Ballesteros v. Garrison Property and Casualty Insurance Company

CourtDistrict Court, D. Nevada
DecidedApril 27, 2023
Docket2:23-cv-00135
StatusUnknown

This text of Ballesteros v. Garrison Property and Casualty Insurance Company (Ballesteros v. Garrison Property and Casualty Insurance Company) is published on Counsel Stack Legal Research, covering District Court, D. Nevada primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ballesteros v. Garrison Property and Casualty Insurance Company, (D. Nev. 2023).

Opinion

1 UNITED STATES DISTRICT COURT

2 DISTRICT OF NEVADA

3 CHRISTOPHER BALLESTEROS, ) 4 ) Plaintiff, ) Case No.: 2:23-cv-00135-GMN-DJA 5 vs. ) ) ORDER 6 GARRISON PROPERTY AND CASUALTY ) 7 INSURANCE COMPANY, et al., ) ) 8 Defendants. )

9 10 Pending before the Court is Defendant Garrison Property and Casualty Insurance 11 Company’s (“Defendant’s”) Motion to Dismiss, (ECF No. 8). Plaintiff Christopher Ballesteros 12 (“Plaintiff”) filed a Response, (ECF No. 10), to which Defendant filed a Reply, (ECF No. 16). 13 For the reasons discussed below, the Court GRANTS in part and DENIES in part 14 Defendant’s Motion to Dismiss. 15 I. BACKGROUND 16 This case arises from injuries Plaintiff sustained in an accident with a third-party driver 17 in April 2021. As a result of the collision, Plaintiff suffered damage to his vehicle and physical 18 injury, including “sprains/strains of the cervical, thoracic, and lumbar spine, right shoulder 19 sprain, headaches, and permanent whole person impairment to his cervical and thoracic spine 20 and right shoulder.” (Am. Compl. ¶ 14, Ex. B to Pet. Removal, ECF No. 1-2). 21 Following the collision, Plaintiff made a demand to the third-party driver’s insurer for 22 the policy limits to provide partial coverage for his injuries. (Id. ¶ 15, Ex. B to Pet. Removal). 23 Because Plaintiff’s medical expenses and future surgical recommendations exceeded the third- 24 party driver’s policy limits, Plaintiff also made a claim for benefits under his policy, Number 25 032284859R71019 (the “Policy”), to Defendant. (Id. ¶ 6, 16, Ex. B to Pet. Removal). On May 1 12, 2021, Defendant was contacted by Plaintiff’s counsel, who requested a “claim evaluation as 2 well as payments of any benefits owed under the Policy. (Id. ¶ 17, Ex. B to Pet. Removal). 3 That same day, Defendant acknowledged receipt of the claim. (Id. ¶ 18, Ex. B to Pet. Removal). 4 On November 22, 2021, Plaintiff sent Defendant further documentation of his injuries 5 and again requested payment of benefits owed under the Policy. (Id. ¶ 19, Ex. B to Pet. 6 Removal). Plaintiff alleges that rather than investigate Plaintiff’s claims, “as it is obligated to 7 do under the Policy and Nevada law,” Defendant informed him that “it would not begin 8 reviewing his claim until he provided written confirmation of the at-fault driver’s policy limits 9 and an affidavit of no additional insurance for the at-fault driver.” (Id. ¶ 20, Ex. B to Pet. 10 Removal). Plaintiff contends that the Policy contains no condition which requires this 11 information prior to Defendant instituting an investigation. (Id. ¶ 21, Ex. B to Pet. Removal). 12 Instead, Plaintiff asserts that Defendant had an “independent obligation to investigate, evaluate, 13 and resolve” Plaintiff’s claims without regard to the conduct of the third-party driver’s insurer. 14 (Id. ¶ 22, Ex. B to Pet. Removal). 15 In January 2022, Defendant made an offer to settle Plaintiff’s claim, which Plaintiff 16 alleges was unreasonable because the offer “was based on an inadequate and incomplete 17 investigation of his” claim” since Defendant solely relied on the opinion of its internal claim 18 handlers rather than medical professionals. (Id. ¶¶ 23–25, Ex. B to Pet. Removal). In response 19 to this purportedly unreasonable settlement offer, Plaintiff hired Kevin Nozawa (“Doctor 20 Nozawa”), a Board Certified Independent Medical Examiner and Certified Life Care Planner, 21 to perform an independent medical examination in March 2022. (Id. ¶ 26, Ex. B to Pet. 22 Removal). Plaintiff provided Defendant with Doctor Nozawa’s evaluation on April 7, 2022, 23 and again requested that Defendant consider all the provided medical evidence and opinion in 24 evaluating his claim. (Id. ¶ 29, Ex. B to Pet. Removal). According to Plaintiff, however, on

