Jаmes Weiss, the insured plaintiff, seeks review of an unpublished decision of the court of appeals,
Weiss v. United Fire & Casualty Co.,
No. 93-3341 (Wis. Ct. App. Sept. 27, 1994), affirming a judgment of the Douglas County circuit court, Robert E. Eaton, judge. The judgment granted the motion of the defendant, United Fire and Casualty Company, the plaintiffs insurer, to change answers in the verdict pursuant to Wis. Stat. § 805.14(5)(c) (1993-94), to conform with the circuit court's dismissal of the plaintiffs bad faith claim. In answering the verdict questions relating to the bad faith claim, the jury found (1) that United Fire had exercised bad faith in denying the plaintiff s claim and (2) that $225,000 should be awarded the plaintiff as punitive damages for the tort of bad faith. We reverse the part of the decision of the court of appeals which is
Three issues are presented for our review. First, relying upon the court of appeals' holding in
Heyden v. Safeco Title Ins. Co.,
We reject the circuit court's and court of appeals' bright-line rule requiring expert testimony in all bad faith tort claims. Cases presenting particularly complex facts and circumstances outside the common knowledge and ordinary experience of an average juror will ordinarily require an insured to introduce expert testimony to establish a prima facie case for bad faith. Under the facts and circumstances of other cases, however, the question of whether an insurer has breаched its duty as a reasonable insurer to evaluate its insured's claim fairly and neutrally will remain well within the realm of the ordinary experience of an average juror and therefore will not require expert testimony. As this court has previously stated, "[t]he requirement of expert testimony is an extraordinary one, and is to [be] applied by the trial court only when unusually complex or esoteric issues are before the jury."
White v. Leeder,
Third, United Fire asserts (1) that the jury did not award the plaintiff compensatory damages on his bad faith claim and (2) that United Fire's conduct does not warrant a punitive damages award. Therefore United Fire contends that even should we uphold the verdict finding that it exercised bad faith in denying the plaintiffs insurance claim, the plaintiff is not entitled to the punitive damages which the jury awarded him. Because we conclude that the jury did award the plaintiff compensatory damages on his bad faith claim and because we also conclude that the evidence supports the jury's finding that punitive damages were warranted, we remand the cause to the circuit court with directions to reinstate the jury's punitive damage award as well.
! — I
For purposes of this review the facts are undisputed. Some facts follow and additional pertinent facts are set forth in the discussion of the legal issues.
On the morning of December 20,1990, the plaintiff set out from his home in Iron River, Wisconsin, to join his family for the holidays. When he arrived in Onalaska, Wisconsin, some five hours later, he was met with the news that a fire had broken out shortly
A three-day jury trial followed in October of 1993. At the close of the plaintiffs case in chief, the circuit court granted United Fire's motion to dismiss the plaintiffs bad faith claim. Relying on
Heyden,
In the interest of avoiding a second trial on the issue of punitive damages in the event that its ruling was reversed, the circuit court nevertheless agreed to submit special verdict questions to the jury regarding the plaintiffs bad faith claim. At the same time, however, the circuit court made clear its intention to abide by its original ruling and direct a verdict for the defendant on the issue of bad faith, regardless of how the jury answered the special verdict questions on bad faith. 2
After the jury was excused, the circuit court reversed the jury's special verdict answers finding that United Fire had breached its duty of good faith and assessing punitive damages against United Fire as a consequence of that breach. The court of appeals affirmed the decision of the circuit court.
f — l H-1
We now turn to the issue of whether expert testimony is required as a matter of law to establish a bad faith claim against an insurer.
To establish a claim for bad faith, the insured "must show the absence of a reasonable basis for denying benefits of the policy and the defendant's knowledge or reckless disregard of the lack of a reasonable basis for denying the claim."
