Thayer v. State Farm
Thayer v. State Farm
Thayer v. State Farm
Opinion
New Mexico
Office of the Director Compilation
'00'07- 15:24:51 2023.11.27 Commission
IN THE COURT OF APPEALS OF THE STATE OF NEW MEXICO
Opinion Number: 2023-NMCA-090
Filing Date: September 25, 2023
No. A-1-CA-37133
WILLIAM THAYER,
Plaintiff-Appellant,
v.
STATE FARM MUTUAL AUTOMOBILE
INSURANCE COMPANY,
Defendant-Appellee.
APPEAL FROM THE DISTRICT COURT OF DOÑA ANA COUNTY
Marci E. Beyer, District Court Judge
Law Firm of Daniela Labinoti, P.C.
Daniela Labinoti
El Paso, TX
for Appellant
Miller Stratvert P.A.
Todd A. Schwarz
Luke A. Salganek
Albuquerque, NM
for Appellee
OPINION
DUFFY, Judge.
{1} Plaintiff William Thayer filed a complaint for breach of contract and bad faith after
State Farm denied his claim for underinsured motorist (UIM) benefits. State Farm
moved for summary judgment, arguing it was not liable for UIM benefits because
Thayer had breached a contract provision requiring him to obtain State Farm’s written
consent before settling with the tortfeasor. Thayer acknowledged that he had settled
without State Farm’s permission, but asserted he had notified State Farm of the offer
and waited more than a year before ultimately accepting the settlement. The district
court granted State Farm’s motion and dismissed the case with prejudice.
{2} The factual circumstances of this case are a matter of first impression in New
Mexico and we must decide whether Thayer, after properly requesting consent to settle
from his insurer, breached the consent-to-settle provision as a matter of law by settling
with the tortfeasor before receiving the insurer’s decision. The answer depends on
whether the insurer acted reasonably to provide or withhold consent to the insured’s
settlement request. We hold that when an insurer has received notice of a proposed
settlement between its insured and a third-party tortfeasor, but fails to notify its insured
of the insurer’s decision to either grant or withhold consent to settle within a reasonable
amount of time, the insurer may have waived its right to rely on a consent-to-settle
clause. In such circumstances, the insured’s settlement will not preclude recovery of
UIM benefits. Because disputed issues of fact exist on these matters, we reverse.
BACKGROUND
{3} In August 2011, Thayer, a New Mexico State Police officer, was directing traffic
along Interstate 10 in Doña Ana County when a semi-truck and trailer crashed into the
back end of a pickup truck, causing the pickup to ignite and severely injuring its driver.
Thayer and another officer were in the path of the crash and quickly ran out of the way,
but both were injured in the process.
{4} The driver of the pickup truck filed a complaint for personal injury against the
driver of the semi-truck (hereinafter referred to as the tortfeasor) and the tortfeasor’s
employer, Quality 1st Produce. Thayer and his fellow officer intervened with their own
injury claims. Quality 1st was insured by Granite State Insurance and had $1 million in
liability coverage available for the three claims.
{5} In August 2012, Thayer attended a mediation with Granite State, during which he
was advised that Granite State was tendering $900,000 to the injured driver of the
pickup, and that the policy deducted costs and expenses from the amount of the limit.
Thayer’s fellow officer received $60,000 from the policy, and Granite State offered to
settle Thayer’s claim for the remainder—approximately $14,000—an amount less than
his total damages. Thayer alleges that during the mediation, he called his own
insurance company, State Farm, to make an underinsured motorist claim and to request
permission to settle.
{6} Thayer’s policy with State Farm contained a consent-to-settle provision that
required Thayer to inform State Farm of any settlement offer and State Farm to respond
in writing. The policy stated:
Consent to Settlement
The Insured must inform us of a settlement offer, if any, proposed by or on
behalf of the owner or driver of the uninsured motor vehicle, and the
insured must request our written consent to accept such settlement offer.
If we:
1. consent in writing, then the insured may accept such settlement
offer.
2. inform the insured in writing that we do not consent, then the
insured may not accept such settlement offer and:
a. we will make payment to the insured in an amount equal to
such settlement offer. This payment is considered a payment
made by or on behalf of the owner or driver of the uninsured
motor vehicle; and
b. any recovery from or on behalf of the owner or driver of the
uninsured motor vehicle shall first be used to repay us.
