Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-4_18-cv-00378/USCOURTS-azd-4_18-cv-00378-5/pdf.json

Nature of Suit Code: 360
Nature of Suit: Other Personal Injury
Cause of Action: 28:1331 Fed. Question: Breach of Contract

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WO

IN THE UNITED STATES DISTRICT COURT

FOR THE DISTRICT OF ARIZONA

Robert Luke Adams, an individual, 

Plaintiff, 

vs.

Symetra Life Insurance Company, an Iowa

corporation, 

Defendant.

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No. CV 18-378-TUC-JGZ (LAB)

REPORT AND RECOMMENDATION 

Pending before the court is the defendant’s motion for partial summary judgment

filed on February 4, 2020. (Doc. 202) The plaintiff filed a response on March 19, 2020. (Doc.

229) The defendant filed a reply on April 3, 2020. (Doc. 239)

The plaintiff, Robert Luke Adams, claims the defendant, Symetra Life insurance

Company (Symetra), breached an insurance contract and breached the duty of good faith and

fair dealing by failing to pay benefits due in accordance with his Long Term Disability Income

Insurance Policy (Policy). (Doc. 1) Symetra argues in the pending motion that summary

judgment is appropriate on the bad faith and punitive damages claims. (Doc. 202)

The case has been referred to Magistrate Judge Bowman for report and

recommendation pursuant to the Local Rules of Practice. LRCiv 72.1. 

The Magistrate Judge recommends that the District Court, after its independent

review of the record, deny the motion. A reasonable person could conclude that Symetra acted

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1 The court construes the facts in the light most favorable to the nonmovant, as it must on a

motion for summary judgment. Soremekun v. Thrifty Payless, Inc., 509 F.3d 978, 984 (9th Cir. 2007).

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in bad faith. A reasonable person could conclude by clear and convincing evidence that Adams

is entitled to punitive damages.

BACKGROUND1

Adams was a self-employed insurance agent who sold Farm Bureau insurance

products. (Doc. 230-1, p. 21, par. 1) (Plaintiff’s statement of facts) Adams purchased a longterm disability insurance policy (Policy) from the defendant, Symetra. (Doc. 203, par. 1)

(Defendant’s statement of facts) Under the Policy, disability is defined as sickness or injury that

prevents the insured from “performing with reasonable continuity the material and substantial

duties of [his] regular occupation” resulting in “a 1% or greater loss of income.” (Doc. 203, par.

13) A person’s regular occupation is defined as “the occupation as it is performed nationally,”

not as that person performed it. (Doc. 203, par. 15) The policy provides for a monthly benefit

of 60% of the insured’s earnings up to $15,000. (Doc. 203, par. 16) For a claimant under the

age of 60, payments are made until the claimant reaches the age of 65. (Doc. 203, par. 17) If,

however, the disability is “caused or contributed to by mental illness, substance abuse, or

special conditions,” payments are limited to 12 months. (Doc. 203, par. 18) A

“musculoskeletal disorder[] of the neck and back” is a special condition. (Doc. 203, par. 19)

“[P]rogressive inflammatory arthritis of the spine,” however, is not. Id.

On January 22, 2018, Adams submitted a claim under the Policy to Symetra. (Doc.

203, par. 3) He reported that he was no longer able to work as an insurance agency owner due

to rheumatoid arthritis. Id., par. 5-6; (Doc. 230-1, p. 23, par. 7) He submitted a Physician’s

Statement from his treating physician, rheumatologist Dr. Ulker Tok. (Doc. 203, par. 7) Tok

listed three diagnoses: Rheumatoid Arthritis, Low Back Pain, and Chronic Pain. Id., par. 8

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Adams’s claim was initially assigned to claims manager Stephanie Cortez. (Doc.

203, par. 11) (Defendant’s statement of facts) Cortez obtained medical records from Dr. Tok

and Dr. Thomas Coury, Adams’s pain management doctor. (Doc. 203, par. 21) Cortez

approved the claim provisionally because Adams was “unable to perform the full duties of his

regular occupation due to low back pain, chronic pain, and RA [rheumatoid arthritis].” Id., par.

23 She marked the claim for follow up attention “for medical updates, [to] monitor [Adams’s]

conditions and assess if [Adams] will remain disabled beyond 12 months for a non-limited

condition.” Id. She believed “back pain” was a special condition that could result in a 12-

month limitation on benefits. Id., par. 24 Cortez called and wrote Adams informing him that

his claim was approved. Id., par. 25-29 She also told him that the policy had a one-year

limitation for special conditions and that low back pain was a special condition. Id., par. 28-29.

