Paulding v. Progressive Direct Insurance CompanyPaulding v. Progressive Direct Insurance Company
OPINION AND ORDER
Before the Court is the “Motion for Summary Judgment, or in the Alternative Motion for Partial Summary Judgment” (Doc. 31) (the “Motion“) by Defendant Progressive Direct Insurance Company (“Progressive“). By consent of the parties (Doc. 14 at 5), the undersigned has the authority to conduct all proceedings and ordеr the entry of final judgment in accordance with
I. Background
The present suit concerns a protracted period of time between a Plaintiff insured‘s initial demand for uninsured motorist benefits and her Defendant insurer‘s subsequent evaluation and offer of benefits under that policy—a period of time falling a week shy of one year. Defendant has argued that its investigation, evaluation, and offer were reasonably delayed as Plaintiff failed to remit documents necessary for evaluating the claim—namely, additional medical records from Cate Chiropractic, a wage verification form frоm her employer along with a doctor‘s note, and written verification that the tortfeasor‘s carrier had tendered its liability limits to Plaintiff. Plaintiff argues these reasons for delay are
Unless stated otherwise, the parties do not dispute the following facts. In March of 2022, Plaintiff Mary Paulding was in a motor vehicle accident. (Doc. 31 at 3). Through her attorney at the time, Robert Rode, she made a demand against her insurance carrier, Defendant, for underinsured motorist (“UIM“) benefits on August 9, 2022. (Id.). Defendant claims, and Plaintiff disputes, that the demand consisted of an incompletе copy of Plaintiff‘s medical records. (Id. at 3; Doc. 41 at 7). Defendant‘s claim adjuster Mike Roell requested the missing records on August 17, 2022, and Rode‘s office emailed a copy of the records previously sent on August 19, 2022. (Doc. 31 at 3). Upon receipt, Roell specifically determined he was likely missing sоme of Plaintiff‘s records from Cate Chiropractic, and emailed Rode‘s office a request for those records as well as a blank medical authorization so that Roell could obtain those records directly. (Id. at 3–4). Plaintiff has noted that Defendant already possessed her medicаl authorization as she included it in her original demand for UIM benefits. (Doc. 41 at 7).
On August 29, 2022, Defendant called and emailed Rode‘s office requesting a recorded statement from Plaintiff. (Doc. 31 at 3). Between September 8, 2022 and January 24, 2023, Defendant made four calls, sent four letters, and sent one fax at variоus times following up on this request for a recorded statement. (Id. at 4–5). Almost five months after Defendant‘s initial request, Rode‘s office called Defendant on January 26, 2023 to schedule
Amanda Tallbull replaced Roell as the adjuster for Plaintiff‘s claim on March 1, 2023. She continued to send requests to Rode‘s office for Plaintiff‘s medical information and a completed wage verification form, and on July 12, Tallbull sent a letter further requesting a “tentative agreement with the tortfeasor.” (Doc. 31 at 6–7); (Doc. 31-3 at 22). This was despite Defendant having confirmed on September 1, 2022, that the tortfeasor‘s insurance carrier had tendered to Plaintiff its insured‘s policy limits, $25,000. (Doc. 31 at 4). On July 31, 2023, Tallbull reached out to the tortfeasor‘s insurance carrier directly and received written confirmation that the $25,000 had been tendered. The nеxt day, August 1, 2023, Tallbull evaluated Plaintiff‘s claim to be worth $25,710 without accounting for lost wages, and she communicated an offer of $710 to Rode‘s office on August 2. (Id. at 7) (Doc. 31-2 at 19). Tallbull reiterated this offer by phone and letter on August 17, 2023, and on August 29, the claim was assigned to a new adjuster, Katie Woolley. (Doc. 31 at 7). Woolley requested a response to the offer several times from August through January, 2024,
Plaintiff has brought claims for breach of contract and breach of the implied duty of good faith and fair dealing, also known as the tort of bad faith. (Doc. 2-1 at 7). Plaintiff claims, among other allegations, that Defendant failed to pay the benefits she was owed, delayed payment of benefits without a reasonable basis, and failed to properly investigate and evaluate Plaintiff‘s claims. (Id. at 8–9). Defendant now moves for summary judgment as tо Plaintiff‘s contract claim,1 her bad faith claim, and her request for punitive damages. (Doc. 31 at 9, 14).
II. Legal Standards
To succeed in moving for summary judgment, the moving party must show that “there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.”