Anderson v. Continental Ins. Co.,
In Wisconsin, expert testimony is generally admissible if the person testifying is qualified and if the testimony will hеlp the trier of fact to understand the evidence or to determine a fact in issue. Wis. Stat. § 907.02 (1993-94);
Kerkman v. Hintz,
The court has long recognized that certain kinds of evidence are difficult for jurors to evaluate without the benefit of expert testimony.
Cedarburg Light & Water Comm'n v. Allis-Chalmers,
But the court has simultaneously emphasized that requiring expert testimony rather than simply permitting it represents an extraordinary step, one to be taken only when "unusually complex or esoteric issues are before the jury."
White,
Thus, for example, we havе required expert testimony in many cases involving medicine, precisely because medical practice demands "special knowledge or skill or experience on subjects which are not within the realm of the ordinary experience of mankind, and which require special learning, study, or experience."
Cramer,
Even in the medical realm, however, courts have limited the application of a requirement of expert testimony to those matters outside the common knowledge and ordinary experience of an average juror. Thus the
Cramer
court, for example, reversed a directed verdict for the defendant and held that the injured person need not introduce expert testimony regarding the hospital's alleged negligence and breach of its standard of care because the question of whether the injured person was properly attended and adequately restrained was not "so technical in nature as to require expert testimony."
Further, the court has "acknowledged the similarity between medical and legal malpractice actions," and has stated that the standard with respect to the need for expert testimony is substantially the same in both types of actions.
Olfe v. Gordon,
Thus "[wjhether expert testimony is required in a given situation must be answered on a case-by-case
The question presented in this case is whether it is necessary, in all tort causes of action alleging an insurer's bad faith, that the insured produce an expert witness to testify about what a reasonable insurer would have done under the particular facts and circumstances. The decision in
Heyden
upon which the circuit court relied declared that what a reasonable insurer would have done under the particular facts and circumstаnces was "a matter beyond the ken of the ordinary juror and, therefore, require[d] expert testimony."
Heyden,
The
Heyden
court cited
Kujawski,
Adhering to the rules and standards we have previously discussed relating to expert witnesses for medical and legal malpractice cases, we reject, as did United Fire in its presentation before this court, a categorical requirement that the insured produce expert testimony to establish every bad faith claim against an insurer. We conclude that when an insurer's alleged breach of its duty of good faith and fair dealing toward its insured involves facts and circumstances within the common knowledge or ordinary experience of an average juror, an insured need not introduce expert testimony to establish a bad faith claim. To the extent that Heyden establishes a contrary rule, it is hereby overruled. Conversely, if the circuit court finds that an insurer's alleged breach of its good faith duty involves "unusually complex or esoteric" matters beyond the ken of an average juror, the circuit court should ordinarily require an insured to introduce expert testimony to establish a prima facie case for bad faith.
We conclude that this case does not present "unusually complex or esoteric" issues requiring expert testimony. Although United Fire contends otherwise, we conclude that in this case the facts and circumstances of United Fire's investigation of the claim and United Fire's analysis of the results of the investigation are within the common knowledge and ordinary experience of an average juror. The investigation at
The crux of the plaintiff s position is that United Fire's incomplete and slipshod investigation of the claim prevented it from learning the true facts on which the plaintiffs claim was based. During the course of his case in chief, the plaintiff introduced evidence establishing that United Fire denied his claim for several reasons, including (1) that its investigator, James Miller, concluded that the fire was caused by arson; (2) that the plaintiffs failure to return home immediately after the fire to observe the extent of the damage appeared to be suspicious behavior from which arson could be inferred; (3) that the plaintiffs apparently precarious financial condition provided a motive to set the fire; and (4) that the plaintiffs personal visit to the insurance agency's office to renew his fire coverage shortly before the fire appeared to be suspicious behavior from which arson could be inferred. The plaintiff produced evidence to contradict each of United Fire's contentions.