She explained that Symetra would make a determination about the applicability of the “special

condition” limitation closer to the one-year mark. Id., par. 31 Adams was distressed at the

possibility that his benefits could be limited and called Symetra numerous times explaining that

his disabling condition was rheumatoid arthritis. Id., par. 33; (Doc. 230-1, p. 28, par 24)

Cortez obtained updated medical records from Drs. Tok and Coury. (Doc. 203, par.

34) In May of 2018, Tok opined that Adams could work full time in a low stress desk job. Id.,

par. 39-40 She further stated as follows: “not sure if [Adams] can perform high stress prior job

as a financial planner/consultant.” Id., par. 43 Coury opined that Adams could not work full

time and this was a permanent restriction. Id., par. 45

Cortez referred the updated medical records to in-house nurse Megan St. Germain.

(Doc. 203, par. 46) St. Germain could not determine whether the restrictions stated by Tok and

Coury were supported. Id., par. 47 Department manager Lindsey Lajoie reviewed the claim

and approved payment of benefits. Id., par. 49

Symetra then transferred Adams’s claim to Peter Skipp, a newly hired claims

adjuster. (Doc. 203, par. 52-55) Skipp was aware that Adams claimed disability due to his

rheumatoid arthritis (RA). (Doc. 230-1, p. 28, par. 23, 25, 26) (Plaintiff’s statement of facts)

He knew that rheumatoid arthritis (RA) causes “sporadic and periodic episodes of the symptoms

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worsening or flare-ups and that these can last for days, weeks, or even months.” Id., p. 28, par.

25 He knew RA was a systemic disease that can cause pain in many parts of the body. Id., p.

28, par. 25 It is a progressive disease meaning “that over time it continues to worsen.” Id.

Skipp “did not dispute or have any doubts that Adams was suffering from significant pain in his

joints, including joints other than his back, and that that pain would be so severe that he can’t

even get out of bed on some days.” Id., p. 29, par. 28 (punctuation modified) He also knew that

an examining physician would ordinarily have greater insight into a person’s condition than a

physician who only reviews documents. Id., p. 29, par. 29 And he knew Tok and Coury had

examined Adams many times over the years. Id. 

Skipp performed internet research and conducted a background search. (Doc. 203,

par. 57) He also ordered surveillance on Adams. Id. The first round of surveillance was

conducted over three days, beginning August 1st. (Doc. 230-1, p. 31, par. 36); (Doc. 234-1, pp.

67-69) (Skipp deposition) On the first day, Adams drove to his workplace and remained for

14 minutes. (Doc. 234-1, p. 67) On the second day, Adams did not leave his house. Id., p. 68

On the third day, Adams was seen helping his children get in and out of his car and changing

the rooftop air conditioning filters. Id., p. 68 Skipp agreed that the surveillance was consistent

with a person with RA who has good days when he can move about and bad days when he must

stay in bed. Id., pp. 67-70 The investigation revealed “nothing to indicate this was not a

payable claim.” (Doc. 234-1, p. 69, l. 18 – p. 70, l. 21); (Doc. 230-1, p. 31, par. 36) The

second round of surveillance was conducted from August 24, 2018 to August 26, 2018. (Doc.

230-1, p. 31, par. 37); (Doc. 234-2, p. 6) Again, there was nothing inconsistent between the

surveillance and Adams’s reported condition. (Doc. 230-1, p. 31, par. 37); (Doc. 234-1, p. 76,

l. 5-14) Skipp requested a third round of surveillance on September 7, 2018. (Doc. 230-1, p.

32, par. 39); (Doc. 234-1, p. 77) Again, there was nothing inconsistent between the

surveillance and Adams’s reported physical limitations. (Doc. 230-1, p. 32, par. 39); (Doc.

