Doe v. State Farm General Insurance Company

District Court, N.D. California·Decided October 11, 2024·No. 3:23-cv-04734·Unknown

Opinion

JAMES DOE, Case No. 23-cv-04734-JSC

Plaintiff, ORDER RE STATE FARM’S MOTION v. FOR SUMMARY JUDGMENT OR PARTIAL SUMMARY JUDGMENT COMPANY, Re: Dkt. No. 48 Defendant.

After losing a luxury watch, Plaintiff James Doe filed an insurance claim with State Farm for the value of that watch. State Farm denied his claim and canceled Plaintiff’s policy. Plaintiff filed suit, alleging breach of contract and breach of the covenant of good faith and fair dealing among other claims. Pending before the Court is State Farm’s motion for summary judgment. Having considered the parties’ written submissions, and having had the benefit of oral argument on October 10, 2024, the Court GRANTS in part and DENIES in part State Farm’s motion for summary judgment. The record reflects a genuine dispute as to whether Plaintiff’s material misrepresentation was made with knowledge of falsity and thus an intent to deceive. A. Facts Plaintiff purchased a Personal Articles Policy from State Farm that included coverage for jewelry. (Dkt. No. 48-5 at 7.)1 The policy contained a “Concealment or Fraud” provision, stating:

This entire policy will be void if, whether before or after a loss, you have intentionally concealed or misrepresented a material fact or circumstance relating to this insurance. (Id. at 12.) On June 19, 2022, Plaintiff left his house in the East Bay to run errands in San Francisco. (Dkt. No. 64-1 ¶ 18.) On his way home, he was rear-ended while driving south on I-880. (Id. ¶¶ 23-24; Dkt. No. 48-5 at 82.) After the accident, Plaintiff drove to the shoulder of the highway. (Dkt. No. 48-5 at 83-84). His vehicle “sustained minor damage including a “dented, broken and partially detached rear bumper.” (Id. at 83.) California Highway Patrol and emergency medical technicians responded to the accident. (Dkt. No. 64-1 ¶ 24.) Plaintiff was transported via ambulance to the Fremont Kaiser Hospital emergency room. (Id.) The emergency room doctor informed Plaintiff he did not sustain a head concussion. (Id. ¶ 25.) He was discharged later that evening and took an Uber home. (Id. ¶¶ 25- 26.) One week after the accident, Plaintiff flew to Montreal, where he owns a condo, to handle taxes, pay bills, and attend the Montreal annual jazz festival. (Dkt. No. 48-5 at 154; Dkt. No. 64-1 ¶ 30.) Two weeks after the accident, on July 3, 2022, Plaintiff filed a claim with State Farm reporting the disappearance of his BlancPain watch. (Dkt. No. 48-5 at 22.) His claim states:

