Ethel Adams v. Farmers Insurance Co.
This car accident injury case is just one of many that demonstrates the need to have an excellent attorney represent an injured party when dealing with an insurance company. Not only did Ethel Adams have to deal with life threatening injuries, she had to negotiate with a double-talking insurance company.
Ethel Adams was happily delivering dentures for her employer on March 23, 2005, when her life forever changed. A crazed man named Michael Testa was chasing his girlfriend Elizabeth Campo down Aurora Avenue. He bashed her with his truck until she lost control and flipped up and over the center line. Her truck crashed head-on into and on top of Ethel’s little Hyundai, smashing it backwards into oncoming following traffic. Ethel was almost crushed to death.
The crash was captured by a surveillance camera of a nearby business. News stations broadcast the haunting images. Ethel’s accident was immediately in the public domain.
Ethel’s catastrophic injury and survival
The crushing and whipping mechanisms involved in the crash almost killed Ethel. She suffered brain injury and concussion that led to a nine day coma. Chest wall trauma involved extensive damage to her respiratory system. Her lungs collapsed and had to be re-inflated by draining the rapidly accumulating blood, using large-bore chest tubes. In all, she had to have four chest tubes inserted to stabilize her breathing.
Ethel fractured her left collarbone and three ribs, each rib in multiple areas. She suffered a fractured sternum (breastbone). Surgery was performed to remove portions of the ribs that were compromising her respiratory system. The ribs lacerated her spleen. Her left radius and ulna were fractured (bones located in the lower portion of the arm). She sustained a fracture of her left ring finger and a fracture of the 11th vertebra.
Continuing down her body, Ethel’s legs were crushed. Her left femur or thighbone sustained an open fracture (the bone protruded through the skin). She suffered bilateral tibial plateau fractures (where the lower legs connect at the knees to form the knee joint). Extensive plates and bone screws were used to re-align the fracture fragments. These fractures affected the integrity of the knee joints and have resulted in permanent deficits. The right tibia and fibula sustained pilon fractures. This means the bones were fractured at both the upper and lower ends. At the lower end, the tibia connects with the ankle to form the ankle joint. Just below the tibia is the calcaneous bone, which was also fractured. As result, the right ankle joint had to be surgically rebuilt.
Ethel’s fractured left femur was surgically reduced and stabilized using external fixator rods. In the area of the right upper hip, a drain suctioned off secretions from her femoral fracture. The large tube just below it drained blood from her chest.
From day one Ethel was stricken with complications. Twice she developed severe infections and had to be placed in strict isolation, while receiving potent IV antibiotics until the infections were cleared. Several times, Ethel required blood transfusions. At one point she developed excessive swelling in her right lower leg. To avoid amputation, surgeons performed an emergency faciotomy. Ethel’s leg was sliced open from knee to ankle. During the days the wound gaped open, but the congested tissues had room to expand and circulation was restored to her foot.
The pain was so unbearable that Ethel asked to die. For each surgery, there were multiple follow up procedures and often complications. Ethel had difficulty breathing due to injury to her chest wall, lungs, and ribs. But to prevent pneumonia, Ethel was forced to take extra deep breaths and cough. Eventually, the four chest tubes needed to be removed from her lungs. But by this time, she was more awake and it was almost as painful as having them inserted. It became time to extubate and wean her off the ventilator. But her chest wall and fractured ribs were still hurting and breathing was still painful.
Ethel will need knee replacement surgery as her knees degenerate. Her right ankle joint will degenerate and require fusion surgery. She will become riddled with arthritis. She will never fully recover from cognitive brain deficits, sleep disturbance, and inability to perform major aspects of daily living. She will never walk unaided again.
After half a year of surgeries and the sheer torture of trying to live, Ethel was finally released from the nursing home. She returned to the apartment she shared with her daughter Vicky. The magnitude of her injuries overwhelmed her. Within days, her life would again spiral downwards upon learning that her insurance company, Farmers, was abandoning her.
The psychotic world of Michael Testa
Witnesses and officers at the scene noted that Testa was acting bizarrely. He had significant criminal history that had recently escalated into fits of rage.
