Insurance company claims fraud after hit-and-run accident claim. $159K arbitration award.

Summary

After plaintiff makes his second UIM claim for a hit-and-run accident, insurer cries foul.

The Case

  • Case Name: Michael Manes v. Allstate Northbrook Indemnity Company
  • Court and Case Number: UM Arbitration
  • Date of Verdict or Judgment: Tuesday, May 26, 2020
  • Date of Arbitration Award : Tuesday, May 26, 2020
  • Date Action was Filed: Friday, September 21, 2018
  • Type of Case: Underinsured Motorist, Vehicles – rear-ender
  • Judge or Arbitrator(s): R. A. Carrington
  • Plaintiffs:
    Michael Manes, 59.
  • Defendants:
    Allstate Northbrook Indemnity Company
  • Type of Result: Arbitration Award

The Result

  • Gross Verdict or Award: $159,508.09
  • Economic Damages:

    $42,068.09

  • Non-Economic Damages:

    $117,440

  • Trial or Arbitration Time: 6 1/2 hours

The Attorneys

  • Attorney for the Plaintiff:

    McDonald Worlely, P.C. by Michael R. Dufour, Los Angeles.

  • Attorney for the Defendant:

    Law Offices of Gregory J. Lucett by Ani S. Garibyan, Glendale.

The Experts

  • Plaintiff’s Medical Expert(s):

    Kiarash Michel, M.D., urology.

  • Defendant's Medical Expert(s):

    Richard Shapiro, M.D., urology.

    Gregory Lercel, M.D., orthopedic surgery.

  • Plaintiff's Technical Expert(s):

    John Gardiner, PhD, P.E., accident reconstruction.

  • Defendant's Technical Expert(s):

    Gregory R. Hora, P.E., accident reconstruction.

Facts and Background

  • Facts and Background:

    On December 5, 2017, at approximately 7:30 p.m., claimant was driving his 2006 BMW 750 LI eastbound on Pico Boulevard in Los Angeles. After passing through the intersection of Fairfax Avenue and Pico Boulevard, claimant was rear-ended by a white SUV with a large front bumper guard.

    The adverse driver immediately fled the scene and claimant was unable to determine the SUV's license plate number. Claimant called 911 from the scene.

  • Plaintiff's Contentions:

    That an unidentified motorist hit claimant's vehicle.

    Claimant's accident reconstruction expert/biomechanical engineer, John Gardiner of MEA Forensics, illustrated that, indeed, the property damage was consistent with the type of vehicle Mr. Manes described as having hit him.

  • Defendant's Contentions:

    Respondent contended that since claimant was in another hit-and-run accident in 2016, and thereafter increased his medical payments coverage from $5,000 to $25,000, that claimant was committing a fraud on respondent so that he would have funds to pay for a necessary surgical procedure.

    Accident reconstruction expert, Gregory Hora, alleged that claimant's property damage was inconsistent with a rear-end collision. Mr. Hora testified and offered opinions in his reports that the property damage was consistent with contact to a rigid barrier or stationary object, rather than the vehicle described by Mr. Manes.

Injuries and Other Damages

  • Physical Injuries claimed by Plaintiff:

    Aggravation of preexisting myofascial injuries, namely, claimant's entire back, neck, and left shoulder.

    The surgery recommended after this accident was a completely different surgery (necessitated by the impact) than that which was recommended before the accident.

  • Permanent damage to claimant's bilateral Interstim Implant (fractured electrodes), which rendered the implant nonfunctional.

Special Damages

  • Special Damages Claimed - Past Medical: $42,068.09