Tiffany Steward Obtains Favorable Arbitration Award in San Diego County
In February 2018, Tiffany Steward obtained a favorable arbitration award in San Diego County on behalf of State Farm Mutual Automobile Insurance Company, wherein the arbitrator found that the insured was not entitled to any proceeds under his Underinsured Motorist Bodily Injury Coverage.
The insured allegedly sustained injury and incurred medical expenses as a result of a motor vehicle accident wherein he was a passenger. The insured settled his case against the at-fault driver for an amount in excess of the driver’s policy limits and then made a claim for Underinsured Motorist Bodily Injury Coverage. The crux of the insured’s claim was a surgical recommendation for an anterior cervical discectomy and fusion. The insured claimed that the procedure was medically necessary and reasonably related to the accident. After careful evaluation it was the carrier’s position that further treatment was not warranted and that the insured had been fully compensated in the underlying suit. Experts for the carrier opined that the injuries were of a sprain/strain nature, such that the mostly lien-based treatment received was medically unnecessary. The experts also explained the reasonable value for the treatment received from the lien-based providers.