Byrd v. Progressive Direct Insurance Company

CourtDistrict Court, W.D. Kentucky
DecidedMarch 31, 2021
Docket3:20-cv-00119
StatusUnknown

This text of Byrd v. Progressive Direct Insurance Company (Byrd v. Progressive Direct Insurance Company) is published on Counsel Stack Legal Research, covering District Court, W.D. Kentucky primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Byrd v. Progressive Direct Insurance Company, (W.D. Ky. 2021).

Opinion

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF KENTUCKY LOUISVILLE DIVISION

BETHANY BYRD et al., Plaintiffs,

v. Civil Action No. 3:20-cv-119-DJH-CHL

PROGRESSIVE DIRECT INSURANCE CO. et al., Defendants.

* * * * *

MEMORANDUM OPINION AND ORDER

Plaintiffs Bethany Byrd, Sandra Vance, and Destiny Hicks assert that Defendants Progressive Direct Insurance Company, Progressive Casualty Insurance Company, and Progressive Paloverde Insurance Company improperly denied them personal injury protection (PIP) benefits. (Docket No. 20) Plaintiffs, both individually and as a putative class, filed this action against Defendants for breach of contract and failure to pay PIP benefits in violation of the Kentucky Motor Vehicle Reparations Act (MVRA); they also seek a declaratory judgment. (Id., PageID # 474–76) Defendants have filed a partial motion to dismiss Plaintiffs’ first amended complaint. (D.N. 26) Specifically, Progressive Direct moves to dismiss all claims asserted by Byrd; Progressive Casualty and Progressive Paloverde move to dismiss Vance and Hicks’s claims for breach of contract, declaratory judgment, and 18% statutory interest and attorney fees under the MVRA; and Progressive Casualty additionally moves to dismiss Hicks’s MVRA claim in its entirety. (Id., PageID # 699–700) For the reasons set forth below, the Court will grant Defendants’ motion in part. I. The Court “take[s] the facts only from the complaint, accepting them as true as [it] must do in reviewing a 12(b)(6) motion.” Siefert v. Hamilton Cnty., 951 F.3d 753, 757 (6th Cir. 2020) (citing Fed R. Civ. P. 12(b)(6)). Byrd, Vance, and Hicks were all insured for PIP benefits: Byrd by Progressive Direct (D.N. 20, PageID # 467), Vance by Progressive Paloverde (id., PageID #

468), and Hicks by Progressive Casualty. (Id., PageID # 469) Each was injured in an auto accident and required subsequent medical treatment: Byrd in 2014 (id., PageID # 467), Vance in 2016 (id., PageID # 468), and Hicks in 2017. (Id.) Upon receiving Plaintiffs’ claims, Defendants submitted each of their materials to a chiropractor for a paper review—no personal examination of the Plaintiffs was conducted. (Id., PageID # 467–69) These reviewers “were biased.” (Id., PageID # 470) Although the reviewers “confirm[ed] the need” for “an independent medical examination,” Defendants “would skip this step and instead simply withhold payment of the benefits.” (Id., PageID # 464–65) Based solely on these paper reviews, Defendants denied, in full or in part, Plaintiffs’ PIP benefits.1 (Id., PageID # 467–69)

Plaintiffs assert that in failing to pay their PIP benefits in full, Defendants breached their contracts with Plaintiffs and violated the MVRA. (Id., PageID # 474–75) Plaintiffs also seek a declaratory judgment that Defendants have waived the right to dispute Plaintiffs’ claims; that Plaintiffs’ claims are timely; that the Defendants’ contracts with Plaintiffs are reformed; and that

1 The amended complaint does not clarify how much of or to what extent each Plaintiff’s claim was denied. (See D.N. 20, PageID # 467 (“Progressive Direct . . . has still not paid the benefits which were denied because of the paper review.”); id., PageID # 468 (“Progressive Paloverde . . . has still not paid [Vance’s] benefits which were denied because of the paper review.”); id., PageID # 469 (“Progressive Casualty . . . did not timely pay the full amount of benefits owed on Hicks’[s] behalf.”)) Defendants “past and continued non-payment of PIP benefits on the basis of paper reviews” lacked reasonable foundation and violated the MVRA. (See id., PageID # 476–77) II. To survive a motion to dismiss for failure to state a claim, “a complaint must contain sufficient factual matter, accepted as true, to ‘state a claim to relief that is plausible on its face.’”

Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (quoting Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007)). A claim is plausible on its face “when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Id. Factual allegations are essential; “[t]hreadbare recitals of the elements of a cause of action, supported by mere conclusory statements, do not suffice,” and the Court need not accept such statements as true. Id. A complaint whose “well-pleaded facts do not permit the court to infer more than the mere possibility of misconduct” does not satisfy the pleading requirements of Federal Rule of Civil Procedure Rule 8 and will not withstand a motion to dismiss. Id. at 679; see Fed. R. Civ. P. 8.

At the motion-to-dismiss stage, “the Court looks to the pleadings . . . the documents attached to them . . . documents referenced in the pleadings that are ‘integral to the claims’ . . . and documents that are not mentioned specifically but which govern the plaintiff’s rights and are necessarily incorporated by reference.” Atlas Techs., LLC v. Levine, 268 F. Supp. 3d 950, 958 (E.D. Mich. 2017) (internal citations omitted). Defendants have attached payment logs detailing partial payment of Byrd and Hicks’s benefits (D.N. 26-2; D.N. 26-3), and Plaintiffs have not disputed the validity of the logs or the Court’s consideration of them. (See D.N. 28, PageID # 764 (acknowledging that Progressive’s last PIP payment to Hicks “was made on March 15, 2018” as reported in the log)) Since Byrd and Hicks’s claims rest entirely on Defendants’ alleged failure to pay their PIP benefits, the logs govern their rights to recovery, “are necessarily incorporated by reference,” and will be considered for purposes of the present motion. See Atlas, 268 F. Supp. 3d at 958. A. Claims preempted by MVRA Defendants argue that the MVRA bars Plaintiffs’ claims for breach of contract and

declaratory judgment. (D.N. 26, PageID # 705–07) The Kentucky Supreme Court has held that the MVRA “provides an exclusive remedy where an insurance company wrongfully delays or denies payment of no-fault [i.e., PIP] benefits.” Foster v. Ky. Farm Bureau Mut. Ins. Co., 189 S.W.3d 553, 557 (Ky. 2006). “[The] MVRA is a comprehensive act which not only relates to certain tort remedies, but also establishes the terms under which insurers pay no-fault benefits, and provides for the penalties to which insurers are subjected if they fail to properly pay no-fault benefits.” Id. The principle set forth in Foster—that the MVRA provides the exclusive remedy when an insurance company denies payment of no-fault benefits—has “been followed in subsequent federal and state [cases].” Sackos v. Geico Ins. Agency, Inc., No. 1:11CV-00072-JHM,

2011 WL 5975293, at *2 (W.D. Ky. Sept. 21, 2011) (collecting cases); see also Risner v. State Farm Mut. Auto. Ins. Co., No. CIV.A. 14-41-HRW, 2014 WL 5431284, at *2 (E.D. Ky. Oct. 23, 2014) (collecting cases) (“This principle is well established in Kentucky and this district.”). Plaintiffs argue that the MVRA “provides the ‘exclusive remedy’ for extracontractual damages” but that it does not preempt their claims for breach of contract because “[a] breach of contract claim is proper when the contract contains benefits, terms and conditions which are in addition to those required by the MVRA.” (D.N. 28, PageID # 752–53) But none of the case law cited by Plaintiffs supports this contention.2 And current case law contradicts it.

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Byrd v. Progressive Direct Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/byrd-v-progressive-direct-insurance-company-kywd-2021.