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 Action: 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

Disclaimer

This is not an official court document. While the publisher believes the information to be accurate, the publisher does not guarantee it and the reader is advised not to rely upon it without consulting the official court documents or the attorneys of record in this matter who are listed above.