Burkitt v. Metlife Auto & Home, et al

Filing 15

ORDER signed by Judge John A. Mendez on 8/21/2014 GRANTING defendant's 3 Motion to Dismiss. This case is DISMISSED with prejudice. (Marciel, M)

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1 2 3 4 5 6 7 8 9 UNITED STATES DISTRICT COURT 10 EASTERN DISTRICT OF CALIFORNIA 11 12 JENICE BURKITT, 13 16 2:14-cv-01294 JAM KJN Plaintiff, 14 15 No. v. ORDER GRANTING DEFENDANT’S MOTION TO DISMISS METLIFE AUTO & HOME METROPOLITAN PROPERTY & CASUALTY INSURANCE Co., and DOES 1 through 20, inclusive 17 Defendant. 18 19 This matter is before the Court on Defendant Metropolitan 20 Property and Casualty Insurance Company’s (“Defendant”) Motion 21 to Dismiss (Doc. #3) Plaintiff Jenice Burkitt’s (“Plaintiff”) 22 Complaint (Doc. #1). 23 Defendant filed a reply (Doc. #9). 24 Defendant’s motion is GRANTED. 1 25 /// Plaintiff opposes the motion (Doc. #7) and For the following reasons, 26 27 28 1 This motion was determined to be suitable for decision without oral argument. E.D. Cal. L.R. 230(g). The hearing was scheduled for July 23, 2014. 1 1 I. 2 FACTUAL ALLEGATIONS AND PROCEDURAL BACKGROUND Plaintiff is an individual resident of Oklahoma. Compl. 3 ¶ 2. Defendant is an insurance company registered and licensed 4 in California. 5 insurance policy from Defendant, effective November 27, 2008 to 6 May 27, 2009. 7 California. 8 injured in a car accident. 9 notified Defendant of her Medical Expense claim on May 8, 2009. Compl. ¶ 2. Compl. ¶ 4. Plaintiff purchased an auto Compl. ¶ 2. The subject policy was issued in On April 11, 2009, Plaintiff was Compl. ¶ 7. Plaintiff initially 10 Compl. ¶ 8. 11 advised her that she needed lumbar surgery. 12 February 24, 2010, Plaintiff notified Defendant of this 13 additional Medical Expense claim. 14 Medical Expense benefits for other claims submitted by 15 Plaintiff,” but “denied Plaintiff’s request for the balance of 16 her Medical Expense policy with regards to the recommended 17 [lumbar] surgery” in writing, on March 1, 2010. 18 the March 1, 2010 letter, Defendant noted that, because 19 Plaintiff “has not yet incurred the medical expenses of a 20 surgery, we are unable to consider payment for the remainder of 21 the Medical Payment limits.” 22 However, in early 2010, Plaintiff’s physicians Compl. ¶ 7. Compl. ¶ 8. On Defendant “paid Compl. ¶ 9. In Vaccarezza Dec., Ex. C. Subsequent to the March 1, 2010 letter from Defendant, 23 Plaintiff underwent an Independent Medical Examination (“IME”) 24 with Dr. Emily Friedman. 25 that Plaintiff undergo lumbar surgery. 26 10, 2012, Plaintiff requested that Defendant reconsider pre- 27 payment for the lumbar surgery, in light of Dr. Friedman’s 28 recommendation. Compl. ¶ 10. Compl. ¶ 11. Dr. Friedman recommended Compl. ¶ 10. On April Plaintiff alleges that Defendant 2 1 “handled this Medical Expense claim in bad faith” because it 2 “knew of the extent and nature of Plaintiff’s injuries and her 3 need for surgery, [but] refused to pay the balance of 4 Plaintiff’s Medical Expense coverage in order for Plaintiff to 5 obtain the recommended surgery.” 6 Compl. ¶ 12. On April 3, 2014, Plaintiff filed the Complaint (Doc. #1, 7 Ex. A) in Sacramento County Superior Court. On May 27, 2014, 8 Defendant filed the Notice of Removal (Doc. #1), alleging 9 diversity jurisdiction under 28 U.S.C. § 1332(a). The Complaint 10 alleges one cause of action: (1) “Bad Faith: Breach of Contract 11 of Covenant of Good Faith and Fair Dealing.” 12 13 II. OPINION 14 A. Judicial Notice 15 Defendant requests that the Court take judicial notice of 16 six documents, all of which relate to a separate state court 17 case between Plaintiff and Defendant, Jenice Burkitt v. MetLife 18 Auto & Home, et al., Sacramento County Superior Court, Case No. 19 34-2012-00122112: (1) Plaintiff’s Complaint for Declaratory 20 Relief; 21 (2) Defendant’s Motion for Summary Judgment; (3) Plaintiff’s 22 Opposition to Defendant’s Motion for Summary Judgment; 23 (4) Defendant’s Reply; (5) May 9, 2014 Minute Order/May 13, 2014 24 correspondence; and (6) Plaintiff’s Request for Dismissal with 25 Prejudice. (Doc. #10). 26 Generally, the Court may not consider material beyond the 27 pleadings in ruling on a motion to dismiss. 28 may take judicial notice of matters of public record, provided 3 However, the Court 1 that they are not subject to reasonable dispute. 