26CO44, 26SA29 - In re Pinto v. USAA

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The opinion summaries are not part of the Colorado Supreme
Court's opinion. They have been prepared solely for the reader's
convenience. As such, they may not be cited or relied upon. If
there is any discrepancy between the language in the summary
and the opinion, the language in the opinion controls.

ADVANCE SHEET HEADNOTE
June 8, 2026

# 2026 CO 44

## No. 26SA29, Pinto v. USAA - Insurance- Evidence- Scope of Discovery.

The supreme court holds that the trial court did not err in declining to
extend Schultz v. GEICO Cas. Co., 2018 CO 87, 429 P.3d 844, to breach of contract
claims. The supreme court further holds that the trial court did not abuse its
discretion in compelling the production of the plaintiff's medical records and
insurance documents, and in ordering the plaintiff undergo an independent
medical examination because these materials were relevant to establishing her
claim for uninsured motorist benefits under her breach of contract claim.

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# The Supreme Court of the State of Colorado 2 East 14th Avenue . Denver, Colorado 80203

2026 CO 44

Supreme Court Case No. 26SA29
Original Proceeding Pursuant to C.A.R. 21
El Paso County District Court Case No. 24CV32208
Honorable Eric Bentley, Judge

In Re
Plaintiff:

Samantha Pinto,

V.

Defendant:

United Services Automobile Association.

Order Discharged
en banc
June 8, 2026

Attorneys for Plaintiff:

Robert J. Anderson, P.C.

Robert J. Anderson

Scott F. Anderson

Timothy G. Buxton

Colorado Springs, Colorado

Attorneys for Defendant:

Gordon Rees Scully Mansukhani LLP

John R. Mann

Katherine Kust

Jessica Schultz

Denver, Colorado

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Attorneys for Amicus Curiae Colorado Defense Lawyers Association:
Sutton Booker P.C.
Katie B. Johnson
Dylan G. Lewis
Denver, Colorado

JUSTICE BLANCO delivered the Opinion of the Court, in which CHIEF
JUSTICE MÁRQUEZ, JUSTICE BOATRIGHT, JUSTICE HOOD, JUSTICE
GABRIEL, JUSTICE SAMOUR, and JUSTICE BERKENKOTTER joined.

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JUSTICE BLANCO delivered the Opinion of the Court.

11
This case involves a discovery dispute implicating Schultz v. GEICO Cas. Co.,
2018 CO 87, 429 P.3d 844. In Schultz, we held that when considering bad faith
claims, a court's review of the insurer's decision is limited to the evidence that was
before the insurer at the time it made its decision. 11 23-24, 429 P.3d at 848-49.

12
In this breach of contract case for uninsured motorist ("UM") benefits,
Samantha Pinto argues that she should not be compelled to provide United
Services Automobile Association ("USAA") with her unredacted medical records
and insurance documents relating to a subsequent accident because these
documents were unavailable to USAA when it made its coverage decision. She
also argues that she should not be compelled to complete an independent medical
examination ("IME") because any evidence it would produce was likewise
unavailable to USAA at the time of its coverage decision.

T3
We hold that Schultz does not extend to breach of contract claims. Therefore,
we conclude that Pinto's medical records, insurance documents, and IME are
relevant to establishing her entitlement to UM benefits in her contract claim.
Accordingly, we conclude that the trial court did not abuse its discretion in
compelling production of Pinto's medical records and insurance documents and
ordering Pinto to complete an IME.

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## I. Facts and Procedural History

14 On December 20, 2020, Pinto's car was rear-ended by another vehicle. Pinto
claimed that she suffered injuries from the accident, including neck pain, back
pain, and a concussion. She also claimed that she suffered cognitive issues because
of the concussion, including anxiety, stress, and nervousness; difficulty in
communicating with others, handling stress, and multi-tasking; diminished
short-term and long-term memory; and mood issues.

