Carolan v. PROGRESSIVE ADVANCED INSURANCE COMPANY

CourtDistrict Court, E.D. Pennsylvania
DecidedMarch 11, 2025
Docket2:24-cv-03248
StatusUnknown

This text of Carolan v. PROGRESSIVE ADVANCED INSURANCE COMPANY (Carolan v. PROGRESSIVE ADVANCED INSURANCE COMPANY) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Carolan v. PROGRESSIVE ADVANCED INSURANCE COMPANY, (E.D. Pa. 2025).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA MICHELE CAROLAN and FRANCIS CAROLAN, Plaintiffs, CIVIL ACTION NO. 24-3248 v. PROGRESSIVE ADVANCED INSURANCE COMPANY, Defendant. OPINION Slomsky, J. March 11, 2025

I. INTRODUCTION ................................................................................................................. 2 II. BACKGROUND .................................................................................................................... 2 III. STANDARD OF REVIEW ................................................................................................... 5 IV. ANALYSIS ............................................................................................................................. 6 A. Bad Faith Claims Under 42 Pa. C.S.A. § 8371 Are Subject to a Two-Part Test .............. 7 B. Plaintiffs Have Not Sufficiently Alleged a Bad Faith Claim (Count II) .......................... 8 1. Plaintiffs Do Not Plausibly Allege Defendant Lacked a Reasonable Basis for Denying Benefits ........................................................................ 8

2. Plaintiffs Have Not Plausibly Alleged That Defendant Disregarded the Need for a Reasonable Basis Upon Which to Deny Benefits .................................. 12

C. Plaintiffs Will Be Granted Leave to Amend the Complaint ........................................... 13 V. CONCLUSION .................................................................................................................... 13 I. INTRODUCTION This action concerns a bad faith claim arising out of a motor vehicle accident in Philadelphia, Pennsylvania. (See Doc. No. 1.) Plaintiffs Michele Carolan and Francis Carolan (collectively, “Plaintiffs”) purchased an underinsured motorist (“UIM”) policy worth $100,000 from Defendant Progressive Advanced Insurance Company (“Defendant”). (Id. at ¶¶ 6, 17.) While

the policy was in effect, Plaintiff Michele Carolan (“Michele”) was involved in a motor vehicle accident with an uninsured motorist. (Id. at ¶¶ 16–17.) As a result, Plaintiffs sent Defendant a settlement proposal for $100,000, the full value of their UIM policy. (Id. at ¶ 18.) In response, Defendant offered Plaintiffs $9,000 to settle their uninsured motorist claim. (Id. at ¶ 22.) Plaintiffs responded with a second demand, again requesting $100,000. (Id. at ¶ 23.) Defendant then increased its offer to $15,000, which Plaintiffs deemed unreasonable. (Id. at ¶ 24.) On July 23, 2024, Plaintiffs filed a Complaint in this Court, alleging claims for breach of contract (“Count I”) and bad faith pursuant to 42 Pa. C.S.A. § 8371 (“Count II”). (See id.) On August 23, 2024, Defendant filed a Motion to Dismiss Count II of the Complaint.1 (Doc. No. 5.) On September 9, 2024, Plaintiffs filed a Response in Opposition to Plaintiff’s Motion. (Doc. No.

7.) For reasons that follow, Defendant’s Motion to Dismiss Count II of the Complaint (Doc. No. 5) will be granted. II. BACKGROUND On July 15, 2020, Plaintiff Michele Carolan was operating a motor vehicle in Philadelphia, Pennsylvania when she was struck by another motor vehicle owned and operated by Francisco

1 Defendant concedes there is a genuine dispute between the parties regarding Plaintiffs’ claim for uninsured motorist benefits. (Doc. No. 5 at ¶ 1.) As such, it does not seek to dismiss Plaintiffs’ breach of contract claim in Count I. Giffony (“Giffony”). (Doc. No. 1 at ¶ 6.) According to Plaintiffs, Giffony’s negligence was the sole cause of the accident.2 (Id. at ¶ 7.) Plaintiffs allege that, as a result of the accident, Michele suffered serious and permanent injuries. (Id. at ¶ 8). The Complaint lists some of her injuries as follows:

[L]umbar disc protrusion at L2-3 with significant left foraminal narrowing; lumbar radiculitis; lumbar strain and sprain; cervical disk extrusion at C5-6 which contacts and impinges the ventral aspect of the cord; disc bulge at C6-7 with an associated central protrusion of the disc as well with thecal sac impingement; cervical strain and sprain; bilateral carpal tunnel syndrome; and a concussion.

