GORDON v. LM GENERAL INSURANCE COMPANY

CourtDistrict Court, E.D. Pennsylvania
DecidedJuly 28, 2022
Docket2:22-cv-02567
StatusUnknown

This text of GORDON v. LM GENERAL INSURANCE COMPANY (GORDON v. LM GENERAL INSURANCE 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
GORDON v. LM GENERAL INSURANCE COMPANY, (E.D. Pa. 2022).

Opinion

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

DAVID GORDON and SAMAYA : CIVIL ACTION GORDON : : v. : NO. 22-2567 : LM GENERAL INSURANCE : COMPANY :

MEMORANDUM KEARNEY, J. July 28, 2022 Persons buying car insurance policies and later claiming their insurer acted in bad faith in the handling of their car insurance claim must allege more than broad conclusions. They must allege facts to allow us to find their bad faith claim plausible. They should also timely answer motions and avoid referencing a fiduciary duty between an insurer and insurers when no case law supports their conclusionary references. We today grant the insurer’s motion to dismiss an insured couple’s bad faith claim against it without prejudice to the insureds timely amending to plead facts consistent with Rule 11. We also strike the insureds’ untimely response but have carefully considered their allegations and conclusory arguments. We also strike the insureds’ references to an unfounded fiduciary duty owed by an insurer to its insureds under Pennsylvania law. I. Alleged facts David Gordon purchased a car insurance policy from LM General Insurance Company.1 He claims non-party Meghan Hill injured him when she drove her car into his car.2 Mr. Gordon sought underinsured motorist benefits from LM General.3 Mr. Gordon claims LM General did not pay benefits allegedly due.4 Mr. Gordon also claims LM General committed bad faith by “low- balling” him during settlement negotiations regarding his bad faith claim.5 But Mr. Gordon does not plead details regarding LM General’s claim handling. Mr. Gordon does not plead when he submitted a claim to LM General, how long LM General took to decide the claim, what settlement offers LM General made to the Gordons, or what amount—if any—LM General ultimately paid Mr. Gordon.

Mr. Gordon and his wife, Samaya Gordon, sue LM General for bad faith, breach of contract, and loss of consortium.6 II. Analysis LM General moves to dismiss the Gordons’ bad faith claim under Federal Rule of Civil Procedure 12(b)(6) and moves to strike the Gordons’ allegations LM General owed the Gordons a fiduciary duty under Rule 12(f).7 The Gordons did not timely respond to LM General’s Motion.8 We consider LM General’s Motion unopposed. We grant LM General’s Motion. We may grant LM General’s Motion simply because the Gordons did not timely oppose it.9 But we further find LM General’s Motion has merit irrespective of the Gordons’ non-opposition.

A. We dismiss the Gordons’ bad faith claim. LM General moves to dismiss the Gordons’ bad faith claim under Federal Rule of Civil Procedure 12(b)(6).10 Our Court of Appeals requires us to apply a three-step analysis to a 12(b)(6) motion.11 “First, we take note of the elements a plaintiff must plead to state a claim.”12 “Next, we identify allegations that are not entitled to the assumption of truth because those allegations are no more than conclusions.”13 Finally, we assume the veracity of well-pleaded allegations and reasonable inferences we may draw from those allegations, “and, construing the allegations and reasonable inferences in a light most favorable to the plaintiff, we determine whether they plausibly give rise to an entitlement to relief.”14 We dismiss the Gordons’ bad faith claim without prejudice. The Gordons do not plead facts plausibly showing LM General committed bad faith. We first note the elements of the Gordons’ bad faith claim. The Pennsylvania General Assembly prohibits insurers from “act[ing] in bad faith toward the insured.”15 “Bad faith on the part of an insurer is any frivolous or unfounded refusal to pay proceeds of a policy.”16 “To recover

on a bad faith claim, a claimant is required to show by clear and convincing evidence that: (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.”17 Judges “recognize[] an inherent difficulty in pleading facts regarding the internal claims- processing procedures of insurers.”18 But plaintiffs 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.”19 1. We disregard most of the Gordons’ allegations because they are legal conclusions. 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.”20 An allegation is conclusory if it “embodies a legal point.”21 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.”22

We must disregard many of the Gordons’ allegations. Boilerplate legal conclusions lacking facts about LM General’s bad faith abound in the Complaint. For example, the Gordons claim LM General “low-ball[ed]” the Gordons, “[f]ail[ed] to make any reasonable offer to settle the underinsured motorist claim; [p]rovid[ed] Plaintiff with no explanation or any reason for not making a reasonable offer to settle . . . [f]orc[ed] Plaintiff to arbitrate reasonable claims which Defendant knowingly and recklessly disregarded; and “[a]ct[ed] in a biased self-serving manner in it’s [sic] claims handling process.”23 The Gordons repeatedly claim LM General acted “reckless[ly],” but provide no facts showing how this is so.24 The Gordons plead one paragraph

including twenty sub-paragraphs in their bad faith claim—but each sub-paragraph constitutes a boilerplate legal conclusion lacking specific factual allegations.25 The Gordons simply plead types of ways an insurer might commit bad faith without pleading how this insurer committed bad faith. Our colleagues overwhelmingly disregard conclusory bad faith allegations like the Gordons’ allegations.26 We follow suit and disregard these allegations as legal conclusions. 2. The few facts the Gordons plead do not plausibly give rise to relief. Buried in a conclusory morass, the Gordons plead one sentence arguably providing a fact about LM General’s bad faith: LM General “[r]epeatedly and needlessly dragg[ed] out the process by requesting volumes of documents, forcing Plaintiff to undergo multiple Statements Under Oath and other dilatory tactics.”27 Unlike the Gordons’ other allegations, this allegation provides

specifics about how LM General handled the Gordons’ claim. But this lone allegation does not plead a bad faith claim. “Delay is a relevant factor in determining whether bad faith has occurred,”28 but “[a]n insurer’s delay in settling a claim ‘does not, on its own, necessarily constitute bad faith.’”29 Delay is relevant only if the plaintiff pleads facts showing the insurer’s delay “did not have a reasonable basis.”30 “[I]f delay is attributable to the need to investigate further or even to simple negligence, no bad faith has occurred.”31 A “mere allegation that Plaintiffs provided documentation and Defendant has failed to make a reasonable settlement offer . . . does not support an inference of bad faith without additional factual support such as the complexity of the claim and the time [which] passed between the date Plaintiffs supplied the necessary information and the date the complaint was filed.”32 We dismiss the Gordons’ bad faith claim because they provide no “additional factual support” regarding their allegation LM General unreasonably delayed handling their claim.

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Bluebook (online)
GORDON v. LM GENERAL INSURANCE COMPANY, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gordon-v-lm-general-insurance-company-paed-2022.