O'Brien v. Encompass Home and Auto Insurance Company

CourtDistrict Court, D. Maryland
DecidedAugust 12, 2024
Docket1:23-cv-02342
StatusUnknown

This text of O'Brien v. Encompass Home and Auto Insurance Company (O'Brien v. Encompass Home and Auto Insurance Company) is published on Counsel Stack Legal Research, covering District Court, D. Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
O'Brien v. Encompass Home and Auto Insurance Company, (D. Md. 2024).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND

* SUSAN O’BRIEN, * * Plaintiff, * * Civ. No.: MJM-23-2342 v. * * ENCOMPASS HOME AND AUTO * INSURANCE COMPANY, * * Defendant. * * * * * * * * * * * *

MEMORANDUM OPINION AND ORDER Susan O’Brien (“Plaintiff”) brings this action against Encompass Home and Auto Insurance Company (“Defendant”), alleging breach of contract and failure to settle claims in good faith under Maryland law. See Am. Compl. (ECF No. 7). Plaintiff’s claims arise out of Defendant’s denial of Plaintiff’s insurance claim related to a storm that damaged Plaintiff’s roof in April 2020. This matter is before the Court on Defendant’s Motion to Dismiss (the “Motion”). ECF No. 9. The Motion is fully briefed and ripe for disposition. No hearing is necessary. See Loc. R. 105.6 (D. Md. 2023). For the reasons set forth below, the Motion is DENIED. I. BACKGROUND1 Plaintiff lives in Millersville, Maryland. Am. Compl. ¶ 7. Her residential property is covered by an insurance policy with Defendant. Id. ¶ 7; ECF No. 9-2. On April 12, 2020, a storm caused damage to the roof of Plaintiff’s residence. Id. ¶ 8. Plaintiff reported the loss to Defendant

1 The facts described herein are drawn from allegations in the Amended Complaint and documents attached to the parties’ motion papers. The authenticity of the parties’ exhibits is not in dispute. and hired a third party, Semper Fi Public Adjusters (“Semper Fi”), to evaluate the claim and secure indemnification from Defendant. Am. Compl. ¶ 9; ECF No. 9-3. Semper Fi investigated the damages and concluded that the total claim was worth $86,535.87. Am. Compl. ¶ 14. Semper Fi submitted its evaluation to Defendant, but Defendant rejected the estimated claim value. Id. ¶ 12.

In a letter dated June 24, 2020, and addressed to Semper FI, Defendant stated it was “issuing payment in the amount of $1,997.37 as [Plaintiff’s] claim payment under the terms of” the insurance policy. ECF No. 9-3 (“June 24 Letter”). Later, in a letter dated August 20, 2020, and addressed to Plaintiff, Defendant stated, in part: “We have completed our investigation of your loss and have determined that there is coverage under your policy for some of your loss, while other areas of damage are excluded from coverage.” ECF No. 9-4 (“August 20 Letter”). The August 20 Letter cited “faulty or inadequate workmanship” as grounds for exclusion from coverage. Id. Notwithstanding Defendant’s statement that it had completed its investigation, it apparently continued to investigate the damage. Specifically, in a letter dated December 19, 2020, and addressed to Semper Fi, Defendant stated that it requested an engineer to inspect the damage. ECF No. 15-1 (“December 19 Letter”).2 In another letter dated February 1, 2021, and addressed

to Plaintiff, Defendant again stated it had “completed [its] investigation of [Plaintiff’s] loss,” and reiterated its conclusion that only part of the claimed loss was covered. ECF No. 15-2 at 1. Ultimately, Defendant paid Plaintiff $2,142.18. Am. Compl. ¶ 14. Thus, Plaintiff alleges Defendant still owes $84,393.69 on the claim. Id. On November 22, 2022, Plaintiff filed a complaint with the Maryland Insurance Administration (“MIA”). ECF No. 9-5 at 4. On April 25, 2023, the MIA found in favor of Defendant. ECF No. 9-6 at 15.