Thayer alleges that during his initial phone call to State Farm during the August 2012
mediation, he informed State Farm of the offer he had received from Granite State, but
State Farm neither provided nor denied consent to settle. Thayer asserts that as a
result, he was unable to settle his claims against the tortfeasor at the mediation.
{7} Thayer alleged in an affidavit that he tried to contact State Farm multiple times
after the mediation without success. About seven months after the mediation, on March
8, 2013, Thayer’s attorney sent State Farm a letter requesting consent to settle. The
letter described the accident, Thayer’s injuries and treatment, and stated that Granite
State was offering to settle Thayer’s claim for approximately $14,000, which
represented the amount remaining under the policy.
{8} State Farm sent a letter in response on April 5, stating that it had called Plaintiff’s
attorney on March 12 to discuss the claim and had left a voice message. The letter went
on to state:
In order to sanction Mr. Thayer[’]s settlement against Granite State
Insurance, we will need the following documentation to begin our
investigation:
*Total payments to parties involved in this accident.
*The declarations page confirming Liability coverage on the policy.
We look forward to your call. Thank you.
Notably, although the letter indicated that State Farm would need additional information,
the letter was unclear as to how the information would be obtained, i.e., whether State
Farm would gather the documentation or whether it was asking Thayer to do so. Thayer
did not respond.
{9} The following month, on May 16, State Farm sent a reservation of rights letter to
Thayer. In addition to various reservation of rights statements, the letter stated, “If you
have any information or materials that may aid us in the analysis of your claim for
coverage, please provide it to us as soon as possible.” As with the previous letter, the
May 16 letter did not directly request any specific documentation from Thayer or state
that Thayer needed to contact State Farm regarding his claim. Again, Thayer did not
respond.
{10} State Farm sent a second reservation of rights letter on June 27, which contained
the same general request quoted above and stated that if State Farm did not hear from
Thayer within thirty days, State Farm would close the claim. Thayer again did not
respond.
{11} Thayer eventually accepted a settlement in the amount of $28,780 from Granite
State in January 2014, having never received a written response from State Farm
indicating that it was either providing or withholding consent to Thayer’s request to
settle. Thayer notified State Farm of the settlement by letter in February 2014 and
requested that State Farm tender the limits of his UM/UIM insurance. State Farm denied
the claim.
{12} Thayer filed suit, asserting claims for breach of contract, bad faith, and violation
of the Unfair Insurance Practices Act and Unfair Trade Practices Act. Thayer alleged
that State Farm improperly disclaimed coverage and breached the UM/UIM contract.
Thayer’s extra-contractual claims were based on allegations that State Farm acted in
bad faith by failing to honor its contractual and statutory obligations under New Mexico
law. Thayer’s complaint included as exhibits the police report and two asset
investigations—one on the tortfeasor and another on Quality 1st—that had been
produced in the underlying lawsuit against the tortfeasor. Those investigations showed
that as of mid-2012, the tortfeasor had limited assets and was effectively judgment-
proof. Quality 1st had approximately $130,000 in liquid assets but was also subject to
five different UCC liens in unspecified amounts that were secured with tangible and
intangible assets.
{13} State Farm moved for summary judgment, arguing that Thayer was not entitled
to UIM benefits under the policy because he had released the tortfeasor without State
Farm’s consent, in breach of the policy’s consent-to-settle provision. State Farm
asserted that it suffered substantial prejudice because the settlement destroyed its
subrogation rights against Quality 1st, and as a result, Thayer was not entitled to UIM
coverage as a matter of law. State Farm attached as exhibits to its motion Thayer’s
letters to State Farm, a single page from the policy containing the consent-to-settle
provision, 1 and an affidavit from a certified fraud investigator who had completed an
asset investigation of the tortfeasor and Quality 1st in April 2014, after Thayer had
settled his claims against them. State Farm’s investigation showed that Quality 1st still
had significant liquid assets but did not list any UCC liens or other encumbrances on
Quality 1st’s assets.
