Lead Opinion
¶ 1 In this appeal we must determine whether expert testimony should be required in cases involving allegations of bad faith in the context of insurance practices. Essentially, Appellant, Herbert Bergman, requests that this Court adopt a per se rule requiring expert testimony in all bad faith actions by an insured against an insurer. For the following reasons, we hold that the admission or exclusion of expert testimony in actions on insurance policies for bad faith remains a matter within the sound discretion of the
¶ 2 The procedural and factual history of this appeal have been properly set forth by the trial court as follows:
I. PROCEDURAL HISTORY
[Appellant], Herbert Bergman, brought this action under 42 Pa.C.S.A. Sec. 8371 in May, 1996, against [Appellee], United Services Automobile Association Group, (USAA), alleging a bad faith claim. The case arose out of the insurance assessment of a vehicular accident involving the [Appellant] and two other individuals that occurred in November 1992.
After a bench trial in September, 1997 and a thorough review of all of the written submissions of the parties on this matter, the [Philadelphia County Court of Common Pleas] entered an Order on December 26, 1997, finding for the [Ap-pellee].
The [Appellant] filed a Motion for Post-Trial Relief on January 5, 1998, requesting this Court to grant a J.N.O.V. or in the alternative, to vacate the judgment and grant a new trial on this matter. After considering the post-trial motions filed by the [Appellant], reviewing the trial notes of testimony, and after a thorough review of all of the written submissions by the parties, this Court now reaffirms its Order of December 26, 1997 and denies all of [Appellant’s post-trial motions, thereby finding in favor of the [Appellee].
The [Appellant] then notified this Court on June 4, 1998 that he is appealing to the Pennsylvania Superior Court. [Appellant’s Notice of Appeal was then placed on the Superior Court docket on June 5, 1998. This Court filed a 1925(b) order on June 16, 1998 according to the Pennsylvania Rules of Appellate Procedure, compelling the [Appellant] to submit a Statement of Matters Complained Of On Appeal. The [Appellant’s sole response was that, “the court erred in refusing to allow [Appellant’s insurance expert to testify at trial.”
II. FACTUAL HISTORY
Specifically, this case involved the [Appellant], Dr. Herbert Bergman, and his automobile insurer, USAA., and the [Appellant’s underinsured motorist coverage (UIM). The [Appellant] had a liability policy that stacked UIM benefits of $600,000.00. The [Appellant] was involved in a vehicular accident with two other cars. After the claims of the other two individuals were resolved, the [Appellant’s attorney filed a UIM claim against USAA.
After the UIM claim was instituted, several demands and counter offers were made on behalf of the [Appellant] and USAA, respectively. On August 6, 1994 the [Appellant] made an initial demand of $300,000.00. Later, the [Appellant] demanded an arbitrator, and soon raised his offer demands to $400,000.00 and $500,000.00, respectively. During the processing of the UIM claim, the [Appellant] failed to forward all information regarding his injuries, medical treatment, or employment losses for claim evaluation.
The [Appellee] then named Michael Greenberg as its attorney and appointed an arbitrator. The [Appellant] was offered and later declined $50,000.00 and $70,000.00, respectively, from USAA. Then, the two parties’ attorneys agreed on a third neutral arbitrator, Thomas Rutter. The arbitration panel awarded the [Appellant] $120,000.00. The [Appellant] then entered a claim of bad faith under 42 Pa.C.S.A Sec. 8371.
(Trial Court Opinion, dated September 4, 1998, at 1-3) (citations to evidence and trial testimony omitted).
DID THE [TRIAL] COURT ERR IN PRECLUDING THE TESTIMONY OF APPELLANT’S EXPERT?
(Appellant’s Brief at iv).
¶ 4 The standard for reviewing an order denying a motion for a new trial is as follows:
[We are] limited to determining whether the trial court acted capriciously, palpably abused its discretion, or committed an error of law which controlled the outcome [of the case]. A new trial will be awarded only when the verdict is so contrary to the evidence as to “shock one’s sense of justice.”
