Porter v. USAA Cas. Ins. Co.
| Docket Number | 19 CV 3912 |
| Decision Date | 11 August 2022 |
| Parties | Kecia Porter, Plaintiff, v. USAA Casualty Insurance Company, Defendant. |
| Court | U.S. District Court — Northern District of Illinois |
Pending before the Court is defendant USAA Casualty Insurance Company's motion for summary judgment. [120].[1] Plaintiff Kecia Porter has filed a response [125], and defendant has replied [131]. For the following reasons, the motion is granted.
This insurance-coverage dispute arises out of a car accident that occurred in 2009. on August 24, 2009, plaintiff was riding in a car driven by her then-husband, Kelly Porter, that collided with another vehicle. [122] 1-2, at ¶¶ 3-4. Plaintiff contends that she injured her back, neck, knee, and shoulder in the accident, and that she continues to experience pain in these areas. [Id.] 2, at ¶ 6. After the accident, plaintiff made a claim under an insurance policy that Kelly Porter held with defendant plaintiff also made a claim against the at-fault driver of the other vehicle. [122-2] 2; [125] 2. Plaintiff settled these claims in 2017 by accepting a $20,000 payment, which included a $5,000 payment from defendant on behalf of Kelly Porter. [122] 2, at ¶ 8; [128] 4, 6.
At the time of the accident, plaintiff held her own automobile insurance policy with defendant. The policy, which was effective from April 20, 2009, to october 20, 2009, provided uninsured and underinsured motorist's coverage for bodily injury with limits of $100,000 per person and $200,000 per accident. [122-1] 2, at ¶¶ 9-10. The policy also included a cooperation clause:
[122-4] 47.
On August 1, 2016, plaintiff submitted an underinsured motorists claim (UIM) to defendant, seeking coverage for the injuries she sustained in the 2009 accident. [37] 8, at ¶¶ 1-2. Defendant reviewed the claim and “confirmed that [plaintiff] would be entitled to [coverage] less” any amount she received from her then-pending claim against the at-fault driver. [128] 63. In December 2016, defendant's claims examiner advised plaintiff that some of her medical records had been received, while others were missing but had been requested. [Id.]. Defendant's efforts to obtain the records continued through mid-2017, but as late as July 2017 many records were still outstanding. See [122-5] 1-2 (list of medical records not received as of May 23, 2017); see also [128] 63-64 (letter from defendant to Illinois Department of Insurance in response to complaint filed by plaintiff recounting, inter alia efforts to gather medical records). Plaintiff complained that the claims process was taking too long and asked that her case be reassigned to a new examiner. [128] 63.
As the investigation continued, defendant discovered that plaintiff had been involved in two car accidents after the 2009 crash one in December 2013 and another sometime in 2015. [122] 5, at ¶ 13; [122-6] 8, at 29:1-16; [id.] 10, at 35:18-36:19; see also [128] 63 (letter to Illinois Department of Insurance stating that defendant's claims manager discussed the 2013 and 2015 accidents with plaintiff on July 26, 2017). At her deposition, plaintiff testified that she sustained a closed-head concussion in the 2013 accident, but she did not recall if she sustained other injuries. [122-6] 9, at 33:2-15. Plaintiff was also injured in the 2015 accident, but she did not remember the nature or extent of those injuries. [Id.] 10, at 34:3-35:1.
On August 30, 2017, the claims examiner called plaintiff and advised her that “a detailed review of the claim” had been completed, but “additional medical documentation” was “still pending.” [128] 64. The examiner also explained that an examination under oath (EUO) would “assist [plaintiff] and [defendant] in understanding what injuries were related to the August 24, 2009 accident and what injuries were not.” [Id.]. In January 2018, after plaintiff rejected defendant's offer to settle the claim for $25,000 and made a demand for $150,000, see [id.] 27, defendant invoked the policy's cooperation clause and requested that plaintiff participate in an EUO. [Id.] 3; see also [id.] 30 (). On March 1, 2018, the parties confirmed that the EUO would take place on April 11, 2018. [122-7] 2.