{14} Thayer responded to the motion by arguing that State Farm had acted with
unreasonable delay in responding to his request for consent to settle, and that he had
accepted the settlement only after State Farm failed to respond to his request for
seventeen months. He also argued that State Farm breached its duty to timely
investigate his claim. The exhibits Thayer attached to his response included affidavits
from Thayer and his wife stating that they had contacted State Farm to request consent
during the August 2012 mediation, the asset investigation conducted on the tortfeasor,
and correspondence from State Farm to Thayer’s attorney. Thayer contended that fact
issues remained as to whether he had waited for a reasonable period of time before
accepting the settlement, and whether State Farm had acted reasonably under the
circumstances. State Farm responded that it had left one voicemail and sent three
letters (two of which were reservation of rights letters) to Thayer’s attorney requesting a
conversation regarding and information related to Thayer’s claim for UM/UIM insurance,
to which no response was received.
{15} After a hearing, the district court granted State Farm’s motion and dismissed all
of Thayer’s claims with prejudice. 2 Thayer appeals.
DISCUSSION
I. Standard of Review
{16} “We review de novo the question of whether the application of law to undisputed
facts supports a summary judgment determination regarding uninsured motorist
coverage.” Haygood v. United Servs. Auto. Ass’n (USAA), 2019-NMCA-074, ¶ 7, 453
P.3d 1235. “[I]n reviewing a district court’s summary judgment decision, we conduct a
whole-record review of the facts in the light most favorable to the party opposing
summary judgment and draw all reasonable inferences in support of a trial on the
merits.” Ridlington v. Contreras, 2022-NMSC-002, ¶ 13, 501 P.3d 444 (internal
quotation marks and citation omitted). If the record indicates a genuine dispute as to
1State Farm asserted as an “undisputed material fact” that the policy at issue states, “There is no
coverage: 1. for an insured who, without our written consent, settles with any person or organization who
may be liable for the bodily injury or property damage.” In support, State Farm referenced the single page
of the policy attached as an exhibit to its motion. That exhibit contains the consent to settle provision
quoted in paragraph six of this opinion, but does not anywhere contain the language quoted by State
Farm in its motion. Nevertheless, Plaintiff did not challenge State Farm’s representation of the policy
language in his response in the district court, and we therefore accept that the policy contains the
coverage exclusion represented by State Farm. See Rule 1-056(D)(2) NMRA (“[M]aterial facts set forth in
the statement of the moving party shall be deemed admitted unless specifically controverted.”).
2The parties have not designated hearing transcripts or recordings for our review. Nevertheless, the
parties agree that this appeal can and should be decided based on the written record.
any material fact, summary judgment will be reversed and the case remanded for
determination at trial. Rummel v. Lexington Ins. Co., 1997-NMSC-041, ¶ 15, 123 N.M.
752, 945 P.2d 970.
II. Consent to Settle
{17} As a general matter, consent to settle provisions in UM/UIM policies are valid and
enforceable under New Mexico law. March v. Mountain States Mut. Cas. Co., 1984-
NMSC-092, ¶ 18, 101 N.M. 689, 687 P.2d 1040, modified on other grounds by State
Farm Mut. Ins. Co. v. Fennema, 2005-NMSC-010, ¶ 6, 137 N.M. 275, 110 P.3d 491.
Our courts have recognized that “the purpose of a consent-to-settle provision is to allow
the insurer an opportunity to protect its subrogation interest.” Fennema, 2005-NMSC-
010, ¶ 9. “[I]f an insured, without the knowledge of his insurer, effectively releases a
wrongdoer from liability, the insured destroys any right of subrogation the insurer may
have against the wrongdoer.” Id. ¶ 5. Under those circumstances, an insured may be
precluded from recovering from his insurer. See id.
{18} Our courts apply a two-step analysis to determine whether an insurance
company may be relieved from paying UIM benefits based on the insured’s alleged
violation of a consent-to-settle provision. Id. ¶¶ 2 14. The first step is to examine
whether the insured breached the consent-to-settle provision. Id. ¶¶ 7, 13; see also
Roberts Oil Co. v. Transamerica Ins. Co., 1992-NMSC-032, ¶ 22, 113 N.M. 745, 833
P.2d 222 (holding that “an insurer must demonstrate substantial prejudice as a result of
a material breach of the insurance policy before to be relieved of its obligations under a
policy” (internal quotation marks and citation omitted)). Once the insurer has established
breach, the second step is to determine whether the insurer was substantially
prejudiced by the settlement of the tort claim. Fennema, 2005-NMSC-010, ¶¶ 5, 11, 13.