Johnson v. Hyundai Motor America,
[t]he role of an appellate court in reviewing the trial court’s final judgment is to determine whether the findings of the trial court are supported by competent evidence and whether the trial court committed error in the application of law. Furthermore, the findings of the trial judge in a nonjury case must be given the same weight as a jury verdict and will not be disturbed on appeal absent error of law or abuse of discretion. When this [C]ourt reviews the findings of the trial judge, the evidence is viewed in the light most favorable to the victorious party below and all evidence and proper inferences favorable to that party must be taken as true and, conversely, all unfavorable inferences rejected.
Tagliati v. Nationwide Ins. Co.,
¶ 5 When determining whether the trial court abused its discretion, we have previously stated:
The test is not whether we would have reached the same result on the evidence presented, but rather, after due consideration of the evidence which the trial court found credible, whether the trial court could have reasonably reached its conclusion.
Terletsky v. Prudential Property and Cas. Ins. Co.,
In Paden [v. Baker Concrete Construction, Inc.,540 Pa. 409 ,658 A.2d 341 (1995) ], [the Supreme Court] set forth the heavy burden that a party complaining of the exercise of a court’s discretion must meet, noting that “an abuse of discretion may not be found merely because the appellate court might have reached a different conclusion, but requires a showing of manifest unreasonableness, or partiality, prejudice, bias, or ill-will, or such lack of support as to be clearly erroneous.” [Id.] at 412,658 A.2d at 343 .
Hoy v. Angelone,
¶ 6 Appellant argues that the trial court abused its discretion in refusing to allow Appellant’s expert witness, Dr. George M. Gottheimer, Jr., to testify at trial. Specifically, Appellant contends that the trial judge could not properly determine whether there had been a reasonable basis for the action and inaction of Appellant’s insurer, USAA, without a yard stick in the form of his expert’s testimony, against which to measure the insurer’s conduct. According to Appellant, Dr. Got-
¶ 7 An expert witness is a witness who possesses knowledge not within ordinary reach or understanding, and who, because of this knowledge, is specially qualified to address a particular subject. Steele v. Shepperd,
¶ 8 Necessity is fundamental to the admissibility of opinion evidence. Cooper v. Metropolitan Life Ins. Co.,
¶ 9 This Court has also emphasized that expert testimony should not invite the fact-finder to abdicate its responsibility to ascertain and assess the facts and, instead, defer to the expert’s opinion. Commonwealth v. Montavo,
¶ 10 Whether a witness may be permitted to testify as an expert is a decision that rests within the sound discretion of the trial court. Flanagan v. Labe,
¶ 11 Pennsylvania law provides a statutory remedy for bad faith on the part of an insurer as follows:
In an action arising under an insurance policy, if the court finds that the insurer has acted in bad faith toward the in*1106 sured, the court may take all of the following actions:
(1) Award interest on the amount of the claim from the date the claim was made by the insured in an amount equal to the prime rate of interest plus 3%.
(2) Award punitive damages against the insurer.
(3) Assess court costs and attorney fees against the insurer.
42 Pa.C.S. § 8871
Our legislature has not defined the term “bad faith” within this statute, but this Court has recognized that “bad faith” has a particular meaning in the insurance context:
Insurance. “Bad faith” on [the] part of [an] insurer is any frivolous or unfounded refusal to pay'proceeds of a policy; it is not necessary that such refusal be fraudulent. For purposes of an action against an insurer for failure to pay a claim, such conduct imports a dishonest purpose and means a breach of a known duty (i.e., good faith and fair dealing), through some motive of self-interest or ill will; mere negligence or bad judgment is not bad faith.
MGA Ins. Co. v. Bakos,
A recovery for bad faith requires clear and convincing evidence of bad faith, rather than mere insinuation, and a showing by the insured that the insurer did not have a reasonable basis for denying benefits under the policy and that the insurer knew of or recklessly disregarded its lack of a reasonable basis in denying the claim. Moreover, when evaluating bad faith under section 8371, a trial court may look to (1) other cases construing the statute and the law of bad faith in general, (2) the plain meaning of the terms in the statute, and/or (3) other statutes addressing the same or similar subjects.
MGA, supra at 754-55 (citations omitted).
