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Urena v. Nationwide Insurance Co. of America

United States District Court, D. South Carolina, Charleston Division

July 30, 2015

EMILIO J. URENA, as assignee of Gregory S. Bryant, Plaintiff,



This matter is before the court following a bench trial held on July 20, 2015. Based on the evidence presented and heard on that date, the court makes the following findings of fact and conclusions of law pursuant to Federal Rule of Civil Procedure 52.


1. On January 22, 2012, a car driven by Gregory Bryant (“Bryant”) struck a car driven by plaintiff Emilio J. Urena (“Urena”) in Moncks Corner, SC Urena sustained severe injuries as a result of the accident and was airlifted to the hospital.

2. At the time of the accident, Bryant was an insured under an insurance policy issued by defendant Nationwide Insurance Company of America (“Nationwide”). The policy provided liability coverage in the amounts of $25, 000 per person for bodily injury and $25, 000 for property damage. Following the accident, Urena filed a claim with Nationwide.

3. The claim was initially assigned to Nationwide claims adjustor Destiny Goodrum (“Goodrum”). In her notes, Goodrum indicated that Urena was hospitalized with severe injuries. On January 27, 2012, Goodrum received a letter of representation from Urena’s counsel and the bodily injury claim was transferred to adjustor Tina Ramsey (“Ramsey”) of Nationwide’s attorney negotiation team. Upon being assigned the claim, Ramsey reviewed Goodrum’s notes in the claim file. Ramsey sent a letter to Bryant the day the case was assigned to her, informing him that there was a potential for personal exposure.

4. After the claim was assigned to her, Ramsey began to investigate the claim. Ramsey made a note in the claim file on February 7, 2012 indicating that

[b]ased on the fact that liability is clear, [insured driver] apparently travelling at an excessively high rate of speed and dui, our limits, both [property damage] and [bodily injury] coverage, will be exhausted. Fotos of both vehicle show significant damage. [Insured vehicle] flipped over and [claimant vehicle’s] rear end is completely missing.

Pl.’s Ex. 7. Ramsey indicated at trial that, as of February 7, 2012, she knew that liability was clear and that the policy limits would be exhausted. Dwayne Singleton (“Singleton”), Ramsey’s supervisor, sent an email to Ramsey the same day stating that he agreed that “this [is] likely a limits case and can be settled once the package is in.” Pl.’s Ex. 5.

5. In a February 15, 2012 note, Ramsey indicated that she was waiting for Urena’s counsel to email her photos so that she could evaluate the bodily injury claim. Ramsey noted that “[w]hat is known is that clmt was significantly injured and hospitalized for several weeks. This is a significant punitive claim and our limits will be exhausted. Will try to call hospital and locate bill, but if unsuccessful, will move forward with the evaluation and resolution of this claim.” Pl.’s Ex. 5. On the afternoon of February 15, 2012, Urena’s counsel emailed Ramsey photos of Urena in the hospital and both of the vehicles involved in the accident. On February 16, 2012, Ramsey evaluated the claim at $109, 000 with medical expenses of at least $59, 000.

6. On February 16, 2012, Urena’s counsel faxed a letter to Larry Epperly (“Epperly”), a Nationwide claims adjustor who was handling Urena’s property damage claim.[1] Epperly alerted Ramsey to the letter around 3:00 p.m. the same day. The letter contained the following time-limit demand: “[I]f we have not received the settlement checks by the close of business tomorrow, or the funds are not wired directly to my trust account, I will advise my client to reject any forthcoming receipt of the policy limits as being untimely.” Pl.’s Ex. 1. Epperly and Ramsey discussed the letter but did not discuss the time-limit demand.

7. Ramsey admitted that due to her own error, she did not read the paragraph containing the time demand. She also indicated that if she had read the letter more closely, she would have complied with the demand. She testified that she had previously sent a check via overnight mail to comply with a time-limit demand and that she could have sent a check via overnight mail to Urena’s counsel. Moreover, Ramsey testified that Nationwide had agents in the Charleston area at that time who could have delivered a check in order to comply with the demand, although she was not sure that they were working on February 17, 2012.

8. Ramsey obtained approval to pay the bodily injury policy limits and issued a check on February 17, 2012. She mailed the check to Urena’s counsel the same day and included both a covenant not to execute and Medicare addendum with the check. Because the following Monday, February 20, 2012, was a federal holiday, Urena’s counsel received the check on February 21, 2012. The same day, Urena’s counsel returned the check because it had not been timely received as required by his demand letter.

9. After returning the check, Urena filed a lawsuit against Bryant in this court. On December 12, 2013, the jury returned a verdict for ...

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