STENGEL, District Judge.
An injured driver brings this diversity action against her automobile insurer based on a partial denial of her underinsured motorist benefits. She asserts a breach of contract claim along with a bad faith claim under Pennsylvania law. The insurer moves to dismiss the bad faith claim under Rule 12(b)(6). I will deny this motion and allow the claim to proceed to discovery.
On September 20, 2011 at around 1:15 p.m., Yolanda Mateo-Placido's car struck the front driver's side of Plaintiff Esther Padilla's car as she proceeded through the intersection of North Front and Buttonwood Streets in Reading, Pennsylvania. Mateo-Placido ran a red light. She was also an underinsured motorist.
As a result of the accident, the plaintiff suffered serious injuries to her jaw, head, back, and ribs. Padilla was taken to Reading Hospital and Medical Center's Emergency Department by ambulance, where she was treated. She received subsequent medical treatment for her injuries, including physical therapy, MRIs, and surgical procedures.
Ms. Mateo-Placido was insured through an automobile insurance policy with State Farm with liability limits of $25,000 per person and $50,000 per occurrence. On
On June 18, 2012, plaintiff's counsel sent State Farm a letter requesting that State Farm waive its subrogation interest and consent to settle with Ms. Mateo-Placido so that Padilla could pursue her underinsured motorist benefits under her own policy. In June 28, 2012, L. Scott Whiteside, the adjuster handling the plaintiff's underinsured motorist claim, waived the subrogation interest and consented to Mateo-Placido's settlement offer of $25,000.
On September 16, 2013, plaintiff's counsel sent State Farm medical records and other information outlining her injuries and treatment. On October 9, 2013, plaintiff's counsel sent additional medical records to State Farm and demanded payment of $200,000 underinsured motorist benefits under the plaintiff's policy. This letter explained why her claim exceeded the combined underinsured motorist coverage limits and the liability limits of Ms. Mateo-Placido.
Subsequently, the plaintiff received a voicemail from the adjuster handling her underinsured motorist claim saying that State Farm was referring her claim to counsel. On October 31, 2013, the plaintiff sent a letter to State Farm requesting an evaluation of her claim.
At the request of State Farm, the plaintiff submitted a statement under oath and an examination by a physician retained by the defendant. On January 27, 2014, plaintiff's counsel requested by letter a written report of this medical examination and again asked for the defendant's evaluation of the plaintiff's claim. After receiving no response, plaintiff's counsel again requested the report and defendant's evaluation of plaintiff's claim in another letter dated February 10, 2014. Plaintiff's counsel sent a third letter requesting the report and evaluation one week later.
Finally, on February 18, 2014, defendant's counsel responded (allegedly to the February 10, 2014 letter) stating that he had still not received the medical examination report and, therefore, could not complete an evaluation of the plaintiff's claim. On February 24, 2014, defense counsel emailed the medical report after plaintiff's counsel faxed another request for it. The report was dated January 27, 2014. Defense counsel still did not provide an evaluation of the plaintiff's claim. On February 27, 2014, defense counsel offered the plaintiff $30,000 to settle her underinsured claim. The plaintiff rejected this offer.
On February 28, 2014, the plaintiff filed this action in the Court of Common Pleas of Berks County. On April 10, 2014, the defendant removed the action to this court based on diversity jurisdiction. The plaintiff is a Pennsylvania resident, while State Farm is an Illinois corporation. The plaintiff alleges one count for underinsured motorist benefits/breach of contract and another count of bad faith. The defendant now moves to dismiss the plaintiff's bad faith claim for failure to state a claim under Pennsylvania law.
A motion to dismiss under Rule 12(b)(6) of the Federal Rules of Civil Procedure for failure to state a claim upon which relief can be granted examines the legal sufficiency of the complaint.
