JOSEPH F. BIANCO, District Judge:
On March 18, 2014, plaintiffs Thomas Foster and Coralie J. Foster ("plaintiffs" or "the Fosters") filed this flood insurance action, bringing claims against the Federal Emergency Management Agency ("FEMA"), Allstate Insurance Company ("Allstate"), and Alan Aronson (collectively, "defendants"). Allstate Insurance Company is a "Write Your Own" ("WYO") flood insurance carrier and the issuer of a flood insurance policy covering plaintiffs residence in Cedarhurst, New York. The instant action rises from Allstate's denial of plaintiffs' insurance claim seeking coverage for the damage their property sustained during Hurricane Sandy.
Plaintiffs bring the following claims against FEMA: (1) a request for relief under 28 U.S.C. §§ 2201, 2202 and a judgment by the Court that the defendants are obligated to pay their insurance claim in full; (2) breach of contract; (3) negligence; (4) breach of fiduciary duty; (5) aiding and abetting a breach of fiduciary duty; (6) unjust enrichment by FEMA; (7) promissory estoppel; (8) respondent superior and vicarious liability by agents and employees of FEMA; (9) intentional infliction of emotional distress; (10) negligent infliction of emotional distress; (11) breach of express and implied covenants; and (12) equitable estoppel.
FEMA now moves to dismiss plaintiffs' claims against it for lack of subject matter jurisdiction pursuant to Federal Rule of Civil Procedure 12(b)(1), because sovereign immunity shields federal agencies from suit and FEMA has not waived its immunity, and for failure to state a claim upon which relief can be granted pursuant to Federal Rule of Civil Procedure 12(b)(6) because: (1) plaintiffs failed to exhaust administrative remedies under the Federal Tort Claims Act ("FTCA");
The following facts are taken from the complaint, and are not findings of fact by the Court. Instead, the Court will assume the facts to be true and, for purposes of the pending motion to dismiss, will construe them in a light most favorable to the plaintiff, the non-moving party. The Court also considers the exhibits and affidavits attached to the parties' moving papers for purposes of considering FEMA's motion under Rule 12(b)(1).
Congress passed the National Flood Insurance Act ("NFIA") in 1968, codified at 42 U.S.C. § 4001 et seq., with the purpose of instituting "a reasonable method of sharing the risk of flood losses" by subsidizing flood insurance through private insurers. 42 U.S.C. §§ 4001(a)-(b). NFIA established the National Flood Insurance Program ("NFIP"), which is "administered by [FEMA and] supported by the federal treasury, which pays for claims that exceed the revenues collected by private insurers from flood insurance premiums." Palmieri v. Allstate Ins. Co., 445 F.3d 179, 183 (2d Cir.2006). The NFIP includes two separate types of government-financed flood insurance. Under the first, known as the "Direct program" or the "Government program," NFIP policyholders are insured directly by FEMA. In the Direct program, "the government `run[s] the NFIP itself — offering federally underwritten policies — with the potential for administrative assistance from private insurers.'" Id. at 183 (quoting Downey v. State Farm Fire & Cas. Co., 266 F.3d 675, 678 (7th Cir.2001)) (citing 42 U.S.C. §§ 4071-4072). Under the second program (the "WYO program"), which is authorized under 42 U.S.C. § 4081(a), NFIP policyholders are insured by participating WYO companies. "Although FEMA may issue policies directly under the Government Program, `more than 90% are written by WYO companies.'" Id. (quoting C.E.R. 1988, Inc. v. Aetna Cas. and Surety Co., 386 F.3d 263, 267 (3d Cir.2004)).
Under the terms of the WYO program the "Federal Insurance Administrator will enter into arrangements with [WYO] companies whereby the Federal Government will be a guarantor in which the primary relationship between the WYO Company and the Federal Government will be one of a fiduciary nature, i.e., to assure that any taxpayer funds are accounted for and appropriately expended." 44 C.F.R. § 62.23(f); see also C.E.R. 1988, 386 F.3d at 267 (noting that the WYO "private insurers may act as fiscal agents of the United States, but they are not general agents. Thus they must strictly enforce the provisions set out by FEMA and may vary the terms of a Policy only with the express written consent of the Federal Insurance Administrator.") (internal citations and quotations omitted).
