Rounds v. Hartford
| Decision Date | 09 March 2022 |
| Docket Number | 4:20-CV-04010-KES |
| Court | U.S. District Court — District of South Dakota |
| Parties | TIM ROUNDS, Plaintiff, v. THE HARTFORD; HARTFORD FINANCIAL SERVICES, INC.; and HARTFORD CASUALTY INS. CO., Defendants. |
ORDER DENYING MOTION FOR SUMMARY JUDGMENT AND ADOPTING IN FULL ORDER GRANTING IN PART AND DENYING IN PART MOTION TO COMPEL
Plaintiff Tim Rounds, filed a complaint against defendants (collectively, “Hartford”) for common law bad faith and for unfair trade practices under SDCL § 58-33-5. Docket 1 at 9. Rounds seeks compensatory and punitive damages and attorney's fees and costs as provided by SDCL §§ 58-12-3 and 58-33-5. Id. at 9-10. Rounds moved to compel discovery for 21 discovery requests he made to Hartford, and he requested attorney's fees for the motion to compel.[1] Docket 27; Docket 28 at 5. Hartford opposed the motion to compel and filed a motion for summary judgment. Dockets 46, 52. Rounds opposes the motion for summary judgment. Docket 81. This court referred the motion to compel to Magistrate Judge Veronica Duffy for ruling. Docket 89. The magistrate judge issued an order granting in part and denying in part Rounds' motion to compel, and granting in part Rounds' request for attorney's fees. Docket 96. Hartford moves to stay the magistrate judge's order, which Rounds opposes, and Hartford filed objections to the magistrate judge's order. Dockets 102, 105, 110.
The facts, viewed in the light most favorable to Rounds, the non-moving party, are as follows:
This case arises from the handling of Rounds' workers' compensation claim. In July 2015, Rounds was working as an insurance adjuster for Doss & Associates. Docket 72-1 at 1. As part of this job, on July 2, 2015, Rounds inspected a damaged steel roof. Id. at 5; Docket 72-2 at 7. Because it had rained that morning, Rounds was “slip-sliding all over” while he was on the roof so much so that he “about went off a couple times.” Docket 72-2 at 7, 16. The sliding was serious enough that the owner of the building became concerned. Id. at 7. After he got off the roof, Rounds felt “pretty shook up, ” and “didn't feel comfortable[.]” Id. Over the next few days Rounds' only activities included doing paperwork and spending time with family that was in town for the holiday weekend. Id. at 8.
On the afternoon of July 5, 2015, Rounds began experiencing a headache that persisted for the next several days. Docket 72-1 at 20-22. On July 7, 2015, his headache worsened, he became nauseous and dizzy, and he had a hard time moving. Docket 72-2 at 10-11. That evening, he went to a clinic where he was diagnosed with allergies. Id. at 11. The next morning, Rounds went to his family physician, who diagnosed an inner ear infection. Id. On Thursday, July 9, 2015, with the symptoms worsening, Rounds went to the emergency room, where he underwent a CT scan and was told he had had a stroke, which was the result of a vertebral artery dissection (VAD). Id. at 12-14. Rounds was then flown to a hospital in Sioux Falls for treatment. Id. at 13. He remained in the intensive care unit for a few days, and then he spent a week in in-patient rehabilitation. Id. at 14. Within a few days after learning he had a stroke, Rounds provided notice to his employer of a work-related injury. See Docket 83-1 at 1, 59.
On August 7, 2015, Christy Thomann, the assigned Hartford claims representative, first spoke with Rounds. See Docket 72-1 at 4. During this conversation, Rounds said that his doctors informed him that “his stroke was likely due to some form of activity-whiplash, hitting his head, etc., ” and that the only corresponding activity was him “crawling on his hands and knees and fe[eling] unsteady” while inspecting the roof. Id. at 5. Thomann informed Rounds that for his claim to be compensable, his “work must [have] contribute[d] in a significant way” to the stroke, and that this determination would “likely . . . boil down to a medical opinion.” Id.
