Carol A. Rollin v. Transamerica Life Insurance Company

District Court, E.D. California·Decided October 16, 2025·No. 1:25-cv-00194·Unknown

Opinion

CAROL A. ROLLIN, No. 1:25-cv-00194-KES-HBK Plaintiff, ORDER GRANTING IN PART AND DENYING IN PART DEFENDANT’S v. PARTIAL MOTION TO DISMISS SECOND AMENDED COMPLAINT COMPANY, Defendant. Doc. 37 Plaintiff Carol A. Rollin has filed a second amended complaint (“SAC”) against defendant Transamerica Life Insurance Company (“Transamerica”) alleging claims for breach of contract, breach of the implied covenant of good faith and fair dealing, and financial elder abuse in violation of the Elder Abuse and Dependent Adult Civil Protection Act, California Welfare and Institutions Code, section 15600 et seq. Doc. 35. Transamerica moves to partially dismiss the SAC for failure to state a claim. Doc. 37. The parties’ briefs have been considered and, for the reasons set forth below, Transamerica’s motion to dismiss is granted in part and denied in part. Rollin’s claims in the SAC for breach of the implied covenant of good faith and fair dealing, financial elder abuse, as well as her request for damages for mental and emotional distress, are dismissed with leave to amend; her request for punitive damages is dismissed without leave to amend. This action concerns a dispute over Rollin’s attempts to collect benefits under a long-term care policy provided by Transamerica. See generally Doc. 35. On July 3, 2025, the Court issued an order granting Transamerica’s motion to dismiss the first amended complaint (“FAC”), with leave to amend.1 Doc. 34. In analyzing Rollin’s breach of contract claim, the Court identified several deficiencies. Id. at 6–10. First, Rollin did not allege, as required to receive policy benefits, that that she was certified as either requiring continual supervision due to a Cognitive Impairment or having an inability to perform two or more of the six Activities of Daily Living such that she required the presence of another person within arm’s reach.2 Doc. 34 at 7. Second, Rollin’s central allegations that she “became eligible” and that she submitted “all necessary documentation” showing her eligibility were found to be conclusory statements insufficient to establish a plausible claim. Id. at 8. Third, even assuming her conclusory allegations had conformed with the policy requirements, Rollin did not allege what benefits were included in any potentially submitted Plan of Care nor what benefits she requested. Id. at 8–9. Those omissions made it impossible to evaluate whether Rollin was improperly denied benefits. Id. Fourth, Rollin did not allege that she requested benefits under the Alternative Payment Benefit provision, which also made unclear whether Transamerica breached the policy by allegedly denying her benefits based on a family member’s ability to care for her. Id. at 9. Fifth, Rollin failed to adequately support her request for damages by failing to identify what damages she actually incurred. Id. at 9–10. In light of the deficiencies summarized above, the Court determined that “Rollin has failed to plausibly allege that she was due benefits under the policy that were wrongfully withheld 1 Because many of the allegations in the SAC remain unaltered from the FAC, those allegations will not be re-summarized in full here. Compare Doc. 21, with Doc. 35. The Court incorporates by reference the factual background section contained in its July 3, 2025 order. Doc. 34 at 2–5. As was the case previously, the long-term care policy is appropriately “considered in connection with Transamerica’s motion to dismiss because it is incorporated by reference into the [second] amended complaint.” Id. at 2 n.2 (citing Knievel v. ESPN, 393 F.3d 1068, 1076 (9th Cir.2005); Engers v. Allstate Ins. Co., 682 F. Supp. 2d 1094, 1097 (E.D. Cal. 2009)).

2 Capitalized terms are defined in the policy. Doc. 25-1. by Transamerica.” Id. at 10. Based on that failure, the Court found that Rollin also failed to plausibly allege her claims of breach of the implied covenant of good faith and fair dealing and financial elder abuse. Id. at 10 (collecting cases). The Court also found that “Rollin’s bad faith and financial elder abuse claims fail independently of her failure to allege a breach of contract, given that she does not provide factual support for either and makes only conclusory allegations.” Id. The FAC was dismissed with leave to amend, providing Rollin an opportunity to address the deficiencies identified. Id. at 11. Rollin filed the SAC on July 15, 2025.3 Doc. 35. The SAC alleges the following in support of Rollin’s claim for breach of contract: In 2003, Rollin was issued a long-term care policy by Transamerica’s predecessor. Doc. 35 at ¶ 6. She thereafter paid all premiums due under the policy. Id. at ¶ 7. In 2024, Rollin became eligible to receive policy benefits “after her psychologist, Christopher M. Bauer, PhD, conducted a neuropsychological evaluation and certified her as needing continual supervision for cognitive impairment.” Id. at ¶ 8. Rollin “initiated and submitted all necessary documentation,” but Transamerica denied her claim via a letter dated July 22, 2024, for failing to submit a Plan of Care. Id. at ¶¶ 9, 10. In September 2024, Rollin submitted an appeal to Transamerica with more supporting documentation, including “a Plan of Care from a Licensed Health Care Practitioner[, t]wo neuropsychological reports prepared by Dr. Bauer,” and “a Medical Cognitive Questionnaire Form.” Id. at ¶ 11. Rollin asserts these documents constitute a Plan of Care as defined by the policy. Id. Her appeal letter “specifically sought benefits under the Alternative [Payment] Benefit Provision, and explained that the provision allows family members to serve as reimbursable caregivers for one-third of the daily maximum benefit.” Id. On February 5, 2025, Transamerica denied the appeal.4 Id. at ¶ 12. It acknowledged that Bauer was a Licensed Health Care Practitioner, “but interpreted his reports . . . [so as to] claim[]

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