Farmers Policyholders Rue Spurned Claims

HONOLULU (CN) - Farmers Insurance uses a "biased" doctor to deny auto injury claims without examining or interviewing the patients or communicating with their treating physicians, seven longtime policyholders claim in court.

Brian Major et al. sued Farmers Insurance and its Hawaii manager Carol Himalaya-Fidele in Oahu First Circuit Court.

"Christopher Brigham ('Dr. Brigham') is a medical doctor who has a reputation in the community and nationally for being biased and predisposed in favor of the insurance companies that hire him," the lawsuit states. "For each plaintiff in this lawsuit, Dr. Brigham was paid a substantial fee to write a report that Farmers used as a pretext for terminating that plaintiff's insurance benefits in direct contravention of the professional recommendations of the treating physicians."

Brigham is not a party to the complaint, which continues: "On each such occasion, Dr. Brigham wrote his report without examining the patient, without interviewing the patient, without conducting any tests on the patient, and without communicating with the patient's treating physicians. On each such occasion, Farmers knew at the time that it hired Dr. Brigham that Dr. Brigham would produce a report that would include a 'medical' opinion which Farmers would use to justify its decision to terminate insurance benefits. Farmers, Ms. Himalaya-Fidele and Dr. Brigham therefore conspired together to defraud each and all plaintiffs by handling and deciding plaintiffs' insurance claims unfairly and in extreme bad faith."

Himalaya-Fidele did not respond to requests for comment.

In addition to denying their claims in bad faith, the plaintiffs say, Farmers had the brass to notify them, in writing, that "submitting a fraudulent insurance claim could result in [their] imprisonment and fine."

Lead plaintiff Major claims he paid Farmers for 23 years and never sought benefits under his auto/medical policy until he was injured in August 2012.

"On December 17, 2012, Dr. Brigham wrote a report without examining Mr. Major, without interviewing Mr. Major, without conducting any tests on Mr. Major, and without communicating with any of Mr. Major's treating physicians. Farmers then used Dr. Brigham's report to justify a termination of Mr. Major's benefits. On December 24, 2012, Farmers notified Mr. Majors that his benefits were terminated, and informed him in writing that he could be imprisoned or fined for submitting a fraudulent claim," Major says in the complaint.

The other plaintiffs tell similar stories.

They seek an injunction and punitive damages for breach of contract, bad faith, fraud, misrepresentation and unfair business practices.

They are represented by Mark Davis with Davis Levin Livingston.

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