Teeter v. Mid-Century Ins. Co.

• Decision Date: 28 November 2017
• Docket Number: DA 17-0241
• Citation: 389 Mont. 407,406 P.3d 464,2017 MT 292
• Parties: Jennifer TEETER, Plaintiff and Appellee, v. MID-CENTURY INSURANCE COMPANY, a Stock Insurance Company, Defendant and Appellant.
• Court: Montana Supreme Court

389 Mont. 407

406 P.3d 464

2017 MT 292

Jennifer TEETER, Plaintiff and Appellee,

v.MID-CENTURY INSURANCE COMPANY, a Stock Insurance Company, Defendant and Appellant.

DA 17-0241

Supreme Court of Montana.

Submitted on Briefs: October 25, 2017

Decided: November 28, 2017

For Appellant: James D. Johnson, Williams Law Firm, P.C., Missoula, Montana

For Appellee: Jeffrey B. Hays, Hays & Hayes, P.L.L.P., Hamilton, Montana

Justice Michael E Wheat delivered the Opinion of the Court.

¶ 1 Mid-Century Insurance Company (Mid-Century) appeals the Opinion and Order of the Twenty-First Judicial District Court, Ravalli County, granting Jennifer Teeter's (Teeter) motion for summary judgment. We reverse and remand.

¶ 2 We restate the issue on appeal as follows:

Whether the District Court erred in granting Teeter's motion for summary judgment under §§ 33-18-201(6) and (13), MCA, concluding that no disputed issues of material fact existed regarding causation and damages.

FACTUAL AND PROCEDURAL BACKGROUND

¶ 3 This case arises from a motor vehicle accident in Missoula, Montana, on May 30, 2014. Derek Colberg (Colberg) rear-ended Plaintiff Teeter's vehicle on Brooks Street. Mid-Century insured Colberg. The officer who arrived at the scene concluded Colberg was responsible for the crash and cited him for careless driving.

¶ 4 Later that day, Teeter sought medical treatment for possible injuries from the crash. The treating physician diagnosed Teeter with whiplash and a right shoulder strain. Following her diagnosis, Teeter saw several health care professionals to treat her physical and psychological injuries including a chiropractor, neurologist, physical therapist, counselor, and masseuse.

¶ 5 Immediately after the accident Teeter retained counsel demanding advance payment of medical costs from Mid-Century. Mid-Century determined its insured Colberg was responsible for the accident and made several advance payments to Teeter for her medical expenses and lost wages. Mid-Century paid in advance $53,347.97 from May 30, 2014, until December 2014. In November 2014, Mid-Century sought Teeter's past medical records and asked Teeter to undergo an independent medical examination (IME) to determine if the ongoing medical expenses were related to the accident. Teeter refused both requests. In December, Mid-Century had Dr. Lennard Wilson conduct a records review of Teeter's post-accident medical records. Mid-Century discontinued Teeter's advance payments based on Dr. Wilson's opinion that Teeter's ongoing expenses were no longer causally related to the accident.

¶ 6 On February 17, 2015, Teeter filed a declaratory action against Mid-Century seeking payment of medical expenses and lost wages incurred after December 16, 2014. During discovery, Mid-Century obtained two IMEs of Teeter. The first IME was with forensic psychiatrist Dr. William Stratford on March 15 and 16, 2016. Dr. Stratford concluded that Teeter's symptoms were almost entirely a psychological issue. The second IME was with board-certified orthopedist Dr. Emily Heid on March 22, 2016. Dr. Heid determined that there was no physiological basis for Teeter's pain complaints.

¶ 7 On June 23, 2016, Teeter filed her motion for summary judgment arguing that there is no dispute of material facts that Colberg's liability is reasonably clear and that Teeter's medical expenses and lost wages were causally related to the accident. The following day, Mid-Century filed its own motion for summary judgment.¹ Mid-Century argued that the opinions of Dr. Wilson, Dr. Heid, and Dr. Stratford (collectively, the Doctors) provided objective evidence establishing a reasonable debate regarding whether Teeter's ongoing medical expenses and wage losses were causally related to the accident. Further, Mid-Century maintained that a declaratory action was inappropriate since there was a clear dispute of fact that should be resolved by a jury in a tort action.

¶ 8 On August 23, 2016, the District Court held oral arguments on the cross-motions for summary judgment. On December 30, 2016, the District Court issued its sixty-nine-page Opinion and Order. The District Court determined the following: (1) a declaratory action was appropriate to resolve narrow issues of fact regarding medical causation and damages; (2) Teeter's sworn statement combined with her treating providers' affidavits made a prima facie showing that it is reasonably clear that her medical expenses and wage losses are causally related to the accident; (3) the opinions of the Doctors did not create a disputed issue of material fact as to medical causation and damages; and (4) the Doctors lacked foundation.