¶ 12 This case presents an issue of first impression for this Court as to whether expert testimony should be required in bad faith actions. Our examination of case law from other jurisdictions reveals a growing trend among the states in favor of holding that expert testimony is not mandated in all bad faith cases. See generally DeChant v. Monarch Life Ins. Co.,
¶ 13 Other courts have held that expert testimony on the issue of bad faith or an insurer’s duty of care, though not required, is admissible where the trial court deems it relevant. See Hall v. Globe Life and Accident Ins. Co.,
¶ 14 Nevertheless, we hold that expert testimony is not required as a per se rule under Pennsylvania law in bad faith actions. In reaching this decision, we are persuaded by the rationale of the United States District Court for the Eastern District of Pennsylvania in Dattilo v. State Farm Ins. Co.,
¶ 15 Here, Appellant’s case proceeded to a bench trial. After a thorough review of Dr. Gottheimer’s report and qualifications, the trial court made several observations. First, the court noted that Dr. Gottheimer’s qualifications to testify as an expert on the issue of bad faith were questionable.
¶ 16 Our independent review of the record reveals that substantial portions of the testimony heard in this trial, during which three witnesses offered the bulk of the testimony, were devoted to exploring whether USAA had acted in bad faith in handling Appellant’s claim. The three witnesses were David Gonzalez (USAA claims examiner who handled Appellant’s case), Leonard Schaeffer, Esq. (Appellant’s attorney for the insurance claim), and Michael Greenberg, Esq. (USAA’s attorney on the insurance claim). Appellant’s counsel took full advantage of his ample opportunity to question the witnesses. In addition, the trial court allowed Appellant’s counsel to make extensive and basically uninterrupted arguments on Appellant’s behalf before Mr. Greenberg testified. (Id. at 302-27.)
¶ 17 We agree with the trial court that Appellant had sufficient opportunity to present evidence in support of his contention that USAA had acted in bad faith in handling his UIM claim. Further, the trial court’s decision to exclude Appellant’s expert testimony is supported by the record. See Tagliati, supra. This case did not involve highly sophisticated insurance concepts or practices,. or call for special knowledge, skill or experience to understand and analyze USAA’s conduct. See Whyte, supra. Moreover, the expert’s report as described in the trial transcript
¶ 19 Order entering judgment in favor of USAA affirmed.
¶ 20 President Judge Emeritus CIRILLO filed a concurring opinion.
Notes
. The court explained, “[Dr. Gottheimer’s] curriculum vitae indicates, a question as to whether or not he could be considered an expert, for the particular matters that we were concerned [with] in this case.” {Id.)
. Counsel for Appellant explained to the court that "in the report [Dr. Gottheimer] talks about the things USAA did or did not do, which did or did not have a reasonable basis, and in his testimony he talks about [this] in detail.... He talks about in detail what the appropriate practice in the industry is, and how these things are viewed within the insurance industry.” (Id. at 291-92.) The court responded, "That’s for the court to determine. ... After [Dr..Gottheimer] finishes [testifying], there’s nothing for the judge to do. [Dr. Gottheimer has] already made the decision.” (Id. at 292.)
. Specifically, the court observed:
I think there has been a tremendous amount of information here from all the witnesses that we have. And I believe that the information to be offered by the expert, ... I have some question about his expertise in this specific problem, and especially from reading his report, the thrust is not in that direction. And I think he will not add anything to the case.
(Id. at 293-94.)
. In fact, counsel’s arguments at that time were so extended that the court observed, "We’re getting into an area of virtually closing arguments, really.” (Id. at 327.)
. A copy of the expert’s report was not part of the certified record on appeal. Therefore, we accept the court’s assessment of the report.
. The trial court also found that Appellant exhibited bad faith in his unreasonable demands during settlement negotiations. The record reveals that Appellant raised his initial demand of $300,000.00 to $400,000.00, and then to $500,000.00, refusing to make realistic counteroffers, in response to the settlement offers of $50,000.00 and $75,000.00 from USAA. We note that USAA’s offers to settle the claim were reasonable in view of Appellant’s ultimate award of $120,000.00 in the arbitration proceeding. Although Pennsylvania law has yet to espouse the concept of comparative bad faith in the context of settlement negotiations, we agree with the trial court that in raising his demands twice fol- - lowing a reasonable counteroffer, Appellant
Concurrence Opinion
concurring:
¶ 1 I join in the reasoning and result reached by the majority. I write separately, however, to address to what extent the majority’s holding should apply in future cases and certain relevant issues that the majority has failed to address.
