Skinner v. Horace Mann Ins. Co.
Skinner v. Horace Mann Ins. Co.
Opinion of the Court
R. Bryan Harwell, United States District Judge *650This matter is before the Court on Defendant's motion to dismiss filed pursuant to Fed. R. Civ. P. 12(b)(6). See ECF No. 16. The Court grants in part and denies in part Defendant's motion for the reasons herein.
Background
On February 10, 2014, Plaintiff Annie Skinner was "severely injured and suffered extensive property damage" when she was involved in an automobile accident with Andrew Poston and another driver. Amended Complaint [ECF No. 1-1] at ¶ 11; Am. Compl. Exh. A [ECF No. 1-1 at p. 21]. At the time, Defendant Horace Mann Insurance Company insured Poston through an automobile insurance policy providing bodily injury liability limits of $ 50,000 per person/$ 100,000 per accident and a property damage liability limit of $ 50,000 per accident.
In April 2014, Defendant issued Plaintiff two checks totaling $ 7,547, and in May 2014, both checks cleared the bank. See Am. Compl. Exh. E [ECF No. 1-1 at p. 40].
On February 12, 2015, Plaintiff's counsel sent Defendant a demand letter offering to settle all claims against Poston in exchange for the full amount of Poston's liability insurance policy limits-$ 100,000 (i.e., both the $ 50,000 bodily injury liability limit and the $ 50,000 property damage liability limit). See Am. Compl. Exh. A; ECF Nos. 16-5 & 16-6. The nine-page letter (laden with lengthy footnotes) set a two-week deadline, imposed various requirements and conditions, and had over 200 pages of attachments primarily consisting of Plaintiff's medical records.
On February 20, 2015, Defendant sent Plaintiff's counsel a check for the $ 50,000 bodily injury liability limit and a proposed settlement agreement (and a covenant not to enforce judgment). See Am. Compl. at ¶ 16; Am. Compl. Exh. B [ECF No. 1-1 at pp. 30-34]; Am. Compl. Exh. C [ECF No. 1-1 at pp. 36-37]. However, on March 5, 2015, Plaintiff's counsel returned the $ 50,000 check in a letter asserting Defendant "failed to comply with the terms of" the February 12, 2015 offer because
the Offer of Compromise called for payment under all applicable policies, which necessarily includes any applicable BI or PD policies, as well as umbrella coverage, if any. It is our understanding that the policy in question provides, at a minimum, for $ 50,000 in per person bodily injury coverage and $ 50,000 in per occurrence property damage coverage.
*651However, the check sent by Horace Mann was only for $ 50,000, an amount less than the applicable policy limits.... Therefore, we have been forced to return the check to you and file suit against your insured.
Am. Compl. Exh. C; see Am. Compl. at ¶ 17.
On March 13, 2015, Defendant's attorney sent a letter to Plaintiff's counsel stating, "I do not understand why you returned the check." Am. Compl. Exh. D [ECF No. 1-1 at pp. 38-39]; see Am. Compl. at ¶ 18. The letter further stated:
In your March 5, 2015 letter, you claim there is Fifty Thousand Dollars ($ 50,000.00) of liability coverage for bodily injury claims and Fifty Thousand Dollars ($ 50,000.00) in coverage for property damage coverage. It is my understanding that this representation is correct. However, you did not make an additional property damage claim in your February 12, 2015 demand letter, and the property damage claim previously presented has been settled. Therefore, there is no property damage claim for the coverage to apply. Was there something that was missed?
The purpose of this letter is to re-offer the Fifty Thousand Dollars ($ 50,000.00) of bodily injury coverage on a Covenant Not to Enforce Judgment basis. Secondly, to ask you if you have some property damage for which you want to make a claim? Finally, please clarify your position because I'm not clear why you are rejecting the tender of the applicable limits. If you have some other basis for rejecting Horace Mann's offer and Covenant Not to Enforce Judgment[,] please let me know because there is nothing that I am aware of from my review that Horace Mann has done to prejudice your client. Please let me hear from you.
Am. Compl. Exh. D.
On April 6, 2015, Plaintiff filed a negligence lawsuit against Poston in state court.
On July 14, 2017, Plaintiff and Poston entered into an "Assignment, Covenant to Postpone Execution and Agreement to Cooperate in Litigation." See Am. Compl. at ¶ 39; ECF No. 17-9. Under this agreement, Poston "irrevocably assign[ed]" Plaintiff "all legally assignable rights, remedies, titles, and/or interest in his claim for damages against Horace Mann," including "contract/tort claims ... arising from the failure of Horace Mann to accept [Plaintiff]'s reasonable offer to settle for [Poston]'s policy limits." ECF No. 17-9 at p. 2.