NFIP policyholders, participating in either the WYO program or the Direct program, "may appeal a decision, including a determination of any insurance agent, adjuster, insurance company, or any FEMA employee or contractor with respect to a claim, proof of loss, and loss estimate" directly with FEMA pursuant to the procedures outlined in 44 C.F.R. § 62.20. 44 C.F.R. § 62.20(b)-(e).
When Hurricane Sandy hit Long Island on October 29, 2012, the Fosters' residence, located at 428 Rugby Road, Cedarhurst, New York ("the property") sustained property damage in excess of $220,000. (Compl. ¶¶ 2, 30.) The property is located within a Flood Zone, and the Foster's mortgage with J.P. Morgan Chase requires flood insurance. (Id. ¶ 31.) The Foster's flood insurance policy ended on September 11, 2012, but included a 30-day grace period in which to extend coverage. (Id. ¶ 31.) The Fosters negotiated the terms of their insurance renewal with Allstate insurance broker Alan Arson between September 11, 2012 and October 11, 2012. (Id. ¶ 32.) On October 22, 2012,
On November 4, 2012, the Fosters filed an insurance claim seeking coverage for the damage their property sustained during Hurricane Sandy. (Id. ¶ 33.) After an Allstate adjuster inspected the Fosters' property, Allstate sent them an advance check in the amount of $10,000 on or around November 26, 2012. (Id. ¶ 34.) Allstate sent the Fosters a second $10,000 check on or around December 5, 2012. (Id. ¶ 35.) Around January 25, 2013, the Fosters received a payment from Allstate in the amount of $42,349.77 covering the structural damage to their property, and another payment of $27,693.14 on or around March 12, 2013 covering the damages to the contents of their residence. (Id. ¶¶ 43, 45.)
However, on March 21, 2013, an Allstate employee notified the Fosters that their flood insurance claim was denied in full. (Id. ¶ 46.) Allstate informed the Fosters that "because they were issued a new policy on October 22, 2012, there was a thirty (30) day lag period which prevented coverage," but noted that the waiting period would be waived if the terms of the Fosters' mortgage mandated flood insurance. (Id. ¶ 47.) In a letter dated March 19, 2013, Allstate formally denied the Fosters' claim, on the grounds that the hurricane damage occurred within the 30-day waiting period and, as a result, the Fosters' policy was not effective until November 23, 2012. (Id. ¶¶ 48, 53.) The letter requested that the Fosters return the $52,349.77 previously paid by Allstate. (Id. ¶ 54.)
Sixty days after receiving Allstate's formal denial letter, the Fosters appealed the denial decision to FEMA under 44 C.F.R. § 62.20. (Id. ¶ 61.) On November 4, 2013, FEMA issued a letter affirming Allstate's denial decision on the grounds that the damage occurred during the 30-day waiting period. (Id. ¶ 62.) Plaintiffs assert that "[b]y their individual and collective conduct FEMA and Allstate have denied a bone fide flood claim in violation of the Flood Policy, federal law, and common law and statute." (Id. ¶ 64.)
Plaintiff commenced this action on March 18, 2014. On December 22, 2014, FEMA filed a motion to dismiss the claims against it. On January 26, 2015, plaintiffs filed a memorandum in opposition to FEMA's motion. Plaintiffs also filed sealed documents in support of their opposition papers on February 4, 2015. On February 13, 2015, FEMA filed a reply memorandum in further support of its motion to dismiss. The Court has fully considered the parties' submissions.
When a court reviews a motion to dismiss for lack of subject matter jurisdiction under Rule 12(b)(1), it "must accept as true all material factual allegations in the complaint, but [it is] not to draw inferences from the complaint favourable to plaintiffs." J.S. ex rel. N.S. v. Attica Cent. Schs., 386 F.3d 107, 110 (2d Cir. 2004). The burden of proving subject matter jurisdiction by a preponderance of
Federal courts are courts of limited jurisdiction and may not preside over cases if subject matter jurisdiction is lacking. Lyndonville Sav. Bank & Trust Co. v. Lussier, 211 F.3d 697, 700-01 (2d Cir. 2000). Unlike lack of personal jurisdiction, lack of subject matter jurisdiction cannot be waived and may be raised at any time by a party or by the Court sua sponte.