Investigator James Miller's report was placed in evidence in the plaintiffs case in chief. The plaintiff testified that Miller had removed pieces of wire from the very two areas where Miller claimed that the fire had started. The plaintiff further testified that Miller's report to United Fire did not mention these wires, did not describe any testing of the wires, did not explain the conclusion that the fire was not electrical in origin, and did not explain why or how other accidental causes
To further support his claim that United Fire did not carefully investigate or evaluate its suspicion of arson, the plaintiff established during his case in chief (1) that the Iron River fire chief had concluded that the fire was not caused by arson; (2) that the fire chief believed the fire to be electrical in origin; and (3) that it was not uncommon for accidental fires to have two points of origin, even though Miller had relied heavily on the fact that the fire had two points of origin in reaching his conclusion of arson. From this evidence the jury could have inferred that United Fire ignored the conclusions of a knowledgeable firefighter.
The plaintiff also testified that the premises had been rewired two years earlier by a person who was not a licensed electrician. This testimony bolstered the inference from other evidence thаt the cause of the fire was electrical in origin. It appears that United Fire's
During his testimony, the plaintiff also addressed the issue of why he had declined to return home immediately after learning about the fire. When the plaintiff spoke with Iron River's fire chief after his arrival in Onalaska, he was told that his house was a "total loss" and that he "had no place to come back to." The jury could have inferred that the plaintiff might therefore elect to spend the holiday with his family rather than return to a house which even United Fire's investigator conceded was "uninhabitable."
The United Fire claims supervisor, both in her answers to the plaintiff s interrogatories during discovery and in her testimony at trial during the plaintiffs case in chief, emphasized the importance of the plaintiffs allegedly precаrious financial condition in her determination that the plaintiff was responsible for the fire. The jury could have concluded that the supervisor based her assessment of the plaintiffs financial position primarily on her knowledge that the plaintiff was in arrears on both his property taxes and his mortgage payments.
Nevertheless, the plaintiffs own banker testified in the plaintiff s case in chief that a person's net worth could be substantial even if that person's tax and mortgage payments were in arrears. The banker described the plaintiffs arrearages in tax and mortgage payments as "a common condition," and estimated the plaintiff s net worth at the time of the fire at more than $200,000. Finally, the banker testified that he was not "overly concerned" about the plaintiffs financial condition. From this evidence, the jury could have concluded that United Fire failed to еxplore fully the plaintiffs actual financial condition.
Hence the jury could have determined that the plaintiffs visit to the insurance agency to rеnew the policy shortly before the fire did not support the inference that the plaintiff committed arson. The jury could have concluded that United Fire did not even consider the fact that the plaintiff was underinsured — a factor negating a motive for arson — in making its determination that the plaintiff had set fire to the premises.
Upon review of the plaintiffs case in chief, we conclude that the facts presented are neither unusually complex nor esoteric but rather well within the ken of
hH I — I hH
United Fire also seeks dismissal of the bad faith claim on the alternative ground that, regardless of his failure to introduce expert testimony, the plaintiff also failed to introduce sufficient evidence in his case in chief to support his bad faith claim. 8
In ruling upon a motion made at the close of a plaintiffs case, a circuit court may not grant the motion "unless it finds, as a matter of law, that no jury could disagree on the proper facts or the inferences to be drawn therefrom," and that there is no credible evidence to support a verdict for the plaintiff.
American Family Mut. Ins. Co. v. Dobrzynski,
Because a circuit court is better positioned to decide the weight and relevancy of the testimony, an
Three recent court of appeals decisions debate a perceived tension between the "no credible evidence" standard and the "clearly wrong" standard.
See Macherey v. Home Ins. Co.,
This tension described in the decisions of the court of appeals is more illusory than real. As the analysis in
Helmbrecht
itself makes clear, the "clearly wrong" standard and the "no credible evidence" standard must be read together. When a circuit court overturns a verdict supported by "any credible evidence," then the circuit court is "clearly wrong" in doing so.
9
When there
In overturning the jury verdict and dismissing the plaintiffs claim in this case, the circuit court stated that it didn't "see any evidence in the record [in the plaintiffs case in chief] that the insurance company willfully overlooked factual information, tried to hide any factual information, or in any way abused its discretion in making its determination."