15 In 2020, Pinto was employed by USAA, and as a result of the accident, she
sought lost wages and employment benefits resulting from the collision. USAA
later terminated Pinto's employment, which she contends was due to her ongoing
health issues. At the time of her termination, Pinto had worked for USAA for
approximately nineteen years. Had she reached twenty years of service, she
would have become eligible for a substantial increase in retirement benefits. As a
result, she also claimed a significant amount of lost income. Her experts later
evaluated her total lost income and lost benefits at $1,371,020.

16
Pinto received $500,000 from the other driver's insurance, which was the
driver's full policy limit.

17 Pinto had a policy with USAA that included UM benefits. The policy had a
coverage limit of $300,000 per person, per accident. Pinto filed a UM claim,
contending that her calculated damages exceeded the driver's available insurance

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coverage. USAA offered Pinto nothing for her claim, explaining that it valued the
claim at approximately $144,000, an amount Pinto had already received from the
other driver's insurance.

18 Pinto filed suit against USAA, asserting, among other things, a breach of
contract claim for UM benefits under her policy with USAA. As part of discovery,
USAA asked the trial court to compel Pinto to (1) produce unredacted medical
records pertaining to her cognitive functioning; (2) produce documents regarding
a separate insurance claim from an April 2022 accident, in which Pinto claimed
similar injuries; and (3) fully cooperate with an IME. Pinto challenged USAA's
discovery requests.

19
The trial court held a hearing to resolve the discovery dispute. At the
hearing, the court concluded that Schultz did not apply to her claim for contractual
damages under the UM policy. The court made several oral findings, including
that the materials that USAA requested were all relevant to Pinto's UM claim and
therefore discoverable. Pinto did not seek a protective order. USAA then
submitted a proposed order that would direct Pinto to (1) produce unredacted
medical records and bills, (2) produce all documentation related to the subsequent
April 2022 accident, and (3) cooperate with the IME.

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110
Pinto requested our review under C.A.R. 21, which we granted.1

## II. Analysis

111 We begin by explaining the basis of our original jurisdiction in this case and
then set forth the applicable standard of review. We next consider whether the

1 The issues set forth in the petition are as follows:

1\. Whether the [t]rial [c]ourt, despite the holding of this [c]ourt in
Schultz v. [GEICO] Casualty [Co.], [2018 CO 87,] 429 P.3d 844 . . . ,
abused its discretion when it compelled [p]etitioner to produce
medical records unrelated to her injuries from the motor vehicle
accident that [p]etitioner claimed as privileged and records that
were not considered, requested, or used by [d]efendant to evaluate
make [sic] its coverage decision to deny [p]etitioner's [UM] benefit.

2\. Whether the [t]rial [c]ourt, despite the holding of this [c]ourt in
Schultz, supra, abused its discretion when it compelled [p]etitioner
to produce records, to include [sic] medical records, traffic
accident reports, vehicle photos, property damage estimates,
medical bills and correspondence with any insurance carrier,
including demand packages with attachments, pertaining to a
subsequent insurance claim for a subsequent motor vehicle
accident and which were not evaluated by [d]efendant at the time
it made its coverage decision to deny [p]etitioner's [UM] benefit.

3\. Whether the [t]rial [c]ourt, despite the holding of this [c]ourt in
Schultz, supra, and Charlson v. Pribble, 2026 WL 31984 (Colo. 2026),
abused its discretion when it compelled [p]etitioner to attend a
[n]europsychiatric IME to create new medical evidence when no
IME was requested or completed by [d]efendant at the time it
made its decision to deny [p]etitioner's [UM]benefit.

4\. Whether the [t]rial [c]ourt abused its discretion by ordering
[p]etitioner to attend and disclose in that [n]europsychiatric IME
information that remains privileged.

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trial court erred by declining to extend Schultz to breach of contract claims, and, if
it did not, whether the court nonetheless abused its discretion by compelling the
production of Pinto's medical records and insurance claim documents from a
previous accident and ordering Pinto to undergo an IME.

## A. C.A.R. 21 Jurisdiction

112 Our original jurisdiction under Rule 21 "is extraordinary in nature and is a
matter wholly within [our] discretion." C.A.R. 21(a)(2). "Such relief will be
granted only when no other adequate remedy is available ... . " Id. "Specifically,
jurisdiction is proper when 'an appellate remedy would be inadequate, a party
may suffer irreparable harm, or a petition raises an issue of first impression that
has significant public importance."" People v. Howell, 2024 CO 42, 1 5, 550 P.3d 679,
682-83 (quoting People v. Seymour, 2023 CO 53, 1 16, 536 P.3d 1260, 1269).