25 1 April 18, 2022, Defendant wrote to Plaintiff’s counsel reiterating its earlier settlement offer 2 without addressing Doctor Nozawa’s report. (Id. ¶ 30, Ex. B to Pet. Removal). 3 On June 15, 2022, Defendant wrote to Plaintiff’s counsel stating it had received his 4 “demand” and was “currently in the process of evaluating it.” (Id. ¶ 31, Ex. B to Pet. Removal). 5 Two days later, Defendant sent another letter conveying its unchanged settlement offer. (Id. ¶ 6 32, Ex. B to Pet. Removal). Plaintiff alleges that to date: (1) Defendant has not provided any 7 contractual or factual basis for its valuation of his claim; (2) not paid him any benefits under the 8 Policy; (3) and not addressed, either to accept or refute Doctor Nozawa’s findings. (Id. ¶¶ 33– 9 35, Ex. B to Pet. Removal). 10 Plaintiff subsequently filed suit in the Eighth Judicial District Court of Nevada. (See 11 generally Compl., Ex. A to Pet. Removal, ECF No. 1-1). Plaintiff then filed an Amended 12 Complaint, alleging claims for: (1) declaratory relief; (2) breach of contract; (3) tortious breach 13 of the implied covenant of good faith and fair dealing; and (4) breach of statutory duties under 14 NRS § 686A.310. (Am. Compl. ¶¶ 38–60, Ex. B to Pet. Removal). Defendant then removed to 15 this Court based on diversity jurisdiction, (see generally Pet. Removal, ECF No. 1), and filed 16 the instant Motion to Dismiss, (ECF No. 8). The Court discusses Defendant’s Motion to 17 Dismiss below. 18 II. LEGAL STANDARD 19 Dismissal is appropriate under Rule 12(b)(6) where a pleader fails to state a claim upon 20 which relief can be granted. Fed. R. Civ. P. 12(b)(6); Bell Atl. Corp. v. Twombly, 550 U.S. 544, 21 555 (2007). A pleading must give fair notice of a legally cognizable claim and the grounds on 22 which it rests, and although a court must take all factual allegations as true, legal conclusions 23 couched as factual allegations are insufficient. Twombly, 550 U.S. at 555. Accordingly, Rule 24 12(b)(6) requires “more than labels and conclusions, and a formulaic recitation of the elements

25 of a cause of action will not do.” Id. “To survive a motion to dismiss, a complaint must contain 1 sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its 2 face.’” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Twombly, 550 U.S. at 570). “A 3 claim has facial plausibility when the plaintiff pleads factual content that allows the court to 4 draw the reasonable inference that the defendant is liable for the misconduct alleged.” Id. This 5 standard “asks for more than a sheer possibility that a defendant has acted unlawfully.” Id. 6 “Generally, a district court may not consider any material beyond the pleadings in ruling 7 on a Rule 12(b)(6) motion.” Hal Roach Studios, Inc. v. Richard Feiner & Co., 896 F.2d 1542, 8 1555 n.19 (9th Cir. 1990). “However, material which is properly submitted as part of the 9 complaint may be considered.” Id. Similarly, “documents whose contents are alleged in a 10 complaint and whose authenticity no party questions, but which are not physically attached to 11 the pleading, may be considered in ruling on a Rule 12(b)(6) motion to dismiss.” Branch v. 12 Tunnell, 14 F.3d 449, 454 (9th Cir. 1994). On a motion to dismiss, a court may also take 13 judicial notice of “matters of public record.” Mack v. S. Bay Beer Distrib., 798 F.2d 1279, 1282 14 (9th Cir. 1986).

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Ballesteros v. Garrison Property and Casualty Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ballesteros-v-garrison-property-and-casualty-insurance-company-nvd-2023.