Law & Legal Expert Witness’ Testimony on Insurance Claims Handling Practices Admitted
Posted on October 11, 2024 by Expert Witness Profiler
Plaintiff Debra O’Neal filed a lawsuit against Defendant State Farm Fire and Casualty Company (“State Farm”) under the Washington Insurance Fair Conduct Act (“IFCA”) for its handling and denial of her claim for coverage of personal property allegedly stolen from a storage facility.
In response, State Farm moved to exclude O’Neal’s insurance expert witness, Robert J. Worth. They argued that he lacked the necessary qualifications and that some of his opinions were inadmissible legal conclusions.
Law & Legal Expert Witness
Robert Jeffrey Worth specializes in first party auto, homeowner and commercial litigation cases. He deals with claims involving disputed coverage matters; mold loss, failure to reasonably investigate and evaluate, efficient proximate cause and statute of limitations issues and commercial litigation of commercial general liability policy interpretation of regular employee verses day laborer regarding wrongful denial. Moreover, he obtained a Juris Doctor Degree from the University of West Los Angeles School of Law, Los Angeles.
Above all, he has an extensive (nearly 15 years) claims background at Farmers Insurance includes the position of (national) Claims Training Administrator responsible for overseeing the company wide training of all liability claims representatives, claims supervisors and managers nationwide.
Discussion by the Court
Worth’s Testimony on Insurance Claims Handling Practices
State Farm contended that Robert J. Worth was only qualified to testify in California insurance cases, not Washington cases. However, State Farm overlooked Worth’s extensive experience in the insurance industry across the country. The Court noted that Worth’s familiarity, or lack thereof, with Washington law could serve as a basis for cross-examination but did not justify exclusion. According to Daubert, vigorous cross-examination and the presentation of contrary evidence are the traditional and appropriate means of attacking shaky but admissible evidence.
Similarly, the substance of Worth’s opinion and whether he considered all the evidence is an appropriate topic for State Farm’s cross-examination and defense, but is not a reason to exclude Worth.
Worth’s Limitations on Legal Conclusions
The Court finds that at various points in Worth’s expert report, Worth crosses the line between opining on State Farm’s compliance with industry standards and offering legal conclusions. For example, Worth’s opinions that State Farm “breached the implied covenant of good faith and fair dealing” and that State Farm violated various laws are impermissible legal conclusions.
Similarly, the Court agrees with State Farm that certain aspects of Worth’s report on whether a “theft” occurred are improper legal conclusions such as opining on how “theft” should be interpreted in the policy and stating that certain evidence “supports the probability that the theft exists and was true.” These opinions intrude on the realm of the Court and are prohibited. However, as part of Worth’s opinion on insurance industry standards and claims handling practices, the Court allowed Worth to explore what State Farm should have considered “theft” when adjusting the claim, or what investigation State Farm should have conducted consistent with applicable industry norms.
In summary, while the Court will not exclude Worth on this basis, he (and any other expert offered by either party) will not be permitted to offer legal conclusions at trial.
Held
The Court denied the Defendant’s motion to exclude the Plaintiff’s insurance expert witness, Robert J. Worth.
Key Takeaways:
Although the Court acknowledged that Worth’s familiarity with Washington law could be challenged during cross-examination, this did not warrant exclusion. Additionally, while the Court restricted Worth from presenting legal conclusions, it affirmed his ability to discuss industry standards and claims-handling practices relevant to the case as a result of which Worth was allowed to explore what State Farm should have considered “theft” when adjusting the claim, or what investigation State Farm should have conducted consistent with applicable industry norms.
Case Details:
| Case caption: | O’Neal V. State Farm Fire And Casualty Company |
| Docket Number: | 2:23cv232 |
| Court: | United States District Court for the Western District of Washington |
| Dated: | October 4, 2024 |