2 The December 19 Letter also references Plaintiff’s allegation that Defendant’s adjuster altered or “tampered with evidence of physical damage to the property.” Am. Compl. ¶ 13. On August 25, 2023, Plaintiff filed her initial Complaint in this Court against “Encompass Insurance Company,” alleging breach of contract and failure to settle claims in good faith. ECF No. 1. On November 21, 2023, Plaintiff filed her First Amended Complaint substituting “Encompass Home and Auto Insurance Company” as Defendant. See Am. Compl. Count I claims

Defendant breached the homeowner’s insurance policy by refusing to pay Plaintiff in accordance with the policy and Maryland law. ECF No. 7 ¶¶ 19–21. Count II alleges Defendant failed to settle the claim in good faith pursuant to Md. Code Ann., Cts. & Jud. Proc. § 3-1701 (“CJP 3-1701”). Am. Compl. ¶ 28. On November 29, 2023, Defendant filed a motion to dismiss the First Amended Complaint for lack of subject matter jurisdiction and arguing the statute of limitations bars Plaintiff’s claim. ECF No. 9 (the “Motion”). Plaintiff filed a response in opposition to the Motion, ECF No. 15, and Defendant filed a reply in support of the Motion, ECF No. 16.

II. STANDARD OF REVIEW A. Rule 12(b)(6) A motion to dismiss under Rule 12(b)(6) constitutes an assertion by a defendant that, even if the facts alleged by a plaintiff are true, the complaint fails as a matter of law “to state a claim upon which relief can be granted.” Fed. R. Civ. P. 12(b)(6). To survive a 12(b)(6) motion to dismiss, a plaintiff must plead enough factual allegations “to state a claim to relief that is plausible on its face.” Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). “A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 663 (2009). When considering a motion to dismiss, a court must take the factual allegations in the

complaint as true and draw all reasonable inferences in favor of the plaintiff. King v. Rubenstein, 825 F.3d 206, 212 (4th Cir. 2016). But “a plaintiff’s obligation to provide the grounds of his entitlement to relief requires more than labels and conclusions, and a formulaic recitation of the elements of a cause of action’s elements will not do.” Twombly, 550 U.S. at 555 (cleaned up). A complaint must contain factual allegations sufficient “to raise a right to relief above the speculative level.” Id. “[T]ender[ing] ‘naked assertion[s]’ devoid of ‘further factual enhancement’” does not

suffice. Iqbal, 556 U.S. at 678 (quoting Twombly, 550 U.S. at 557). Generally, in evaluating a motion to dismiss, the court cannot consider any evidence outside of the complaint. Hayes v. Md. Transit Admin., Civ. No. JRR-23-01195, 2023 WL 8829260, at *3 (D. Md. Dec. 21, 2023). “A court may consider documents attached to a motion to dismiss if the document is ‘integral to and explicitly relied on in the complaint and [if] the plaintiffs do not challenge its authenticity.’” Id. (quoting Am. Chiropractors Ass’n, Inc. v. Trigon Healthcare Inc., 367 F.3d 212, 234 (4th Cir. 2004)). A document is integral to the complaint when “by ‘its very existence, and not the mere information it contains, gives rise to the legal rights asserted.’” Chesapeake Bay Found. Inc. v. Severstal Sparrows Point, LLC, 794 F. Supp. 2d 602, 611 (D. Md. 2011) (quoting Walker v. S.W.I.F.T. SCRL, 571 F. Supp. 2d 801, 806 (E.D. Va. 2007)).

A party may move for dismissal under Rule 12(b)(6) based on a statute-of-limitations defense. See Manion v. N.C. Med. Bd., 693 Fed. App’x 178, 180 (4th Cir. 2017). Such motions, however, will be granted “only if the time bar is apparent on the fact of the complaint.” Id. (quoting Semenova v. Md.

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O'Brien v. Encompass Home and Auto Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/obrien-v-encompass-home-and-auto-insurance-company-mdd-2024.