A jury awarded a paraplegic former Marine more than $19 million Wednesday in a ruling against his insurance company, which had refused to pay the bulk of a $38,150 claim he submitted as a result of a lengthy hospital stay, according to the plaintiff's attorneys.
Stonebridge Life Insurance had decided it was not medically necessary for Thomas Nickerson to have spent 109 days in the hospital and instead paid for only a 19-day stay, said Nickerson's attorney William Shernoff.
The Los Angeles jury deliberated for less than two hours before delivering its verdict against Stonebridge and awarding millions to the Westminster, Calif., resident. The jury awarded $35,000 for pain and suffering and $19 million in punitive damages.
"I think it was a good decision from the jury," said the stunned Nickerson, 59. "I'm still a little light-headed. It's a blessing."
Jim Wood, who represented Stonebridge in the case, said he was disappointed with the verdict and promises an appeal.
"Stonebridge acted in good faith in evaluating Mr. Nickerson's claim and the company handled his situation appropriately based on his policy and its coverage terms," Wood said in a statement.
In 2008, Nickerson said, he fell off a ramp while trying to get into his handicapped van and broke his right leg in two places. Nickerson said he was admitted to Veterans Administration Hospital in Long Beach where doctors determined he needed to stay for 109 days.
Nickerson had an accident indemnity policy and expected Stonebridge to pay $350 a day during his hospital stay to help pay for non-medical bills such as rent and electricity. The total for 109 days would have been $38,150.
"They only paid him for 19 days and said the rest was not medically necessary," Shernoff said. "The broader implications of the case is that on questions of medical necessity that doctors should make these decisions and not insurance companies."