234-1, p. 78, lines 4-13) Skipp admitted “there’s nothing inconsistent with what Mr. Adams

reported he could do on a good day, and a third of the time he did not – he was not observed

outside of his residence.” (Doc. 234-1, p. 76, l. 11-14)

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Skipp obtained updated records from Tok and Coury. (Doc. 203, par. 58)

(Defendant’s statement of facts) He referred the claim to Sandra Boyd for an occupational

analysis. (Doc. 203, par. 59-60) Boyd concluded that the insurance agent occupation requires

light exertion and occasional travel. Id., par. 62 Skipp then referred the claim to two nonexamining consultants, rheumatologist Dr. Vikram Garg and occupational medicine physician

Dr. Frank Polanco. (Doc. 203, par. 66, 70) 

Garg reviewed the medical reports and the surveillance reports, and he spoke with

Dr. Tok. (Doc. 203, par. 72) Garg opined that while Adams had seronegative rheumatoid

arthritis, he had no restrictions or limitations. Id., par. 75 He explained that his assessment of

functional limitation was based on the fact that there was “no evidence of persistent small joint

synovitis or restriction in peripheral joint range motion.” Id., par. 75, 80 Furthermore, he stated

in his written opinion that the surveillance videos showed inconsistencies. (Doc. 230-1, p. 35,

par. 49); (Doc. 234-2, p. 111) (Garg deposition); see also (Doc. 234-1, p. 101) (Skipp

deposition) 

Polanco was instructed to review any non-rheumatological diagnoses and

limitations. (Doc. 203, par. 68) He reviewed the medical documentation and wrote his own

report. (Doc. 203, par. 70, 82) In that report, Polanco opined that while Adams experienced

chronic pain and periodic flare ups from his RA, he had no limitations from nonrheumatological diagnoses, and he was able to work full time. (Doc. 203, par. 87, 88)

Skipp determined that Adams was not disabled and never had been. (Doc. 203, par.

92) His determination was approved by the department manager. (Doc., par. 94) Skipp sent

Adams a letter explaining Symetra’s final decision. (Doc. 203, par. 95); (Doc. 234-2, pp. 58-

63) The letter reads in pertinent part as follows: “In order to address any restrictions and

limitations that would be medically supported from a rheumatological perspective, an

independent board-certified rheumatologist was consulted. Based on the information in the file,

the reviewing rheumatologist opined there were no supported restrictions and limitations

preventing you from performing sustained activities of any level.” (Doc. 234-2, p. 62) 

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The letter also contains the following justification: “Additionally, independent

observation of your activities shows you engaging in a level of functioning that is inconsistent

with what you have reported. The movement observed by surveillance is contrary to your

reported restrictions and limitations and is consistent with an ability to perform light work.”

(Doc. 234-2, p. 63) “Therefore, while you do appear to have diagnoses of rheumatoid arthritis

and degenerative disc disease and associated low back pain, given the information currently

available, we have determined that those conditions do not impair you from performing the

material duties of your Regular Occupation as an insurance agent.” Id.

Standard of Review: Summary Judgment

Summary judgment is available only “if the movant shows that there is no genuine

dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed.

R. Civ. P. 56(a). There is a genuine dispute “if the evidence is such that a reasonable jury could

return a verdict for the non[-]moving party.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242,

248, 106 S.Ct. 2505, 2510 (1986). 

The initial burden rests on the moving party to point out the absence of any genuine

issue of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 2553

(1986). “Where the moving party will have the burden of proof on an issue at trial, the movant

must affirmatively demonstrate that no reasonable trier of fact could find other than for the

moving party.” Soremekun v. Thrifty Payless, Inc., 509 F.3d 978, 984 (9th Cir. 2007). “Where

the non-moving party bears the burden of proof at trial, the moving party need only prove that

there is an absence of evidence to support the non-moving party’s case.” In re Oracle Corp.

Securities Litigation, 627 F.3d 376, 387 (9th Cir. 2010).

Once initially satisfied, the burden shifts to the non-movant to demonstrate through

the production of probative evidence that an issue of fact remains to be tried. Celotex Corp.,

477 U.S. at 324, 106 S.Ct. at 2553. “If a reasonable jury viewing the summary judgment record

could find by a preponderance of the evidence that [the plaintiff is] entitled to a verdict in his

favor, then summary judgment [is] inappropriate; conversely, if a reasonable jury could not find

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liability, then summary judgment [is] correct.” Cornwell v. Electra Cent. Credit Union, 439

F.3d 1018, 1027-28 (9th Cir. 2006).

“In judging evidence at the summary judgment stage, the court does not make

credibility determinations or weigh conflicting evidence.” Soremekun v. Thrifty Payless, Inc.,

509 F.3d 978, 984 (9th Cir. 2007). “Rather, it draws all inferences in the light most favorable

to the non[-]moving party.” Id.

Discussion: Bad Faith

In the pending motion, Symetra argues first that summary judgment is appropriate

on the issue of bad faith. (Doc. 202, p. 11) The court does not agree.