Applying the Fennema analysis here, we conclude there are disputed issues of material
fact as to the threshold question of breach.
{19} This case stands in contrast to previous consent-to-settle cases in New Mexico
because Thayer fully complied with his initial obligations under the policy’s consent-to-
settle provision: he provided notice to his insurer of the proposed settlement and
requested the insurer’s permission to accept the settlement. Cf. Salas v. Mountain
States Mut. Cas. Co., 2007-NMCA-161, ¶ 4, 143 N.M. 113, 173 P.3d 35 (“[W]ithout the
knowledge of consent of [her insurer], [the p]laintiff settled the personal injury case and
executed a [r]elease.”), aff’d, 2009-NMSC-005, 145 N.M. 542, 202 P.3d 801; see
March, 1984-NMSC-092, ¶ 2 (concluding that an insured’s release and settlement with
the tortfeasor, without the knowledge or consent of his insurance company, relieved the
insurer of its obligations to the insured). Upon receiving notice of the proposed
settlement, the policy required State Farm to exercise one of two options, either (1)
consent to the settlement or (2) withhold consent and tender payment to Thayer in an
amount equal to the settlement offer. It is undisputed that State Farm never notified
Thayer in writing of its election, and Thayer accepted the settlement either eleven or
seventeen months after first requesting permission to do so, depending on whether the
fact-finder believes Thayer’s first request for consent occurred over the telephone at the
August 2012 mediation or by letter in March 2013.
{20} State Farm maintains that Thayer’s settlement with the tortfeasor necessarily
amounts to a breach of the consent-to-settle provision. Thayer maintains that the
insurer’s conduct after receiving notice and a request for consent bears on the
enforceability of the consent-to-settle provision. Thayer’s essential position on appeal is
that an insurer has a duty to respond reasonably promptly to an insured’s request for
consent to settle, and an insurer’s failure to do so may waive its right to enforce the
consent provision. Both propositions find support in New Mexico law and elsewhere.
{21} In Fennema, our Supreme Court made clear that “[t]he insurer must act
reasonably under the circumstances to investigate [the] claim and to evaluate whether
to consent to a settlement between its insured and the tortfeasor.” 2005-NMSC-010,
¶ 12. The Court observed that this requirement arises out of the insurer’s statutory and
common law duties of good faith. Id. In light of the insurer’s “duty to make a timely and
fair investigation,” the Court assumed that the insurer’s decision of whether to pursue
subrogation would be made relatively quickly. Id.
{22} Our Supreme Court has also recognized that an insurer can waive its right to
enforce consent provisions through unreasonable delay. See Stahmann v. Maryland
Cas. Co. 1940-NMSC-025, 44 N.M. 289, 101 P.2d 1021. In Stahmann, a worker’s
compensation insurance carrier failed to respond to an employer’s request to pay an
injured worker’s medical expenses and benefits. Id. ¶ 3. The insurance policy included a
consent provision requiring the employer to seek the insurer’s written consent before
paying any indemnifiable compensation expenses. Id. ¶ 15. After the insurer failed to
respond to two requests for indemnification, the employer paid the injured worker’s
medical expenses and benefits and promptly filed suit against the insurer. Id. ¶ 4.
{23} The trial court sustained the insurer’s demurrer on the basis that payment was
not made with the insurer’s consent. Id. ¶ 17. On appeal, our Supreme Court noted that
the consent provision gave control over the claim to the insurer, and because of this
power imbalance, the insurer “should not be allowed, by inaction or indifference, to
prejudice the rights of the insured.” Id. ¶ 26. The Court held that the insurer had a duty
to respond to the insured with “reasonable promptness,” but had failed to do so, noting
that the employer had not made payment until the carrier “had its opportunity to either
settle or demand suit. [The insurer] stood by and refused to act.” Id. ¶¶ 26-27. The Court
concluded that under the circumstances, “the provisions in the policy contract
prohibiting a settlement unless directed in writing should be considered waived, and the
insurance company estopped to rely on the provisions to defeat a recovery by the
insured upon the ground that the insured settled the claim without its authority.” Id. ¶ 26.
