Opinion ID: 2651525
Heading Depth: 3
Heading Rank: 6

Heading: July 12, 2007-March 28, 2008 (~8 months)

Text: We agree that State Farm had a legitimate reason for the eight-month period of delay between July 12, 2007 and March 28, 2008 because State Farm was actively attempting to resolve causation issues related to James’s injuries. As discussed above, on July 12, 2007, Powell informed Hamilton that the medical records presented conflicting information about the age of James’s injuries and advised him that “[w]e will likely need some of [James’s] prior records to confirm her condition prior to the loss as opposed to following the loss so you may want to request those as well.” Powell also talked to Hamilton multiple times in August, and he assured her that he would obtain clarification from Staggs. Once Powell received the medical records from Hamilton, Powell conducted a prompt review and then sought a second opinion from another State Farm employee, who also pointed out the conflicting information about the 17 Case: 11-60458 Document: 00512514313 Page: 18 Date Filed: 01/28/2014 No. 11-60458 etiology of the injuries.9 On September 25, 2007, Powell requested that Hamilton provide one year of prior records from all of James’s doctors. On March 28, 2008, State Farm received, from Hamilton, Staggs’s clarification about his medical records. Therefore, based on the evidence in the record, we conclude that State Farm was engaged in an active investigation of the cause of James’s medical condition. As this justifies a payment delay, we conclude that State Farm had a legitimate reason for its delay during this time period. See Caldwell, 686 So. 2d at 1098.