Ms. Bertrand was injured in a car accident in 2012. The at-fault driver’s insurance company, Farm Bureau, tendered its policy limits of $15,000 in early 2013. Subsequently, Ms. Bertrand notified Progressive, her UM insurer, of the accident and demanded payment of her $15,000 UM policy limits.
Progressive received Ms. Bertrand’s demand letter but requested an additional medical record from her treating physician. Upon receiving this record, Progressive promptly issued payment. However, due to a communication issue, Ms. Bertrand’s attorney indicated that the payment had not been received, leading Progressive to stop the initial payment and reissue it.
Ms. Bertrand’s attorney then raised concerns about the language on the reissued check and accompanying release document, suggesting they constituted a conditional tender rather than the unconditional tender required by law. Progressive assured Ms. Bertrand’s counsel that the tender was unconditional.
Ms. Bertrand eventually negotiated the check but later filed a lawsuit against Progressive, claiming they failed to issue an unconditional tender within the statutory timeframe and seeking penalties, attorney fees, and costs.
The Court of Appeal focused on two key issues:
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Satisfactory Proof of Loss: The court determined that Progressive did not receive a satisfactory proof of loss until it received the additional medical record from Ms. Bertrand’s physician. This record was crucial in confirming the extent of Ms. Bertrand’s injuries and their relation to the accident.
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Unconditional Tender: The court concluded that Progressive’s subsequent communication clarifying the unconditional nature of the payment constituted an unconditional tender.
Furthermore, the court addressed procedural objections raised by Ms. Bertrand regarding the evidence presented by Progressive. It determined that Progressive’s submissions complied with the relevant legal requirements.
Based on its analysis, the Court of Appeal affirmed the trial court’s judgment, dismissing Ms. Bertrand’s claims against Progressive. It held that Ms. Bertrand failed to prove that Progressive’s actions were arbitrary, capricious, or without probable cause, which is necessary to recover penalties and attorney fees.
This case highlights the importance of clear communication and complete documentation in insurance claims, particularly when dealing with UM coverage. It emphasizes the insurer’s right to request additional information to assess the claim’s validity and the insured’s obligation to provide a satisfactory proof of loss. Additionally, the ruling underscores the necessity of demonstrating an insurer’s bad faith to recover penalties and attorney fees.
Additional Sources:AMANDA BERTRAND VERSUS PROGRESSIVE SECURITY INSURANCE COMPANY
Written by Berniard Law Firm
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