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Joseph v. Liberty Mutual Group, Inc.

United States District Court, W.D. Kentucky, Louisville Division

February 1, 2018



          Joseph H. McKinley, Jr., Chief Judge

         This matter is before the Court on a motion by Defendant, Liberty Mutual Group, Inc., for partial summary judgment on Plaintiffs claims for punitive damages [DN 28] and a motion by Plaintiff, King Joseph X, for partial summary judgment on his claim for underinsured motorist benefits against Defendant [DN 31]. Fully briefed, these matters are ripe for decision.

         I. BACKGROUND

         On May 9, 2015, Plaintiff was injured in a car accident when the car in which he was riding was hit by another vehicle. At the time of the accident, Plaintiff was the passenger in a vehicle that was insured under a policy of insurance issued by Defendant that contained underinsured motorist (UIM) coverage. Plaintiff was treated at Jewish Hospital with complaints of head, neck, and back pain. Plaintiff received PIP benefits paid by Defendant. Plaintiff settled his claim against the driver that caused the accident and his insurance company, Nationwide, for the policy limits of $25, 000. Plaintiff then made a demand for the underinsured motorist coverage "policy limits" against Defendant on February 16, 2016.

         After reviewing Plaintiffs medical records, Defendant denied the UPM claim. According to Defendant, the medical records indicate that seven months prior to the accident, Plaintiff had been involved in a separate motor vehicle accident where he was diagnosed with a head injury and cervical strain. Defendant determined that the second accident did not significantly change Plaintiffs medical condition and was not a causative factor for the medical expenses that were incurred after the PIP benefits ($10, 000) were exhausted.

         As a result of the denial of the UIM benefits, Plaintiff filed suit in Jefferson Circuit Court alleging breach of contract and seeking payment of UIM benefits against Defendant. Defendant filed an answer in which it acknowledged issuing the policy in question that included UIM coverage, but denied Plaintiffs claims for damages. Defendant timely removed the matter to federal court. The Court denied Plaintiffs motion to remand finding that when Plaintiff had been asked to specify the amounts claimed as damages against the Defendant, he responded with an amount of $469, 478.12. [Order, DN 13]

         Plaintiff now moves for partial summary judgment on the issue of liability, and Defendant moves for partial summary judgment on Plaintiffs claim for punitive damages.


         Before the Court may grant a motion for summary judgment, it must find that there is no genuine dispute as to any material fact and that the moving party is entitled to judgment as a matter of law. Fed.R.Civ.P. 56(a). The moving party bears the initial burden of specifying the basis for its motion and identifying that portion of the record that demonstrates the absence of a genuine issue of material fact. Celotex Corp. v. Catrett 477 U.S. 317, 322 (1986). Once the moving party satisfies this burden, the non-moving party thereafter must produce specific facts demonstrating a genuine issue of fact for trial. Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247-48 (1986).

         Although the Court must review the evidence in the light most favorable to the non-moving party, the non-moving party must do more than merely show that there is some "metaphysical doubt as to the material facts." Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio Corp., 475 U.S. 574, 586 (1986). Instead, the Federal Rules of Civil Procedure require the non-moving party to present specific facts showing that a genuine factual issue exists by "citing to particular parts of materials in the record" or by "showing that the materials cited do not establish the absence ... of a genuine dispute[.]" Fed.R.Civ.P. 56(c)(1). "The mere existence of a scintilla of evidence in support of the [non-moving party's] position will be insufficient; there must be evidence on which the jury could reasonably find for the [non-moving party]." Anderson, 477 U.S. at 252.


         A. UIM Benefits [DN 31]

         Plaintiff moves for partial summary judgment on the issue of liability of the UIM benefits claim. Plaintiff argues that Defendant conceded that Plaintiff is entitled to coverage under the UIM policy at issue. Plaintiff maintains that Defendant will not call any witnesses to challenge liability or to criticize Plaintiffs treatment or medical care. According to Plaintiff, the only issue in dispute at trial is the amount of damages the Plaintiff is entitled to under Defendant's UIM policy. As a result, Plaintiff requests the Court enter a judgment stating the following: (1) Plaintiff is covered under the Liberty Mutual policy of insurance and is entitled to UIM benefits; (2) the only issue at trial will be one of damages; (3) the medical bills of $19, 478.12 are reasonable and medically necessary and a judgment for same is entered; and (4) the only issues to be decided at the trial of this matter are fair and reasonable amounts for pain and suffering and lost wages. In response, Defendant argues that there are genuine disputes of fact as to the UIM benefits claim.

         In this action, Plaintiff seeks compensation under Liberty Mutual's underinsured motorist coverage. KRS § 304.39-320(1) defines an "underinsured motorist" as a party with motor vehicle liability insurance coverage in an amount less than a judgment recovered against that party for damages resulting from a motor vehicle accident. If the claimant and the adverse driver's liability insurance carrier agree to a settlement, and the amount paid will not fully compensate the claimant for damages sustained in the accident, then the claimant is to provide his own insurance carrier with notice of the proposed settlement. The claimant's carrier has the option to substitute payment of the settlement to the claimant and retain its right of subrogation against the adverse driver, or consent to the settlement. KRS § 304.39-320(3) and (4). As has happened here, if the carrier does not elect to substitute payment, then the claimant is authorized to accept payment from the adverse driver's liability insurance carrier and execute a release of the driver without prejudice to his ability to pursue underinsured motorist benefits from his own carrier. Id. The underinsured motorist insurance carrier is entitled to a credit against any damages awarded the claimant for the amount of the adverse driver's liability insurance limits, regardless of whether the full limits were paid in settlement. KRS ยง 304.39-320(5). Consequently, the Plaintiff will only be entitled to benefits under the ...

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