A rule of extracontractual liability applied by most if not all Courts to measure the Settlement Conduct of Liability Insurers, has even been extended to First-Party Insurers in some jurisdictions. That is what happened as well in the recent decision in the case of Berg v. Nationwide Mutual Insurance Company, 2012 PA Super. 88, 44 A.3d 1164 (Pa. Super. April 17, 2012), Download Berg v. Nationwide Mut. Ins. Co. (Pa. Super. Ct. No. 12 MDA 2008, Opinion Filed April 17, 2012) PUBLIC ACCESS.
The Berg case involved a claim of First-Party Bad Faith based on an Auto Insurance Company's denial that a vehicle was a total loss, despite an appraisal that the vehicle was a total loss, among other things. In that Pennsylvania case, the Superior Court held:
The duty of good faith originates from the insurer's status as a fiduciary for its insured under the insurance contract, which gives the insurer the right, inter alia, to handle and process claims.
Berg v. Nationwide Mut. Ins. Co., 2012 PA Super. 88, 44 A.3d 1164, 1170 (Pa. Super. April 17, 2012).
Parenthetically, the Berg v. Nationwide decision is an interesting new decision for many other reasons, including that the appellate court held that when the case is retried, the Trial Court should admit evidence that Nationwide paid its attorneys nearly $1 Million to defend the lawsuit which Nationwide's Policyholders filed against it. Nationwide allegedly paid these rather large defense fees pursuant to a litigation strategy documented by its own claims manual, to deter the filing of small value claims. The Superior Court noted that this assertion would have also been supported at Trial by other evidence which the Policyholders proferred and which the Trial Judge excluded, concerning Nationwide's practices followed in this case including the large amounts paid to its attorneys. Berg v. Nationwide Mut. Ins. Co., 2012 PA Super. 88, 44 A.3d 1164, 1176-77 (Pa. Super. April 17, 2012). The Court accordingly held that it was reversible error to exclude all this evidence, which the Trial Court should admit into evidence, all other things being equal more or less, when it retries the case.
What the Court wrote in that new case concerning the adjustment and evaluation of claims is relevant to both Liability Insurance Companies and First-Party Insurers adjusting claims, alike:
A claim must be evaluated on its merits alone, by examining the particular situation and the injury for which recovery is sought.
Berg v. Nationwide Mut. Ins. Co., 2012 PA Super. 88, 44 A.3d 1164, 1177 (Pa. Super. April 17, 2012). There may not be many areas of overlap between the handling of Casualty Claims and the handling of Property Claims. This quoted judicial observation, however, is among the truths of claim adjusting and evaluation regardless of the type of Policy under which a claim is being adjusted.
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