Hahn v. Erie Insurance Exchange

1 Pa. D. & C.3d 635, 1976 Pa. Dist. & Cnty. Dec. LEXIS 139
Pennsylvania Court of Common Pleas, Northampton County·Decided December 22, 1976·No. no. 438·Published

Opinion

WILLIAMS, J.,

This matter comes before the court on defendants’ preliminary objections in the form of a motion for a more specific pleading, a demurrer, and various motions to strike. Plaintiffs filed the original complaint in trespass and assumpsit, to which defendants filed preliminary objections. Thereafter, an amended complaint was filed containing nearly identical averments. Defendants renewed their objections bringing the matter before this court. We note that the court has been aided in the resolution of this matter by the well prepared briefs of both parties.

Plaintiffs’ complaint alleges that defendant-insurer failed to indemnify plaintiffs for the loss of their modular home pursuant to a “Home Protector Policy” issued by defendant. According to the complaint, plaintiffs notified defendant’s agent, Harold Heberling, on or about August 19, 1975, that their home had collapsed. Heberling informed them that the policy did not cover the risk. Plaintiffs relied on this representation and did not file proofs of loss. Subsequently they learned that the [637] denial of liability may have been in error and suit was initiated in assumpsit under the policy and in trespass based upon the alleged misrepresentation.

The ciritical issue in defendants’ preliminary objections is whether plaintiff has stated a cause of action in trespass. Accordingly, we will address ourselves to defendants’ demurrer to count two of the complaint, the action in trespass. For purposes of a demurrer, all well-pleaded facts are deemed admitted: Lynch v. Gates, 433 Pa. 531, 252 A.2d 633 (1969); Madara v. Commonwealth, 13 Pa. Commonwealth Ct. 433, 323 A.2d 401 (1974).

The underlying action here is an insurance claim premised on an insurance contract. It is possible, of course, to have a tort claim arise out of a contractual relationship: the negligent performance of a duty created by a contract gives rise to a cause of action in trespass: Henry Bower Chemical Mfg. Co. v. Selas Corp. of America, 85 Montg. 217 (1965); fraudulent performance of a contract is grounds for a tort action: Universal Film Exchanges, Inc. v. Hirsch, 21 D. & C. 2d 154 (1960); bad faith on the part of one party to the contract may give rise to an action in negligence: Epstein v. Erie Indemnity, 39 D. & C. 117, aff’d per curiam 340 Pa. 417, 16 A.2d 47 (1940). A landlord’s promise to repair leased premises may give rise to an action in trespass.or assumpsit: Reitmeyer v. Sprecher, 431 Pa. 284, 243 A.2d 395 (1968). The contract may be such that the public welfare imposes on it such controls that the duties created go beyond contractual rights and create rights actionable in trespass: Behrend v. Bell Telephone Co., 53 D. & C. 2d 421 (1971).

While the above is not exhaustive, it is illustra[638] tive. It is not an answer to the case at bar, however. To determine if an action in trespass lies, it is necessary to review the elements of such a claim.

“The essential elements of a prima facie case based on negligence are (1) the act or omission to act where there is an affirmative duty to do so (Ebbert v. Philadelphia Elec. Co., 330 Pa. 257 (1937)); (2) the establishing of some duty owed by defendant to plaintiff; (Stevens v. Reading St. Ry. Co., 384 Pa. 390 (1956)); (3) the breach of that duty by defendant’s act or omission to act (i.e., defendant’s conduct has in some manner fallen short of the duty of care owed to plaintiff) (Stevens v. Reading Ry. Co., supra); (4) proof that defendants’ acts are the actual cause of harm to plaintiff (Whitner v. Lojeski, 437 Pa. 448 (1970)); and (5) a legal demonstration that the policy of the law extends the responsibility for the conduct to the consequences which have, in fact, occurred, i.e., whether in law defendants’ actions are the proximate cause of plaintiff’s injuries; whether the duty owed extends to the particular plaintiff.” Behrend v. Bell Telephone Co., 53 D. & C. 2d 421, at 425 (1971).

A key issue for determination is whether defendant insurance company and its agent owed a duty to its insured which has been breached. An insurance agent owes certain duties to the insured. See 3 Couch on Insurance 2d, §25:37. Among these is the duty to provide correct information regarding the scope of coverage under a liability policy. This has provided a basis for liability, however, only when the information provided to the insured was that certain risks were covered by the policy when, in fact, they were not: Aresto v. Milie, 184 Pa. Superior Ct. 114, 133 A.2d 304 (1957). The question of whether false information to the effect that [639] the policy does not cover a given incident gives rise to a negligence action is a novel one. A denial of liability does act as a waiver of policy provisions requiring proof of loss within a specified time: Arlotte v. National Liberty Insurance Co., 312 Pa. 442, 167 Atl. 295 (1933), and we conclude that it may also be a breach of a duty owed to the insured.

Insurance policies have a deserved reputation for incomprehensibility. As the insurance policy is drawn by defendant, plaintiff-insured reasonably relies on the interpretation of that policy by the agent of insurer. Additionally, the Unfair Insurance Practices Act of July 22, 1974, P.L. 589 (No. 205), 40 P.S. §1171.1 et seq., imposes a duty on insurance carriers to not misrepresent policy coverage, to adopt reasonable standards for investigation of claims, and to provide a reasonable explanation for the denial of a claim. The mere fact that there has been a breach of duty does not establish liability, however. There must also be a showing that defendant’s acts are the actual cause of harm to plaintiff.

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Hahn v. Erie Insurance Exchange, 1 Pa. D. & C.3d 635, 1976 Pa. Dist. & Cnty. Dec. LEXIS 139 (Pa. Super. Ct. 1976).

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