Plaintiff appeared for the EUO, but she informed the attorney representing defendant that she “had limited time due to transportation issues[.]” [122-10] 1. During the EUO-which lasted, according to plaintiff, “two hours or more” [122-6] 25, at 7:22-23-plaintiff stated that she “suffered injuries to [her] back as well as [her] hip.” [122-10] 2. Plaintiff also explained that, immediately after the accident, she sought treatment for her injuries at Advocate Health Center - Beverly Center and from Dr. Chandra Anand. [Id.].
After the EUO concluded, plaintiff sent defendant a “cease and desist letter regarding . . . any and all inadmissible questioning, ordered by [defendant] as EUO[.]” [122-9] 1. Plaintiff asserted that defendant was using the EUO process to “intentional[ly] delay paying” her “valid UIM claim.” [Id.]. Calling the EUO “illegal,” plaintiff asked that defendant “supply me with any legal right you have to continue to question me under my policy provisions; should you choose to continue with this illegal EUO.” [Id.] (emphasis in original).
On May 18, 2018, defendant sent plaintiff a letter requesting that she participate in a continued EUO. [122-10] 1. In support, defendant advised plaintiff that her insurance policy authorized defendant to “ask an insured to submit to an EUO multiple times so long as it is reasonable and is required to aid in the investigation of said claim.” [Id.]. Defendant then explained that plaintiff had created “a self-imposed time limit” at the first EUO when she left early due to transportation issues, which “did not allow us ample time to conduct a thorough examination under oath regarding the merits of your claim.” [Id.] 2. Defendant stated that, despite plaintiff's assertion at the first EUO that she was treated after the accident at Advocate Health Center and by Dr. Anand, records from these providers “were never provided to our office for review prior to your EUO.” [Id.]. Defendant explained that it had requested and expected to receive records from Advocate Health by mid-June, but that without those records and records from Dr. Anand, “the only document[ed] injury for the accident of August 2009 may be a soft tissue sprain strain injury of your neck and maybe shoulder.” [Id.] 3. “[B]y gathering medical records and requesting a continuation of your Examination Under Oath,” defendant concluded, “we are attempting to document what injuries, if any, you sustained in the accident which you were involved in August 2009.” [Id.]. Defendant advised that the continued EUO would proceed on June 27, 2018, but that plaintiff could contact defendant if she were unavailable that day. [Id.]. However, plaintiff did not appear for the continued EUO. [122-6] 26, at 98:6-99:8.
In December 2018, plaintiff, proceeding pro se, sued defendant in the Circuit Court of Cook County, Illinois, alleging that defendant (1) breached the insurance contract by failing to pay her UIM claim, and (2) unreasonably and vexatiously delayed paying her claim in violation of 215 ILCS 5/155. [1]; [120] 1; [121] 4. Defendant removed the case based on diversity jurisdiction.[2] After the conclusion of discovery and the exhaustion of settlement discussions, defendant filed the pending motion for summary judgment.[3]
A party is entitled to summary judgment only if it demonstrates that “there is no genuine dispute as to any material fact and [it] is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a). A genuine dispute about a material fact exists “if the evidence is such that a reasonable [factfinder] could return a verdict for the nonmoving party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). “The controlling question is whether a reasonable trier of fact could find in favor of the non-moving party on the evidence submitted in support of and opposition to the motion for summary judgment.” White v. City of Chicago, 829 F.3d 837, 841 (7th Cir. 2016). In answering this question, the Court construes all facts and draws all reasonable inferences “in favor of the party against whom the motion under consideration was filed.” Richardson v. Chicago Transit Auth., 926 F.3d 881, 886 (7th Cir. 2019). “Evidence supporting or opposing summary judgment must be admissible if offered at trial, although depositions and other written testimony can substitute for live testimony.” Reyes v. Menard, Inc., No. 21 CV 359, 2022 WL 2757666, at *1 (N.D. Ill. Jul. 14, 2022).
Defendant argues that it is entitled to summary judgment on plaintiff's breach-of-contract claim because the undisputed evidence establishes that plaintiff failed to perform her obligations under the insurance policy-namely, to cooperate with defendant in its investigation of her claim and participate in the continued EUO. [121] 4-5. Because there is no genuine dispute that plaintiff failed to sit for the continued EUO, defendant argues that no reasonable jury could find that plaintiff performed her obligations under the insurance policy. In a related vein, defendant argues that no reasonable jury...
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