Fair v. State Farm Mutual Automobile Insurance

18 Pa. D. & C.4th 78, 1992 Pa. Dist. & Cnty. Dec. LEXIS 42
CourtPennsylvania Court of Common Pleas, Lancaster County
DecidedOctober 22, 1992
Docketno. 1537 of 1992
StatusPublished

This text of 18 Pa. D. & C.4th 78 (Fair v. State Farm Mutual Automobile Insurance) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, Lancaster County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Fair v. State Farm Mutual Automobile Insurance, 18 Pa. D. & C.4th 78, 1992 Pa. Dist. & Cnty. Dec. LEXIS 42 (Pa. Super. Ct. 1992).

Opinion

ALLISON, J.,

This case is before us to dispose of preliminary objections of defendant, State Farm Mutual Automobile Insurance Co. and Julie Dickson, trading and doing business as Julie Dickson Insurance to a complaint filed by Ross G. Fair, individually and as administrator of the estate of his wife, Susanne M. Fair.

In January of 1991, the plaintiffs visited the office of State Farm agent Julie Dickson, to apply for a health insurance policy. At this time, however, agent Dickson was not available and the Fairs’ application was filled out by an office person, Peggy L. Enck. Once the application was filled out the Fairs signed a “conditional receipt” and paid State Farm a check for $323.12. The check covered the membership fees and the initial premium for both Ross and Susanne Fair for two months. State Farm cashed this check on January 24, 1991.

On January 31, 1991, Susanne Fair was diagnosed as having acute leukemia. On or about February 22, 1991, State Farm received from the Fairs an additional premium check in the amount of $123.06. State Farm cashed this check on February 25, 1991. On March 13, 1991, an [80]*80underwriting supervisor for State Farm notified agent Dickson that Susanne Fair would be denied medical coverage due to her medical history of “headaches, back and neck disorder, knee disorder, sore throat, fever and myalgia.”1 The Fairs were subsequently notified that they were denied coverage on March 15,1991. On August 2,1991, Susanne Fair died of acute lymphocytic leukemia.

Plaintiff filed a complaint on December 5, 1991, containing the following counts: Count 1 — Breach of Contract; Count II — Violation of the Unfair Trade Practices Act and the Consumer Protection Law; Count III — Negligent and/or Intentional Misrepresentation; Count IV— Bad Faith; Count V — Intentional Infliction of Emotional Distress; and Count VI — Negligence. Defendant timely filed preliminary objections requesting the court to dismiss plaintiff’s claims arising out of State Farm’s alleged violation of the Unfair Insurance Practices Act, dismiss plaintiff’s claim for intentional infliction of emotional distress, dismiss plaintiff’s claim for punitive damages generally and under 42 Pa.C.S. §8371, strike plaintiff’s claim for an amount in excess of $100,000 and order plaintiff to file an amended complaint pleading special damages specifically.

We first address defendant’s claim that plaintiff may not base a claim for “bad faith” or punitive damages against an insurance company upon an alleged violation of the Unfair Insurance Practices Act.2

The Unfair Insurance Practices Act was intended by our state legislatures to serve the public and handle complaints from insureds as to unfair and deceptive insurance practices conducted on a regular basis. The statutory prohibitions within the Act are enforced by the Insurance [81]*81Commissioner of Pennsylvania, who is empowered to examine and investigate the affairs of every person engaged in the business of insurance in this state to determine whether the Act has been violated. D’Ambrosio v. Pennsylvania National Mutual Casualty Insurance Co., 494 Pa. 501, 431 A.2d 966 (1981), 40 P.S. §1171.7. In essence, the intent of our state Legislature in passing the Act was to regulate and enforce provisions of the Act with the insurance departments of Pennsylvania and not through a court of law. Our appellate courts have acknowledged as such in recent decisions. See Gordon v. Pennsylvania Blue Shield, 378 Pa. Super. 256, 548 A.2d 600 (1988), and Moy v. Schreiber Deed Security Co., 392 Pa. Super. 195, 572 A.2d 758 (1990), (specifically acknowledging that a cause of action under the Unfair Insurance Practices Act was not an action within the court’s jurisdiction). After reading plaintiff’s complaint we conclude that he is asserting specific claims based on the violation of the Unfair Insurance Practices Act (UIPA) and therefore we grant defendants’ request to strike from the complaint any allegations of bad faith based upon the UIPA.

