{"id":5309,"date":"2020-01-08T14:28:38","date_gmt":"2020-01-08T19:28:38","guid":{"rendered":"https:\/\/www.millerthomson.com\/bad-faith-punitive-damages-update-case-commentary-stewart-v-lloyds-underwriters\/"},"modified":"2024-09-16T11:06:26","modified_gmt":"2024-09-16T15:06:26","slug":"bad-faith-punitive-damages-update-case-commentary-stewart-v-lloyds-underwriters","status":"publish","type":"post","link":"https:\/\/www.millerthomson.com\/en\/insights\/lloyds-brief\/bad-faith-punitive-damages-update-case-commentary-stewart-v-lloyds-underwriters\/","title":{"rendered":"Bad faith & punitive damages update – case commentary – Stewart v. Lloyd\u2019s Underwriters<\/i>"},"content":{"rendered":"

Introduction<\/h2>\n

Recently, in Stewart <\/em>v. Lloyd\u2019s Underwriters, <\/em>2019 BCSC 1582, the British Columbia Supreme Court considered a claim for punitive damages arising from the insurer\u2019s alleged breach of its duty of good faith.\u00a0 Ultimately, the court agreed that punitive damages were warranted and made an award in the amount of $100,000.\u00a0 While far from the $1 million punitive damages awarded in the leading case of Whiten <\/em>v. Pilot Insurance Co.<\/em> 2002 SCC 18, the court\u2019s award is the largest in BC since Whiten.\u00a0 <\/em><\/p>\n

Details of the Case<\/h2>\n

On May 31, 2015, the plaintiff, Christopher Stewart, was on vacation in Reno, Nevada.\u00a0 While sitting at a bar he suffered a brief loss of consciousness, fell to the floor and hit his neck.\u00a0 He was hospitalized for 12 days, had a pacemaker inserted and underwent surgery to his spine to correct a slippage of a vertebra.\u00a0 The health care bills from his hospitalization amounted to $293,127.60 USD.<\/p>\n

Prior to travelling to Reno, Mr. Stewart purchased travel medical insurance from the defendant insurers.\u00a0 He made a claim on the policy for coverage of his health care bills.\u00a0 Health Insurance B.C. paid $3,574.64 USD and the insurers paid $15,500.00 USD to have Mr. Stewart flown to a hospital in BC, leaving a balance owing of $274,052.97.<\/p>\n

In September 2015, the insurers denied coverage, taking the position that Mr. Stewart\u2019s injuries were directly or indirectly due to alcohol intoxication.\u00a0 On December 18, 2018, three-and-a-half months prior to the trial, the insurers advised Mr. Stewart that they were no longer denying coverage.\u00a0 The insurers filed an Amended Response to Civil Claim formally admitting coverage under the policy.\u00a0 The insurers also settled all of Mr. Stewart\u2019s health care bills prior to the trial for a significant discount.<\/p>\n

The trial proceeded with Mr. Stewart claiming, among other things, punitive damages for a breach of the duty of good faith.<\/p>\n

The insurers denied they acted in bad faith in denying the claim, arguing that the test is not whether the denial of coverage is wrong, but rather whether the assessment of coverage was made in good faith.<\/p>\n

In considering whether the insurers breached their duty of good faith, the court reiterated the following principles: there is no obligation upon an insured to prove coverage and the insured does not bear the onus of proving an exclusion in the policy.\u00a0 The court also reviewed the entire history of the insurers\u2019 coverage investigation to determine if the insurers met the duty of good faith and fair dealing.\u00a0 The court found the insurers\u2019 investigation in this case to be \u201coverwhelmingly inadequate\u201d, stating that there was not a balanced review of the claim but rather a search for a reason to deny coverage.\u00a0 The insurers delayed in obtaining a toxicology report to address a potential error in the calculation of Mr. Stewart\u2019s blood alcohol content.\u00a0 Further, the insurers failed to carry out a balanced and reasonable investigation, giving as much attention to Mr. Stewart\u2019s interests as their own.\u00a0 It was incumbent upon the insurers to investigate the non-alcohol-related cause as it was to investigate the alcohol-related causes.\u00a0 The purpose of a coverage investigation is \u201cnot to look for a putative basis for denying the claim and then to stop the investigation\u201d.<\/p>\n