“[T]here is a legal duty implied in an insurance contract that the insurance company

must act in good faith in dealing with its insured on a claim, and a violation of that duty of good

faith is a tort.” Deese v. State Farm Mut. Auto. Ins. Co., 172 Ariz. 504, 506-507, 838 P.2d

1265, 1267-1268 (1992). “The duty of good faith arises because an insurance contract is not

an ordinary commercial bargain; implicit in the contract and the relationship is the insurer’s

obligation to play fairly with its insured.” Demetrulias v. Wal-Mart Stores Inc., 917 F. Supp.

2d 993, 1004 (D. Ariz. 2013) (punctuation modified). “An insurance relationship carries some

duties of a fiduciary nature.” Id. “Among them are equal consideration, fairness and honesty.”

Id.

“There are two elements to the tort of bad faith: (1) that the insurer acted

unreasonably toward its insured, and (2) that the insurer acted knowing that it was acting

unreasonably or acted with such reckless disregard that such knowledge may be imputed to it.”

Miel v. State Farm Mut. Auto. Ins. Co., 185 Ariz. 104, 110, 912 P.2d 1333, 1339 (App. 1995).

Although bad faith actions are often brought because the insurer denied a specific insurance

claim, bad faith may result from any act that breaches the implied covenant of good faith and

fair dealing, even acts that do not breach an express term in the policy. Deese, 172 Ariz. at 509,

838 P.2d at 1270. A plaintiff “need not prevail on the contract claim in order to prevail on the

bad faith claim. . . .” Id.

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In the pending motion, Symetra argues that it “had a reasonable basis to conclude

that Plaintiff was not disabled.” (Doc. 202, p. 11) That, however, is not the test. On summary

judgment, it is not enough for Symetra to prove that a reasonable person could find in its favor.

Symetra must show that no reasonable person could find in Adams’s favor. That is different.

This court finds to the contrary that a reasonable person could find Symetra breached the duty

of good faith. Summary judgment therefore should be denied. See Cornwell v. Electra Cent.

Credit Union, 439 F.3d 1018, 1027-28 (9th Cir. 2006).

It is instructive to examine the letter that Skipp sent to Adams rejecting his claim.

This letter provides a window into Symetra’s thought processes and says much about how

reasonably it considered the interests of its insured.

The letter explains that Symetra gathered medical opinions from Adams’s treating

physicians, Tok and Coury. The letter states correctly that Coury believed Adams was

“incapable of working full-time.” (Doc. 234-2, p. 60) The letter further states that Tok found

that Adams was “capable of performing a low stress job with symptoms at that time. . . .” (Doc.

234-2, p. 60) This is misleading. Tok did say that Adams could work at a low stress job, but

she also said she was “not sure if [Adams] can perform high stress prior job as a financial

planner/consultant.” (Doc. 203, par. 41, 43) She qualified her opinion based on the type of job.

The letter elides this qualification. 

In fact, Adams was not a financial planner/consultant. He was the owner of an

insurance agency, but the exact nature of his job is not important. What is important is that

Tok’s opinion as to whether Adams can work depends on the nature of his job – high stress or

low stress. Adams asserts that he has a high stress job and assuming he is correct, as the court

must on summary judgment, Tok’s opinion does not support a finding that Adams can still

work. (Doc. 230-1, p. 21, par. 2, 3) (“Though the work is stressful . . .”); (Doc. 230-1, p. 30,

par. 31); see also (Doc. 234-1, p. 65, l. 6-11) (Skipp knew Tok believed Adams was disabled

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2 One could argue that between the two treating physicians, Coury’s opinion should be given

greater weight because Adams maintains that he is disabled due to pain and Coury is a pain

management specialist.

3 The letter denying benefits contains a short segue regarding the “special condition” issue.

Specifically, the letter states that, “[w]hen the rheumatology reviewer spoke with Dr. Tok, she noted

it was somewhat difficult to distinguish exactly what was causing your limitations but she felt that it

is more of issues related to your back.” (Doc. 234-2, p. 62) (punctuation modified) And “[a]lthough

we do not find that you are restricted or limited from performing the material duties of your Regular

Occupation . . . the opinion of Dr. Tok . . . reflects that your claimed restrictions and limitations are

contributed to by your lower back condition, which would subject your claim to the Special Conditions

limitation noted above.” Id., pp. 62-63 The court considers this section of the letter to be something

of a red herring. Symetra denied benefits based on its conclusion that Adams was not disabled, not

because his limitations were caused by a special condition. (Doc. 203, par. 96) Furthermore, even if

benefits could be denied under the special condition, this court’s analysis of the pending motion would

not change. Bad faith can be found even where the underlying contract claim fails. See Deese, 172

Ariz. at 509, 838 P.2d at 1270.

