MARCH 2015 BAD FAITH CASES: PLEADING FACTS ABOUT AN INSURER’S CONDUCT, WITHOUT PLEADING ADDITIONAL FACTS AS TO WHY THAT CONDUCT WAS UNREASONABLE, INTENTIONAL AND/OR RECKLESS, COULD NOT SET OUT A PLAUSIBLE BAD FAITH CLAIM UNDER TWOMBLY/IQBAL (Philadelphia Federal)
In Allen v. State Farm Mutual Automobile Insurance Company, the insured brought breach of contract and bad faith claims arising out of an uninsured motorist case. The insured had promptly filed an uninsured motorist claim after the accident, and alleged that she and the insurer “’failed to agree on the amount of uninsured motorist benefits’ that she is entitled to recover[, that the insurer], has not requested a defense medical examination … and has failed to ‘negotiate’ regarding the claim.”
The court dismissed the insured’s bad faith claim without prejudice. It applied the Third Circuit rule in Fowler to evaluate the motion to dismiss that claim, using a two-step approach that separates out the facts and legal theories: (1) look at the well-pleaded facts as true; and (2) then rule whether these facts set out a plausible claim for relief. A plaintiff needs to pleads facts that show an entitlement to relief, a plausible claim, vs. a possible claim.
After stripping out the legal conclusions and recitation of the bad faith claims elements, the court found there the facts pleaded did not set a plausible claim. There were no facts pleaded shedding light of the insurer’s reasonableness in not negotiating or conducting a medical examination, and there were no facts pleaded that it “knew or recklessly disregarded its lack of a reasonable basis in denying the claim.”
Plaintiff was given leave to amend to meet the pleading standards in an amended complaint, if she could.