Mr. Stewart alleged that the insurers breached its duty of good faith by obtaining unconscionable discounts from health care providers on the false premise that the claim was not covered.\u00a0 Mr. Stewart sought indemnification of the difference between the settlement amount and the full amount of the bills.\u00a0 The insurers took the position that there was no misrepresentation, fraud or impropriety in settling the health care bills at a discounted rate.\u00a0 The court held that the duty of good faith is owed to the insured, not to the health care providers.\u00a0 However, the insurers\u2019 duty of good faith to Mr. Stewart included a duty to negotiate the health care bills in a manner that did not put Mr. Stewart at moral or legal risk.\u00a0 The insurers settled the health care bills without input from Mr. Stewart and failed to advise the health care providers that the claim was insured.\u00a0 It was a breach of the insurers\u2019 duty of good faith to Mr. Stewart to not specifically advise the health care providers that the decision on coverage had been reversed prior to settling the health care claims.\u00a0 However, this did not give rise to an award of damages to Mr. Stewart for the amount of the health care bills.\u00a0 The court ordered that if Mr. Stewart is pursued by any health care provider, the insurers must indemnify him.<\/p>\n

In considering the award of punitive damages, the court found that while there was not malicious behaviour directed toward Mr. Stewart, the circumstances warranted an award of punitive damages.\u00a0 Although the investigation was overwhelmingly inadequate, it only reached the level of being high-handed, malicious, arbitrary or highly reprehensible once the insurers received a toxicology report in November 2018, which did not support intoxication as a basis upon which to deny coverage.\u00a0 The court found that the conduct of the insurers in settling the health care bills, without advising the health care providers that coverage was granted, appeared to have been motivated solely by the economic interests of the insurers and was reprehensible in the most egregious of the circumstances.\u00a0 While the insurers told Mr. Stewart this was a covered claim, they did not advise any of the health care providers.\u00a0 The insurers paid no heed to Mr. Stewart\u2019s interest, which was to have the health care bills negotiated and settled transparently.\u00a0 A significant factor in awarding punitive damages was the \u201cprofit\u201d the insurers gained as a result of their coverage denial and subsequent settlement of these claims.\u00a0 As a result of the initial denial and delay in accepting coverage, the insurers were able to obtain enormous discounts on the claims, which would not have been available had coverage been accepted in 2015.\u00a0 The court stated that if punitive damages were not awarded, the breach of bad faith would be unpunished and the insurers allowed to benefit from their denial of coverage and manner in which the claims were settled.<\/p>\n

Conclusion<\/h2>\n

The Stewart <\/em>case is a reminder that the mere acceptance of coverage and payment of claims is insufficient to fulfil an insurer\u2019s duty of good faith.\u00a0 Insurers must conduct balanced investigations into coverage and avoid undue delay in accepting coverage.\u00a0 Most importantly, insurers must make sure to avoid profiting from a coverage denial.<\/p>\n","protected":false},"excerpt":{"rendered":"

Introduction Recently, in Stewart v. Lloyd\u2019s Underwriters, 2019 BCSC 1582, the British Columbia Supreme Court considered a claim for punitive damages arising from the insurer\u2019s alleged breach of its duty of good faith.\u00a0 Ultimately, the court agreed that punitive damages were warranted and made an award in the amount of $100,000.\u00a0 While far from the […]<\/p>\n","protected":false},"author":1,"featured_media":14371,"parent":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[536],"insight-format":[416],"class_list":["post-5309","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lloyds-brief"],"acf":[],"yoast_head":"\nBad faith & punitive damages update - case commentary - Stewart v. 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Lloyd\u2019s Underwriters, 2019 BCSC 1582, the British Columbia Supreme Court considered a claim for punitive damages arising from the insurer\u2019s alleged breach of its duty of good faith.\u00a0 Ultimately, the court agreed that punitive damages were warranted and made an award in the amount of $100,000.\u00a0 While far from the […]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.millerthomson.com\/en\/insights\/lloyds-brief\/bad-faith-punitive-damages-update-case-commentary-stewart-v-lloyds-underwriters\/\" \/>\n<meta property=\"og:site_name\" content=\"Miller Thomson\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/MillerThomsonLaw\/\" \/>\n<meta property=\"article:published_time\" content=\"2020-01-08T19:28:38+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-09-16T15:06:26+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.millerthomson.com\/wp-content\/uploads\/2024\/10\/Insights_Lloyd-s-Brief_Post-Image.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1776\" \/>\n\t<meta property=\"og:image:height\" content=\"994\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@millerthomson\" \/>\n<meta name=\"twitter:site\" content=\"@millerthomson\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.millerthomson.com\/en\/insights\/lloyds-brief\/bad-faith-punitive-damages-update-case-commentary-stewart-v-lloyds-underwriters\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.millerthomson.com\/en\/insights\/lloyds-brief\/bad-faith-punitive-damages-update-case-commentary-stewart-v-lloyds-underwriters\/\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\/\/www.millerthomson.com\/en\/#\/schema\/person\/3f9143e8aec04617923b89fecf6886ea\"},\"headline\":\"Bad faith & punitive damages update – case commentary – Stewart v. 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