Essis v. United Servs. Auto. Association, 2024 U.S Dist. LEXIS 226599 (U.S. Dist. Ct., Middle Dist. of Pa., December 16, 2024) (Kane, J.)
On June 21, 2018, Mr. Essis was involved in an automobile collision that occurred at “approximately 12:32 P.M. on Lincoln Way in Franklin County, Pennsylvania.” (Doc. No. 1 ¶ 7.) Mr. Essis was a passenger in an automobile operated by third party Rodney Sheaffer (“Mr. Sheaffer”) when an automobile in front of Mr. Essis and Mr. Sheaffer began to slow [*2] down. (Id. ¶¶ 8-9.) Mr. Sheaffer applied the brakes in response to the slowing vehicle, when, at the same time, Jada Loreman (“the tortfeasor”) “was operating her automobile behind Mr. Sheaffer’s automobile” and “failed to slow and caused her automobile to strike the rear end of Mr. Sheaffer’s automobile.”
Defendant issued Plaintiffs an automobile insurance policy under policy number 011125793U71027, which Plaintiffs assert was in effect on the date of the collision. (Id. ¶ 23.) Under Plaintiffs’ policy, the underinsured motorist protection limit was set at three hundred thousand dollars ($300,000) per person, and it could be “stacked times two vehicles for a total of” six hundred thousand dollars ($600,000). (Id. ¶ 24.) Thus, Plaintiffs began to pursue an underinsured motorist claim with Defendant. (Id. ¶ 28.) Plaintiffs provided various documents to Defendant including medical records and lien information concerning Mr. Essis’s injuries, condition, treatment, and prognosis. (Id. ¶ 29.) On December 21, 2022, Plaintiffs, through legal counsel, submitted a written demand to Defendant to tender an offer of the underinsured motorist coverage with documentation that Plaintiffs’ claims were worth more than the four hundred thousand dollars ($400,000) they received from Allstate and Liberty Mutual. (Id. ¶¶ 30-31.) On July 11, 2023, Plaintiffs sent supplemental documentation to Defendant in support of their claim.
The Court finds that Plaintiffs have sufficiently pleaded facts giving rise to a plausible inference of Defendant’s bad faith. First, the Court finds that Plaintiffs’ complaint pleads facts sufficient to support a plausible determination that Defendant failed to conduct a good faith investigation of the claim. The facts in the complaint state that Defendant denied Plaintiffs’ claim without (1) consulting physicians or (2) completing an IME. (Doc. No. 1 ¶ 34). Plaintiffs’ complaint further alleges that they submitted a written demand package containing “the opinions of four treating physicians and one physician assistant who had physically observed [Mr.] Essis and had reviewed [his] files.”
In addition, the Court finds that the complaint’s allegations of Defendant’s failure to communicate also gives rise to a plausible inference of bad faith. The Court notes that, as alleged by the complaint, nineteen months elapsed between Plaintiffs’ first written demand to Defendant and Plaintiffs’ filing of this action. Those allegations serve as evidence of bad faith not only on the ground of failure to communicate but also on the ground of delay. As alleged in the complaint, despite Plaintiffs’ proactive attempts to communicate with Defendant and provide it with relevant documents, Defendant communicated only three times over a span of nineteen months with Plaintiffs.
The Court finds that the allegations of Plaintiffs’ complaint, accepted as true, are sufficient to support a plausible inference that Defendant knew or recklessly disregarded its lack of a good faith investigation.
Given that Defendant initially denied Plaintiffs’ claim, later rescinded that decision, and then acknowledged both the complicated nature of Mr. Essis’s injuries and the fact that it may need an expert’s input in evaluating Plaintiffs’ claim, the Court can plausibly infer from the factual allegations in the complaint that Defendant knew or recklessly disregarded its lack of a good faith investigation.
For the foregoing reasons, Defendant’s motion to dismiss Count II of Plaintiffs’ complaint (Doc. No. 8) will be denied. An appropriate Order follows.