III. Discussion
Under Oklahoma law, insurers have an “implied-in-law duty to act in good faith and deal fairly with the insured to ensure that the policy benefits are received.” Badillo v. Mid Century Ins. Co., 121 P.3d 1080, 1093 (Okla. 2005) (quoting Christian v. Am. Home Assurance Co., 577 P.2d 899, 901 (Okla. 1977)). Where an insurer violates this duty, thе insured may bring “an action in tort for which consequential and, in a proper case, punitive, damages may be sought.” Christian, 577 P.2d at 904. To succeed in such an action, the insured “must present evidence from which a reasonable jury could conclude that the insurer did not have a reasonable good fаith belief for withholding payment of the insured‘s claim.” Oulds v. Principal Mut. Life. Ins. Co., 6 F.3d 1431, 1436 (10th Cir. 1993) (citing McCoy v. Okla. Farm Bureau Mut. Ins. Co., 841 P.2d 568, 572 (Okla. 1992)).
Before sending the issue of bad faith to a jury, Oklahoma courts often use a two-step inquiry in analyzing an insured‘s claim. Shotts v. GEICO Gen. Ins. Co., 943 F.3d 1304, 1315 (10th Cir. 2019). First, the court “considers whether there is a legitimate dispute between the insurer and the insured regarding coverage or the value of the claim. If there
A. Legitimate Dispute
An “insurer does not breach the duty of good faith by refusing to pay a claim or by litigating a dispute with its insured if there is a legitimate dispute as to coverage or amount of the claim.” Timberlake Constr. Co. v. U.S. Fid. & Guar. Co., 71 F.3d 335, 340 (10th Cir. 1995) (quoting Oulds, 6 F.3d at 1436). To determine whether there is a legitimate dispute as to the coverage оr value of an insurance claim, the Court considers whether “a reasonable jury could find in favor of the insurer based on all facts known or that should have been known by the insurer when it denied a claim.” Shotts, 943 F.3d at 1316 (quoting Oulds, 6 F.3d at 1442). If a jury could find in favor of the insurer, that is “strong evidence” that there is a legitimate dispute, and the Court should not submit the issue of bad faith to a jury without additional evidence. Id.
In viewing the undisputed facts in the light most favorable to the nonmoving party, the Court concludes that a reasonable jury could find that Defendant reasonably withheld
B. Reasonable Investigation
In determining the validity of a claim, insurers are required to “conduct an investigation reasonably appropriate under the circumstances,” Buzzard v. Farmers Ins. Co., 824 P.2d 1105, 1109 (Okla. 1991), and “[t]he investigation of a claim may in some circumstances permit one to reasonably conclude that the insurer has acted in bad faith.” Oulds, 6 F.3d at 1431. An insurance bad faith claim premised on the insurer‘s inadequate investigation may only proceed where the plaintiff has shown that “material facts were overlooked or that a more thorough investigation would have produced relevant information.” Timberlake, 71 F.3d at 345 (citing Oulds, 6 F.3d at 1442). It is not enough to show that the insurer‘s investigation was simply incomplete. Bannister, 692 F.3d at 1128. Rather, the claimant must show that a complete investigation would have changed the undеrlying facts known to the insurer such they would not have a reasonable belief to
Here, Plaintiff has advanced sufficient facts, supported by evidence, to create a triable issue of whether Defendant performed a reasonable investigation under the circumstances. In its Response, Plaintiff argued that Defendant undervalued Plaintiff‘s claim by failing to account for the permanency of her injuries. (Doc. 41 at 24–25). Plaintiff supports her argument by citing to adjuster Tallbull‘s claim notes and to the transcript of Tallbull‘s deposition. (Id.). In that deposition, Tallbull states that, despite noting Plaintiff had a kind of рermanent injury—disc herniation—she marked “not applicable” next to “[w]hether the injuries are permanent” in her calculation of the claim‘s value, and she confirmed that she “didn‘t give [Plaintiff] anything for permanent injury.” (Id. at 25). Viewing these facts in the light most favorable to Plaintiff, a reasonable jury could conclude that Defendant, through Tallbull, failed to reasonably investigate the permanency of Plaintiff‘s injuries and subsequently undervalued Plaintiff‘s claim. Plaintiff‘s bad faith claim may subsequently proceed under the theory that Defendant did not conduct an investigation reasonably appropriate under thе circumstances.
C. Timely Payment
In Oklahoma, insurers “must take prompt action to determine what payment is due and may not delay the payment of benefits until exhaustion of liability limits” in responding to an underinsured motorist claim. Buzzard, 824 P.2d at 1112. The insurer‘s obligation applies to “the entire loss of its injured insured from the first dollar up to the рolicy limits.” Burch v. Allstate Ins. Co., 977 P.2d 1057, 1064 (Okla. 1998).
As discussed, a reasonable jury could find for Defendant by determining that delays
D. Punitive Damages
Defendant has moved the Court to render summary judgment against Plaintiff‘s request fоr punitive damages. (Doc. 31 at 14). This would normally be appropriate where
IV. Conclusion
Based on the above analysis, Defendant‘s Motion for Summary Judgment is denied.
DATED this 21st day of July, 2026.
Christine D. Little
United States Magistrate Judge