Doe v. State Farm General Insurance Company

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

Opinion

1 2 3 4 UNITED STATES DISTRICT COURT 5 NORTHERN DISTRICT OF CALIFORNIA 6 7 JAMES DOE, Case No. 23-cv-04734-JSC

8 Plaintiff, ORDER RE STATE FARM’S MOTION 9 v. FOR SUMMARY JUDGMENT OR PARTIAL SUMMARY JUDGMENT 10 STATE FARM GENERAL INSURANCE COMPANY, Re: Dkt. No. 48 11 Defendant.

12 13 After losing a luxury watch, Plaintiff James Doe filed an insurance claim with State Farm 14 for the value of that watch. State Farm denied his claim and canceled Plaintiff’s policy. Plaintiff 15 filed suit, alleging breach of contract and breach of the covenant of good faith and fair dealing 16 among other claims. Pending before the Court is State Farm’s motion for summary judgment. 17 Having considered the parties’ written submissions, and having had the benefit of oral argument 18 on October 10, 2024, the Court GRANTS in part and DENIES in part State Farm’s motion for 19 summary judgment. The record reflects a genuine dispute as to whether Plaintiff’s material 20 misrepresentation was made with knowledge of falsity and thus an intent to deceive. 21 BACKGROUND 22 A. Facts 23 Plaintiff purchased a Personal Articles Policy from State Farm that included coverage for 24 jewelry. (Dkt. No. 48-5 at 7.)1 The policy contained a “Concealment or Fraud” provision, 25 stating:

26 This entire policy will be void if, whether before or after a loss, you 27 have intentionally concealed or misrepresented a material fact or 1 circumstance relating to this insurance. 2 (Id. at 12.) 3 On June 19, 2022, Plaintiff left his house in the East Bay to run errands in San Francisco. 4 (Dkt. No. 64-1 ¶ 18.) On his way home, he was rear-ended while driving south on I-880. (Id. ¶¶ 5 23-24; Dkt. No. 48-5 at 82.) After the accident, Plaintiff drove to the shoulder of the highway. 6 (Dkt. No. 48-5 at 83-84). His vehicle “sustained minor damage including a “dented, broken and 7 partially detached rear bumper.” (Id. at 83.) 8 California Highway Patrol and emergency medical technicians responded to the accident. 9 (Dkt. No. 64-1 ¶ 24.) Plaintiff was transported via ambulance to the Fremont Kaiser Hospital 10 emergency room. (Id.) The emergency room doctor informed Plaintiff he did not sustain a head 11 concussion. (Id. ¶ 25.) He was discharged later that evening and took an Uber home. (Id. ¶¶ 25- 12 26.) 13 One week after the accident, Plaintiff flew to Montreal, where he owns a condo, to handle 14 taxes, pay bills, and attend the Montreal annual jazz festival. (Dkt. No. 48-5 at 154; Dkt. No. 64-1 15 ¶ 30.) 16 Two weeks after the accident, on July 3, 2022, Plaintiff filed a claim with State Farm 17 reporting the disappearance of his BlancPain watch. (Dkt. No. 48-5 at 22.) His claim states:

18 Mysterious disappearance; I was driving home in my car (Honda Accord) and was rear ended by another car on 6/19/2022. The back 19 of my head struck the headrest hard upon impact. I could not keep my eyes open because of extreme light sensitivity to lights. Ambulance 20 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 21 before the accident. 22 (Id.) The following day, a State Farm representative spoke with Plaintiff about his claim. He 23 stated “he was wearing [the watch] while driving and while accident happened.” (Id. at 26.) 24 State Farm realized Plaintiff had filed a similar claim in 2018, which State Farm paid. 25 (Dkt. Nos. 48-5 (“Insured was crossing the street when he was hit. Lost hi[s] watch.”); Dkt. No. 26 48-6 (issuing payment for replacement value of the watch).) State Farm thus reassigned the claim 27 to its Special Investigative Unit. (Dkt. No. 48-2 ¶¶ 5-6.) 1 spoke with Plaintiff. (Id. ¶¶ 1, 6.) Plaintiff recounted to Ms. Davidson he went to San Francisco 2 “to take the watch to a jeweler to fix the clasp” but the jeweler was closed, and he was on his way 3 home when the accident occurred. (Dkt. No. 48-5 at 64.) Plaintiff “did not call police, EMS, tow 4 company, or Uber to see if [the watch] was found.” (Id. at 65; see also Dkt. No. 64-1 ¶ 50 5 (attesting that upon request of State Farm’s attorney, Plaintiff “promptly notified the Blancpain 6 corporation, Kaiser Permanente, the ambulance company, and Uber, about the disappearance of 7 his watch.”).) The Claims Specialist scheduled a recorded statement for July 20, 2022. (Id. at 63; 8 Dkt. No. 48-2 ¶ 10.) 9 On July 19, 2022, Plaintiff met with a neurologist. (Dkt. No. 64-12 at 2.) The doctor 10 noted Plaintiff was stuttering and “extremely photosensitive” and his “CT scan of the brain was 11 rather unremarkable.” (Id. at 2, 6, 8.) The diagnosis was “postconcussion syndrome.” (Id. at 8.) 12 On July 20, 2022, Ms. Davidson called Plaintiff for the recorded statement. Plaintiff told 13 her he was taking medication. (Dkt. No. 64-1 at 15.) According to Ms. Davidson’s notes, 14 Plaintiff “was difficult to understand . . . he did stutter sometimes but his words were also not clear 15 and sometimes slurred.” (Dkt. No. 48-5 at 104.) She canceled the recorded statement and referred 16 Plaintiff for an examination under oath. (Id.; Dkt. No. 64-1 ¶ 46.) 17 During the examination under oath, Plaintiff said the lost watch was in “the pocket of the 18 hoodie that [he] was wearing” during the accident, (Dkt. No. 48-5 at 134), which contradicted his 19 previous statement about wearing the watch during the accident. 20 On January 3, 2023, State Farm sent Plaintiff a letter informing him his claim had been 21 denied pursuant to the concealment and fraud provision. (Dkt. No. 48-5 at 163-67.) State Farm 22 also reported the suspected fraudulent claim to the California Department of Insurance. (Dkt. No. 23 48-5 at 191-92.) 24 B. Procedural History 25 On August 17, 2023, Plaintiff filed suit in state court under a pseudonym, alleging nine 26 causes of action on behalf of himself and a putative class. (Dkt. No. 10-1.) State Farm filed a 27 motion to dismiss and a motion to strike. (Dkt. No. 10.) The Court struck the class claims and 1 (1) breach of contract, (2) breach of the covenant of good faith and fair dealing, (3) Unruh Civil 2 Rights Act, (4) defamation, and (5) wrongful policy cancellation. (Id. at 16-17.) 3 Now pending before the Court is State Farm’s motion for summary judgment on all claims, 4 or in the alternative, partial summary judgment on the extracontractual claims, including for 5 punitive damages. (Dkt. No. 48.) State Farm also filed a request for judicial notice and an 6 administrative motion to consider whether another party’s material should be sealed. (Dkt. Nos. 7 48-4, 49.) Plaintiff opposes the motion for summary judgment. (Dkt. No. 64.) 8 LEGAL STANDARD 9 Under Federal Rule of Civil Procedure 56, summary judgment is proper “if the movant 10 shows that there is no genuine dispute as to any material fact and the movant is entitled to 11 judgment as a matter of law.” The moving party—here State Farm—bears the initial burden of 12 demonstrating the lack of a genuine issue of material fact. Celotex Corp., 477 U.S. at 323. “[T]he 13 burden then moves to the opposing party, who must present significant probative evidence tending 14 to support its claim.” Intel Corp. v. Hartford Acc. & Indem. Co., 952 F.2d 1551, 1558 (9th Cir. 15 1991) (cleaned up). 16 In ruling on a motion for summary judgment, the Court must “view the evidence presented 17 through the prism of the substantive evidentiary burden.” Anderson v. Liberty Lobby, Inc., 477 18 U.S. 242, 254 (1986). The evidence of the non-movant is to be believed, and all justifiable 19 inferences are to be drawn in the non-movant’s favor. Id. at 255.

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