4 The court assumes without deciding that Symetra was justified in seeking additional medical

opinions. But see, e.g., Demetrulias v. Wal-Mart Stores Inc., 917 F. Supp. 2d 993, 1007 (D. Ariz.

2013) (“Using an [independent medical expert] to ‘limit the extent of the injury’ could show that

Walmart intended the act or omission and formed that intent without reasonable or fairly debatable

grounds.”) (Punctuation modified).

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partially due to stress.) A reasonable person could conclude that the opinions of Adams’s

treating physicians2

 do not support Symetra’s conclusion that Adams can still work.3

The letter then explains that Symetra sought the opinions of a rheumatologist, Dr.

Vikram Garg, and an occupational medicine physician, Dr. Frank Polanco.4

 (Doc. 203, par. 70)

These physicians opined that Adams was not disabled. Then, Symetra decided to adopt the

opinions of Garg and Polanco and reject the opinions of Coury and Tok. In order for Symetra

to win on summary judgment, it must show that no reasonable person could find that Symetra

acted unreasonably when it made this decision. It cannot. The court concludes that a

reasonable person could find that Symetra’s decision here was unreasonable.

Skipp knew that Coury and Tok were treating physicians who, by virtue of their

numerous examinations and interactions with Adams, were in the best position to accurately

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evaluate his impairment and the extent of his functional limitations. Nevertheless, Skipp

decided to reject their opinions and adopt the opinions of the non-examining consultant

physicians, Garg and Polanco. This is a counterintuitive decision, and it requires an

explanation. Fortunately, the letter denying benefits gives one. The letter states as follows:

“Additionally, independent observation of your activities shows you engaging in a level of

functioning that is inconsistent with what you have reported. The movement observed by

surveillance is contrary to your reported restrictions and limitations and is consistent with an

ability to perform light work.” (Doc. 234-2, p. 63) Apparently, Symetra rejected the opinions

of Adams treating physicians and adopted the opinions of the non-examining consulting

physicians because the surveillance discovered that Adams was engaging in activities

inconsistent with disability. Or so the letter says.

The record indicates, however, that the surveillance did not catch Adams engaging

in activities inconsistent with disabling RA. Skipp conceded at his deposition that the

surveillance was consistent with a person with RA who has good days when he can move about

and bad days when he must stay in bed. (Doc. 234-1, pp. 67-70) Polanco did not see any

inconsistencies in the surveillance either. (Doc. 234-1, p. 102, l. 4-8) So was Skipp lying? Not

necessarily. In his written opinion, Garg stated that the surveillance showed Adams acting in

a manner inconsistent with the limitations described by his treating physicians. (Doc. 234-2,

p. 111) It is possible that Skipp was simply deferring to Garg. In his deposition, however,

Garg stated that “I don’t think there’s many — much in the way of inconsistencies with respect

to the surveillance and what the doctors have told me.” (Doc. 234-2, p. 111) When pressed,

he said he was “not sure” why he stated in his opinion that the surveillance showed

inconsistencies and said, “I’d have to go back and look and review everything.” (Doc. 234-2,

p. 111) No one from Symetra contacted Garg to clarify why he put the statement about

inconsistencies in his opinion. (Doc. 234-2, p. 111) A reasonable person could conclude that

Garg did not see any inconsistencies either. 

A reasonable person could conclude that the surveillance showed no inconsistencies

whatsoever, and the proffered reason given in the letter for rejecting the opinions of Adams’s

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treating physicians was false. A reasonable person could further find that this false reason is

a pretext for the real reason, which is simply that Symetra wanted to save some money. Adams

was making well over $500,000 per year. (Doc. 230-1, p. 22, par. 3) He filed for disability

when he was 38 years old. Id. If disabled, he was entitled to approximately $160,000 per year

for 27 years – over four million dollars. (Doc. 203, par. 16, 17); (Doc. 234-2, p. 63) A

reasonable person could conclude that Symetra “acted unreasonably toward its insured” by

putting its own financial interest ahead of the Adamses’. See Miel v. State Farm Mut. Auto. Ins.

Co., 185 Ariz. 104, 110, 912 P.2d 1333, 1339 (App. 1995).

