DiDomenico v. New York Life Insurance

837 F. Supp. 1203, 28 Fed. R. Serv. 3d 316, 1993 U.S. Dist. LEXIS 16635, 1993 WL 494143
CourtDistrict Court, M.D. Florida
DecidedNovember 19, 1993
Docket93-564-CIV-T-17A
StatusPublished
Cited by3 cases

This text of 837 F. Supp. 1203 (DiDomenico v. New York Life Insurance) is published on Counsel Stack Legal Research, covering District Court, M.D. Florida primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
DiDomenico v. New York Life Insurance, 837 F. Supp. 1203, 28 Fed. R. Serv. 3d 316, 1993 U.S. Dist. LEXIS 16635, 1993 WL 494143 (M.D. Fla. 1993).

Opinion

ORDER ON DEFENDANT’S MOTION TO DISMISS/MOTION TO STRIKE AND DEFENDANT’S MOTION FOR A RULE 16(a)(5) CONFERENCE

KOVACHEVICH, District Judge.

This cause is before the Court on Defendant’s motions, which include motion to dismiss pursuant to Fed.R.Civ.P. Rule 12(b)(6), motion to strike Plaintiffs emotional damages claim, and motion seeking a conference under Fed.R.Civ.P. Rule 16(a)(5).

BACKGROUND

This is an insurance coverage action upon a disability income policy. Paul Pastorella, now deceased, was insured by Defendant under a disability income policy. According to the complaint, Pastorella had been disabled pursuant to the terms of his disability policy since August of 1991. The complaint alleges that Pastorella provided Defendant with the contractually required claim for benefits and that all other conditions precedent to receiving benefits were either satisfied, waived or excused. The complaint claims that, despite Pastorella’s compliance with the terms of the disability policy, Defendant has denied Pasto-rella’s claim or has unreasonably withheld payment of benefits, so as to constitute a breach of the disability contract. As a result of Defendant’s breach, Pastorella claimed to have suffered consequential damages, including financial losses and emotional distress.

Pastorella initially filed this action in state court, but Defendant exercised its right to remove the case to this Court under diversity jurisdiction. Subsequently, on April 11, 1993, Paul Pastorella died. On August 3, 1993, this Court granted the motion for substitution of Laura DiDomenieo as decedent’s personal representative and executrix.

MOTION TO DISMISS

A. STANDARD OF REVIEW

A complaint should not be dismissed for failure to state a claim under Rule 12(b)(6) “unless it appears beyond a doubt that the plaintiff can prove no set of facts in support of his claim which would entitle him to relief.” Conley v. Gibson, 355 U.S. 41, 45-46, 78 S.Ct. 99, 102, 2 L.Ed.2d 80 (1957). When ruling on a motion to dismiss, a trial court must view the complaint in the light most favorable to the plaintiff. Scheuer v. Rhodes, 416 U.S. 232, 236, 94 S.Ct. 1683, 1686, 40 L.Ed.2d 90 (1974).

B. ANALYSIS

Defendant argues that this suit is premature because it has not yet denied Plaintiffs benefits claim, and therefore, Plaintiff has not established all of the necessary elements of the cause of action. In support of its position, Defendant maintains that Plaintiff has not submitted all medical information required by the terms of the disability policy, therefore, Plaintiff is not yet entitled to any disability payments.

Rule 8 of the Federal Rules of Civil Procedure sets forth three requirements which a pleader must satisfy when filing a complaint. According to the Rule, a complaint:

Shall contain (1) a short and plain statement of the grounds upon which the court’s jurisdiction depends, unless the court already has jurisdiction and the claim need no new ground of jurisdiction to support it, (2) a short and plain statement of the claim showing that the pleader is entitled to relief, and (3) a demand for judgment for the relief the pleader seeks.

A complaint, therefore, “need not specify in detail the precise theory giving rise to recovery.” Sams v. United Food & Commercial Workers Int’l, 866 F.2d 1380, 1384 (11th Cir.1989). Instead, it has long been established that a complaint satisfies the Rule if it contains allegations sufficient to notify the defendant “as to the claim being asserted against him and the grounds on which it rests.” Conley, 355 U.S. at 47, 78 S.Ct. at 103. Since the drafters of the Federal Rules *1205 of Civil Procedure intended liberal construction of pleadings, Rule 8(a)(2) is generally-viewed as placing only a minimal requirement of technical exactness on the pleader. Irizarry v. Palm Springs Gen. Hosp., 657 F.Supp. 739, 740 (S.D.Fla.1986).

When considering a motion to dismiss, this Court must consider as true all allegations set forth in the complaint. After reviewing the complaint, this Court finds that Plaintiffs complaint fulfills the requirements of Fed.R.Civ.P. Rule 8. Plaintiff has alleged the existence of a contractual agreement with Defendant, satisfaction or waiver of all conditions precedent to recovery, breach by Defendant in denying or unreasonably delaying payment of disability income benefits, and damages. These allegations, if proven, provide a basis for granting Plaintiff relief. Defendant’s motion to dismiss contains factual assertions contradicting Plaintiffs claim that all conditions precedent to recovery have been satisfied, waived or excused. However, resolution of the issue of whether all conditions precedent to bringing this action have been satisfied requires factual determinations which are inappropriate at this stage of litigation. When a complaint only meets the minimum requirements of the rule, litigants may utilize liberal discovery rules and other pretrial procedures to remedy gaps in the facts surrounding an action. Conley, 355 U.S. at 48, 78 S.Ct. at 103.

In support of its Rule 12(b)(6) motion, Defendant has cited to cases where courts have granted similar motions on the basis that the suit was filed prematurely. The Court finds those cases either distinguishable or inapplicable to this matter. For example, Romano v. American Casualty Co. of Reading, Pennsylvania, 834 F.2d 968 (11th Cir.1987), the ease most factually analogous to the instant case, involved a plaintiff who sued its insurer for failing to settle in good faith a claim filed against the insured by a third party. The plaintiff in Romano was the liable party in an auto accident; he sued his insurance company for failing to use good faith in settlement negotiations with the driver injured in the collision. Id. at 969. The essence of the third party “bad faith” action at issue in Romano was that the insurer breached its duty by failing to promptly or properly defend the claim filed by a third party against the insured. See, e.g., Fidelity and Casualty Co. of N.Y. v. Cope, 462 So.2d 459, 460 (Fla.1985). This third party “bad faith” cause of action only accrues when an insurer fails to settle in good faith a third party’s action against an insured, thus resulting in a judgment against an insured in an amount exceeding its insurance coverage. Romano, 834 F.2d at 968. Defendant also cited Fortson v. St. Paul Fire and Marine Ins. Co., 751 F.2d 1157

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Cite This Page — Counsel Stack

Bluebook (online)
837 F. Supp. 1203, 28 Fed. R. Serv. 3d 316, 1993 U.S. Dist. LEXIS 16635, 1993 WL 494143, Counsel Stack Legal Research, https://law.counselstack.com/opinion/didomenico-v-new-york-life-insurance-flmd-1993.