Intentional infliction claim dismissed by Maryland federal court
In Respess v. Travelers Cas. & Sur. Co. of Am., 2011 U.S. Dist. Lexis 28531 (D. Md. 2011), the United States District Court for the District of Maryland analyzed the factual circumstances necessary to support a cognizable claim for intentional infliction of emotional distress and gross negligence against an insurer for failure to authorize care for a patient, leading to the patient’s suicide.
Patricia Respess (“Respess”) was physically and sexually assaulted at work in 1987. She suffered from various psychiatric conditions as a result of the incident and required medical treatment. Travelers Casualty & Surety Company of America and the Travelers Indemnity Company of America (“the Insurers”) paid for her medical treatment pursuant to a worker’s compensation claim. From January of 2008- April of 2008, Respess received 24 hour care from a mental health care facility (“facility”). Near the end of April, her treating physicians determined that 24 hour care was no longer required and that she could return home.
Shortly after her discharge from the facility, Respess began experiencing suicidal thoughts and practicing unsafe medication management. Her home health care nurse contacted the Insurers and informed them that Respess needed urgent 24 hour care. The Insurers would not authorize the treatment. The nurse then consulted a medical doctor who had formerly treated Respess; he too contacted the Insurers to request that they authorize immediate 24 hour care. Though acknowledging that Respess’s health had deteriorated since her release from the facility, the Insurers again refused to authorize the requested treatment. Ms. Respess overdosed and died shortly thereafter, leaving behind a suicide note that stated she did “not have any fight in her to challenge the [Insurers] anymore.”
Ms. Respess’s family (“Plaintiffs”) filed suit against the Insurers, asserting claims of intentional infliction of emotional distress and gross negligence. They alleged that the Insurers’ refusal to authorize the requested 24 hour treatment was intended to cause Respess emotional distress and/or made in reckless and deliberate disregard of the high degree of probability that emotional distress or death would ensue.
The court dismissed the Plaintiffs’ complaint on the basis that it failed to state a claim upon which relief could be granted. Specifically, the court held that the allegation that the Insurers failed to authorize 24 hour treatment for Respess, despite knowledge of her frail mental health, fell woefully short of meeting the exacting standards required to state a viable claim for intentional infliction of emotional distress or gross negligence under Maryland law. The court noted that insurers are not health care providers and that Respess’s treating physician never contacted the Insurers to request authorization for 24 hour care. It thus concluded that the Complaint did not contain factual allegations sufficient to establish that the Insurers’ conduct was shocking to the conscious, egregious, or deliberately intended to cause Respess harm.
This decision illustrates how difficult it is for a plaintiff to prevail on an intentional infliction of emotional distress claim.