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Federal Court Judge Wolson Allows Plaintiff to Secure Claims Evaluation Documentation From UIM Carrier in Discovery

By Daniel Cummins on January 20, 2025
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Federal Court Judge Wolson Allows Plaintiff to Secure Claims Evaluation Documentation From UIM Carrier in Discovery
In the case of Long v. Progressive Adv. Ins. Co., No. 2:24-CV-01735-JDW (E.D. Pa. Dec. 11, 2024 Wolson, J.), the court addressed a Motion to Compel filed by a Plaintiff against a UIM carrier.

According to the Opinion, the Plaintiff was involved in a motor vehicle accident and brought a UIM claim against Progressive.

During the course of the matter, Plaintiff’s counsel sent a demand package to Progressive requesting the tendering of the limits. The court noted that the Defendant had not yet evaluated the Plaintiff’s claim but did so thereafter.

It was noted that, when Progressive produced a claim evaluation documentation in discovery, the carrier had redacted information from the document, including the value it had placed on the Plaintiff’s claim as well as with respect to the analysis with the specific elements of the Plaintiff’s claim. Progressive redacted the documents on work product grounds.

The Plaintiff filed a Motion to Compel the Defendant carrier to produce an unredacted document.

The court granted the Plaintiff’s Motion after finding that the Defendant carrier had failed to meet its burden of showing that it had created the information, which had been redacted, in anticipation of litigation.

The court noted that the UIM carrier had a duty to investigate and evaluate the Plaintiff’s UIM claim and, based on the court’s review of the record before it, the carrier had not yet investigated and evaluated the claims presented by the time it created the claim evaluation document.

Although the court acknowledged that the demand letter from Plaintiff’s counsel could have prompted the Defendant to conduct the evaluation or to complete it quicker, the court found that the Defendant had a separate, business-related (i.e, not litigation-related) obligation to perform the evaluation.

Judge Wolson additionally noted that the demand letter did not demand any more than what Progressive had offered or more than the policy limits. The demand letter also did not threaten a bad faith claim. Accordingly, the court found that there were no circumstances to suggest that the evaluation by the carrier was prepared in anticipation of litigation.

Judge Wolson noted held that there was no per se rule that every document created by an insurance company after receiving a demand letter from an insured qualified as a document protected by the work product doctrine. The court ruled in this fashion after finding that a demand letter did not absolve an insurance company of its obligation to evaluate a claim.

Accordingly, the court rejected the carrier’s assertion of the work product privilege over a claim evaluation document where the carrier had a legal obligation to evaluate an insured’s claim and had not yet evaluated the claim when the insured sent a demand letter. 

In essence, the court in this matter felt that this demonstrated that the evaluation was prepared in the ordinary course of business, rather than in anticipation of litigation.

Accordingly, the court granted the Plaintiff’s Motion to Compel discovery.

It is noted that the court began its Opinion by indicating “[i]insurance companies evaluate claims as part of their business, and their claims evaluations often result in demands from policyholders and then litigation. In discovery, that reality poses a challenge: “litigants (and then judges) must decide when an insurance company created a claim evaluation document in the course of its business and when it did so in anticipation of litigation. The first category of documents is discoverable, but the latter is work product that Federal Rule of Civil Procedure 26(b) protects.”

Judge Wolson noted that the work product doctrine, which is codified under Federal Rule of Civil Procedure 26(b)(3) protects materials prepared in anticipation of litigation from discovery unless certain exceptions apply. The court noted that the work product immunity shelters an attorney’s mental processes, providing a privileged area for the attorney to analyze and prepare his client’s case.

The court also noted that a party claiming work product protection bears the burden of showing that the materials in question were prepared in the course of preparation for possible litigation.

The court reiterated that, because insurance companies evaluate claims made by their insureds in the ordinary course of their business, and outside of any possible litigation in the future, discovery disputes involving insurance company claims file often present problems for the parties in the court.

As noted, under the circumstances presented in this case, Judge Wolson found that claim evaluation documentation prepared by the carrier did not amount to a document that was prepared in preparation for litigation.  The Judge found, after an in camera review, that the document, in the Judge’s eyes, revealed claims handling matters and not litigation analysis.  As such, the Plaintiff’s Motion to Compel was granted.  

Anyone wishing to review a copy of this decision may click this LINK.

Source: “The Legal Intelligencer Federal Case Alert.” www.Law.com (Jan. 9, 2025).

Photo of Daniel Cummins Daniel Cummins

Daniel E. Cummins is a civil litigator and Partner in the Clarks Summit, Pennsylvania law firm of Cummins Law, which is located in northeastern Pennsylvania, just outside of Scranton. He has served as a columnist for the Pennsylvania Law Weekly and appeared in…

Daniel E. Cummins is a civil litigator and Partner in the Clarks Summit, Pennsylvania law firm of Cummins Law, which is located in northeastern Pennsylvania, just outside of Scranton. He has served as a columnist for the Pennsylvania Law Weekly and appeared in the Best Lawyers in America Director every year since 2015. He is the creator and sole author of Tort Talk, a blog dedicated to discussing updates, trends, and thoughts regarding Civil Litigation Law.

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  • Posted in:
    Insurance
  • Blog:
    Tort Talk
  • Organization:
    Foley, Comerford & Cummins
  • Article: View Original Source

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