State Farm Mutual Automobile Insurance Co. v. Fisher
418 P.3d 501
Colo.2018Background
- In 2010 Dale Fisher was injured by an underinsured motorist; his medical expenses totaled about $61,125 and were undisputedly reasonable, necessary, and causally related to the accident.
- Fisher held multiple State Farm UIM policies with combined limits of $400,000; he settled the tortfeasor’s $25,000 liability limit and pursued UIM benefits from State Farm.
- State Farm conceded the medical bills were covered but withheld payment, disputing other components of Fisher’s UIM claim (e.g., lost wages), and refused piecemeal payments.
- Fisher sued under Colo. Rev. Stat. § 10-3-1115 (unreasonable delay/denial of first-party benefits) and § 10-3-1116 (remedies), and a jury found State Farm violated § 10-3-1115.
- The trial court awarded the policy limit plus a statutory penalty (double medical expenses); the Colorado Court of Appeals affirmed, and the Supreme Court granted certiorari.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether § 10-3-1115 requires insurers to pay undisputed portions of a UIM claim even when other portions remain in dispute | Fisher: § 10-3-1115 prohibits unreasonable delay or denial of any "covered benefit," so insurer must pay undisputed covered benefits (here, medical expenses) without awaiting resolution of entire claim | State Farm: UIM scheme and § 10-4-609 envision a single, final damages payment; insurer may withhold partial payments while disputing the remainder of the claim | Court: § 10-3-1115’s plain text bars unreasonable delay or denial of a covered benefit; insurer must not unreasonably withhold payment of undisputed covered benefits even if other claim components are disputed |
Key Cases Cited
- Sunahara v. State Farm Mut. Auto. Ins. Co., 280 P.3d 649 (Colo. 2012) (discusses UIM purpose of placing insured in same position as if tortfeasor had equal limits)
- Granite State Ins. Co. v. Ken Caryl Ranch Master Ass’n, 183 P.3d 563 (Colo. 2008) (clear statutory language controls; no resort to construction rules)
- Sooper Credit Union v. Sholar Grp. Architects, P.C., 113 P.3d 768 (Colo. 2005) (courts will not read limitations into statute the General Assembly omitted)
- State v. Nieto, 993 P.2d 493 (Colo. 2000) (statutes construed according to ordinary meaning when possible)
- Moffat Coal Co. v. McFall, 186 P.2d 1021 (Colo. 1947) (court will not ignore clear statutory provisions under guise of harmonization)