American Fidelity to pay $10.8M
Insurance company calls the verdict ‘outlandish'
American Fidelity to pay $10.8M

Comments Comment on this article9

By Don Mecoy
Published: February 2, 2008

American Fidelity Assurance Co. said Friday that it was "astonished” by a jury verdict ordering the Oklahoma City insurance company to pay $10.8 million for improperly reducing the benefit owed to the mother of a policy holder who died.

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"We are astonished in this case and believe the outcome is unjust and unwarranted,” the company said in a statement issued Friday afternoon. "Without question, the $10.8 million jury award in this case is not only outlandish, but it also is completely out of line when you consider this case was over a benefit dispute of $1,110.13.”

"Our first response will be to seek a judicial review and ask the judge to set this verdict aside,” the company said.

Dolores Metzger claimed the company improperly changed its policy for paying "actual charges” for limited benefit health insurance policies, such as the cancer policy purchased by Metzger's son. Before 1994, American Fidelity paid whatever the patient was billed. In 1994, American Fidelity began paying only the often-discounted amount that health care providers charged insurance companies.

The company, in court documents, admitted that it changed its definition of "actual charges” in 1994. But American Fidelity denied that it violated Oklahoma law or public policy or that it acted in bad faith.

‘She just wanted justice...'
Metzger's son, Michael, bought a cancer policy from American Fidelity in 1992 and named his mother beneficiary. The University of Central Oklahoma economist was diagnosed with cancer in November 2004 and died Jan. 4, 2005. Dolores Metzger filed her lawsuit Oct. 11, 2005.

Metzger declined to comment Friday on the verdict.

Oklahoma City Attorney Tony Gould, who represented Metzger, said the company heavily marketed cancer policies to Oklahoma teachers.

"This was never about the money to her,” Gould said. "She just wanted justice for Oklahoma educators.”

Gould initially sought to have the case certified as a class action but was denied. However, he said if American Fidelity seeks to appeal the ruling, he will appeal the denial of class action status based on what happened at the eight-day federal trial before U.S. District Judge Vicki Miles-LaGrange.

Jurors deliberated about an hour before returning their verdict Thursday, and then deliberated another hour before ordering American Fidelity to pay more than $10 million in punitive damages.

Gould said evidence about the company's change in its pay-out policy and later attempts to defend the policy "enflamed the jury.”

Under questioning from Gould on Monday, imprisoned former Insurance Commissioner Carroll Fisher invoked his Fifth Amendment right more than 40 times to avoid incriminating himself. Gould asked Fisher whether he changed his interpretation of "actual charges” to match American Fidelity's after the company donated $1,625 to his charitable foundation.

Gould also asked American Fidelity officials about the company's efforts to pass legislation in 2006 altering the legal definition of "actual charges.”

"It seeks to deprive teachers fighting cancer the full benefits of their policies,” Gould said of the legislation. "It's egregious what our Legislature's done. That's what made the jury really mad.”


 

Related Topics: Civil Trials, Trials

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American Fidelity deserves every penny of this punishment. Who cares what there employees are saying regarding how great it is to work there. Bet they wouldnt get the same response and corresponding Forbes rating if they polled actual policy-holders. Thank god this made it to a jury.
steve, enid - Feb 25, 2008 at 5:26 pm
I think the insurance company was very fortunate in this case to get off with only $10M. Had I been on this jury I would probably have held out for a much higher award. About Mr.Gould's fee in this case, that's between him and his client. He earned it. This lady wasn't looking for a big settlement, just what she deserved. The corporation tried to change the rules in the middle of the game and lost. Our system is alive and well.
howard, Oklahoma City - Feb 3, 2008 at 9:59 am
To those comments supporting tort reform below, simply how ill-informed you are. I guess by reading this Oklahoman article (whom is unabashadly for tort reform) you have decided that you knew more than the men and women (teachers, nurses, concrete workers) in reading this article than they did by listening to the facts and circumstances that made up this case. THis case whom the defense drug out for ten years. This case which the Plaintiff attorney spent thousands of dollars of his own money own. I mean, sitting in front of your computer you are so informed as to the incricate facts such as what the basis of the award was for. I mean, just maybe could it have been punitatives equaling one day of profits for the insurance company? Hmmmm, go ahead judge, continue to spout your ignorance based upon this written article by a pro-tort reform newspapers and comments from a defense lawyer who lost the case and in the future possibly his client.

I recall O.J. Simpson's lawyer tell everyone he was innocent, did you believe them? Or Jeffrey Dahmers say he was innocent, did you believe them? Well based upon your comments here I suppose you would have let Dahmer, Nichols, and the like off the hook because their "lawyers" said they really didn't do it.

Shame on your ignorance. Actually learn to form opinions and read up on the justice system before you judge, lest one day your same fate is before a jury who says your life is only worth $250,000.00 since your a stay at home mom with no loss income or medical bills. I mean, emotionally, your kids won't miss you more than that. Even though the jury thought that that drunk semi driver who had killed three others and still been hired by the rich corporate trucking company should have to pay ten million for the loss of life and companionship your grief stricken husband and children suffered. But hey, you and the prostitute republicans in the state house (before you go there, i'ma republican whom they have lost in their lies)know better than the neighbor teacher, nurse, acountant, construction worker.

No actually shame on you for commenting on something you know little about.
Jeremy, Moore - Feb 2, 2008 at 9:35 pm
The courtroom is the last place the average Joe has a chance against getting run over by corporations. Period. That's why corporations want to limit awards. They want to take away our last opportunity to bring them to justice.
B, Oklahoma City - Feb 2, 2008 at 6:20 pm
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You "tort reformers" always cry that the sky is falling when an irresponsible company is on the receiving end of justice. This lawyer invested his time and money on a case I dare say few would have the guts to take. And he fought against a billion dollar company with unlimited resources. And he exposed the company and the Oklahoma legislature as corrupt. And the verdict was rendered by a jury of your fellow Oklahomans who sat through the evidence. You can second guess them all you want and you can fly your tort reform banner. But your ignorance will never stand in the way of one of the finest cornerstones of our Constitution-trial by a jury of your peers.
tim, fort worth - Feb 2, 2008 at 9:52 am
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Everything is wrong until your loved one gets murdered then everything will change. Excessive! Not hardly!
Desiderius, Tuttle - Feb 2, 2008 at 9:34 am
While I agree that the verdict is excessive, you can't say the companies actions were responsible either. It's kind of a catch 22....if companies no longer have ANY fear of a big verdict, it makes you wonder if they will take advantage?
Philip, Oklahoma City - Feb 2, 2008 at 9:14 am
It's also a perfect example why we need tort reform in Oklahoma. This lady reminds me of the lady who sued McDonald's over her coffee being too hot! 10.8 million over a 1,100 dispute? Wow
B, Edmond - Feb 2, 2008 at 8:38 am
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This is a perfect example of what is wrong with American health care. A stupid, stupid jury thinks giving $10mil to a trial lawyer like Tony Gould (he'll take 75% of the award - plus expenses) is going to 'punish' one of the best companies in the country. It isn't the insurance company's fault that hospitals and doctors are trying to raise prices by playing games with the invoices - ask for $1000 but accept $100 from everyone who knows the game. And then this newspaper story forgets to mention that the deceased *had all his medical bills paid*. The trial lawyer just wanted to steal some gravy from all the other teachers who had bought policies from AFI.
c, Oklahoma City - Feb 2, 2008 at 7:38 am
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