It is axiomatic that "[a] case is properly dismissed for lack of subject matter jurisdiction pursuant to Rule 12(b)(1) when the district court lacks the statutory or constitutional power to adjudicate it." Makarova, 201 F.3d at 113. "[T]he United States, as sovereign, is immune from suit save as it consents to be sued ... and the terms of its consent to be sued in any court define that court's jurisdiction to entertain the suit." United States v. Testan, 424 U.S. 392, 399, 96 S.Ct. 948, 47 L.Ed.2d 114 (1976) (internal quotation marks and citation omitted). In other words, the United States enjoys sovereign immunity from suit except to the extent to which, and under the terms of which, it consents to be sued. See Millares Guiraldes de Tineo v. U.S., 137 F.3d 715, 719 (2d Cir.1998) (citing United States v. Sherwood, 312 U.S. 584, 586, 61 S.Ct. 767, 85 L.Ed. 1058 (1941)).
When a court reviews a motion to dismiss for failure to state a claim for which relief can be granted pursuant to Rule 12(b)(6), it must accept the factual allegations set forth in the complaint as true and draw all reasonable inferences in favor of the plaintiff. See Cleveland v. Caplaw Enters., 448 F.3d 518, 521 (2d Cir.2006); Nechis v. Oxford Health Plans, Inc., 421 F.3d 96, 100 (2d Cir.2005). "In order to survive a motion to dismiss under Rule 12(b)(6), a complaint must allege a plausible set of facts sufficient `to raise a right to relief above the speculative level.'" Operating Local 649 Annuity Trust Fund v. Smith Barney Fund Mgmt. LLC, 595 F.3d 86, 91 (2d Cir.2010) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 555, 127 S.Ct. 1955, 167 L.Ed.2d 929 (2007)). This standard does not require "heightened fact pleading of specifics, but only enough facts to state a claim to relief that is plausible on its face." Twombly, 550 U.S. at 570, 127 S.Ct. 1955.
The Supreme Court clarified the appropriate pleading standard in Ashcroft v. Iqbal, setting forth a two-pronged approach for courts deciding a motion to dismiss. 556 U.S. 662, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009). The Court instructed district courts to first "identify[ ] pleadings that, because they are no more than conclusions, are not entitled to the assumption of truth." Id. at 1950. Although "legal
The Court notes that in adjudicating this motion, it is appropriate to consider: "(1) facts alleged in the complaint and documents attached to it or incorporated in it by reference, (2) documents `integral' to the complaint and relied upon in it, even if not attached or incorporated by reference, (3) documents or information contained in defendant's motion papers if plaintiff has knowledge or possession of the material and relied on it in framing the complaint, (4) public disclosure documents required by law to be, and that have been, filed with the Securities and Exchange Commission, and (5) facts of which judicial notice may properly be taken under Rule 201 of the Federal Rules of Evidence." In re Merrill Lynch & Co., 273 F.Supp.2d 351, 356-57 (S.D.N.Y.2003) (internal citations omitted), aff'd in part and reversed in part on other grounds sub nom., Lentell v. Merrill Lynch & Co., 396 F.3d 161 (2d Cir.2005), cert. denied, 546 U.S. 935, 126 S.Ct. 421, 163 L.Ed.2d 321 (2005); see also Cortec Indus., Inc. v. Sum Holding L.P., 949 F.2d 42, 48 (2d Cir.1991) ("[T]he district court... could have viewed [the documents] on the motion to dismiss because there was undisputed notice to plaintiffs of their contents and they were integral to plaintiffs' claim."); Brodeur v. City of New York, No. 04 Civ. 1859(JG), 2005 WL 1139908, at *2-3, 2005 U.S. Dist. LEXIS 10865, at *9-10 (E.D.N.Y. May 13, 2005) (court could consider documents within the public domain on a Rule 12(b)(6) motion to dismiss).
FEMA moves pursuant to Rule 12(b)(1) to dismiss plaintiffs' claims against it for lack of subject matter jurisdiction, asserting that plaintiffs' claims under the NFIA are barred by sovereign immunity. FEMA argues that the court lacks subject matter jurisdiction over plaintiffs' breach of contract and non-tort claims, because the "United States may be sued only if it has clearly consented to be sued" and here "there has been no waiver of sovereign immunity under the NFIA for Plaintiff to bring this action against FEMA." (FEMA's Mem. of Law, ECF No. 82 at 8.) For the reasons that follow, the Court agrees and dismisses plaintiffs' breach of contract and non-tort claims under Rule 12(b)(1).