2 Sherman v. Stryker Corp., 2009 WL 2241664 at *2 (C.D. Cal. 2009) 3 (citing Lee v. City of Los Angeles, 250 F.3d 668, 688 (9th Cir. 4 2001) and Fed. R. Evid. 201). 5 See, e.g., All six documents listed above are public court filings. 6 Furthermore, Plaintiff has not opposed Defendant’s request, and 7 the documents are not subject to reasonable dispute. 8 Defendant’s request is GRANTED. 9 B. Therefore, Discussion 10 Defendant argues that Plaintiff’s first (and only) cause of 11 action for breach of the implied covenant of good faith and fair 12 dealing should be dismissed because it is time barred. 13 6. 14 commence this action within two years of Defendant’s March 1, 15 2010 letter, which was an unequivocal denial of Plaintiff’s 16 claim. 17 letter “was not an unequivocal denial since Defendant made the 18 representations that future payments made [sic] be made and 19 since in fact Plaintiff’s Medical Expense claim remained ongoing 20 and active.” 21 developments subsequent to the March 1, 2010 letter indicate 22 that that letter was merely a tentative denial. 23 Mot. at Specifically, Defendant contends that Plaintiff failed to Mot. at 6-7. Plaintiff responds that the March 1, 2010 Opp. at 5. Plaintiff also appears to argue that Opp. at 6. In diversity actions, federal courts apply the state law 24 statute of limitations. See Guar. Trust Co. of N.Y. v. York, 25 326 U.S. 99, 110 (1945) (noting that, “[a]s to consequences that 26 so intimately affect recovery or non-recovery a federal court in 27 a diversity case should follow State law”). 28 arguments in favor of and in opposition to the motion focus 4 The parties’ 1 primarily on a two year statute of limitations for Plaintiff’s 2 claim for breach of the implied covenant of good faith and fair 3 dealing. 4 § 335.1 and § 339.1). 5 law, “[a] claim for [breach of] the covenant of good faith and 6 fair dealing has a two year statute of limitations when it 7 sounds in tort, and a four-year statute of limitations if it 8 sounds in contract.” 9 at *4 (N.D. Cal. Jan. 2, 2012) (citing Love v. Fire Ins. Exch., Mot. at 6 (citing Cal. Civ. Proc. Code Opp. at 6. However, under California Fehl v. Manhattan Ins. Grp., 2012 WL 10047 10 221 Cal.App.3d 1136 (1990)). 11 2010 denial occurred more than four years prior to Plaintiff’s 12 filing of the Complaint on April 3, 2014. 13 Court need not determine whether Plaintiff’s claim sounds in 14 tort (2 year statute of limitations) or contract (4 year statute 15 of limitations). 16 unequivocal denial, then Plaintiff’s claim is time-barred, even 17 under the more generous contract-based four year statute of 18 limitations. 19 Nevertheless, the alleged March 1, Accordingly, the If the March 1, 2010 letter constituted an Both parties agree that, for a bad faith claim against an 20 insurance company, the statute of limitations begins to run upon 21 the unequivocal denial of the insured’s claim. Mot. at 7. 22 at 5. See Migliore v. 23 Mid-Century Ins. Co., 97 Cal.App.4th 592, 604 (2002). 24 Accordingly, the central issue is whether the March 1, 2010 25 letter constituted an “unequivocal denial” of Plaintiff’s claim. 26 This is consistent with California law. Opp. Plaintiff alleges that she “requested the balance of her 27 Medical Expense policy on February 24, 2010,” so that she could 28 use that money to fund her lumbar surgery. 5 Compl. ¶ 8. 1 Plaintiff further alleges that, on March 1, 2010, “Defendants 2 denied Plaintiff’s request for the balance of her Medical 3 Expense policy with regards to the recommended surgery.” 4 ¶ 9. 5 1, 2010 letter constituted a denial of Plaintiff’s claim for 6 policy benefits for prospective lumbar surgery. 7 is consistent with the language of the March 1, 2010 letter, 8 which stated: Compl. 9 Thus, by the terms of Plaintiff’s own complaint, the March This allegation “As Ms. Burkitt has not yet incurred the medical expenses of a surgery, we are unable to consider payment for the remainder of the Medical Payment limits. However, if she obtains the surgery within the three year Medical Payment time limit, please forward the bills and records and we will review for any applicable payment at that time.” Vaccarezza Dec., Ex. C. 10 11 12 13 14 The Court finds that this letter unequivocally denies 15 Plaintiff’s request that Defendant pay for medical services not 16 yet incurred. 