United States District Court, D. Arizona
Murray Snow Chief United States District Judge
before the Court are the Motion for Summary Judgment of
Defendant Privilege Underwriters, Inc. (Doc. 163) and the
Motion for Partial Summary Judgment of Plaintiffs Louis and
Randi Wikler (Doc. 161). For the reasons set forth below,
both motions are denied.
Court “evaluate[s] each motion [for summary judgment]
independently, giving the nonmoving party in each instance
the benefit of all reasonable inferences.” Lenz v.
Universal Music Corp., 815 F.3d 1145, 1150 (9th Cir.
2015) (citation and internal quotation marks omitted).
The Wiklers' Injuries
Wiklers were involved in an automobile accident on April 14,
2014. Louis Wikler was diagnosed with a contusion of the
chest wall as a result of the accident. Randi Wikler was more
seriously injured than her husband-she fractured part of her
left foot, and the injury aggravated an underlying congenital
condition. After a few months in a protective boot, the
fractures healed, and Ms. Wikler was able to take short hikes
with the aid of hiking poles. Soon thereafter, however, she
experienced pain in her ankle and was diagnosed with torn
ligaments. On the recommendation of her doctor, Ms. Wikler
underwent surgery in June 2016. However, that surgery was
also not entirely successful, and Ms. Wikler's doctors
have recommended another future operation.
The Wiklers' Claim
other driver was at fault in the accident but was insured
only with state minimum liability limits of $15, 000/$30,
000. The Wiklers accepted the policy limits offered by the
other driver's insurance a few months after the accident.
At the time of the accident, the Wiklers' insurance
policy with Defendants Privilege Underwriters Reciprocal
Exchange and Privilege Underwriters, Inc.
(“PURE”) provided underinsured motorist coverage
(“UIM”). The UIM provision of the contract
We will pay compensatory damages which an
“insured” is legally entitled to recover from the
owner or operator of an “underinsured motor
vehicle” because of “bodily injury”:
1. Sustained by an “insured”; and
2. Caused by an accident.
(Doc. 162 at 53).
Wiklers informed PURE that they would be claiming the balance
of their expenses pursuant to the UIM provision. PURE
assigned Sandra Manzella to handle the claim.
January 2015, Ms. Manzella asked the Wiklers if she could
provide medical authorization forms to them to sign so that
Ms. Manzella could begin gathering medical records. The
Wiklers declined, citing implications with possible medical
liens against them. In July 2015, Ms. Manzella sent medical
authorization forms to the Wiklers so she could begin
gathering the medical records. By October, the Wiklers had
not signed the medical authorizations, but did send a demand
letter to Ms. Manzella along with partial medical records.
The following January, the Wiklers sent more medical records
to Ms. Manzella.
response to the demand letter, Ms. Manzella made a settlement
offer: $8, 000 for Louis, and $40, 000 for Randi. The Wiklers
informed Ms. Manzella that Randi had been forced to miss work
from April 2015 to August 2015; Ms. Manzella responded that
the records provided so far did not indicate that Randi had
missed five months of work, and that without documentation of
the missed work she could not simply take the Wiklers'
word for it.
February 2016, Ms. Manzella made a global settlement offer of
$60, 000 based on the records available to her. She also
indicated that she would be willing to review any additional
documentation that the Wiklers provided. The Wiklers made a
counteroffer of $100, 000. Ms. Manzella countered that offer
with an offer of $70, 000. The Wiklers then informed Ms.
Manzella that Randi had been advised that she needed surgery
on her ankle, and Ms. Manzella stated that she would need to
re-evaluate the claim based on that information. Following
the surgery, the Wiklers notified Ms. Manzella that Randi had
lost her job because of her injuries. Ms. Manzella informed
the Wiklers that she needed documentation to evaluate the
claim and sent medical and employment authorizations to the
months later, in February 2017, the Wiklers provided the
signed authorizations. Ms. Manzella then requested and
received medical records from various medical providers and
employers. In March 2017, the Wiklers sent another demand
letter to Ms. Manzella in the amount of $1, 432, 450.50. Ms.
Manzella again responded that she would review the demand
once she had obtained the necessary records. After the
Wiklers provided more medical records, Ms. Manzella informed
the Wiklers she would be completing her evaluation based on
the records in her possession as of April 5, 2017.
Wiklers' claim file around that date contains the
-2 fractures in ankle with no surgery, up to 2 years