$742K UIM arbitration award against Wesco Insurance Company. San Diego County.

Facts and Background

• Facts and Background:

  This incident involved a severe T-bone crash on March 13, 2019 caused by an underinsured motorist, who, while driving drunk, ran a red light at a speed of approximately 50 mph on eastbound Oceanside Boulevard at Crouch Street in Oceanside. The underinsured motorist’s vehicle violently crashed into the passenger side of the pick-up truck driven by claimant, which was making a left turn on a green turn arrow from westbound Oceanside Boulevard to southbound Crouch Street.

  Wesco Insurance Company did not dispute the liability of the underinsured motorist for this collision, but only the nature and extent of the injuries and damages. At the time of the crash, claimant was a healthy 32-year-old construction superintendent who was on his way home from work.

  Both vehicles involved were declared total losses.

• Plaintiff's Contentions:

  That the crash caused neck and back herniations as well as a hip labral tear and shoulder impingement, all of which would require surgery. Claimant did undergo an L5-S1 lumbar discectomy and fusion surgery on November 6, 2020, performed by Dr. Moazzaz, before the arbitration hearing.

  Claimant also underwent extensive chiropractic treatment from Dr. Tetz as well as cervical and lumbar epidural injection by Dr. Patel. His hip injury was evaluated by Dr. Muldoon. 

  Claimant contended that Wesco was incorrect both as to the facts and its legal contentions concerning Pearce's right to claim past-paid medical bills and past-wage loss incurred.

• Defendant's Contentions:

  That the arbitration should not have proceeded because Wesco was entitled to a stay while claimant pursued worker’s compensation benefits and because Wesco was entitled to have claimant examined by an orthopedic surgeon because of his last-minute surprise contentions of the need for additional surgeries. Claimant made an excellent recovery from his back surgery at L5-S1, with only ibuprofen for pain and returned to work full time.

  Claimant never proved he needed low back surgery to L4-5. Claimant never proved he needed neck surgery. Claimant never proved he needed surgery to his right shoulder. Claimant surprised Wesco with a last-minute opinion by Dr. Muldoon that claimant needed hip surgery and the arbitrator refused to let Dr. Richly examine claimant.  

  Wesco agreed with the arbitrator that claimant was entitled only to loss of earnings of $3,465 because he was paid by his employer. Claimant was not entitled to future loss of earnings because he continued to work full time after the accident. Offsets should apply for worker’s compensation benefits to which claimant was entitled and for the $50,000 he already received.