Cognizant of the circuit court's superior advantage for judging the testimony, we nevertheless disagree with the circuit court's analysis of the evidence presented in the plaintiff s case in chief. Drawing the inferences as favorably to the plaintiff (the non-moving party) as the evidence in his case in chief permits, we conclude that there is credible evidence that United Fire had no reasonable basis for denying the plaintiff the policy benefits and either knew or recklessly disregarded the absence of a reasonable basis for denying the claim. There was credible evidence that United Fire acted unreasonably in ignoring information that the fire might have been accidental in origin, that the
There was credible evidence that the plaintiffs failure to return home was not suspicious behavior but reasonable under the circumstances.
There was credible evidence that despite United Fire's reliance on the plaintiffs supposedly precarious financial condition, United Fire did not act reasonably when it failed to investigate fully the plaintiff s financial status or to uncover readily available information that the plaintiffs financial health was good.
Furthermore, the plaintiffs underinsured status was credible evidence from which inferences could be drawn that the plaintiff had no motive to commit arson and that the plaintiffs inquiries about renewal of the insurance policy at the local insurance agency's office were routine.
In short, even after giving substantial deference to the circuit court's better "ability to assess the. evidence,"
James,
IV.
Finally, United Fire argues that even if the court should uphold the jury's finding of bad faith, the jury's award of punitive damages shоuld be overturned. United Fire contends that awarding punitive damages is inappropriate because the jury awarded the plaintiff compensatory damages in conjunction only with his breach of contract claim and not with his bad faith tort
Wisconsin does not allow punitive damages to be awarded in the absence of an award of actual damages.
Tucker v. Marcus,
Following the instructiоn conference, the circuit court submitted the following four questions to the jury:
QUESTION NO. 1: Did the plaintiff James C. Weiss intentionally cause the loss insured by the policy of insurance issued by the defendant United Fire and Casualty Company?
QUESTION NO. 2: If you answered Question No. 1 "No," then answer this question: What amount of benefits under the policy and consequential damages is plaintiff James C. Weiss entitled to recover pursuant to the insurance policy with defendant United Fire & Casualty Company?
QUESTION NO. 3: If you have answered Question No. 1 "No,” then answer this question: Did the defendant United Fire & Casualty Company exercise bad faith in denying the claim of James Weiss?
QUESTION NO. 4: If you answer Question No. 3 "Yes," then answer this question: What sum of money do you assess against defendant United Fire & Casualty Company as punitive damages?
During the jury instruction conference, counsel for United Fire objected to this verdict form on the ground that the verdict questions did not differentiate between the compensatory damagеs for the loss sustained under the policy (breach of contract) and for the tort of bad faith. United Fire wanted a special verdict question form asking separate compensatory damage questions for each of the plaintiff s two claims.
The circuit court concluded that its verdict form adequately addressed the damages issues. The jury answered "No" to the first question and proceeded to award the plaintiff $225,000 under question No. 2. The jurors then answered "Yes" to the third question and proceeded to award the plaintiff an additional $225,000 under question No. 4.
Bearing in mind that "[w]e must assume the jury followed the instructions,"
Johnson v. Pearson Agri-Systems, Inc.,
If the jury were to adhere to the instruction that punitive damages were not to be awarded unless the jury awarded compensatory damages, the jury would have had to award compensatory damages for the bad faith claim. The only place the jury could make an award of compensatory damages for the bad faith claim was in response to question No. 2. 13
Second, the jury's award to the plaintiff in response to question No. 2 for "benefits [due] under the policy and consequential damages" was in the amount of $225,000. This amount exceeded the plaintiffs claim for $149,250 under the policy.