On March 23, 2005, Liz Campo, Mike’s long time girlfriend she packed everything she could salvage into a second truck Mike had bartered for. She headed for her sister’s place in Ballard. Earlier that day, a pawn-shop owner had warned Liz: Be careful. Mike was just by and was threatening to kill you. He’s said that before, she replied, and headed out the door.
Mike, on his way back to the duplex, spotted her truck on Aurora Avenue North. His pockets were full of fake gold jewelry that the pawn shop had refused to buy. Liz had the real stuff, he thought. He flipped a U-turn, gunned his engine and went after her. Liz looked up and saw him in the rearview mirror. He’s going to kill me, she thought.
Mike chased Liz as she tore through parking lots in a panic. He caught up to her back on the street and rammed her truck until it flipped upside down, skidded and smashed into oncoming traffic. The six-car pileup was all over the news that night. Mike was hauled off to King County Jail. He was sent to Western State Hospital. His diagnosis: schizophrenia on June 21, 2005. The very next day, Farmers officially denied Ethel coverage for Testa’s acts.
Farmers’ bad faith claims handling
While Ethel was still in critical condition in the hospital, her daughter Vicky was her lifeline. Vicky not only interfaced with the doctors, but she was able to contact Cindy Reimers, Ethel’s employer and friend. Ms. Reimers provided support and gave good news that there was UIM coverage on the car for the benefit of Ethel. During that first week Ethel remained in a coma and Vicky lived at Harborview. Dale, the long time insurance agent of Edgewood Dental called. He told Vicky not to worry – there was $1M in UIM coverage and he believed there was another $1M umbrella. Vicky was reassured to know that her mother would have funds to provide for her care. When she regained consciousness, a frightened and delirious Ethel was told that financially at least, she would be okay.
Just to be sure, Vicky arranged for her mother to hire counsel. It was a good thing she did. Shortly after Ethel’s counsel contacted Farmers, they received a very different response. On April 29, 2005, Farmers indicated it was reserving its right to deny coverage for “any claims arising out of the incident.”
Ethel received no further word until Farmers completed its internal process. On June 22, 2005 Farmers expressly denied Ethel any coverage for Michael Testa’s acts.
Ethel’s attorneys filed summons and complaint on October 13, 2005. At the same time Ethel braved several interviews by the press, with the hope that somehow it would help. She did not seek the attention and was terrified by the reporters’ gentle questioning. Little did she know that her story would rouse the wrath of an entire community against Farmers.
Danny Westneat was and is a columnist for The Seattle Times. His writings tapped into the collective conscience of the public.
October 13, 2005:
“It’s also not unexpected or unforeseen that if you are ramming a car from behind with the intent of pushing it into oncoming traffic, you’re going to hit some people,” Dinning said in an interview. “That’s what Testa did. Liability insurance is only for accidents, and this wasn’t an accident.”
The logic here is impressively tortured, even for an industry known for exploiting technical loopholes. To argue that Testa, who went on a rampage and then was sent to a psychiatric hospital for delusions, could have possibly intended to crash a car into Adams, a woman he didn’t know existed, is truly an outrage.
“That sounds like more of a crime than what happened to me (in the wreck),” Adams said.
Police interviewed Testa twice the day of the crash. His statements were wildly erratic. Testa initially told police his girlfriend’s Ford truck rammed his truck from behind. Later he confessed he “hit her in the ass end of the Ford and flipped it.” But he never says his goal was to push her truck into oncoming lanes. He never mentions other cars at all.
That was the last time Mr. Dinning was permitted to speak on behalf of Farmers. By the next day, Danny Westneat had received over 400 emails from very upset Washingtonians. He also received a statement from Farmers out of California that insulted the integrity of his reporting.
Farmers double speak did not throw any of the reporters off the track. After all, its denial letter was quite clear on the issue. In its busy efforts to mend its image, Farmers continued its pattern of acting without regard to Ethel. Farmers did not reach out to Ethel nor retract its denial of coverage. It grossly underestimated the magnitude of outrage it had generated. One Seattle Post Intelligencer article simply printed a sample of the irate emails sent to the OIC.