Mysterious disappearance; I was driving home in my car (Honda Accord) and was rear ended by another car on 6/19/2022. The back of my head struck the headrest hard upon impact. I could not keep my eyes open because of extreme light sensitivity to lights. Ambulance took me to the ER and my car was towed. I just realized my BlancPain watch is missing and that I was wearing that watch on my right wrist before the accident. (Id.) The following day, a State Farm representative spoke with Plaintiff about his claim. He stated “he was wearing [the watch] while driving and while accident happened.” (Id. at 26.) State Farm realized Plaintiff had filed a similar claim in 2018, which State Farm paid. (Dkt. Nos. 48-5 (“Insured was crossing the street when he was hit. Lost hi[s] watch.”); Dkt. No. 48-6 (issuing payment for replacement value of the watch).) State Farm thus reassigned the claim to its Special Investigative Unit. (Dkt. No. 48-2 ¶¶ 5-6.) spoke with Plaintiff. (Id. ¶¶ 1, 6.) Plaintiff recounted to Ms. Davidson he went to San Francisco “to take the watch to a jeweler to fix the clasp” but the jeweler was closed, and he was on his way home when the accident occurred. (Dkt. No. 48-5 at 64.) Plaintiff “did not call police, EMS, tow company, or Uber to see if [the watch] was found.” (Id. at 65; see also Dkt. No. 64-1 ¶ 50 (attesting that upon request of State Farm’s attorney, Plaintiff “promptly notified the Blancpain corporation, Kaiser Permanente, the ambulance company, and Uber, about the disappearance of his watch.”).) The Claims Specialist scheduled a recorded statement for July 20, 2022. (Id. at 63; Dkt. No. 48-2 ¶ 10.) On July 19, 2022, Plaintiff met with a neurologist. (Dkt. No. 64-12 at 2.) The doctor noted Plaintiff was stuttering and “extremely photosensitive” and his “CT scan of the brain was rather unremarkable.” (Id. at 2, 6, 8.) The diagnosis was “postconcussion syndrome.” (Id. at 8.) On July 20, 2022, Ms. Davidson called Plaintiff for the recorded statement. Plaintiff told her he was taking medication. (Dkt. No. 64-1 at 15.) According to Ms. Davidson’s notes, Plaintiff “was difficult to understand . . . he did stutter sometimes but his words were also not clear and sometimes slurred.” (Dkt. No. 48-5 at 104.) She canceled the recorded statement and referred Plaintiff for an examination under oath. (Id.; Dkt. No. 64-1 ¶ 46.) During the examination under oath, Plaintiff said the lost watch was in “the pocket of the hoodie that [he] was wearing” during the accident, (Dkt. No. 48-5 at 134), which contradicted his previous statement about wearing the watch during the accident. On January 3, 2023, State Farm sent Plaintiff a letter informing him his claim had been denied pursuant to the concealment and fraud provision. (Dkt. No. 48-5 at 163-67.) State Farm also reported the suspected fraudulent claim to the California Department of Insurance. (Dkt. No. 48-5 at 191-92.) B. Procedural History On August 17, 2023, Plaintiff filed suit in state court under a pseudonym, alleging nine causes of action on behalf of himself and a putative class. (Dkt. No. 10-1.) State Farm filed a motion to dismiss and a motion to strike. (Dkt. No. 10.) The Court struck the class claims and (1) breach of contract, (2) breach of the covenant of good faith and fair dealing, (3) Unruh Civil Rights Act, (4) defamation, and (5) wrongful policy cancellation. (Id. at 16-17.) Now pending before the Court is State Farm’s motion for summary judgment on all claims, or in the alternative, partial summary judgment on the extracontractual claims, including for punitive damages. (Dkt. No. 48.) State Farm also filed a request for judicial notice and an administrative motion to consider whether another party’s material should be sealed. (Dkt. Nos. 48-4, 49.) Plaintiff opposes the motion for summary judgment. (Dkt. No. 64.) Under Federal Rule of Civil Procedure 56, summary judgment is proper “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” The moving party—here State Farm—bears the initial burden of demonstrating the lack of a genuine issue of material fact. Celotex Corp., 477 U.S. at 323. “[T]he burden then moves to the opposing party, who must present significant probative evidence tending to support its claim.” Intel Corp. v. Hartford Acc. & Indem. Co., 952 F.2d 1551, 1558 (9th Cir. 1991) (cleaned up). In ruling on a motion for summary judgment, the Court must “view the evidence presented through the prism of the substantive evidentiary burden.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 254 (1986). The evidence of the non-movant is to be believed, and all justifiable inferences are to be drawn in the non-movant’s favor. Id. at 255. “Credibility determinations, the weighing of the evidence, and the drawing of legitimate inferences from the facts are jury functions, not those of a judge… ruling on a motion for summary judgment.” Id. As a general matter, Plaintiff argues State Farm’s motion is premature because (1) “State Farm has advised Plaintiff that it intends to take his deposition and independent medical examination (“IME”) in person upon his return to the Bay Area from Bangkok in November 2024,” and (2) “expert testimony could be useful to

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