113 This court has exercised its original jurisdiction to protect privacy interests
that are implicated when, as here, an individual is ordered to disclose medical
records or ordered to undergo a medical examination against their will. E.g.,
Schultz, [ 13, 429 P.3d at 847. This is because a violation of an individual's privacy
interests in their body and health cannot adequately be remedied on appeal. Id .;
Ortega v. Colo. Permanente Med. Grp., P.C., 265 P.3d 444, 447 (Colo. 2011).

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## B. Standard of Review

114 We review a district court's interpretation and application of our precedent
de novo. Phillips v. People, 2026 CO 21, 1 24, 586 P.3d 1102, 1107.

115 We review discovery rulings, including orders compelling production of
documents, for an abuse of discretion. Garcia v. Centura Health Corp., 2025 CO 15,
1 24, 566 P.3d 999, 1006; Hayes v. Dist. Ct., 854 P.2d 1240, 1243 (Colo. 1993). A trial
court abuses its discretion if its decision is "manifestly arbitrary, unreasonable, or
unfair." Freedom Colo. Info., Inc. v. El Paso Cnty. Sheriff's Dep't, 196 P.3d 892, 899
(Colo. 2008). "An appellate court will find such an abuse of discretion only where
'there is a showing that the findings and conclusions of the trial court are so
manifestly against the weight of evidence as to compel a contrary result."" In re
Weisbard, 25 P.3d 24, 28 (Colo. 2001) (quoting In re Application for Water Rts. of Hines
Highlands Ltd. P'ship, 929 P.2d 718, 728 (Colo. 1996)).

## C. Schultz Does Not Extend to Breach of Contract Claims

116 Pinto argues that Schultz precludes USAA from seeking evidence that was
unavailable at the time it made its coverage decision. Schultz holds that, in the
context of bad faith claims, a court's review of the insurer's decision is limited to
the materials that were before the insurer at the time it made that decision.
TT 23-24, 429 P.3d at 848-49. But the rationale of Schultz is confined to bad faith
claims in which the inquiry focuses on the reasonableness of the insurer's conduct.

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Accordingly, Schultz does not extend to breach of contract claims that do not
involve a reasonableness inquiry.

117 In Schultz, we addressed the scope of discovery for bad faith claims and their
defenses. Id. at TT 1-2, 429 P.3d at 845-46. There, the plaintiff alleged that the
insurer breached its duty of good faith and fair dealing and unreasonably delayed
payment. Id. at 12, 429 P.3d at 845-46. The insurer had offered to pay the
plaintiff's full policy limit before litigation began and without requesting that the
plaintiff undergo an IME. Id. at 16, 429 P.3d at 846. After the plaintiff sued, the
insurer denied liability, disputing the claimed injuries and requesting that the
plaintiff undergo an IME to support its defenses. Id. at 11 7-8, 429 P.3d at 846.

118 To prevail on a bad faith claim, the insured "must establish that the insurer
acted unreasonably and with knowledge of or reckless disregard for the fact that
no reasonable basis existed for denying the claim." Id. at | 15, 429 P.3d at 847
(quoting Travelers Ins. Co. v. Savio, 706 P.2d 1258, 1274 (Colo. 1985)). When
assessing the reasonableness of an insurance company's decision to deny benefits,
we must evaluate the decision "based on the information before the insurer at the
time it made its decision." Id. at | 22, 429 P.3d at 848. This is because "a bad faith
claim requires an assessment of whether the insurer's coverage decision was
unreasonable when it occurred, 'not whether later developments could have

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vindicated the [i]nsurer's decision."" Id. at | 24, 429 P.3d at 849 (quoting Fireman's
Fund Ins. Cos. v. Alaskan Pride P'ship, 106 F.3d 1465, 1470 (9th Cir. 1997)).