14
To give full effect to the jury's verdict, we have to conclude that the jury thought that "benefits due under the policy" referred to
This interpretation of the jury verdict was proposed by United Fire in its brief as cross appellant before the court of appeals. United Fire argued that "[a]ny damages awarded by the jury over and above this amount [of $149,250.00] must necessarily represent compensatory damages attributable to the tort of bad faith." Brief for Cross Appellant at 11,
Weiss v. United Fire & Casualty Co.,
No. 93-3341 (Wis. Ct. App. Sept. 27, 1994).
16
Hence it is rather late in the case for United Fire to argue for the first time before this court that "[i]t is clear that all of the damages awarded by the jury, with the exception of punitive
On the basis of the record before us, the better argument was the one United Fire made in the circuit court and court of appeals: that in responding to the second verdict question the jury addressed compensatory damages for the breach of contract and the bad faith tort claims. Accordingly, because we conclude that the jury awarded the plaintiff compensatory damages for his bad faith tort claim, thе necessary prerequisite exists for upholding a punitive damages award on the same claim.
Turning to the award of punitive damages itself, United Fire contends that there was insufficient evidence to warrant the jury's punitive damages award. United Fire points out that punitive damages in bad faith insurance cases are only appropriate when, above and beyond a finding that an insurer has acted in bad faith toward its insured, there has been an additional showing that the insurer has manifested an "evil intent deserving of punishment or of something in the nature of special ill-will or wanton disregard of duty or gross or outrageous conduct."
Anderson,
We disagree with United Fire. As we have stated previously, "[t]o sustain an award for punitive damages, the law does not require a specific finding of an intentional and ruthless desire to injure, vex or аnnoy. The injured party need show only a wanton, willful or reckless disregard of the rights of others on the part of the wrongdoer."
Fahrenberg v. Tengel,
The primary witness for the defense was United Fire's investigator James Miller. When cross examined by counsel for the plaintiff, he could not explain why he had removed electrical wires from the scene, why he had failed to record his possession of those wires in his evidence log, why he had failed to mention the wires when asked in his deposition to account for all of the evidence he had removed from the scene, and why, given that hе was not an electrical engineer, he had failed to hire an expert to examine either the wires he had removed or the electrical wiring in the plaintiff s home before eliminating the possibility that the fire was electrical in origin. Miller also admitted that the electrical entry box on the plaintiffs home had only one-third of the capacity this home required. Finally, on the last day of trial, Miller testified that he had not only removed and forgotten to record the aforementioned wires, but that he had also forgotten to record having taken an electrical fixture removed from one of the fire's two origin points.
In another case in which Miller discarded similar electrical evidence indicative of a possible electrical fire, the court of appeals upheld an award of punitive damages. The court of appeals еxplained that decision as follows:
[Ejvidence indicating that Lumbermans' investigators lied about what they found in their investigation and knowingly destroyed what might have been a crucial piece of evidence permitted the jury to conclude that Lumbermans did not have a good faith belief that the fire was caused by arson and that it acted with malice or ill will in investigating and denying the claim.
Upthegrove Hardware, Inc. v. Lumbermans Mut. Ins. Co.,
In this case, the jury had even more evidence on which to base its determination of punitive damages. Not only did United Fire's investigator both remove and then fail to test or acknowledge possessing potentially dispositive evidence, but United Fire's home office failed to take into account the fact that the plaintiff was underinsured. Furthermore, United Fire's home office failed to investigate fully the plaintiffs finances even though the negative inferences drawn from its limited financial informatiоn played a large role in its ultimate decision to deny the plaintiffs claim. Viewing this evidence in the light most favorable to the plaintiff, we must sustain the jury's award which was reached on the basis of proper instruction regarding the "outrageous" behavior that makes punitive
For the reasons set forth, we reverse the part of the decision of the court of appeals which is before us and remand the cause to the circuit court with directions to reinstate the jury verdict and to enter judgment in accordance with this decision.
By the Court. — The part of the decision of the court of appeals which is before us is reversed; the cause is remanded to the circuit court with directions to reinstate the jury verdict and to enter judgment in accordance with this decision.