The Federal Rules of Civil Procedure do not require a plaintiff to plead in detail all of the facts upon which she bases her claim. Conley, 355 U.S. at 47, 78 S.Ct. 99. Rather, the Rules require a "short and plain statement" of the claim that will give the defendant fair notice of the plaintiff's claim and the grounds upon which it rests. Id. The "complaint must allege facts suggestive of [the proscribed] conduct." Twombly, 550 U.S. at 564, 127 S.Ct. 1955. Neither "bald assertions" nor "vague and conclusory allegations" are accepted as true. See Morse v. Lower Merion School Dist., 132 F.3d 902, 906 (3d Cir.1997); Sterling v. Southeastern Pennsylvania Transp. Auth., 897 F.Supp. 893 (E.D.Pa. 1995). The claim must contain enough factual matters to suggest the required elements of the claim or to "raise a reasonable expectation that discovery will reveal evidence of" those elements. Phillips v. County of Allegheny, 515 F.3d 224, 234 (3d Cir.2008) (quoting Twombly, 550 U.S. at 556, 127 S.Ct. 1955).
A court "may dismiss a complaint only if it is clear that no relief could be granted under any set of facts that could be proved consistent with the allegations." Brown v. Card Service Center, 464 F.3d 450, 456 (3d Cir.2006) (quoting Hishon v. King & Spalding, 467 U.S. 69, 73, 104 S.Ct. 2229, 81 L.Ed.2d 59 (1984)).
The plaintiff alleges that the defendant acted in bad faith by, inter alia, delaying investigation of the plaintiff's claim, offering a settlement that was unreasonable in light of the facts of the investigation, and failing to provide an evaluation of her claim — despite multiple requests for such information. The defendant argues that the plaintiff's factual allegations do not support a finding of bad faith.
Pennsylvania's bad faith statute allows a plaintiff to recover interest, punitive damages, court costs, and/or attorney's fees if an insurer has acted in bad faith in handling a claim.
In deciding whether an insurer had a reasonable basis for denying benefits, a court should examine what factors the insurer considered in evaluating a claim. See Terletsky, 649 A.2d at 688-89. "Bad faith claims are fact specific and depend on the conduct of the insurer vis à vis the insured." Condio v. Erie Ins. Exchange, 899 A.2d 1136, 1143 (Pa.Super.2006) (citing Williams v. Nationwide Mutual Ins. Co., 750 A.2d 881, 887 (Pa.Super.2000)).
Under the second part of the analysis, mere negligence or bad judgment does not constitute bad faith.
The plaintiff sustained serious injuries after her car was struck by an underinsured motorist who ran a red light. No facts indicate that the plaintiff was at fault. She timely paid premiums for $200,000 worth of UIM insurance so that she would be covered in the event that she was involved in this type of accident. In June 2012, the plaintiff was permitted to settle with the other driver. In September 2013, the plaintiff then forwarded medical records to the defendant and provided additional records of her condition shortly thereafter.
Despite several requests for a settlement offer, the plaintiff was not given any sense of the value of her claim until the end of February 2013.
The defendant supports its arguments with three cases from courts within this Circuit: Sypeck v. State Farm, Blockus, et al. v. State Farm, and Bremme v. State Farm. These cases are not helpful and are factually distinguishable.
In Sypeck, the plaintiff based her bad faith claim simply on the fact that the insurer's settlement offer appeared unreasonably low. Unlike Ms. Padilla, Sypeck offered no other facts to support her claims that the insurer failed to investigate her claim or delayed settlement.
In Blockus, the plaintiffs based their bad faith claim on the fact that the defendant claimed it had not received the plaintiffs' demand package and asked for the package
Bremme dismissed the plaintiff's bad faith claim because the complaint contained "nothing more than unsupported, threadbare assertions that Defendant unreasonably refused to settle Plaintiff's UM claim."
Unlike Sypeck, Blockus, and Bremme, Ms. Padilla's complaint offers specific and relevant facts regarding her communication with the defendant about her UIM claim. From the record provided, she has established a plausible bad faith claim. I will deny the defendant's motion and allow the claim to proceed beyond the motion to dismiss.
For the foregoing reasons, the defendant's motion to dismiss the plaintiff's bad faith claim is denied.
An appropriate Order follows.
42 Pa.C.S.A. § 8371.
Terletsky, 649 A.2d at 688 (quoting Black's Law Dictionary 139 (6th ed.1990)) (citing Rottmund v. Continental Assurance Co., 813 F.Supp. 1104, 1108-09 (E.D.Pa.1992); Coyne v. Allstate Ins. Co., 771 F.Supp. 673, 677-78 (E.D.Pa.1991)).
