COUSART v. STATE FARM FIRE AND CASUALTY COMPANY

CourtDistrict Court, E.D. Pennsylvania
DecidedJanuary 31, 2023
Docket2:22-cv-04900
StatusUnknown

This text of COUSART v. STATE FARM FIRE AND CASUALTY COMPANY (COUSART v. STATE FARM FIRE AND CASUALTY 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
COUSART v. STATE FARM FIRE AND CASUALTY COMPANY, (E.D. Pa. 2023).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE EASTERN DISTRICT OF PENNSYLVANIA

JUDITH COUSART, CHRISTOPHER : CIVIL ACTION COUSART : : v. : NO. 22-4900 : STATE FARM FIRE AND CASUALTY : COMPANY :

MEMORANDUM KEARNEY, J. January 31, 2023 Homeowners purchased an insurance policy in which they agreed to sue their insurer for denying a claim within one year of their damage. They made a claim for losses under their insurance policy. Their insurer reviewed the claim but did not promptly pay their demand in full under an agreed appraisal process. So the homeowners sued their insurer within the contractually- required one year for breach of their insurance contract and a claim of statutory bad faith. The insurer would not agree to toll the litigation while they continued to resolve their claim dispute. The insured, among other conclusory allegations, claimed the insurer’s requirement the parties proceed with litigation violates Pennsylvania’s bad faith statute. The insurer now moves to dismiss the bad faith claim as lacking specific facts and the homeowners cannot base a bad faith claim on the parties’ agreement to bring suit within a year of the claim and to then not stay the case. We agree with the insurer. The homeowners fail to plead specifics of bad faith beyond an alleged breach of contract. The homeowners do not plead a single fact allowing us to find the insurer’s decision not to toll or stay the litigation could be bad faith. We dismiss the homeowners’ conclusory claims for bad faith without prejudice. We decline to stay the claim pending the insurer’s continuing review. I. Alleged facts material to the bad faith claim. Judith and Christopher Cousart insure their home under terms of an insurance policy they purchased from State Farm Fire and Casualty Company.1 The Cousarts agreed in their insurance policy, among other things, to file suit challenging a delay or denial of insurance proceeds within one year of their harm.

Wind and storm damage allegedly caused physical loss and damage to the Cousarts’ home on September 1, 2021.2 The Cousarts told State Farm of the alleged loss and demanded payment under the insurance policy.3 The Cousarts asked State Farm to appraise the property damage before their policy’s one year limitations period.4 State Farm refused to pay the loss in the requested timeframe. State Farm took over one year to evaluate the Cousarts’ claim.5 The Cousarts then filed a writ of summons in Pennsylvania state court on August 30, 2022 – one day shy of the one year limitations period in their insurance policy. They allege State Farm breached their insurance contract and acted in bad faith under Pennsylvania’s bad faith statute.6 The Cousarts allege State Farm acted in bad faith by: “(a) in failing to complete a prompt and

thorough investigation of Plaintiff’s claim; (b) in failing to objectively and fairly evaluate Plaintiff’s claim for over one year after Plaintiff’s date of loss; in acting unreasonably and unfairly in response to Plaintiff’s claim, including, but not limited to, requiring Plaintiff to incur costs of litigation and cost of an umpire in appraisal simultaneously; (d) in unnecessarily and unreasonably compelling Plaintiff to institute this lawsuit to obtain policy benefits for a covered loss, that Defendant should have paid promptly and without the necessity of litigation; (e) in forcing Plaintiff to incur litigation fees and expenses knowing that the initial Writ of Summons was filed solely for the purpose of preserving the statute; (f) in forcing Plaintiff to incur litigation fees and expenses knowing that the claim is in the process of being resolved through appraisal; (g) in refusing to toll the statute or otherwise limit Plaintiff’s litigation expenses without reasonable basis in fact or law.”7 State Farm denies acting in bad faith, forcing the Cousarts to initiate litigation, and acting in bad faith by refusing to toll the statute of limitations or agreed to stay progress in this case.8 The Cousarts respond they sufficiently pled a bad faith claim, request leave to amend their Complaint,

and ask we stay the bad faith claim.9 We agree with State Farm and dismiss the bad faith claim without prejudice should discovery allow the Cousarts to plead facts allowing us to plausibly infer statutory bad faith. II. Analysis State Farm moves to dismiss the Cousarts’ statutory bad faith claim.10 State Farm denies forcing the Cousarts to file this case and denies acting in bad faith by refusing to toll the statute of limitations or stay progress in this case.11 The Cousarts respond they pled a factually plausible bad faith claim.12 The Cousarts also seek leave to amend (for a third time) and stay the bad faith claim.13 We grant State Farm’s Motion without prejudice. The Cousarts failed to sufficiently plead State

Farm acted in bad faith. They may find evidence in discovery of bad faith and may move for leave to amend under Rule 15. But they have not plead a bad faith claim yet. A. The Cousarts do not plead facts allowing us to infer bad faith. State Farm moves to dismiss the Cousarts’ bad faith claim under Federal Rule of Civil Procedure 12(b)(6).14 The Cousarts contend they pled a sufficient bad faith claim under Federal Rule of Civil Procedure 8. The Cousarts allege State Farm is “actively forcing [the Cousarts] to continue to incur unnecessary litigation costs[.]”15 The Cousarts argue they “provid[ed] details above and beyond what is required by F.R.C.P. 8(a).”16 We first note the elements of the Cousarts’ bad faith claim. The Pennsylvania General Assembly prohibits insurers from “act[ing] in bad faith toward the insured.”17 The Pennsylvania General Assembly enacted the statute “to provide a statutory remedy to an insured when the insurer denied benefits in bad faith.”18 The General Assembly wanted to protect “its own residents/insured from overreaching insurance companies” and passed the statute “as part of a comprehensive

insurance bill” thus “there is no legislative history.”19 “Bad faith on [the] part of [an] insurer is any frivolous or unfounded refusal to pay proceeds of a policy[.]”20 To recover on a bad faith claim, the Cousarts are required to show by clear and convincing evidence: “(1) the defendant insurer did not have a reasonable basis for denying the policy benefits; and (2) [ ] the insurer knew or recklessly disregarded its lack of reasonable basis when it denied the claim.”21 We “recognize[] an inherent difficulty in pleading facts regarding the internal claims- processing procedures of insurers[.]”22 But insureds must at least “allege the limited facts of which they are aware, including but not limited to: the nature of the correspondence with the insurance company; details of how the negotiations, if any, proceeded; and more detailed allegations supporting claims of injury necessitating benefits.”23

We next identify allegations not entitled to the presumption of truth. We must “disregard threadbare recitals of the elements of a cause of action, legal conclusions, and conclusory statements.”24 An allegation is conclusory if it “embodies a legal point.”25 In the bad faith context, allegations are conclusory if they simply allege the insurer did not have “a reasonable basis for denying benefits under the policy” or “knew or recklessly disregarded its lack of a reasonable basis in denying the claim.”26 The Cousarts have not plead the most rudimentary of facts which could allow them to proceed on a bad faith claim. We are persuaded by Judge Jones’s analysis in Clapps v.

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Bluebook (online)
COUSART v. STATE FARM FIRE AND CASUALTY COMPANY, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cousart-v-state-farm-fire-and-casualty-company-paed-2023.