{24} Although Stahmann has not been widely cited, New Mexico courts have
indicated in more recent opinions that the same waiver principles may apply to consent-
to-settle provisions in UIM policies. See Salas, 2007-NMCA-161, ¶ 26 (stating that for
waiver to apply to a settlement without consent, the insurer must “be on notice that it
had a UIM subrogation claim that it needed to protect and then chose not to protect its
right,” but concluding the facts did not support waiver because the insurer did not know
about the settlement negotiations before the plaintiff executed the release); see also
March, 1984-NMSC-092, ¶ 15 (observing that “the insured is protected by the generally-
accepted notion that an insurer’s arbitrary and unreasonable withholding of consent
would constitute a waiver of the consent requirement” but that “no such waiver was
possible where the insured never even gave the insurer an opportunity to consent”).
{25} And since Stahmann was decided, our Legislature has codified an insurer’s duty
to “act reasonably promptly upon communications with respect to claims from insureds
arising under policies,” as well as to promptly investigate claims and effectuate
reasonable settlements. See NMSA 1978, § 59A-16-20(B), (C), (E) (1997). Likewise,
“[u]nder the common law, all insurance contracts include an implied covenant of good
faith and fair dealing that the insurer will not injure its policyholder’s right to receive the
full benefits of the contract.” Sherrill v. Farmers Ins. Exch., 2016-NMCA-056, ¶ 34, 374
P.3d 723 (internal quotation marks and citation omitted). In view of an insurer’s statutory
and common law duties, we believe the waiver rule articulated in Stahmann applies
equally to consent-to-settle provisions in the UIM context. See 1940-NMSC-025, ¶ 26
(reasoning that an insurer places the insured “at a disadvantage that it ought not be
subjected to” when it fails to advise the insured of its decision with reasonable
promptness). Consequently, we hold that if an insurer fails to notify the insured of its
decision to either grant or withhold consent within a reasonable amount of time after
receiving an insured’s request for consent to settle, the insurer may waive the consent
requirement and may not rely on the consent-to-settle provision as a basis to deny
coverage.
{26} Our holding aligns with a number of other jurisdictions that have concluded
consent to settle provisions can be waived through inaction. See Fisher v. USAA Cas.
Ins. Co., 973 F.2d 1103, 1107 (3d Cir. 1992) (applying Pennsylvania law and holding
that an insurer may not unduly delay a coverage decision arising from a request for
consent to settle); Taylor v. Gov’t Emps. Ins. Co., 978 P.2d 740, 749 (Haw. 1999) (“If
the carrier denies the claim of its insured without a good faith investigation into its
merits, or if the carrier does not conduct its investigation in a reasonable time, the
carrier may not deny UIM benefits to its insured.” (emphasis, internal quotation marks,
and citation omitted)); Tate v. Secura Ins., 587 N.E.2d 665, 672 (Ind. 1992) (holding that
an insurer’s delay in providing consent to settle created issues of waiver and estoppel);
Ferrando v. Auto-Owner’s Mut. Ins. Co., 2002-Ohio-7217, ¶ 91, 781 N.E.2d 927 (“[If] the
insurer failed to respond within a reasonable time to a request for consent to the
settlement offer . . . the release will not preclude recovery under the UIM policy.”);
Fulmer v. Insura Prop. & Cas. Co., 760 N.E.2d 392, 399 (Ohio 2002) (“[W]e hold that
when an insured has given her underinsurance carrier notice of a tentative settlement
prior to release, and the insurer has had a reasonable opportunity to protect its
subrogation rights by paying its insured the amount of the settlement offer but does not
do so, the release will not preclude recovery of underinsurance benefits.”); Gaston v.
Tenn. Farmers Mut. Ins. Co., 120 S.W.3d 815, 819-20 (Tenn. 2003) (holding that an
insurer’s delay in responding to a request for consent to settle created issues of material
fact as to whether the insurer waived the provision); see also 14 Plitt, et al., Couch on
Ins. § 124.12, Westlaw (database updated June 2023) (“An insured is not precluded
from recovering uninsured/underinsured (UM/UIM) benefits as a consequence of
entering into a nonconsensual settlement if the insurer has, through its actions, waived
its right to rely on a ‘consent to settle’ clause. An insurer may waive its right to rely on
the clause if . . . it does not notify the insured of its decision to either grant or withhold
consent within a reasonable amount of time.” (citations omitted)).