¶ 2 ' The majority states that the appellant is asking for essentially a per se rule requiring expert testimony in insurance bad faith actions, which the majority declines to adopt. However, nowhere in appellant’s brief does he state he would like this court to adopt such a rule. The proper question is not on such a high level, but rather the issue here is simply: “Did the trial court err in precluding the testimony of appellant’s expert?”
¶ 3 Presently, Bergman, as the insured, appealed the decision of the trial court because the court precluded the testimony of his insurance expert. The majority cites in its decision the case of McDaniel v. Merck, Sharp & Dohme,
¶4 In Dattilo v. State Farm Ins. Co.,
¶ 5 Since the answer to the first question above is “no,” we need not address the second question under McDaniel.
¶ 6 As the majority agreed with the appellee’s request for this court to adopt the rationale of Dattilo, it is, however, slightly distinguishable from the present case, although both cases relate to whether an expert witness for an insured in a bad faith case is needed. In Dattilo, the court decided the expert “qualified” as an expert, but also decided his testimony would only amount to subjective speculation. Dattilo at 4. Here, the majority finds that the testimony of Dr. Gottheimer would “not contribute anything that had not already been said either in his report or by other witnesses of record in this case.” See Majority Opinion at 1108. Basically, the majority holds the report and testimony of Dr. Gottheimer would be cumulative, repetitive, or even unnecessary testimony to assist the factfinder, without ever first deciding if Dr. Gottheimer qualified as an expert, as the court positively decided in Dattilo.
¶ 7 Moreover, the court in Dattilo made a distinction between the admissibility of experts in bad faith cases versus malpractice cases, where an insurer would be judged by the standards of the insurance industry. Dattilo at 4. Therefore, another item should be addressed: whether the majority’s opinion should be followed in malpractice cases, where an expert in insurance matters would be helpful and necessary to the factfinder? Even if the expert qualifies as such, as Dr. Got-theimer would not have, a bad faith case is not a malpractice case. Here, an insurer’s conduct would not be judged by the standards of the insurance industry, as it would in a malpractice case. Since this bad faith case was not a case requiring a comparison of the United Services Automobile Association’s claims adjuster against that of the entire insurance industry, it is even more understandable why an expert would be precluded from testifying.
¶ 8 The final feature of this case which the majority ignores is that this was a bench trial. The majority does not relate the importance of this fact. The trial court noted that bad faith cases are usually bench trials:
One thing that’s a little different about these bad faith cases is that in the State Court, generally the courts have agreed that they should be a non-jury case ... The analysis in the Federal Court has been different because of the 7th Amendment. So that when these cases are filed in the Federal Court, they get juries ... So, it [is] a different analysis as to whether or not you need an expert, because you have a jury that may not be familiar with the handling of claims, procedures involved in claims. It has been my experience that in a non-jury case, you [do not] have the same analysis. There really [is not] in my view a need to educate the Court on how claims are handled.
¶ 9 This is an important distinction to be made in this state court case, which is not bound by the United States Constitution’s Seventh Amendment. This may be the real reason that the trial court judge precluded the testimony because the judge was the factfinder and the interpreter of the law. It appears that in bad faith cases the trial court judge will hold the discretionary call as to whether an expert will be
¶ 10 With the addition of the foregoing, I join the majority.
. As the majority declines to adopt a per se rule requiring an expert in this type of case, the majority does not address whether this holding also applies to insurers (rather than insureds as the case here) who may want to bring forth an expert in later cases. Should an insurance company wish to put an expert on the stand to address insurance-related matters in a bad faith case, it, too, would fail to meet prong one of McDaniel, which asks whether the issue is of a technical nature beyond the scope of average layperson’s knowledge.
. Another distinguishing factor is that Dattilo was a federal jury case, whereas the instant case was a state non-jury case.
