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Tedrow v. Sentry Insurance a Mutual Co.

United States District Court, D. Colorado

October 3, 2019

WILLIAM TEDROW, Plaintiff,
v.
SENTRY INSURANCE a MUTUAL COMPANY, Defendant.

          ORDER DENYING PLAINTIFF'S MOTION FOR DETERMINATION OF ENFORCEABILITY OF CONTRACT PROVISION

          WILLIAM J. MARTÍNEZ, JUDGE

         In this insurance dispute, Plaintiff William Tedrow (“Tedrow”) sues Sentry Insurance (“Sentry”) for (1) breach of insurance contract; (2) common-law bad faith breach of an insurance contract; and (3) unreasonable delay or denial of insurance benefits in violation of Colorado Revised Statutes §§ 10-3-1115 and -1116. (ECF No. 6.)

         Currently before the Court is Tedrow's Motion for Determination of Enforceability of Contract Provision (the “Motion”; ECF No. 17). For the reasons explained below, Tedrow's Motion is denied.

         I. FACTUAL & PROCEDURAL BACKGROUND

         Tedrow was insured by Sentry under a Personal Auto Policy (“Auto Policy”; ECF No. 17-1). (¶ 5.)[1] On December 12, 2016, Tedrow was waiting to make a right turn at an intersection when he was rear-ended by another vehicle. (¶ 6.) Tedrow sustained injuries as a result of the collision and allegedly incurred more than $47, 000 in accident related medical expenses. (¶¶ 5, 11.) In early 2018, Tedrow was paid the policy limit of $25, 000 by the driver-at-fault's liability carrier. (¶¶ 9-11.)

         On April 26, 2018, Tedrow tendered his underinsured (“UIM”) claim to Sentry, seeking recovery of all damages he incurred in excess of the driver-at-fault's $25, 000 policy-limit settlement. (¶ 11.) Sentry subsequently assigned Quynh Nguyen to evaluate and administer Tedrow's claim. (¶ 12.)

         On May 29, 2018, Nguyen sent a letter to Tedrow's counsel, which stated, in relevant part, as follows:

We have concerns as to causation based on Mr. Tedrow's activities prior to and post loss.[ [2] ] We also have concerns as to the mechanism of injury and subsequent treatment as the damage to both vehicles was very minor.

Based on our review of the information provided, we ask that you provide us with complete medical records and employment history for five years prior to the motor vehicle accident. . . .
look forward to speaking with you in greater detail about this claim and the information needed to finalize our evaluation.

(ECF No. 17-2 at 2; see also ¶ 13.) Attached to the letter was a blank medical release form and an accompanying cover letter. (ECF No. 17-2 at 4-7.) In the cover letter, Nguyen stated: “In order for us to proceed with handling this claim, we need you to complete and return the enclosed form[]. Please fill out the form[] carefully and completely . . . to avoid delaying this matter.” (Id. at 4.)

         On June 5, 2018, Tedrow returned the medical release form to Sentry. (ECF No. 17-3; see also ¶ 14.) On the form, Tedrow only provided his signature and left the rest of the document blank because he did not regularly visit medical professionals or have a primary care doctor, and the only treatment he could recall receiving was an appendectomy. (ECF No. 17-3 at 1-4.) Thus, Tedrow did not fill out the form so that Sentry could “obtain medical records from whomever [Sentry] wish[ed].” (ECF No. 17-3 at 1.)

         On September 21, 2018, Nguyen sent a letter to Tedrow's counsel, which stated, in pertinent part, as follows:

Based on the information provide[d], we have considered reasonable medical expenses of $7920. Thus, we do not find that there are any uncompensated losses outside of the $25, 000 provided by the liability carrier. However, in an effort to resolve this matter, we will extend an offer of $1500 as ...

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