DEBELLIS v. FARMERS INSURANCE et al

Filing 16

ORDER granting in part and denying in part 4 Motion to Dismiss. Signed by Judge Arthur J. Schwab on 3/15/2018. (lmt)

IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF PENNSYLVANIA

JOHN DEBELLIS,
Plaintiff,
18cv0214
v.

ELECTRONICALLY FILED

FARMERS INSURANCE and MIDCENTURY INSURANCE COMPANY,
Defendants.
MEMORANDUM ORDER OF COURT
Presently before the Court in this breach of contract and bad faith case is Defendants’
Motion to Dismiss and Brief in Support of same. Doc. nos. 3, 7. Plaintiff filed a Response in
Opposition to Defendants’ Motion to Dismiss. Doc. no. 14. Defendant filed a Reply. Doc. no.
15. The Motion is now ripe for disposition and will be granted in part and denied in part.
I.

Standard of Review - Rule 12(b)(6)

In considering a Rule 12(b)(6) motion, Federal Courts require notice pleading, as
opposed to the heightened standard of fact pleading. Fed. R. Civ. P. 8(a)(2) requires only “‘a
short and plain statement of the claim showing that the pleader is entitled to relief,’ in order to
‘give the defendant fair notice of what the . . . claim is and the grounds on which it rests.’” Bell
Atlantic Corp. v. Twombly, 550 U.S. 554, 555 (2007) (quoting Conley v. Gibson, 355 U.S. 41, 47
(1957)).
Building upon the landmark United States Supreme Court decisions in Twombly and
Ashcroft v. Iqbal, 556 U.S. 662 (2009), the United States Court of Appeals for the Third Circuit

explained that a District Court must undertake the following three steps to determine the
sufficiency of a complaint:
First, the court must take note of the elements a plaintiff must plead to state a
claim. Second, the court should identify allegations that, because they are no more
than conclusions, are not entitled to the assumption of truth. Finally, where there
are well-pleaded factual allegations, a court should assume their veracity and then
determine whether they plausibly give rise to an entitlement for relief.
Connelly v. Steel Valley Sch. Dist., 706 F.3d 209, 212 (3d Cir. 2013) (citation omitted).
The third step requires this Court to consider the specific nature of the claims presented
and to determine whether the facts pled to substantiate the claims are sufficient to show a
“plausible claim for relief.” Covington v. Int’l Ass’n of Approved Basketball Officials, 710 F.3d
114, 118 (3d Cir. 2013). “While legal conclusions can provide the framework of a Complaint,
they must be supported by factual allegations.” Iqbal, 556 U.S. at 664.
This Court may not dismiss a Complaint merely because it appears unlikely or
improbable that Plaintiff can prove the facts alleged or will ultimately prevail on the merits.
Twombly, 550 U.S. at 563 n.8. Instead, this Court must ask whether the facts alleged raise a
reasonable expectation that discovery will reveal evidence of the necessary elements. Id. at 556.
Generally speaking, a Complaint that provides adequate facts to establish “how, when, and
where” will survive a Motion to Dismiss. Fowler v. UPMC Shadyside, 578 F.3d 203, 212 (3d
Cir. 2009).
In short, a Motion to Dismiss should not be granted if a party alleges facts, which could,
if established at trial, entitle him/her to relief. Twombly, 550 U.S. at 563 n.8.

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II.

Discussion

First, Defendants and Plaintiff agree that Defendant Farmers Insurance is not a proper
Defendant in this matter and that it should be dismissed from this lawsuit as a matter of law.
Accordingly, the portion of Defendants’ Motion seeking the dismissal of Farmers Insurance will
be granted, and this Court will dismiss Defendant Farmers Insurance from the instant lawsuit.
Next, Defendants argue that Plaintiff cannot assert a bad faith claim for first party
medical benefits. According to Defendant, Pennsylvania law does not recognize a bad faith
claim for failure to pay first-party medical benefits. See doc. no. 7, p. 3-4, citing 42 Pa.C.S.A.
§§ 1797, 8317 and Barnum v. State Farm Mut. Auto. Ins. Co. 635 A.2d 155 (Pa. 1993), rev’d on
other grounds 652 A.2d 1319 (Pa. 1994). Plaintiff counters by asserting that his claim is not just
based on the failure to pay first-party medical benefits; rather, he asserts that his claim raises
questions about the Defendants’ failure to Plaintiff’s pay wage loss and UIM benefits as well.
This Court finds that at this juncture of the pleadings the Complaint has adequately pled a
cause of action for bad faith with respect to UIM benefits and failure to pay his wage loss. See
doc. no. 1-2, ¶ 17-22. As for the legal argument that Plaintiff is not entitled to raise a bad faith
claim for Defendants’ alleged failure to pay first party medical benefits, this Court will defer
ruling on that matter until discovery is completed. The Court finds that discovery of any
evidence of the medical treatment sought by Plaintiff and medical expenses incurred may be
necessary to further prove Plaintiff’s inability work and thus, his wage loss and UIM claims.
Notably, Defendants argue that Plaintiff filed his UIM bad faith claim within two months of
submitting the UIM claim, and without supplying any of his medical records. Thus, the Court
finds that medical discovery could benefit both parties. In addition, the remaining Defendant

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may opt to re-raise its bad faith/failure to pay first party medical benefits issue in a Motion for
Partial Summary Judgment, once discovery is complete.

ORDER OF COURT
AND NOW, this 15th day of March, the Court GRANTS IN PART Defendants’ Motion
to Dismiss as to Defendant Farmers Insurance, but DENIES Defendants’ Motion in all other
respects.
s/Arthur J. Schwab
Arthur J. Schwab
United States District Judge
cc: All ECF counsel of record

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