PHILADELPHIA – A motor vehicle accident victim from Texas claims an insurance provider based in Pennsylvania and Illinois is in violation of its policy with him by not paying his benefits in the wake of that accident.
On May 12, Brian Brice of Plano, Texas, filed suit in the Philadelphia County Court of Common Pleas against State Farm Indemnity Company of Philadelphia and State Farm Mutual Automobile Insurance Company, of Bloomington, Ill.
Prior to the aforementioned accident, Brice underwent a previous back surgery in 2002 or 2003, after which he was able to return to work as a salesman and be physically active. But on Aug. 30, 2013, Brice says he was involved in an automobile accident in which he sustained serious and permanent injuries, which have left him unable to work or participate in physical activities.
Brice suffered lumbar radiculopathy, post-operative lumbar instability, failed back syndrome and a left hip injury, which required replacement surgery. These injuries resulted in Brice undergoing a lumbar laminectomy in June 2014, a left hip replacement in January 2015 and a spinal fusion surgery in December 2015.
Brice claims he is unable to walk comfortably, unable to stand for long periods of time and requires the use of a cane, in addition to suffering a post-operative seroma and bladder dysfunction. It is averred Brice will require future medical care, including radiological, neurological, surgical and pain management services at a cost of $113,000.
After arbitration of the claim against the third-party tortfeasor of the action was completed in the State of New Jersey on Oct. 18, 2016, Brice was awarded a net award of $540,000.
The third-party insurance carrier, Progressive Insurance Company, a non-party to the case, tendered its policy limits of $50,000 to settle the underlying claim against the tortfeasor in the accident. Subsequent to obtaining consent from the defendants, Brice settled with Progressive for the amount of $50,000.
Brice contacted State Farm on March 16 to demand payment from them in the amount of his own UIM policy limits, which he believed was $100,000 – a payment he says they have continually refused to provide, or conduct any evaluation of or resolution for.
For counts of breach of contract regarding underinsured motorist benefits, bad faith and breach of contract regarding first-party personal injury protection benefits, the plaintiff is seeking damages in excess of $50,000 plus interest (at a rate of 12 percent annually under the Pennsylvania Motor Vehicle Financial Responsibility Law), fees, costs and other relief the Court deems just and appropriate in this matter.
In addition, the plaintiff seeks a declaration that he is entitled to coverage under the applicable UIM policy.
The plaintiff is represented by Danielle L. Duffy of Spivack & Spivack, in Philadelphia.
Philadelphia County Court of Common Pleas case 170502288
From the Pennsylvania Record: Reach Courts Reporter Nicholas Malfitano at nickpennrecord@gmail.com