{27} Returning to the case at hand, there are genuine issues of fact as to whether
Thayer breached the consent-to-settle provision as a result of his settlement with the
tortfeasor. Thayer presented evidence that could allow a jury to infer that State Farm
had a reasonable opportunity to respond to Thayer’s request for consent to settle but
failed to do so, and thereby waived its right to rely on the consent-to-settle provision of
the contract.
{28} For example, the record demonstrates a genuine issue of fact as to when State
Farm was first put on notice of Thayer’s request for consent to settle. Thayer produced
evidence in response to State Farm’s motion for summary judgment showing that he
first requested consent to accept Granite State’s settlement offer by phone at the
August 2012 mediation. State Farm disputes this, asserting that it has no record of that
phone call and instead received notice for the first time upon receiving Thayer’s March
2013 letter. This factual dispute is material to the issue of waiver because its resolution
by a fact-finder establishes the starting point for evaluating State Farm’s response.
Thayer asserts that if the period of delay is measured from his phone call to State Farm
during the mediation, State Farm did not respond in any fashion for over seven months,
and “a reasonable trier of fact could find that State Farm failed to comply with its
obligations to respond within a reasonable time to Thayer’s request for consent to
settle.” See Fennema, 2005-NMSC-010, ¶ 12 (stating that the insurer has a duty to
timely investigate upon receiving an insured’s request for consent to settle). State Farm
maintains that its first notice of the claim occurred in March 2013 when it received
Thayer’s letter, and that it responded promptly by calling and sending a series of three
letters to Thayer.
{29} In addition to disputing the amount of time at issue, the parties also offer
competing interpretations of the nature and effect of State Farm’s letters to Thayer.
Thayer states that after writing to State Farm in March 2013, he “continued to wait for
State Farm to provide an explanation and consent for him to settle with the tortfeasor,”
but that State Farm never expressly granted or denied consent. State Farm states that it
was entitled to investigate Thayer’s claim in order to evaluate whether to consent to the
settlement. See id. State Farm asserts that it made multiple attempts to contact Thayer
in order to obtain more information so that it could evaluate the proposed settlement,
and because Thayer never responded, State Farm was “prevented . . . from exercising
its right to protect its subrogation interests.” We observe, however, that State Farm’s
letters never expressly asked Thayer to provide any particular information to State
Farm, instead stating its general need for certain specific and nonspecific information,
and it was not until June 2013—three months after receiving Thayer’s written request
for consent to settle—that State Farm clearly requested contact from Thayer within thirty
days. The record is silent as to what information, if any, State Farm needed from Thayer
in order to evaluate his request for consent to settle. Put differently, State Farm has not
established that there was information necessary to its investigation that it was unable
to obtain without Thayer’s assistance. On the record before us, State Farm’s
investigation consisted of one phone call and three letters to Thayer’s attorney (two of
which were reservation of rights letters), and an asset investigation conducted
approximately one year after receiving Thayer’s March 2013 letter. Whether these facts
demonstrate that State Farm acted reasonably under the circumstances to investigate
Thayer’s claim and evaluate whether to consent to the settlement, or whether they
demonstrate that State Farm failed to comply with its obligations to investigate and
respond to Thayer’s request for consent to settle within a reasonable time, are disputed
factual issues that must be decided by the fact-finder.
{30} The resolution of these factual issues bears on whether State Farm is entitled to
enforce the consent provision as a basis to deny UIM coverage. Because there are
factual disputes about whether State Farm waived the policy provision requiring consent
to settle, we hold that State Farm was not entitled to judgment as a matter of law.
CONCLUSION
{31} For the foregoing reasons, the summary judgment for State Farm is reversed,
and the case is remanded for further proceedings consistent with this opinion.
{32} IT IS SO ORDERED.
MEGAN P. DUFFY, Judge
WE CONCUR:
J. MILES HANISEE, Judge
ZACHARY A. IVES, Judge
Case-law data current through December 31, 2025. Source: CourtListener bulk data.