119 In Schultz, we concluded that the insurer could not use new evidence to
retroactively justify its prior decision because (1) it did not show that the "newly
developed medical evidence would be pertinent to the question of what [the
insurer] knew when it made its coverage decision in this case" and (2) it did not
explain "how the state of [the plaintiff's] medical condition today would be
relevant to her medical condition over a year ago, when [the insurer] made its
coverage decision." Id. at 11 3, 24, 25, 429 P.3d at 846, 849.

120 But Schultz does not extend to breach of contract claims because, unlike bad
faith claims, the reasonableness of the insurer's conduct is not a consideration.
Instead, the only consideration is whether the insured can establish an entitlement
to the benefits under the policy. See Salazar v. State Farm Mut. Auto. Ins. Co., 148
P.3d 278, 282 (Colo. App. 2006) (holding that a plaintiff must establish that the
insurer refused to pay their claim and that the policy terms required payment to
prove entitlement to UM benefits).

121 A division of the court of appeals recognized this principle in Peiffer v. State
Farm Mutual Automobile Insurance Co., 940 P.2d 967, 970-71 (Colo. App. 1996), aff'd,
955 P.2d 1008 (Colo. 1998). There, the division concluded that the insurer could
present the testimony of a neuropsychologist who had examined the plaintiff's

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medical and psychological records after the litigation had begun because the
testimony was relevant to support its theory about the nature and extent of the
plaintiff's injuries. Id. at 971.

122 Likewise, the United States District Court for the District of Colorado has
held on numerous occasions that Schultz does not extend beyond bad faith claims.
E.g., Fifer v. Travelers Prop. Cas. Co. of Am., No. 23-cv-00294-NYW-CYC, 2025 WL
2513472, at *5 (D. Colo. Sep. 2, 2025) ("[A]n insurer's failure to seek certain
information during the adjustment of a claim does not necessarily form a bar to
further discovery once litigation commences for breach of contract." (emphasis
omitted) (quoting Rowell v. Nw. Mut. Life Ins. Co., No. 21-cv-00098-PAB-NYW, 2021
WL 5072064, at *5 (D. Colo. Aug. 23, 2021))); Ioerger v. State Farm Mut. Auto. Ins.
Co., No. 1:22-cv-01807-REB-SP, 2023 WL 11756921, at *3-5 (D. Colo. June 30, 2023)
(concluding that Schultz was inapplicable because the parties still disputed the
"the nature and extent of injuries and damages," so the breach of contract claim
remained in the case); D'Antonio v. Am. Fam. Mut. Ins. Co., S.I., No. 21-cv-02363-
PAB-NRN, 2022 WL 3681984, at *2 (D. Colo. Aug. 25, 2022) (concluding that
"because defendant has not made its coverage decision - since plaintiff demands
more benefits than have been paid-the Schultz rule that an insurer cannot
retroactively justify its coverage decision is irrelevant and does not bar defendant
from seeking an IME"); Anchondo-Galaviz v. State Farm Mut. Auto. Ins. Co., No. 18-

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cv-01322-JLK-NYW, 2019 WL 11868519, at *10 (D. Colo. July 19, 2019) (rejecting the
proposition "that an insurer waives the right to pursue an independent medical
examination in the context of litigation by failing to pursue a medical examination
during the adjustment of a claim, when a plaintiff's physical condition remains at
issue"); see also Kovac v. Farmers Ins. Exch., 2017 COA 7M, 1 19, 401 P.3d 112, 115
("Although we are not bound by decisions of federal courts applying Colorado
law, we may look to federal decisions for guidance and follow the analysis that we
find persuasive." (citation omitted)).

123 Accordingly, we hold that Schultz does not apply to breach of contract
claims. The trial court thus did not err when it distinguished Schultz and
determined that it did not preclude discovery concerning Pinto's medical
condition as it relates to her contract claim for UM benefits.

## D. The Trial Court Did Not Abuse Its Discretion in Compelling Production of Pinto's Medical Records and Insurance Claim Documents and Ordering Pinto to Complete an IME

T24 We next consider whether the trial court abused its discretion by ordering
Pinto to (1) produce her unredacted medical records and insurance claim
information from the April 2022 accident and (2) undergo an IME, based on its
finding that this evidence was relevant to the jury's determination of which
injuries resulted from the accident. We address each in turn.