As discussed above, it is well-established that the United States is immune from suit unless it consents to be sued. United States v. Dalm, 494 U.S. 596, 608, 110 S.Ct. 1361, 108 L.Ed.2d 548 (1990). This immunity extends to federal agencies and officers acting in their official capacities. F.D.I.C. v. Meyer, 510 U.S. 471, 475, 114 S.Ct. 996, 127 L.Ed.2d 308 (1994) ("Absent a waiver, sovereign immunity shields the Federal Government and its agencies from suit."); Dotson v. Griesa, 398 F.3d 156, 177 (2d Cir.2005); Gildor v. U.S. Postal Serv., 376 F.Supp.2d 284, 287 (N.D.N.Y.2005), aff'd, 179 Fed.Appx. 756 (2d Cir.2006). The NFIA contains a partial waiver of sovereign immunity for suits against FEMA for denial of insurance coverage.
42 U.S.C. § 4072. The Second Circuit has held that this provision allows claimants to sue both FEMA and WYO companies in federal court for denial of coverage claims. Palmieri, 445 F.3d at 184-86 (concluding that under the terms of § 4072 an "action against the [Administrator's] fiscal agent is `an action against the [Administrator]'" and that the "statutory framework ... indicates not only that private insurers are to act as fiscal agents of the government in administering the federal program, but also that all claims for benefits under an NFIA policy, whether issued as part of the Industry Program or the Government Program and whether sought from a private insurer or the government, are to be litigated exclusively in federal court.").
However, though the Second Circuit has not addressed the issue, courts across the country have narrowly circumscribed § 4072's waiver of sovereign immunity. Specifically, courts have consistently held that this provision does not allow WYO program policyholders to sue FEMA when the WYO company denies their claims. See, e.g., Remy v. Hartford Fire Ins. Co., No. 135666, 2014 WL 6390862, at *1 (E.D.La. Nov. 10, 2014) ("In cases involving disputes arising out of a standard flood policy issued by a WYO provider, the WYO insurer, not the federal government, is the only real party of interest and is solely liable for the coverage of the standard policy that it provided."); Kronenberg v. Fidelity Nat'l Ins. Co., No. 074877, 2008 WL 631277 (E.D.La. Mar. 5, 2008) (same).
Thus, "[t]he applicable federal regulations consistently state that if a claim is issued under a WYO policy, the WYO Company stands in for FEMA and is the proper party to be sued." Hower, 2004 WL 2577503 at *2. The WYO program is designed, by statute and regulation, to endow the WYO companies with the authority and responsibility to adjust and process insurance claims. Accordingly, "[w]here a WYO insurance company has handled the claim adjustment and denial process and FEMA was not the decision maker, courts have been clear that the limited waiver of sovereign immunity in § 4072 does not allow an insured to bring a claim against FEMA." Jokumsen v. FEMA, No. 13-CV-05003, 2013 WL 3716436, at *4 (D.Neb. July 11, 2013) (collecting cases); see also Bruno, 2009 WL 377300, at *6 ("Courts have confirmed that FEMA is not a proper party when WYO Companies handle the claim adjustment and denial process.") (collecting cases).
Notably, FEMA's role in adjudicating an appeal of a WYO company's denial of coverage does not amount to "disallowance" sufficient to trigger § 4072's limited waiver of sovereign immunity. FEMA's disposition of an appeal under 44 C.F.R. § 62.20(b) for either Direct plan or WYO plan claims "is defined as the insurer's final claim determination, and ... constitutes FEMA acting in an administrative review capacity, not as an insurer that denies a claim." Fowl, 2012 WL 1886013 at *4 (citing Mertz, 2011 WL 3563113, at *5; Bruno, 2009 WL 377300, at *6) (additional internal citations and quotations omitted). In fact, courts have found that even when FEMA "render[s] an appeal decision that wholly substitute[s] a new decisional basis for [a private insurer's] grounds for nonpayment," that does not constitute a "disallowance" under § 4072. Id. Accordingly, in this case, FEMA's affirmation on appeal of Allstate's denial of coverage is not a "disallowance" "within the meaning of the statutory waiver of sovereign immunity." Id.; see also Jokumsen, 2013 WL 3716436, at *4 ("FEMA's administrative review of Metropolitan's disallowance does not trigger the limited waiver under 42 U.S.C. § 4072."); Gottlandsini v. Fugate, No. 11-11907-RWZ, 2012 WL 3860594, at *2 (D.Mass. Sept. 5, 2012) ("FEMA's upholding of Hartford's denial does not convert FEMA into the party making the denial."); Mertz, 2011 WL 3563113, at *5 ("The fact that FEMA reviewed the claim does not turn the WYO Program policy into a policy written by the federal government."); Bruno, 2009 WL 377300, at *5-6 (noting that "FEMA's administrative review of Nationwide's disallowance does not trigger the limited waiver under 42 U.S.C. § 4072.")
