Vallino v. Columbia Accident & Health Insurance

6 Pa. D. & C.3d 434, 1978 Pa. Dist. & Cnty. Dec. LEXIS 331
CourtPennsylvania Court of Common Pleas, Alleghany County
DecidedMay 10, 1978
Docketno. GD 76-23227
StatusPublished

This text of 6 Pa. D. & C.3d 434 (Vallino v. Columbia Accident & Health Insurance) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, Alleghany County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Vallino v. Columbia Accident & Health Insurance, 6 Pa. D. & C.3d 434, 1978 Pa. Dist. & Cnty. Dec. LEXIS 331 (Pa. Super. Ct. 1978).

Opinion

FINKELHOR J.,

The above matter is before the court on the preliminary objections of defendant, Columbia Accident & Health Insurance Company, in the nature of a demurrer to counts two and three of plaintiff’s amended complaint and a motion to strike the claim for punitive damages. This suit stems from the refusal of defendant company to make payment to plaintiff-insured under a disability income policy and the unilateral cancellation of said policy. Plaintiff [435]*435seeks recovery, not only for breach of the insurance contract (count one) but in trespass for dereliction of the insurer’s duty to deal in good faith (count two) and misrepresentation of the terms of the agreement (count three). Defendant’s motion is limited to the trespass counts.

Thus, the issue underlying defendant’s preliminary objections is whether plaintiff-insured has stated a cause of action in tort for refusal to honor an insurance agreement. It is defendant’s position that plaintiffs relief, if any, is limited to an action in assumpsit and, further, that the facts, as stated, do not prove the alleged breach of faith.

It is well established that in ruling on preliminary objections in the nature of a demurrer, the court is limited to the facts, set forth in the pleadings, and must accept as true all well-pleaded material facts and the inferences reasonably deducible therefrom. A demurrer can only be sustained where it appears with certainty that plaintiff has failed to state a cause of action and any doubts must be resolved in plaintiffs favor: Firing v. Kephart, 466 Pa. 560, 353 A. 2d 833 (1976); Bear v. Reformed Mennonite Church, 462 Pa. 330, 341 A. 2d 105 (1975); Clouser v. Shamokin Packing Co., 240 Pa. Superior Ct. 268, 361 A. 2d 836 (1976).

The facts, as set forth in the complaint, are briefly as follows.

On or about November 12, 1974, defendant, a Pennsylvania-based insurance company, issued a guaranteed renewal disability income insurance policy to plaintiff to provide disability insurance of 24 monthly payments at $300 per month in the event of total disability. The effective date of the policy was September 12, 1974, with an initial premium payment of $101 and $91 to be paid [436]*436semi-annually thereafter. A copy of the policy was attached to plaintiffs complaint and included an endorsement to exclude disabilities resulting from disc disorders or “any disorder of the spine, sacroiliac or lumbar region or complications thereof.” The policy further provided for renewal until the age of 65 by the timely payment of premiums.

Premiums were paid by plaintiff in a timely fashion up to and including March of 1975 when plaintiff was injured1 at work. Proper notice was given of the injury to defendant but the disability payment of $300 per month, as set forth in the policy, was refused.

Plaintiff further alleges that defendant-insurer unilaterally and without notice cancelled the policy and seeks punitive or exemplary damages.

It is plaintiffs contention, under the facts alleged, that defendant breached its implied duty of good faith and fair dealing in handling the claim of plaintiff and terminating the agreement and that, under the Unfair Insurance Practices Act of July 22, 1974, P.L. 589, 40 P.S. §1171.1 et seq., the insured may bring an action in trespass to recover for damages caused by unfair insurance practices including punitive damages. It is plaintiffs further contention that the cancellation of the policy was contrary to the terms of the policy itself and therefore the essential elements of a cause of action of misrepresentation are present. Plaintiff admits that there are no Pennsylvania cases specifically on this issue, but argues that changes in the law in other jurisdictions should be applied by the Pennsylvania courts.

[437]*437Defendant alleges, in its brief, that the insured failed to supply correct information in the application for the insurance policy. Ultimately, this may be a justification for defendant’s refusal to pay and cancellation of the policy, but it is not properly before the court on preliminary objections.

LIABILITY IN TORT

The traditional view that an insurance agreement is governed solely by the principles of contract law and that the breach of said agreement is limited to an action under the terms of the contract has been under judicial scrutiny in Pennsylvania and other jurisdictions. As noted by scholarly commentators, 2 the financial disparity of the parties to the insurance agreement produces unequal bargaining power. A contract of insurance, as opposed to an agreement between equals, may not be the result of a bargained-for exchange and the insured has little choice as to the terms of the agreement: Brakeman v. Potomac Ins. Co.

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Bluebook (online)
6 Pa. D. & C.3d 434, 1978 Pa. Dist. & Cnty. Dec. LEXIS 331, Counsel Stack Legal Research, https://law.counselstack.com/opinion/vallino-v-columbia-accident-health-insurance-pactcomplallegh-1978.