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Never Underestimate the Requirement of Factual Averments in Pleadings (PA)

June 6, 2019

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<p style="text-align: justify;">Under Pennsylvania law, “[t]he limits of coverages available [for uninsured and UIM benefits] for an insured shall be the sum of the limits for each motor vehicle as to which the injured person is an insured.” 75 Pa. Cons. Stat. § 1738(a). In other words, “stacking” provides insureds with the ability to add coverages available from different vehicles and/or policies to provide a greater amount of coverage. Nevertheless, a named insured “may waive coverage providing stacking of uninsured or underinsured coverages in which case the limits of coverage available under the policy for an insured shall be the stated limits for the motor vehicle as to which the injured person is an insured.” 75 Cons. Stat. § 1738(b).</p>
<p style="text-align: justify;">In <a href=""><em>Pommells v. State Farm Ins.</em></a><a href=""></a>, the Court examined the factual averments in the complaint in determining whether to grant State Farm’s motion to dismiss. In July 2012, Latrisse Pommells (“Pommells”) signed a Pennsylvania Stacked Underinsured Coverage Limits (Acknowledgement of Coverage Rejection) (“Waiver”). The declarations page of the automobile insurance policy she obtained from State Farm listed three insured vehicles: (1) a 2013 Nissan; (2) a 2007 Nissan; and (3) a 2010 Dodge. In addition, the declarations page provided each vehicle included underinsured motorist coverage (“UIM”) coverage in the amount of $25,000 per person.</p>
<p style="text-align: justify;">The coverage dispute arose when Pommells sustained bodily injury while driving an insured vehicle. After settling her third-party tort claim for $23,000 (out of the available $25,000 in coverage) from the tortfeasor’s insurance carrier, she submitted a claim for underinsured motorist (“UIM”) benefits under her State Farm policy. When State Farm denied her claim, Pommells commenced the instant action against State Farm, asserting, <em>inter alia</em>, claims of breach of contract, Pennsylvania statutory bad faith, and common law bad faith. State Farm subsequently filed a motion to dismiss.</p>
<p style="text-align: justify;">In regard to the breach of contract claim, State Farm argued Pommells’ maximum amount of recovery was $25,000, as Pommells allegedly rejected stacking for the three vehicles when she signed the Waiver in July 2012. According to Pommells’ reply brief to State Farm’s motion to dismiss, however, Pommells allegedly added the 2013 Nissan to the policy after she executed the Waiver. Although State Farm acknowledged it would have been required to obtain a new Waiver from Pommells if a new vehicle was added to the policy after Pommells executed the Waiver, State Farm argued Pommells did not truly “add” a third vehicle to the policy; instead, State Farm asserted Pommells merely substituted one vehicle for another. After considering the foregoing, the Court turned to the Federal Rules of Civil Procedure – noting the determination of whether Pommells added or substituted a vehicle on the policy was irrelevant. Specifically, the Court held Pommells failed to include facts related to the procurement of coverage for her 2013 Nissan – an integral requirement to sustain her cause of action. Accordingly, the Court found no basis to conclude Pommells was entitled to UIM benefits above $25,000. Notwithstanding the deficiencies in her complaint, however, the Court granted State Farm’s motion to dismiss without prejudice – thereby, permitting Pommells to amend her complaint to include factual allegations to establish a claim for damages above $25,000.</p>
<p style="text-align: justify;">In addition, State Farm moved to dismiss Pommells’ claim for statutory bad faith, arguing the claim was insufficiently pled. The Court highlighted State Farm’s and Pommells’ respective arguments, which both centered on the question of whether Pommells did in fact “add” the 2013 Nissan to her policy with State Farm. Yet, like her breach of contract claim, the Court determined Pommells’ complaint only contained conclusory allegations in support of her claim for statutory bad faith as she failed to plead any factual allegations in support of her claim.</p>
<p style="text-align: justify;">While the Court did not dismiss Pommells’ complaint in its entirety, as the Court left open the ability for Pommells to file an amended complaint, this ruling illuminates the weight given to the averments in a complaint, and how, in the context of UM/UIM coverage disputes, attention to detail is pertinent for a plaintiff to survive a motion to dismiss.</p>
<p style="text-align: justify;">Thanks to Lauren Berenbaum for her contribution to this post. Please email <a href="">Vito A. Pinto</a> with any questions.</p>


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