SOLANO-SANCHEZ v. STATE FARM MUTUAL AUTO INSURANCE COMPANY

CourtDistrict Court, E.D. Pennsylvania
DecidedJanuary 24, 2020
Docket5:19-cv-04016
StatusUnknown

This text of SOLANO-SANCHEZ v. STATE FARM MUTUAL AUTO INSURANCE COMPANY (SOLANO-SANCHEZ v. STATE FARM MUTUAL AUTO 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
SOLANO-SANCHEZ v. STATE FARM MUTUAL AUTO INSURANCE COMPANY, (E.D. Pa. 2020).

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF PENNSYLVANIA ____________________________________

NIDIA SOLANO-SANCHEZ : Plaintiff, : : v. : No. 5:19-cv-04016 : STATE FARM MUTUAL AUTO : INSURANCE COMPANY, : Defendant. : ____________________________________

O P I N I O N Defendant’s Motion to Dismiss for Failure to State a Claim—DENIED

Joseph F. Leeson, Jr. January 24, 2020 United States District Judge

I. INTRODUCTION In this diversity action, Plaintiff Nidia Solano-Sanchez sues her automobile insurance provider, State Farm Mutual Auto Insurance Company (“State Farm”), for State Farm’s alleged failure to timely pay underinsured motorist benefits pursuant to an insurance policy. See generally, Solano-Sanchez’s Complaint (“Compl.”), ECF No. 1. State Farm has filed a motion to dismiss the Complaint under Federal Rule of Civil Procedure 12(b)(6), contending that the facts alleged fail to support (1) Solano-Sanchez’s cause of action for State Farm’s alleged bad faith, as well as (2) her request for attorneys’ fees on her breach of contract claim. See generally State Farm’s Memorandum in Support of its Motion to Dismiss (“State Farm’s Mem.”), ECF No. 9-10; see also Solano-Sanchez’s Memorandum in Opposition (“Opp’n. Mem.”), ECF No. 14-2. For the reasons set forth below, State Farm’s motion to dismiss is denied. II. BACKGROUND A. Facts Alleged in the Complaint1 On or about October 12, 2016, Solano-Sanchez was the driver of the last vehicle in a three-vehicle, rear-end automobile accident occurring in Reading, Pennsylvania. Compl. ¶ 8. As

a result of this accident, Solano-Sanchez sustained serious injuries to her back, spine, neck, upper extremities, lower extremities, and left leg, for which she subsequently sought medical attention. Id. ¶¶ 9-10. According to the Complaint, Solano-Sanchez’s injuries have left her in constant pain, and she believes she will require ongoing medical care. Id. ¶¶ 12-13. At the time of her automobile accident, Solano-Sanchez was covered by an automobile insurance policy issued by State Farm under policy number 2604022238002 (“the Policy”).2 Compl. ¶¶ 17, 24. The Policy provided for first-party underinsured motorist benefits in the amount of $15,000 per vehicle in accordance with the Pennsylvania Motor Vehicle Financial Responsibility Law. Id. ¶ 26. Solano-Sanchez paid all premiums under the Policy as required, and the terms of the Policy were in full force and effect at the time of the accident. Id. ¶¶ 19-20,

24. The Complaint avers that Solano-Sanchez met all the requirements to qualify for underinsured motorist benefits under the terms of her policy.3 Id. ¶ 21.

1 These facts are drawn from the Complaint and accepted as true, with all reasonable inferences drawn in Solano-Sanchez’s favor. See Lundy v. Monroe Cty. Dist. Attorney’s Office, No. 3:17-CV-2255, 2017 WL 9362911, at *1 (M.D. Pa. Dec. 11, 2017), report and recommendation adopted, 2018 WL 2219033 (M.D. Pa. May 15, 2018). With several noted exceptions, the Court’s recitation of the facts does not include conclusory assertions or legal contentions, neither of which need be considered by the Court in determining the viability of Solano-Sanchez’s claims. See Brown v. Kaiser Found. Health Plan of Mid-Atl. States, Inc., No. 1:19-CV-1190, 2019 WL 7281928, at *2 (M.D. Pa. Dec. 27, 2019). 2 Certain documents related to the Policy are attached to the Complaint as Exhibit A. 3 Although this allegation and several others included here might be considered “legal” rather than factual in nature, the Court incudes them for purposes of continuity and context. According to the Complaint, “at the very latest, on or about March 16, 2017,” State Farm received correspondence from Solano-Sanchez of an anticipated underinsured motorist claim arising out of the October 12, 2016 accident.4 Compl. ¶ 28. On March 2, 2018, State Farm advised Solano-Sanchez that she had “stacked” underinsured motorist benefits for three vehicles and that these stacked benefits were applicable to her underinsured motorist benefits claim.5 Id.