17 Plaintiff’s bad faith insurance claim began to run on March 1, 18 2010. Accordingly, the statute of limitations for 19 The Court does not find persuasive Plaintiff’s argument 20 that the March 1, 2010 letter was not an unequivocal denial. 21 Although Plaintiff notes that “Defendant had continued to 22 process and pay out Medical Expense benefits to Plaintiff,” 23 these payments were for undisputed expenses already incurred. 24 Opp. at 5. 25 future lumbar surgery was separate and distinct from her 26 approved claims for coverage of already-incurred medical 27 expenses. 28 for her bad faith insurance claim: “Defendants paid Medical The disputed claim for coverage of Plaintiff’s The terms of Plaintiff’s own Complaint set the scope 6 1 Expense benefits for other claims submitted by Plaintiff, 2 however, at issue is Defendants’ failure to tender the remaining 3 Medical Expense coverage based on Plaintiff’s need to undergo 4 lumbar surgery.” 5 the undisputed claims does not affect the denial of Plaintiff’s 6 disputed claim for expenses not yet incurred. 7 Therefore, Defendant’s continued payment of Moreover, Plaintiff’s citation to Migliore is misplaced. 8 Opp. at 5 (citing Migliore v. Mid-Century Ins. Co., 97 9 Cal.App.4th 592, 605 (2002). Plaintiff contends that Migliore 10 stands for the proposition that an unequivocal denial must 11 unambiguously rule out any possibility that further benefits 12 will be provided on the disputed claim. 13 Migliore, the court concluded that an insurer’s letter was an 14 unequivocal denial, in part because it stated that “no further 15 benefits will be provided beyond those previously paid.” 16 Migliore, 97 Cal.App.4th at 605. 17 Migliore also contained the following language: “This decision 18 is based upon the information available to us at this time. 19 you have any other information which you believe may effect 20 [sic] Mid-Century Insurance Company's decision on your claim, 21 please let us know so we can consider it.” 22 Cal.App.4th at 599. 23 the March 1, 2010 letter to review additional bills and records 24 “if [Plaintiff] obtains the surgery within the three year 25 Medical Payment time limit” is analogous to the language in the 26 Migliore letter. 27 statement of willingness to reconsider [a denial upon receipt of 28 further pertinent information] does not render a denial Opp. at 5. In However, the letter in If Migliore, 97 In the case at bar, Defendant’s offer in It is well settled California law that “a 7 1 equivocal.” 2 Allstate Ins. Co., 63 Cal.App.4th 135, 147-48 (1998)). 3 March 1, 2010 letter was unequivocal in its denial of 4 Plaintiff’s request to pre-pay benefits before the particular 5 medical expenses were incurred. 6 Migliore, 97 Cal.App.4th at 605 (citing Singh v. The Finally, Plaintiff’s subsequent Independent Medical 7 Examination (“IME”) – and Defendant’s consideration of the IME 8 recommendations – does not transform the March 1, 2010 letter 9 into an equivocal statement. Recently, the Ninth Circuit held 10 that an insurer’s reopening of a claim to consider additional 11 information does not reset the statute of limitations. 12 v. Deloitte & Touche, LLP Grp. Long Term Disability Plan, 749 13 F.3d 746, 751 (9th Cir. 2014). 14 “would discourage reconsideration by insurers even when 15 reconsideration might be warranted.” 16 Rather, the statute of limitations continues to run as long as 17 the insurer demonstrates “a clear and continuing repudiation of 18 a claimant's rights[.]” 19 present case, Defendant never wavered from its position that it 20 would not provide payments for medical expenses not yet 21 incurred. 22 consideration of the IME recommendations did not reset the 23 statute of limitations. 24 Gordon The court noted that such a rule Gordon, 749 F.3d at 751. Gordon, 749 F.3d at 750. In the Accordingly, Plaintiff’s IME and Defendant’s Plaintiff filed the Complaint on April 3, 2014, over four 25 years after the unequivocal denial of her claim in the March 1, 26 2010 letter. 27 action is time barred and Defendant’s Motion to Dismiss is 28 GRANTED WITH PREJUDICE. Accordingly, Plaintiff’s first and only cause of As Defendant’s statute of limitations 8 1 argument is dispositive, the Court need not reach Defendant’s 2 remaining arguments. 3 4 5 6 III. ORDER For the reasons set forth above, the Court GRANTS WITH PREJUDICE Defendant’s Motion to Dismiss: 7 IT IS SO ORDERED. 8 Dated: August 21, 2014 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 9

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