(Id. at ¶ 8.) Based on the injuries, Plaintiffs assert that Michele has incurred and will continue to incur medical expenses that “have or may exceed the sums and value recoverable under 75 Pa. C.S.A. Section 1711 . . . .” (Id. at ¶ 9.) Additionally, Plaintiffs allege that Michele has suffered or may suffer “a severe loss of her earnings and her earning capacity . . . severe physical pain and trauma, mental upset and anguish and humiliation . . . [and] a diminution in her ability to enjoy life and life’s pleasures . . . .” (Id. at ¶¶ 10–12.) Finally, Plaintiff Francis Carolan, Michele’s husband, avers a claim for loss of consortium. (Id. at ¶ 13–14.) At the time of the accident, Plaintiffs had an automobile insurance policy with Defendant. (Id. at ¶ 16.) The insurance policy included $100,000 of uninsured motorist (“UIM”) coverage. (Id. at ¶ 17.) On July 27, 2023, Plaintiffs’ counsel sent a settlement proposal to Defendant’s claims adjuster, Lauren Gieseler (“Gieseler”). (Id. at 18.) In the proposal, Plaintiffs sought the full policy limit of $100,000 to settle their UIM claim. (Id.) According to Plaintiffs, the proposal also

2 Plaintiffs filed suit against Giffony in a separate action. (Doc. No. 1 at ¶ 15.) On August 7, 2023, Giffony’s insurance carrier offered Plaintiffs $15,000, the full value of Giffony’s automobile insurance policy, to settle the case. (See id. at ¶ 20.) On August 11, 2023, Defendant waived its subrogation rights against Giffony and his insurance provider and permitted Plaintiffs to proceed with settlement. (Id. at ¶ 21.) included “a complete medical packet[,]” which contained a report from Michele’s treating physician, an orthopedic surgeon. (Id. at ¶¶ 18–19, Ex. C.) On August 11, 2023, Gieseler responded to Plaintiffs’ demand, offering $9,000 to settle their UIM claim. (Id. at ¶ 22.) In Geisler’s email tendering the offer, she explained that she had reviewed the records and requested

photographs to confirm that Michele had suffered leg lacerations. (Id. at ¶ 39.) On October 27, 2023, Plaintiffs sent a second settlement proposal to Defendant, again requesting the $100,000. (Id. at ¶ 23, Ex. G.) In response, Gieseler increased Defendant’s settlement offer to $15,000. (Id. at ¶ 24, Ex. H.) Gieseler also requested records from Michele’s primary care provider and any footage showing the accident. (Id. at ¶ 45.) On July 23, 2024, Plaintiffs filed a Complaint in this Court, alleging claims for breach of contract (“Count I”) and bad faith pursuant to 42 Pa. C.S.A. § 8371 (“Count II”). (See id.) In support of Count II, Plaintiffs assert, among other things, that Defendant “violate[ed] the fiduciary duty owed to Plaintiffs” and did “not attempt[] in good faith to effectuate a fair, prompt and equitable settlement of Plaintiff’s claim . . . .” (Id. at ¶ 33(e).)

On August 23, 2024, Defendant filed a Motion to Dismiss Count II of the Complaint for failure to state a claim pursuant to Federal Rule of Civil Procedure 12(b)(6). (Doc. No. 5.) In the Motion, Defendant claims that Plaintiffs have not sufficiently alleged specific facts to support their bad faith claim. (See id.) On September 5, 2024, Plaintiffs filed a Response in Opposition to Defendant’s Motion to Dismiss, contending that: (1) “Plaintiffs cannot be any more specific as to how Progressive acted in bad faith” and (2) Defendant “is placed on ample notice as to how it acted in bad faith.” (Doc. No. 7 at 7.) However, if the Court were to grant Defendant’s Motion to Dismiss, Plaintiffs requested that the Court afford them leave to amend their Complaint in Count II. (Id. at 8.) Defendant’s Motion is now ripe for disposition. III.

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Carolan v. PROGRESSIVE ADVANCED INSURANCE COMPANY, Counsel Stack Legal Research, https://law.counselstack.com/opinion/carolan-v-progressive-advanced-insurance-company-paed-2025.