$15.5 Million Awarded Son, Father in Benefits Suit

The son and husband of a woman who was denied medical insurance benefits for six months in 1980 while she lay dying won a $15.5-million award Friday against an investigative agency that falsely reported that she was ineligible for the benefits.

The verdict came on the sixth anniversary of Patricia Bancroft’s death.

“It’s ironic that six years ago today my mother passed away,” said Jon P. Bancroft, 31, of Lake Forest.

Bancroft described how he and his father, John Bancroft, cared for the dying woman in their home and sold a car, a motorhome and personal effects to pay the bills that an insurance company refused to cover.

The verdict was returned against Equifax Services Inc., a national investigation firm whose headquarters is in Atlanta. The Bancrofts’ insurance company, Associated Life Insurance Co. of Chicago, asked Equifax to investigate the first claims for medical payments for Patricia Bancroft, then denied benefits when Equifax reported that she was not eligible.

Award Called ‘Excessive’

The $15-million punitive-damage award, representing 15% of the firm’s net worth, is “excessive” and will be appealed, an Equifax attorney said.

“The jury gave us way beyond what we had asked for or even imagined,” Jon Bancroft said.

The Bancrofts’ attorneys, Christopher B. Mears and Martin C. Handweiler, had asked jurors for punitive damages amounting to 10% of Equifax’s net worth of $98 million to punish the firm and deter wrongdoing.

The jury also awarded the father $290,000 and the son $240,000 to compensate them for their losses.

Jon Bancroft called Friday “a good day but a bad day.”

“We had to relive what we went through six years ago, not just trying to take care of her but dealing with the insurance company, losing our business, selling personal possessions, just so we could pay the bills,” Bancroft said. “It brought up a lot of painful memories.”

Mother, father and son were partners in and the main work force at Little Italy, a restaurant in Garden Grove. Less than a year after Patricia Bancroft died, while they were still struggling to pay the medical bills, the Bancrofts lost the restaurant to creditors.

Patricia Bancroft died Oct. 3, 1980, at 47, of complications from diabetes, circulatory ailments and blood clots in the lungs.

The family bought a group medical insurance policy for employees of the restaurant on Feb. 10, 1980. Patricia Bancroft was first admitted to Anaheim Memorial Hospital in March, and claims for her care were sent to Associated Life.

The insurance company, which settled its part of the Bancroft lawsuit in 1983 for $185,000, hired Equifax to investigate her condition.

Two Equifax employees--Pamela Shaver, an investigator, and Robert Parr, a supervisor--sent the report and charged Associated Life $60.

Report, Testimony Conflict

The report included copies of Patricia Bancroft’s medical records, which were supplied by her physician, Dr. Mark Miller. The report stated that Miller felt Patricia Bancroft was totally disabled before the policy was purchased.

Miller and two members of his office staff testified during the seven-day trial before Orange County Superior Court Judge Richard W. Luesebrink that they had not talked to Equifax employees. Miller testified that Patricia Bancroft was not disabled at the time the policy was purchased.

Jon Bancroft said he felt the insurance firm was justified in relying on Equifax’s report.

“They were using what they considered to be a reliable source,” Bancroft said. “This is supposed to be a well-known investigating company. They relied on this company to feed them the right information. But, unfortunately, Equifax didn’t double-check or triple-check their information.”

Associated Life refused to pay the hospital bills, and Anaheim Memorial officials asked the Bancrofts to take the dying woman home, said Mears, one of their attorneys.

‘A Nightmare’

She was shuttled to and from the hospital, Mears said, being admitted during life-threatening emergencies and asked to leave when her condition stabilized.

“She was dying,” said Mears, who emphasized that he believes the hospital was blameless. “When she was medically stable, they asked her to leave. But she needed continuous nursing care, whether she was home or in the hospital.

“The family was asked to take her home. They did so. Nursing care fell to them. They had to change her diapers, feed her, help her with every bodily function.

“Their life was turned into a nightmare. The death and illness of Patricia was not caused by Equifax; there’s no doubt about that. But at a time when the family should have been given adequate medical support in her final days, it was denied to them.”

Equifax attorney Peter R. Taft said three years passed before his client was named as a defendant in the lawsuit. The Bancrofts’ attorneys had filed suit against Associated Life, but it was not until after the insurance company agreed to an out-of-court settlement that Equifax was named as a defendant, according to attorneys for the Bancrofts and for Equifax.

Taft said Equifax employees could shed little light on the case after so much time had passed.

When they testified, both Shaver and Parr said they could not recall any details of the Bancroft case, according to attorneys for both sides.

Patricia Bancroft’s eligibility for the medical benefits was not questioned during the trial. Shaver and Parr both testified that the report should not have been forwarded to the insurance firm without further information, but they could not say why it had been sent.

“The jury said this kind of conduct will not be tolerated,” Mears said. “If they engage in this kind of conduct in the future, they will understand that one day they will be faced with a jury, in Orange County at least, that is going to exact a very heavy penalty.”

John Bancroft, 58, lives in Anaheim and is an auto parts salesman. He has remarried. Jon Bancroft is a nurse.