INSURER COMPELLED TO PRODUCE “BEST PRACTICES” GUIDE (Western District)
In this case, Western District Magistrate Judge Kelly ordered production of the insurer’s claim handling guidelines.
The insurer denied UIM coverage, claiming the insureds waived their benefits. The carrier conceded its UIM waiver forms did not comply with Pennsylvania law, but took the position it still properly denied the claim under the circumstances. The insureds sued for breach of contract and bad faith.
The insured’s document requests sought “all written policies, claims and manuals, company manuals, operational guidelines, and/or any other policies, procedures, guidelines, manuals, and/or instructional/educational material pertaining to the handling of underinsured motorist claims ….” The insurer objected on the basis that these documents were confidential and proprietary, but that “if plaintiffs’ counsel will agree to sign a confidentiality order, [the insurer] will produce a copy of the Table of Contents for its claims manual and the plaintiffs can identify which chapter or chapters they believe they need to review.”
The carrier later stated there were no claim manuals, but rather the insurer maintained a “Best Practices” guide. The insurer produced part of its Best Practices guide, with redactions and removed pages, regarding liability, subrogation, and first party medical benefits. The redactions were not specifically identified and there was no privilege log.
The insured moved to compel greater production.
The carrier responded that “evidence of claims handling is irrelevant to this proceeding because the … claim was ‘never ‘handled’ since [the carrier] concluded there was nothing to handle.” It also took the position that neither liability nor the nature and extent of the injuries were in dispute, and the only issue was whether coverage was properly denied.
Separately, the carrier objected to production because such “production would otherwise cause it harm based on the nature of the plaintiffs’ counsel’s law firm; that is, a well-advertised law firm that represents ‘injured people.’” Apparently, the carrier was concerned that plaintiffs’ counsel would use its manual in future lawsuits, brought by different plaintiffs against the insurer.
In addressing the insureds’ motion to compel, the court first observed that claims manuals and training materials are “relevant [in bad faith cases] because the manuals contain instructions concerning procedures used by insurance company employees in handling UIM claims, like Plaintiffs’ claims herein. Though departures from established standards in handling a UIM claim would not alone establish bad faith, such information ‘is probative evidence for plaintiff to demonstrate bad faith.’”
The court rejected the insurer’s argument that it did not have to produce these materials because there had been no claim handling. “That [the insurer] failed to process the claim at all does not necessarily render guidelines as to how claims are ordinarily processed irrelevant and, at this stage of the proceedings, it cannot be said that the information sought is unrelated to the facts at issue.” The insureds had agreed that discovery could have some limits, and the insurer did not have to produce materials in the Best Practices guide “pertaining to rental vehicles, property damage, vehicle theft, and other sections unrelated to the evaluat[ion] and/or handling of an injury claim….”
Thus, the insureds “met their initial burden to establish the relevance of the requested material within the broad scope of permissible discovery and [the insurer] failed to adequately show that the information, limited to the handling of UIM claims for bodily injury, is irrelevant simply because it denied the claim.”
As to the second objection, the court found nothing in the Federal Rules of Civil Procedure imposing a discovery “limitation based on a law firm’s advertising budget or the nature of its legal representation of injured persons….” Any concern that these materials might be used in some future litigation could be addressed with plaintiff’s counsel in negotiating and drafting an appropriate confidentiality agreement.
Thus, the insurer had to produce the Best Practices guide, with only the redactions and limitations described above.