We also reject plaintiff’s argument that his references to a violation of the UIPA were only put forth to establish a cause of action under the Consumer Protection Law. The law is quite clear that whether the alleged violations of the UIPA are raised as a primary claim or a secondary claim it will not be entertained by the court. In this case, in order to determine whether defendants violated the CPL it must first be determined whether they violated the Unfair Insurance Practices Act. Since that initial determination is not within the authority of the court to decide, it is also not within the authority of the court to entertain the primary claim under the CPL. See Moy v. Schreiber Deed Security Co., supra, at 200, 572 A.2d at 760-761.

[82]*82Next this court considers defendant’s request for a demurrer to Count V of the complaint which is the allegation of intentional infliction of emotional distress. When confronted with preliminary objections in the nature of a demurrer the court will accept as true all properly pleaded allegations and material facts in the pleadings which give rise to the objections. Pennsylvania Medical Providers Assn. v. Foster, 136 Pa. Commw. 232, 582 A.2d 888 (1990). The court will also accept as true every inference deducible from those facts as well as facts from which the court can take judicial notice. Babjack v. Mt. Lebanon Parking Authority, 102 Pa. Commw. 499, 518 A.2d 1311 (1986). The question presented by demurrer is whether on the facts averred the law says with certainty that no recovery is possible. A demurrer cannot be sustained if there is any doubt as to whether the complaint adequately states a claim for relief under any theory of law. Snyder v. City of Philadelphia, 129 Pa. Commw. 89, 564 A.2d 1036 (1989).

Plaintiff alleges that this claim is an independent cause of action and should not be considered as a damage element to plaintiff’s claim for breach of contract contained in Count I of the complaint. However, after reviewing the complaint ourselves we find that the claim for intentional infliction of emotional distress arises directly from the alleged breach of the health contract. In other words, if not for the alleged breach there would not be an intentional infliction of emotional distress count. Therefore we are treating Count V as a damage element to the breach of contract action.

Ordinarily, emotional distress damages are not recoverable under a breach of contract action but there are two exceptions. The first is when the emotional distress is accompanied by bodily harm. The second is when the contract or the breach is of such a kind that serious [83]*83emotional disturbance was a particularly likely result. Rodgers v. Nationwide Mutual Insurance Co. 344 Pa. Super. 311, 496 A.2d 811 (1985). Restatement (Second) of Contract §353. We note that this restatement section has not been adopted in Pennsylvania.

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Related

Feld v. Merriam
485 A.2d 742 (Supreme Court of Pennsylvania, 1984)
Snyder v. City of Philadelphia
564 A.2d 1036 (Commonwealth Court of Pennsylvania, 1989)
Rizzo v. Haines
555 A.2d 58 (Supreme Court of Pennsylvania, 1989)
Moy v. Schreiber Deed Security Co.
572 A.2d 758 (Supreme Court of Pennsylvania, 1990)
Mason v. Western Pennsylvania Hospital
453 A.2d 974 (Supreme Court of Pennsylvania, 1982)
Rodgers v. Nationwide Mutual Insurance
496 A.2d 811 (Supreme Court of Pennsylvania, 1985)
Delahanty v. First Pennsylvania Bank, N.A.
464 A.2d 1243 (Supreme Court of Pennsylvania, 1984)
Commonwealth v. Hutchinson
556 A.2d 370 (Supreme Court of Pennsylvania, 1989)
Gordon v. Pennsylvania Blue Shield
548 A.2d 600 (Supreme Court of Pennsylvania, 1988)
Pennsylvania Medical Providers Ass'n v. Foster
582 A.2d 888 (Commonwealth Court of Pennsylvania, 1990)
Rittenhouse Regency Affiliates v. Passen
482 A.2d 1042 (Supreme Court of Pennsylvania, 1984)
Babjack v. Mt. Lebanon Parking Authority
518 A.2d 1311 (Commonwealth Court of Pennsylvania, 1986)

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Bluebook (online)
18 Pa. D. & C.4th 78, 1992 Pa. Dist. & Cnty. Dec. LEXIS 42, Counsel Stack Legal Research, https://law.counselstack.com/opinion/fair-v-state-farm-mutual-automobile-insurance-pactcompllancas-1992.