PHILADELPHIA – A major insurance provider had its motion to dismiss a claim of acting in bad faith towards a policy holder who sustained serious injuries in 2012 motor vehicle accident granted in federal court last week.
Senior Judge Ronald L. Buckwalter, of the U.S. District Court for the Eastern District of Pennsylvania, ruled on May 28 in favor of State Farm Insurance Company, which sought to have the bad faith claim put forth by Philadelphia resident Anna Pasqualino dismissed from her complaint.
Pasqualino, a Philadelphia resident, was insured under a State Farm policy that included coverage for damages sustained in an accident with an uninsured motorist.
On Dec. 12, 2012, that exact event occurred, with Pasqualino being seriously injured in a collision with an uninsured motorist who bore full responsibility for the crash.
According to the lawsuit, Pasqualino sustained permanent injuries in the accident, including “acute traumatic sprain and strain involving the cervical spine, thoracic spine, and lumbosacral region of the spine; clinical aggravation of underlying rheumatoid arthritis; and clinical aggravation of preexisting cervical and lumbar disc pathology.”
On Jan. 8, 2014, Pasqualino submitted her medical records and request for a settlement of her uninsured motorist collision claim, per her established insurance coverage, and submitted a sworn statement on April 10, 2014 in compliance with Defendant’s request.
On Sept. 26, as a result of ongoing treatment, Pasqualino’s counsel provided additional medical records to State Farm. Despite this, State Farm refused to offer Pasqualino more than $12,000 to resolve her claim.
In January, Pasqualino filed suit against State Farm, charging it breached its insurance policy coverage contract with her, since they “failed to objectively and fairly evaluate her claim, promptly offer payment of the reasonable and fair value of the claim to her, and reasonably investigate her claim “inasmuch as a thorough and proper inquiry would reveal.”
Pasqualino’s suit included a second count of State Farm allegedly acting in bad faith by the aforementioned actions and not seeking a “fair, prompt and equitable” settlement to the matter.
On March 27, State Farm moved to dismiss the bad faith claim Pasqualino brought against it, and Buckwalter ruled on that point on May 28. Buckwalter stated in order to successfully prove a bad faith claim, a plaintiff must show the insurer “(1) lacked a reasonable basis for denying benefits and (2) knew or recklessly disregarded its lack of a reasonable basis.”
“Essentially, plaintiff’s cursory allegations assert that defendant lacked a reasonable basis for denying plaintiff’s claim for benefits, but do not provide any factual allegations from which the Court could make a plausible inference that defendant knew or recklessly disregarded its lack of a reasonable basis for denying benefits,” Buckwalter said.
“While such assertions perhaps suggest that a bad faith claim is possible, they do not allow for any non-speculative inference that a finding of bad faith is plausible. Accordingly, the Court grants defendant’s motion to dismiss count two of plaintiff’s Complaint.”
Buckwalter dismissed Pasqualino’s bad faith claim without prejudice at that time.
Pasqualino further requested if the defense’s motion is granted, that she be given leave to amend her complaint. The Court complied, and provided Pasqualino a time period of 20 days from the day of Buckwalter’s ruling to provide a “factual basis” to her claims of State Farm acting in bad faith, or else her claim will be dismissed with prejudice.
The plaintiff is represented by Frank N. DiMeo, Jr. of Rosen Schafer & DiMeo, in Philadelphia.
The defendant is represented by Gary A. Drakas of Forry Ullman, in Bethlehem.
U.S. District Court for the Eastern District of Pennsylvania case 2:15-cv-00077
From the Pennsylvania Record: Reach Courts Reporter Nicholas Malfitano at firstname.lastname@example.org