¶ 9 Following the District Court's Opinion and Order, Teeter petitioned for supplemental relief seeking fees and costs. Mid-Century objected to the petition. On March 23, 2017, the District Court granted Teeter's petition and ordered Mid-Century to pay Teeter's unpaid medical expenses, lost wages, medically related mileage, attorney fees and costs. Mid-Century appeals the District Court's order granting Teeter summary judgment and the award of fees and costs.

STANDARD OF REVIEW

¶ 10 We review a district court's grant of summary judgment de novo, applying the same criteria of M. R. Civ. P. 56 as the district court. Pilgeram v. GreenPoint Mortg. Funding, Inc., 2013 MT 354, ¶ 9, 373 Mont. 1, 313 P.3d 839. We review a district court's conclusions of law to determine whether they are correct and its findings of fact to determine whether they are clearly erroneous. Pilgeram, ¶ 9. Under Rule 56(c), summary judgment will be granted if the moving party can show there is no genuine issue as to any material fact and the moving party is entitled to a judgment as a matter of law. Roe v. City of Missoula, 2009 MT 417, ¶ 14, 354 Mont. 1, 221 P.3d 1200.

DISCUSSION

¶ 11 Whether the District Court erred in granting Teeter's motion for summary judgment under §§ 33-18-201(6) and (13), MCA, concluding that no disputed issues of material fact existed regarding causation and damages.

¶ 12 Mid-Century argues the District Court erred in granting summary judgment to Teeter because it was not reasonably clear that the medical expenses and wage losses were causally related to the accident. Further, Mid-Century maintains that the issues of fact as to causation and damages should be resolved by a jury in a tort action. Lastly, Mid-Century argues that the District Court erroneously disregarded the opinions of the Doctors.

¶ 13 Teeter counters that the District Court properly granted summary judgment because there was no issue of material fact as to causation and damages. Further, Teeter counters that the declaratory action is the appropriate method to resolve this case. Finally, Teeter contends the District Court properly disregarded the opinions of Mid-Century's Doctors because they provided unsworn testimony and lacked foundation.

¶ 14 The Montana Uniform Declaratory Judgments Act provides the following:

Any person interested under a deed, will, written contract, or other writings constituting a contract or whose rights, status, or other legal relations are affected by statute, municipal ordinance, contract or franchise may have determined any question of construction or validity arising under the instrument, statute, ordinances, contract or franchise and obtain a declaration of rights, status or other legal relations thereunder.

Section 27-8-202, MCA. Thus, a declaratory action is appropriate to "afford relief from uncertainty with respect to rights, status and other legal relations." Tarlton v. Kaufman, 2008 MT 462, ¶ 33, 348 Mont. 178, 199 P.3d 263. "A declaratory proceeding is primarily intended to determine the meaning of law or a contract and to adjudicate the rights of the parties therein, but not to determine controversial issues of fact such as the existence or denial of procedural due process." Tarlton,¶ 33 (internal citations omitted).

¶ 15 In Ridley v. Guaranty Nat'l Ins. Co., the plaintiff sought a declaratory judgment that §§ 33-18-201(6) and (13), MCA, required an insurer to pay medical expenses as they were incurred when the tortfeasor's liability was reasonably clear. 286 Mont. 325, 332-33, 951 P.2d 987, 991 (1997). We held that under the statutes an insurer is required to pay an injured third party's medical expenses when liability is reasonably clear for the expense that is submitted. Ridley, 286 Mont. at 334, 951 P.2d at 992. However, "even though liability for the accident may be reasonably clear, an insurer may still dispute a medical expense if it is not reasonably clear that the expense is causally related to the accident in question." Ridley, 286 Mont. at 334, 951 P.2d at 992. Therefore, Ridley is a two-part test: (1) whether liability is reasonably clear and (2) whether it is reasonably clear that a medical expense is causally related to the accident.

¶ 16 We later clarified our "reasonably clear" legal standard in Peterson v. St. Paul Fire & Marine Ins. Co., 2010 MT 187, 357 Mont. 293, 239 P.3d 904. We adopted the following standard: liability is reasonably clear "when a reasonable person, with knowledge of the relevant facts and law, would conclude, for good reason, that the defendant is liable to the plaintiff." Peterson, ¶ 39. Further, we concluded that if liability was reasonably clear it "would leave little room for objectively reasonable debate." Peterson, ¶ 39. Essentially, the reasonably clear standard of Ridley is comparable to the "clear and convincing evidence" standard. Peterson, ¶ 37. Even though in Peterson we only addressed whether liability is reasonably clear, the reasonably clear standard applies to the causal relationship of a medical expense and the accident as set forth in Ridley. Therefore, if there is an objectively reasonable debate about whether a medical expense is causally related to the accident then a Ridley declaratory action would be inappropriate because a controversial issue of fact exists.

¶ 17 Our Ridley cases demonstrate that a Ridley...