In this case, the Fosters purchased their flood insurance policy directly from Allstate, filed their claim for coverage related
Plaintiffs also bring a number of tort claims against FEMA under the Federal Tort Claims Act ("FTCA"), 28 U.S.C. §§ 1346(b), 2671-2680, including claims of state law negligence, intentional infliction of emotional distress, and negligent infliction of emotional distress. FEMA argues that plaintiffs have failed to adequately plead plausible tort claims because they failed to exhaust their required administrative remedies under the FTCA, before filing this action. For the reasons that follow, the Court agrees and dismisses plaintiff's tort claims under Rule 12(b)(6).
The Supreme Court has clearly stated that the FTCA "provides that a tort claim
Here, there is nothing in the complaint to suggest that the plaintiffs exhausted their administrative remedies under the FTCA. In fact, in their opposition brief, the Fosters readily acknowledge that they did not file an administrative claim with FEMA before bringing this action. (Pl. Mem. of Law, ECF No. 93 at 17-18.) Nonetheless, plaintiffs argue that presentment and exhaustion in this case were "simply unnecessary" and they were "in no way ... obligated to pursue any said remedies in this action," because any attempt to pursue "administrative remedies would be futile." (Id.) However, plaintiffs have "alleged no facts and presented no evidence that suggests that exhaustion of these remedies would have been futile." Lubrano v. U.S., 751 F.Supp.2d 453, 454 (E.D.N.Y.2010). Instead, plaintiffs merely contend that FEMA would inevitably deny their insurance claim, given that FEMA issued a directive in 2013 to WYO companies advising them to actively pursue litigation against overpaid claimants. (Pl. Mem. of Law, ECF No. 93 at 18-19.) However, courts in this circuit have held that "`[u]ntil [an agency] has acted and actual bias has been demonstrated, the orderly administrative procedures of the agency should not be interrupted by judicial intervention.'" Lipkin v. S.E.C., 468 F.Supp.2d 614, 616 (S.D.N.Y.2006) (denying the plaintiff's request to "recognize an exception to the exhaustion requirement because filing an administrative claim would be futile" solely based on vague
Accordingly, given that plaintiffs, by their own admission, did not present a claim or exhaust their administrative remedies under the FTCA, and that "[p]laintiffs cite no precedent, and this Court is aware of none, in which a district court has permitted a plaintiff to proceed with an FTCA claim without exhausting administrative remedies," Lipkin, 468 F.Supp.2d at 616, the Court concludes that plaintiffs' claims under the FTCA against FEMA must be dismissed pursuant to Rule 12(b)(6) for failure to exhaust their administrative remedies. Sherman-Amin-Braddox:Bey v. McNeil, No. 10-CV-5340 (ARR)(JMA), 2011 WL 795855, at *2 (E.D.N.Y. Feb. 25, 2011) ("Plaintiff bears the burden of pleading compliance with the FTCA's exhaustion requirement.") (citing In re "Agent Orange" Product Liability Litigation, 818 F.2d 210, 214 (2d Cir. 1987)). Therefore, plaintiffs' claims of negligence, intentional infliction of emotional distress, and negligent infliction of emotional distress are dismissed under Rule 12(b)(6).
For the foregoing reasons, the Court grants FEMA's motion to dismiss the Fosters' NFIA claims under Rule 12(b)(1) for lack of subject matter jurisdiction. The Court also dismisses the Fosters' FTCA claims under Rule 12(b)(6) for failure to exhaust administrative remedies. The Clerk of the Court shall enter judgment accordingly.
SO ORDERED.