Notes
The remaining parts of the court of appeals' decision, such as the issue of setoff against thе plaintiffs compensatory damages award, are not before the court.
In the interest of economizing scarce judicial resources, the court has long encouraged circuit judges to reserve ruling on motions challenging the sufficiency of the evidence until after submitting the issue in dispute to the jury so that a remand for a
We discuss the second prong and its relation to the facts of this case below.
See also Kujawski v. Arbor View Ctr,
The court of appeals cited
C.J. v. State,
United Fire's claims supervisor, whom the plaintiff called as an adverse witness during his case in chief, admitted that she had never verified Miller's qualifications. Had the supervisor examined Miller's qualifications, she might have found that in another fire investigation Miller had also failed to disclose that electrical evidence had been removed from the premises, and that his conduct had triggered a punitive damages award against the insurer in that case.
See Upthegrove Hardware, Inc. v. Lumbermans Mut. Ins. Co.,
The plaintiffs policy did not insure him for the replacement value of the goods he lost; he received only monies equivalent to his goods' depreciated value. His house was insured for $79,000; United Fire's own investigation concluded that it would сost $93,000 just to make repairs, exclusive of costs for debris removal. The plaintiff s coverage for his personal goods was for just over $39,000; the actual, depreciated cost of his destroyed personal goods as determined by United Fire was $47,000 and the replacement cost was $65,000.
We note in passing that the plaintiffs counsel might have been able to incorporate evidence introduced after the conclusion of his case in chief if he had moved to reopen his case in chief. "The general rule is that after the evidence of the defendant is closed the plaintiff will be confined to rebutting evidence, and will not be allowed to produce original or direct evidence on his part, or go into his original case again; but the rule is not inflexible, and the court may, in its discretion, allow or refuse to receive such evidence."
Diener v. Heritage Mut. Ins. Co.,
See, e.g., Helmbrecht v. St. Paul Ins. Co.,
The circuit court relied on
Mills v. Regent Ins. Co.,
Wis JI — Civil 2761 (1991).
Wis JI — Civil 1707 (1994).
The circuit court had instructed the jury to award compensatory damages in an amount that would reasonably compensate the plaintiff for all losses that were the natural and probable results of United Fire's breach of contract. The circuit court did not, however, give two instructions about compensatory damages, one for the breach of contract claim and one for the tort claim of bad faith.
Neither party elected to place the opening and closing arguments on the record. Thus the court does not know whether plaintiffs counsel subsequently asked the jury for damages greater thаn those to which he had laid claim in his complaint.
Before the court of appeals, United Fire contended that any reference to consequential damages in the instruction was erroneous because the plaintiff was entitled only to the benefits payable under the terms of the insurance contract. The court of appeals did not address this issue, asserting that United Fire waived this objection because it had failed to object at the circuit court to the special verdict question on this ground.
Nor was this argument an aberration. United Fire made the same argument in its memorandum in support of its motions after the verdict, in which it stated that "[a]ny damages in addition to the policy proceeds are attributable to the alleged tort of'bad faith' which was dismissed by the Court at the close of the plaintiffs case." Repeating this argument, United Fire stated thаt "[t]he damages which [the plaintiff] contends he sustained over and above the benefits under the insurance policy are compensatory damages which would flow from the tort of bad faith." Because this court denied United Fire's petition for cross review of the award of consequential damages under the second special verdict question, United Fire has not had occasion to advance such an argument here.
In Upthegrove as well as in the present case, other witnesses refused to rule out the possibility that the fire being investigated was electrical in origin. There, as here, those witnesses were denied the opportunity to investigate evidence of an electrical fire — a lamp cord — because of Miller's conduct. For example, Rodney Pevytoe, an investigator employed by the Arson Bureau of the Wisconsin Department of Justice who testified in this case that he could not rule out the possibility that the fire was electrical in origin, neither knew of nor had access to the wires and fixture in Miller's possession.
