Allstate wins partial reprieve from million-dollar judgment over failure to pay attendant care benefits
James Douglas suffereda traumatic brain injury in 1996 when he was struck by a car while riding his bike. Allstate Insurance company was assigned his claim through the Assigned Claims Facility, but refused to pay attendant care to his family. After a bench trial (where a judge decides the facts, rather than a jury), Douglas' family was awarded $1.1 million dollars in unpaid expenses.
The Court of Appeals rejected many of Allstate's arguments--including the claim that compensation for his wife's supervisory attendance on Douglas should be limited to actual minutes when she was required to intercede on his behalf. The Court also rejected the argument that a treating psychologist could not offer opinions based on a review of the medical chart and his interviews with the injured party.Nevertheless, the award was overturned and the case was sent back to the trial judge to confirm whether the family members expected to be compensated for their efforts. While the individuals did not need to submit actual billings or executed contracts, they are required to confirm the hours and work performed, and show an expectation of payment. The Court also held that the record did not adequately document when Allstate received reasonable proof of loss in order to make attorneys' fees payable.