A reasonable person could further find that Symetra “acted knowing that it was

acting unreasonably or acted with such reckless disregard that such knowledge may be imputed

to it.” See Miel v. State Farm Mut. Auto. Ins. Co., 185 Ariz. 104, 110, 912 P.2d 1333, 1339

(App. 1995). Skipp knew that the surveillance did not uncover any evidence that Adams was

not disabled. Nevertheless, he stated in the letter that this was one of the reasons why Adams’s

treating physicians’ opinions were rejected. He either did this knowing the reason was false or

he did it because he believed Garg might have seen something important in the surveillance.

If the latter, a reasonable person could conclude that he should have followed up by asking Garg

what he saw in the surveillance because he, Skipp, saw nothing inconsistent with disability. A

reasonable person could conclude that Skipp did not follow up, which displayed a reckless

disregard for the interests of the insured.

A reasonable person could find that Symetra acted in bad faith. Summary judgment

on this issue should be denied. See, e.g., Demetrulias v. Wal-Mart Stores Inc., 917 F. Supp. 2d

993, 1011 (D. Ariz. 2013) (“[A] jury could find that [claims supervisor] Stewart intentionally

made false statements to Dr. Borowsky regarding the existence of surveillance tape and

incorporate those statements in a larger picture of bad faith.”).

Discussion: Punitive Damages

“[T]o obtain punitive damages, plaintiff must prove that defendant’s evil hand was

guided by an evil mind.” Rawlings v. Apodaca, 151 Ariz. 149, 162, 726 P.2d 565, 578 (1986).

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“The evil mind which will justify the imposition of punitive damages may be manifested in

either of two ways.” Id. “It may be found where defendant intended to injure the plaintiff.”

Id. “It may also be found where, although not intending to cause injury, defendant consciously

pursued a course of conduct knowing that it created a substantial risk of significant harm to

others.” Id.

“Summary judgment on the question of punitive damages is inappropriate if a

reasonable jury could find the requisite evil mind by clear and convincing evidence.”

Demetrulias v. Wal-Mart Stores Inc., 917 F.Supp.2d 993, 1010-1011, 2013 WL 135273, 14

(D.Ariz. 2013) (quoting Thompson v. Better–Bilt Aluminum Prods. Co., 171 Ariz. 550, 558,

832 P.2d 203, 211 (1992)). “The evil mind can be shown by some combination of evil actions,

spiteful motives, or outrageous, oppressive or intolerable conduct that creates a substantial risk

of tremendous harm to others.” Id. (punctuation modified). “Put another way, the court

considers the nature of the defendant’s conduct, including the reprehensibility of the conduct

and the severity of the harm likely to result, as well as the harm that has occurred, the duration

of the misconduct, the degree of defendant’s awareness of the harm or risk of harm, and any

concealment of it.” Id.

In this case, a reasonable person could conclude there is clear and convincing

evidence that Symetra “consciously pursued a course of conduct knowing that it created a

substantial risk of significant harm to [its insured].” See Rawlings v. Apodaca, 151 Ariz. 149,

162, 726 P.2d 565, 578 (1986). Rather than accept the opinions of disability offered by

Adams’s treating physicians, Symetra sought the opinions of two non-examining consulting

physicians. When these consulting physicians submitted opinions of non-disability, Symetra

adopted those opinions, not because they were inherently more reliable, but because they

offered Symetra a way to save millions of dollars. This savings for Symetra came at the

expense of the Adamses’ financial well-being. See (Doc. 230-1, p. 28, par. 24) Symetra then

gave a pretextual reason to conceal the true reason why it adopted the opinions of the nonexamining consulting physicians. The court should deny Symetra’s motion for partial summary

judgment on the issue of punitive damages.

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RECOMMENDATION:

The Magistrate Judge recommends the District Court, after its independent review

of the record, enter an order 

DENYING the defendant’s motion for partial summary judgment filed on February

4, 2020. (Doc. 202) A reasonable person could conclude that Symetra acted in bad faith. A

reasonable person could conclude by clear and convincing evidence that Adams is entitled to

punitive damages.

Pursuant to 28 U.S.C. §636(b), any party may serve and file written objections

within 14 days of being served with a copy of this report and recommendation. If objections

are not timely filed, the party’s right to de novo review may be waived. The Local Rules permit

the filing of a response to an objection. They do not permit the filing of a reply to a response

without the permission of the District Court.

DATED this 4th day of May, 2020.

Case 4:18-cv-00378-JGZ Document 257 Filed 05/04/20 Page 13 of 13