¶ 27. According to the Complaint, this meant that the available benefits under the policy totaled $45,000.00. Id. On or about January 12, 2018, Solano-Sanchez forwarded all relevant records to State Farm and sought State Farm’s consent to settle with the third-party insurance carrier of the tortfeasor, “The General,” for the available insurance amount of $15,000.00. Compl. ¶ 29. On January 16, 2018, State Farm granted consent for Solano-Sanchez to settle with the third-party insurance carrier and waived its subrogation rights.6 Id. ¶ 30. Solano-Sanchez subsequently entered into a settlement and release agreement with the tortfeasor and “The General” for $15,000.00. Id. ¶ 31.

On or about March 30, 2018, State Farm advised Solano-Sanchez that her underinsured motorist benefits claim was being “evaluated.”7 Compl. ¶ 32. On April 13, 2018, State Farm requested via telephone that Solano-Sanchez submit to an examination under oath (“EUO”), to which she agreed. Id. ¶ 33. State Farm informed Solano-Sanchez on April 19, 2018, that the law firm of Forry-Ullman had been assigned to conduct an EUO.8 Id. ¶ 34. On May 4, 2018, State

4 This and all subsequent correspondence from Solano-Sanchez referenced here was made through her counsel, Danielle Duffy. A copy of this correspondence is attached to the Complaint as Exhibit C. 5 A copy of this correspondence is attached to the Complaint as Exhibit B. 6 A copy of this correspondence is attached to the Complaint as Exhibit D. 7 A copy of this correspondence is attached to the Complaint as Exhibit E. 8 A copy of this correspondence is attached to the Complaint as Exhibit F. Farm, through Forry-Ullman, notified Solano-Sanchez that her EUO would take place on July 18, 2018.9 Id. ¶ 35. Solano-Sanchez subsequently requested that her EUO be held sooner, and she was given a new date of July 9, 2018, on which date her EUO was conducted at Forry- Ullman’s offices.10 Id. ¶ 36.

On or about July 20, 2018, Solano-Sanchez advised State Farm that she would settle her underinsured motorist benefits claim for the “stacked” policy limit of $45,000.00.11 Compl. ¶ 37. Several days letter, on or around July 23, 2018, State Farm, through counsel, advised Solano-Sanchez that it was awaiting arrival of several of her medical records, and after completing a review of these records it would likely direct her to undergo an independent medical examination (“IME”).12 Id. ¶ 38. On or about July 26, 2018, Solano-Sanchez requested that State Farm’s counsel advise her as to when her IME might be scheduled.13 Id. ¶ 39. In correspondence dated the following day, July 27, 2018, State Farm, through counsel, declined to provide a specific date for Solano-Sanchez’s IME, and instead reiterated that her IME would be scheduled once her records were received.14 Id. ¶ 40. On or around August 1, 2018, Solano-

Sanchez provided State Farm’s counsel with a copy of her most recent medical records and requested that State Farm advise her whether it needed anything else to schedule her IME. Id. ¶ 41.

9 A copy of this correspondence is attached to the Complaint as Exhibit G. 10 A copy of the transcript of Solano-Sanchez’s EUO is attached to the Complaint as Exhibit H. 11 A copy of this correspondence is attached to the Complaint as Exhibit I. 12 A copy of this correspondence is attached to the Complaint as Exhibit J. 13 A copy of this correspondence is attached to the Complaint as Exhibit K. 14 A copy of this correspondence is attached to the Complaint as Exhibit L. Between October 16, 2018, and February 27, 2019, Solano-Sanchez executed a “slew” of authorizations to release additional medical records to State Farm, including but not limited her records from “Dynamic Physical Therapy, St.

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SOLANO-SANCHEZ v. STATE FARM MUTUAL AUTO INSURANCE COMPANY, Counsel Stack Legal Research, https://law.counselstack.com/opinion/solano-sanchez-v-state-farm-mutual-auto-insurance-company-paed-2020.