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## 1. Unredacted Medical Records and Insurance Claim Documents

125 The trial court determined that Pinto's unredacted medical records were
"clearly relevant to [Pinto's] claim of injury for this accident" and that the
insurance claim documents from the April 2022 accident were "clearly directly
relevant to the jury's determination of which injuries stem from the accident at
issue in this case."

126 Evidence is relevant when it has the "tendency to make the existence of any
fact that is of consequence to the determination of the action more probable or less
probable than it would be without the evidence." CRE 401.

127 Pinto argues that the trial court abused its discretion when it compelled
production of her unredacted medical records because these documents were not
evaluated by USAA at the time it made its coverage decision. But, as previously
explained, Schultz does not preclude an insurer from reviewing documents made
after its coverage decision with respect to breach of contract claims. Because Pinto
claimed she suffered cognitive impairment from the concussion she sustained in
the accident, whether she had similar cognitive impairment before the accident is
relevant to whether she may be entitled to UM coverage.2

2 To the extent that Pinto wishes to maintain her privacy as it relates to her
unredacted medical records, she may request a protective order.

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[28 Pinto further argues that her April 2022 accident and related claims she
made to another insurer are not relevant to her claim for UM benefits arising from
the December 2020 accident. But, as the trial court explained, Pinto's
communication and demands to insurance carriers relating to her claims for
damages with respect to the April 2022 accident are relevant to the jury's
determination of which injuries stem from the December 2020 accident for her UM
claim in this case.

129 Accordingly, we conclude that the trial court did not abuse its discretion in
compelling these documents. We will next consider the trial court's decision to
order Pinto to complete an IME.

## 2. IME

130 The trial court determined that because Pinto placed her mental health at
issue by claiming she had suffered cognitive impairments resulting from the
accident, "it [was] legitimate for [USAA] to inquire into whether there [were] other
causes for [Pinto's] cognitive deficit other than the motor vehicle accident at issue."
Consequently, it ordered Pinto to complete an IME.

131 C.R.C.P. 35(a) provides that a court may order, upon a showing of good
cause, a mental examination of a party whose mental condition is in controversy.
Determination of good cause is within a trial court's sound discretion. People in
Int. of A.W.R., 17 P.3d 192, 199 (Colo. App. 2000). Generic damage claims for

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mental suffering are insufficient to place a litigant's mental condition "in
controversy" for purposes of determining whether that litigant should be subject
to a medical examination. Tyler v. Dist. Ct., 561 P.2d 1260, 1262 (Colo. 1977).

132 Relying on Charlson v. Pribble, No. 25SA281, 2026 WL 31984 (Colo. Jan. 5,
2026) (unpublished order), Pinto argues that she did not place her mental health
in controversy because her injuries included a concussion resulting in brain fog,
poor comprehension, anxiety, stress, irritability, difficulty concentrating, and
nervousness. Id. at *1 (citing Tyler, 561 P.2d at 1262-63) ("A plaintiff's general
allegations of mental suffering, mental anguish, emotional distress and the like, do
not place his mental condition in controversy under C.R.C.P. 35(a)."). But, as the
trial court explained, Pinto placed her mental health at issue when she asserted
that her cognitive impairments should be covered under the UM policy because
those impairments directly relate to her mental health. As a result, USAA
reasonably inquired whether causes other than the motor vehicle accident
contributed to her alleged cognitive deficits. Accordingly, the trial court did not
abuse its discretion in ordering Pinto to undergo an IME.

## III. Conclusion

133 We hold that the trial court did not err in declining to extend Schultz to
breach of contract claims. We also hold that the trial court did not abuse its
discretion in compelling production of Pinto's medical records and insurance

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documents, and in ordering Pinto to undergo an IME.3 Accordingly, the order to
show cause is discharged.

3 USAA filed a motion to strike Exhibit 17 from Pinto's reply brief. Because our
analysis does not rely on Exhibit 17, USAA's motion is denied as moot.