On September 9, 2015, Jennifer Born, an investigator with Hartford, met with Rounds at his home. Docket 72-2 at 3. During this conversation, Rounds informed Born that his doctors told him his VAD was the result of an injury, which could mean a chiropractic injury, “somebody hit[ting him] in the back of the head, or in a car accident, or a fall, or a hard sneeze.” Id. at 15. Rounds told her that, after thinking through his activities on the days leading up to the onset of his symptoms, he identified his slipping during the roof inspection as the only possible source of the type of injury his doctors described. See Id. at 15-16. Born understood from this conversation that “it [was] possible [Rounds] jolted backward during the inspection any number of times when he tried to catch himself.” Docket 83-1 at 29. Rounds provided authorization for the insurer to have access to his medical records, and he provided Born with a list of medical providers. Id. at 30.
On September 16, 2015, prior to any medical records being received, Kevin Wagenknecht, who was Thomann's supervisor, noted that Id. at 31. On September 24, 2015, Hartford received medical records from two visits Rounds made to Dr. Noel Chicoine, a family practice physician, in the weeks following his stroke.
Docket 72-3 at 3-4; Docket 83-1 at 32-33. The notes from the first visit do not include any mention of the roof inspection, but the notes from the second visit recount that Rounds “wonders if the stroke may [have] been precipitated by a job he was on that required a large amount of head flexion and rotation while up on a building[.]” Docket 72-3 at 3-4. The notes from the first visit also state that because Rounds “does not have Ehlers-Danlos or Marfan [syndromes] or other similar problems, he likely fits in the category of idiopathic.” Id. at 3. Later that same day, Wagenknecht entered a note in the claim file stating that Docket 72-1 at 11; Docket 83-1 at 40. At this point, Hartford had not yet received all of Rounds' medical records. See Docket 83-1 at 40.
Shortly thereafter, Hartford received medical records from a September 25, 2015 visit Rounds made to his neurologist, Dr. Jitendra Sharma. These records recount that Rounds was working on a roof when “he started slipping” and that “he had to catch himself multiple times and hold onto the ladder to maintain his balance.” Docket 72-3 at 7. Though Dr. Sharma noted that Rounds did not fall during this time, the notes include that he “almost felt that he may fall from the roof” and that “he may have put some physical strain on his body including his neck during that time.” Id.
On October 20, 2015, Thomann emailed Rounds, telling him that, once Hartford received all his medical records, then she “would need to obtain a medical causation opinion regarding [his] stroke.” Docket 83-1 at 40-41. She also informed him that under South Dakota law, “the work activity must be a major contributing cause” of the stroke to be compensable. Id. at 41. Then, on November 6, 2015, Thomann emailed Rounds again, asking him if he had “medical documentation from [his] physician that confirms that the stroke was related to work activity[, ]” and noting that from the records she had received, his stroke was “idiopathic.” Docket 72-1 at 13-14. Later that same day, Thomann sent Rounds another email, in which she references Dr. Chicoine's notes and states that Rounds' stroke “fits in to the category of idiopathic vs trauma or activity related.” Id. at 14. She stated that in order for Rounds' injury to be covered, Hartford “must confirm that the injury is related to work activity[, ]” but that based on the medical records Hartford had, “this cannot be confirmed.” Id. Thus, she concluded, Hartford was unable to cover his claim at that time. Id.
After these emails, Rounds called Thomann and said that he would have his doctors send her a letter. Id. at 15. A few days later, Dr. Sharma sent Hartford an addendum to the notes from Rounds' September 25th visit with him. Id. This addendum included Dr. Sharma's opinion that “based on the MRI findings . . . [i]t is possible that when [Rounds] was working up on the roof and was slipping and ha[d] to maintain his balance with some neck strain, that this may have resulted in this stroke.” Docket 83-1 at 39. It also noted that “at the same time, it is hard to pinpoint the right time when it all started.” Id. Soon after, Thomann emailed Rounds once more, attaching the addendum from Dr. Sharma, and informing him that because the addendum “indicates that it is possible that the stroke was caused by the work on the roof, ” but does not “confirm that this was the cause[, ]” his claim would still not be covered. Docket 72-1 at 17. A few days later, Wagenknecht makes a note in the claim file, asking Id. at 18.
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