Court: District Court, D. Colorado; December 27, 2011; Federal District Court
Defendant's Motion to Preclude Plaintiffs Expert Richard Hodges' Opinions has been granted by Magistrate Judge Boyd N. Boland. The case involves a claim for underinsured motorist (UIM) insurance benefits stemming from an accident on February 5, 2010, where the plaintiff, an 89-year-old woman, was struck by a vehicle driven by Elise Henderson. The plaintiff sustained severe injuries, including a shattered left leg and head injuries, resulting in over $200,000 in medical bills and permanent impairment, which has compromised her ability to live independently.
Henderson's insurance paid the maximum liability of $50,000. The plaintiff also received $50,000 from her own Ohio Casualty insurance policy. Additionally, the plaintiff is a resident-relative of an individual insured by American Family Mutual Insurance Company, which has three policies providing $100,000 in UIM benefits each.
On October 13 and November 10, 2010, the plaintiff requested American Family to evaluate her claim for $300,000 in UIM benefits, providing all pertinent medical documentation. However, American Family unreasonably delayed the evaluation, continuously seeking unnecessary information, and ultimately offered only $22,000, which was significantly below the damages incurred. The plaintiff's claims against American Family include breach of contract, bad faith breach of contract, and violations of Colorado Revised Statutes regarding unreasonable delay and denial of UIM benefits.
Richard Hodges, retained by the plaintiff, is an experienced lawyer with a history in the insurance industry, having worked for Allstate Insurance Company from 1968 to 1982 and practiced law since 1984. He frequently lectures on insurance topics and has served as an expert witness in over 58 cases. The defendant does not contest his qualifications but aims to exclude specific opinions he plans to present at trial.
First, the defendant seeks to exclude Hodges' opinion regarding American Family's obligation to pay undisputed claims, asserting that the insurer should promptly pay amounts not in dispute, and citing a minimum amount of $32,000 that American Family evaluated for Ms. Baumann's claim as of February 23, 2011. Hodges also contends that American Family was obligated to pay the undisputed amount it determined for Ms. Baumann’s underinsured motorist (UIM) claim.
Second, the defendant seeks to exclude Hodges' assertion that American Family did not adequately investigate the non-economic aspects of Ms. Baumann’s claim beyond initial inquiries.
Finally, the defendant aims to prevent Hodges from testifying that American Family’s claim evaluation process included problematic requirements for submitting bills through its computer system, which he describes as convoluted and unreasonable, particularly in requesting additional information to meet those requirements.
The proponent of expert testimony is responsible for demonstrating the admissibility of the testimony, as outlined under Rule 702, which mandates that the district court ensure the testimony is both reliable and relevant to assist the jury.
To determine the admissibility of expert testimony, a district court must first assess whether the expert possesses the necessary qualifications, including knowledge, skill, experience, training, or education. If qualified, the court then evaluates the reliability of the expert's opinion by examining the underlying reasoning and methodology, as established in Daubert v. Merrell Dow Pharmaceuticals, Inc. This reliability assessment may involve scrutiny of the expert’s data, methods, and the application of those methods to the data. The party presenting the expert must demonstrate that the method used is scientifically sound and that the opinion meets the reliability standards of Rule 702. The focus should be on the expert's methodology rather than their conclusions, although methodology and conclusions are interconnected.
The gatekeeping role established in Daubert has been extended to all forms of expert testimony, as affirmed in Kumho Tire Co. Ltd. v. Carmichael. Importantly, courts may reject opinion evidence that lacks a sufficient analytical connection to the underlying data, as noted in General Electric Co. v. Joiner.
Regarding attorneys as expert witnesses, the Tenth Circuit in Specht v. Jensen emphasized that while expert opinions can assist juries on ultimate issues, the trial judge retains the exclusive role of interpreting the law for the jury. An attorney should not overstep this function, as demonstrated in Marx Co. v. Diners’ Club, Inc. However, experts may reference legal standards as long as they do not attempt to define the law that governs the jury's decision-making. Testimony aimed at guiding juries on legal standards is inadmissible, preserving the court's authority in legal interpretation.
In United States v. Jensen, the 10th Circuit established that expert witnesses are prohibited from stating legal conclusions, assessing the credibility of evidence, or directing juries on outcomes. This principle is reiterated in subsequent cases such as A.E. By and Through Evans, Holman Enterprises, and Rieger v. Orlor, which emphasize that expert testimony must avoid encroaching on legal determinations reserved for the jury. In Rieger, the court identified that an expert's opinion, while qualified, can become impermissible if it incorporates legal standards or conclusions, effectively substituting the jury's role in applying the law to facts. A Kansas district court further clarified that while experts can discuss industry practices, they cannot provide opinions on specific legal definitions or claims, as these are determinations the jury can make independently. Mr. Hodges' opinions regarding the obligations of an insurance company are similarly framed as legal duties, which also fall outside the permissible scope of expert testimony.
Mr. Hodges' opinions are deemed inappropriate as they infringe upon the trial judge's role in instructing the jury on legal standards. Although he could have indicated that it is standard practice in the insurance industry to pay undisputed claims while negotiating disputed ones, his testimony instead attempts to define the legal standards relevant to the case. This is contrary to established precedents, which hold that expert testimony should not guide the jury's understanding of legal principles, as it can lead to confusion and conflicting interpretations. Furthermore, Hodges' conclusions regarding the investigation of the plaintiffs' noneconomic damages are factual matters for the jury to decide, and his interpretation does not aid their understanding. His negative characterization of American Family’s computer program and speculative claims about their information requests are also considered inflammatory and unhelpful. Consequently, the motion to exclude Mr. Hodges' testimony is granted, preventing him from presenting the contested opinions.