October 20, 2005:
- “The claim that they need not pay because the act was intentional and not an accident is both spurious and unethical … I have notified my Farmers agent that if Farmers does not reverse its position in this case, I will move the several policies I have had with them for many years, not wishing to be at risk with an untrustworthy company.”
- “I’ll bet she got sheets of paper with legal mumbo-jumbo that no one understands. Insurance companies should have to give clear, bullet lists with explanations of anything they are not going to cover.”
- “People are very angry about this. It was the talk of the water cooler yesterday. And I am sure people will be looking for a favorable outcome … I am also calling my agent to make sure my insurance company would not pull something like this.
- “This is just outrageous! And don’t give me any of this buyer beware B.S. As a public servant, it is your job to protect all of us against this kind of corporate greed and hubris that allows them to try this kind of stunt … It is time for you to earn your money. As a trusted public servant, it is time for you to get off your keister and help this woman out, and maybe in the process, you can give the insurance industry a little spanking and actually improve an industry that many people feel is a bit shady in the way they operate.”
Because Farmers had violated the law and betrayed public trust, the Office of Insurance Commissioner marched into the fray.
October 15, 2005:
Hundreds of you mentioned the central point that ought to be blindingly obvious to Farmers: that Testa intended to hit his girlfriend, not Ethel Adams.
Also calling was the state Office of the Insurance Commissioner, where a spokeswoman said the general mood was “outrage.” I suggested yesterday the Legislature might change some laws. But Sandi Peck, insurance-commission spokeswoman, said, “It seems to us the issue is that they aren’t applying the law correctly.”
In a statement, Farmers took issue with my column, saying the company has not actually denied Adams’ claim and it’s “still under investigation.” Well, I have a letter in which the company’s lawyer denies Adams’ claims connected to the guy who was at fault for the wreck, Testa. That is tantamount to denying her claim.
By now the Farmers debacle was all over talk radio and the internet.
October 14, 2005:
Farmers only cares that there’s a loophole that the company can scurry under. “Gets you back where you belong”? Maybe. If where you belong is in the pit of insurance hell.
The Insurance Commissioner personally charged in. He rejected Farmers absurd posturing and decided to take swift and direct action. He gave Farmers three days to get its act together or threatened to yank its license!
Finally, the day before the OIC deadline, Farmers blinked. It reversed its claim denial via a public news release. It did not first telephone Ethel or her attorneys. Nor did it send them a copy of the news release. Ethel’s counsel first heard of the coverage reversal second hand through a reporter. Yet again, Farmers placed its own public relations interests above extending a simple courtesy to Ethel. The reporters cut Farmers little slack.
October 20, 2005:
Rather than doing something honorable, such as admitting it screwed up, Farmers instead took the opportunity to heap praise on its entire operation.
October 21, 2005:
Every time one of these cases comes up, followed by a flurry of media reports and the fury of outraged customers and consumers, it’s obvious that the damage inflicted on the corporate image costs far more than simply paying the legitimate claim in the first place. There’s not enough money in the world to buy the bad publicity the company bought itself with this mess.
The post script to Ethel’s story is that the legislature unanimously passed “Ethel’s Law” in March 2006. To some extent Farmers invited this result by trying to excuse its behavior by blaming the law. The insurance industry distanced itself from Farmers. It testified in favor of the bill, while Farmers stayed mute. Even the insurance industrys’ own national publication was critical of Farmers conduct.
One year after her life changed forever, Ethel’s courage closed forever the loophole Farmers tried to use unfairly to escape its obligations.
“Most people assume they know what the word “accident” means. They also believe if they pay their insurance premiums they will have coverage in their time of need. I believe the current law is clear, but this bill will make certain that no insurance carrier pulls a similar stunt in the future.” Comm. Mike Kreidler
SHB 2415. Effective date: June 7, 2006
The purpose of this section is to protect innocent victims of motorists of uninsured motor vehicles. Covered persons are entitled to coverage without regard to whether an incident was intentionally caused. A person is not entitled to coverage if the insurer can demonstrate that the covered person intended to cause the damage for which underinsured motorists’ coverage is sought. As used in this section, and in the section of policies providing the underinsured motorist coverage described in this section, “accident” means an occurrence that is unexpected and unintended form the standpoint of the covered person.