen to reduce the deterrent value of exemplary
damages by restricting the extent that wrongdoers may be punished is not
persuasive evidence that exemplary damages for conduct occurring before
the legislative change are excessive."
[I don't understand exactly what happened here except that we are seeing
Racketeering at its finest. Insurance companies want carte blanche to
engage in bad faith, fraud, oppression, malice, extortion and whatever,
so they lobby for "tort" reform to reduce punitive damages for the few,
the lucky, the persistent that can actually make it
to court. Now I know I lose some of you when I start talking about
conspiracies, but it's quite obvious from the cases we've been reading
that the insurance companies are engaging in illegal activity, we know
they have immense lobbying power and "influence" both with politicians
and with legislators, and we know "tort" reform has limited punitive
damages in may civil cases in many states. This needs to be brought
into the courtroom and examined
right along with the merits and facts of the case. OUR LEGAL RIGHTS TO
A JURY OF OUR PEERS and to let them exam the facts and decide the
punishment is being LEGISLATED AWAY behind our backs by the rich and
powerful corporations that would disobey any law they choose and only
have to worry about minimal consequenses.
This is a constitutional issue, the point of the legal system is to put
the weak and poor on an equal standing with the rich and powerful, and
let the juries be swayed only by the facts. If money and might make
right, why have laws at all? If the rich and powerful do not have to
obey the law, why should the rest of us?]
Here's the rest of the case:
In this case since the actions occurred before the tort reform, even
though the lawsuit wasn't yet filed, the North Dakota Supreme Court
didn't have to deal with this sticky issue.
They were able to affirm in all respects the lower courts ruling and
penalties.
This is what insurance law says in North Dakota (and in most states and
the NAIC Rules of Ethics, I believe).
"The following unfair methods of competition and unfair and deceptive
acts or practices in the business of insurance:
Unfair claim settlement practices. Committing any of the following
acts, if done without just cause and if
performed with a frequency indicating a general business practice:
a. Knowingly misrepresenting to claimants pertinent facts or policy
provisions relating to coverages at issue.
c. failing to adopt and implement reasonable standards for the prompt
investigation of claims arising under insurance policies.
d. Not attempting in good faith to effecturate prompt, fair, and
equitable settlements of claims submitted in which liability has become
reasonably clear.
e. compelling insureds to institute suits to recover amounts due under
its policies by offering substantially less than the amounts ultimately
recovered in suits brought by them when the insureds have made claims
for amounts reasonably similar to the amounts recovered.
--
k. refusing payment of claims solely on the basis of the insured's
request to do so without making an independent evaluation of the
insured's lability based upon all available information."
"Ingalls testified that when he 'bought this Paul Revere policy...I
certainly didn't expect this. I didn't expect this at all. I expected
them to pay me."
[Commentary - In one of my letters to the Massachusetts Department of
Insurance I quoted them similar tenets to this that constitute insurance
law. They were ignored, not addressed, blown off.
My legal research is indicating that courts will not rule on causes of
action they are not asked to rule on or award
money they are not specifically asked for. The reason insurance
companies like this have not been found guilty of extortion is because
no one yet, has accused them of such in a lawsuit. The amount of
damages to curtail this type of behavior in the insurance industry is
going to have to be much greater than that awarded in this case, as
evidenced by the lack of deterrent effect this verdict had. Much more
evidence needs to be brought into these cases to prove the widespread
and malicious nature of the transgressions, the political lobbying for
tort reform to limit damages instead of paying claims and there needs
to be punitive damages assessed for the practice of insurance companies
to appeal verdicts like this just to vex, annoy and oppress claimants
even further. In my opinion, the plaintiffs punitive damages of $2.5
million dollars should have been tripled by the appeals court to punish
Revere for appealing this obviously extremely egregious case. But they
weren't asked to so they didn't. The amount of damages needed to deter
these insurance practices is going to have to asked for AS PART of the
SUIT.
Like we were told when we went to lobby congress for CFS research funds
"If you don't ask, you don't get."
We know the insurance industry is not the least bit shy about asking for
what they want - TO LEGISLATE AWAY OUR RIGHTS.. And how sickening it is
that this company goes by the name of Paul Revere. This is the very
kind
of stuff the colonists were fighting against.]
Judydoc
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at: bhammel AT graham DOT main DOT nc DOT us
The URL for this document is:
http://graham.main.nc.us/~bhammel/INS/IvPR.html
Created: August 30, 1998
Last Updated: May 28, 2000