Falcone v. Liberty Mutual Insurance Co.

Summary

The Oklahoma Supreme Court reviewed whether Liberty Mutual acted in bad faith by withholding payment for emergency-room Level 2 trauma charges under an uninsured/underinsured motorist policy. The court held that, although an insurer may consider the reasonableness of claimed medical expenses, whether the insurer's conduct and settlement offers constituted bad faith was a question for the trier of fact. The court reversed summary judgment for the defendants and remanded the case for further proceedings.

Holdings

1. Summary judgment for the insurers was premature because whether their withholding of payment for the trauma-center charges was unreasonable and in bad faith was a question for the jury.
2. Medical expenses, including the emergency-room and trauma-center charges at issue, may constitute compensatory damages recoverable under the UM coverage; the insurer's challenge to those charges did not establish as a matter of law that no bad faith occurred.

Questions Presented

1. Whether the insurers were entitled to summary judgment on Falcone's bad-faith claim based on their refusal to pay the full Level II trauma-center charges under the UM policy.
2. Whether the reasonableness and good-faith character of the insurers' withholding payment were questions for the trier of fact.

Disposition

reversed_and_remanded