State tells insurer to pay

You don't have to take my word for it anymore that Farmers Insurance is off its rocker in refusing insurance coverage to car-wreck victim Ethel Adams.

The state is giving Farmers until the end of the day tomorrow to either agree to pay Adams, injured in a road-rage crash, or face legal action. State Insurance Commissioner Mike Kreidler met yesterday with Farmers lobbyist Mike Kapphahn in Olympia and told him: "It's not a question of if you pay Ethel Adams, but when."

"Nobody here has ever seen an insurance company come up with such a bizarre and imaginative way of applying insurance law as this case," Kreidler said in an interview. "They're just wrong, and it's obvious they're wrong. The bottom line is they are going to pay this claim."

Adams' odyssey into insurance hell started last March when a man named Michael R. Testa rammed his girlfriend's truck from behind to run it off the road. Testa bashed the truck across the centerline and into oncoming traffic, where it crashed into the Hyundai Adams was driving, squashing it.

The 60-year-old Everett woman spent nine days in a coma and five months in a hospital and a nursing home.

Testa had no insurance. But Farmers decided that the $2 million uninsured-motorist policies covering Adams didn't apply to anything Testa did because he caused the wreck on purpose.

In Farmers' view, the wreck therefore was not an accident — even for Adams, who was just driving by, minding her own business.

Adams' medical bills so far top $500,000. They have been paid through state workers' compensation because she was on the job when she was hit. Adams is seeking insurance coverage for the remainder of her lost wages and other expenses, as she suspects she will never work again.

Kreidler mentioned the case of Ryan Wade-Everett, the guy charged with stealing a car two weeks ago and leading police on a chase around the Eastside. Wade-Everett slammed into dozens of cars, then boasted about it afterward.

"So by Farmers' logic, none of those people who got hit would be covered?" Kreidler said. "We've never seen a company try to make a ridiculous argument like that."

Yesterday, Farmers continued to insist it has not actually denied Adams' claim. Kreidler called these statements "disingenuous," as the company wrote a letter denying all claims relating to the driver at fault — Testa — back in June. That is the same letter I quoted in a column last Friday.

Farmers also issued a statement Monday saying it has been "stymied in its efforts" to get the police report from the King County Sheriff's Office. If it had the report, it could "resolve this claim immediately."

Hmm. The Farmers letter denying Adams any coverage relating to Testa quotes from two such reports, the Police Traffic Collision Report and the King County Sheriff Incident Report. Those reports have been public record since late March.

"They're clearly trying to blame us now," said sheriff's Sgt. John Urquhart. "It's irritating, to say the least."

Farmers has said it might pay Adams if it can find any other driver who was at fault in the accident, and that it is continuing to investigate the wreck. But Urquhart said only Testa was at fault.

To Kreidler, the entire show of searching for other negligent drivers is a charade. If the company continues to refuse to pay, the state will initiate an administrative hearing accusing Farmers of violating the insurance code. That's the first step in suing them.

"We could always suspend their certificate to do business in this state as well," Kreidler added.

Hundreds of readers have contacted me wondering whether they'd be covered if some lunatic runs into them.

"If what you have reported is true, then if a person wants to attempt suicide and crosses the centerline to hit someone they don't know but want to end their own life, the person who gets hit is not involved in an 'accident' and their insurance doesn't have to pay?" wrote Paul Merz of Seattle. "Why do we have insurance? This is so bogus."

It is bogus. But a lawyer for the insurance commissioner's office said the state has left itself open to a company possibly exploiting this area of the law because the Legislature has never explicitly defined the word "accident."

"Almost every other state forces insurance companies to examine the facts of a case from the victim's point of view," said Carol Sureau, state deputy commissioner for legal affairs.

In Farmers' letter arguing that Adams was technically not in an accident, the company cites a 1990 Pierce County case in which a woman purposely crashed into a car driven by her ex-husband. The state Supreme Court ruled then that insurance didn't have to cover the ex-husband's injuries, in part because the outcome wasn't "unexpected or unforeseen" — that is, it wasn't an accident.

Sureau said the 1990 case doesn't apply to Ethel Adams' case for the simple reason that nobody was intending to hit Adams.

To make sure no company tries to work such a crafty angle again, Kreidler and his aides are introducing legislation to define "accident" as something bad that happens that's unexpected to whomever it happened to.

I guess we have to state the obvious to protect ourselves from tone-deaf corporations.

Someone suggested calling it "Ethel's Law."

Better to call it "Farmers' Law," so we can remember who tried to shine us on with this nonsense in the first place.

Danny Westneat's column appears Wednesday and Friday. Reach him at 206-464-2086 or dwestneat@seattletimes.com.