Thereafter, Plaintiff filed the instant action in state court against Defendant. See ECF No. 1 at p. 1. On February 1, 2018, Plaintiff filed an amended complaint asserting four causes of action: (1) breach of contract, (2) negligence/gross negligence, (3) bad faith, and (4) negligence per se. See Am. Compl. at ¶¶ 41-87.
On April 5, 2018, Defendant removed the action to this Court based on diversity *652jurisdiction pursuant to
Legal Standard
"To survive a Rule 12(b)(6) motion, the complaint must contain sufficient factual matter, accepted as true, to state a claim to relief that is plausible on its face." Elliott v. Am. States Ins. Co. ,
The Fourth Circuit has explained that documents attached to the complaint as well as documents submitted with the motion to dismiss may be considered in certain circumstances:
A motion to dismiss tests the sufficiency of a complaint, and our evaluation is thus generally limited to a review of the allegations of the complaint itself. However, we also consider documents that are explicitly incorporated into the complaint by reference, and those attached to the complaint as exhibits. And, ... we may consider a document submitted by the movant that was not attached to or expressly incorporated in a complaint, so long as the document was integral to the complaint and there is no dispute about the document's authenticity.
Goines v. Valley Cmty. Servs. Bd. ,
Discussion
Defendant argues it "is entitled to dismissal of Plaintiff's claims because, as a matter of law, [it] had no duty under the Tyger River[
As mentioned above, Plaintiff asserts four causes of action in her amended complaint: (1) breach of contract, (2) negligence/gross negligence, (3) bad faith, and (4) negligence per se.
The Court concludes the amended complaint states plausible claims for breach of contract and bad faith . As for breach of contract, the amended complaint sufficiently alleges that Poston
*654However, the Court concludes the amended complaint fails to state plausible claims for negligence/gross negligence and negligence per se . As for negligence/gross negligence, the crux of this cause of action is that Defendant was negligent in processing, handling, and adjusting Plaintiff's claim against Poston and that Defendant's conduct was a "breach of the covenant of good faith and fair dealing." See Am. Compl. at ¶¶ 47-53. The negligence/gross negligence claim is duplicative of the bad faith claim, and as other judges in this District have recognized, a freestanding claim of negligence is improper in these specific circumstances. See Maranto v. State Farm , No. 2:98-cv-03131-PMD, ECF No. 19 at pp. 3-4 (filed Aug. 11, 1999) (citing Nichols
Conclusion
For the foregoing reasons, the Court GRANTS IN PART AND DENIES IN PART Defendant's motion to dismiss [ECF No. 16]. Plaintiff's only remaining claims are breach of contract and bad faith. The Court DIRECTS the parties to submit a proposed consent amended scheduling order (including an extension for the filing of dispositive motions) no later than March 4, 2019, for the Court's consideration.
IT IS SO ORDERED.
The Court decides the motion without a hearing pursuant to Local Civil Rule 7.08 (D.S.C.).
Defendant and Plaintiff both agree the amended complaint mistakenly alleges the property damage liability limit is $ 25,000 rather than $ 50,000. See ECF No. 16-1 at p. 3 n.2; ECF No. 17 at p. 2 n.2. Plaintiff explains this mistake is a scrivener's error, see ECF No. 17 at p. 2 n.2, and the attachments to the amended complaint and Defendant's motion confirm that limit is $ 50,000. See, e.g. , Am. Compl. Ex. C [ECF No. 1-1 at p. 36]; ECF No. 16-2 at p. 1 (policy declarations).
The other attachments were an affidavit from Poston and a South Carolina Traffic Collision Report Form. See ECF No. 16-5 at pp. 10-13.
It is unclear whether Plaintiff's counsel answered the March 13, 2015 letter before suing Poston.
In September and October 2015, additional correspondence occurred between Defendant's attorney and Plaintiff's counsel but did not result in a settlement. See Am. Compl. Exhs. E, F, & G [ECF No. 1-1 at pp. 40-42]. Defendant paid Plaintiff $ 50,090 in partial satisfaction of the judgment; thus, the unsatisfied portion of the judgment totals $ 4,949,910.
Various exhibits are attached to Defendant's motion and Plaintiff's response. See ECF Nos. 16-2 through 16-7; ECF Nos. 17-1 through 17-9. Neither party appears to contest the integrality or authenticity of the exhibits.
Tyger River Pine Co. v. Maryland Cas. Co. ,
As indicated above, Poston assigned his rights to Plaintiff. See generally BAC Home Loan Servicing, L.P. v. Kinder ,
Defendant asserts that these four elements "are frequently cited in bad-faith refusal to pay first party benefits" and that "[n]o South Carolina [c]ourt has recognized and applied these elements in the context of a bad faith third-party liability claim." ECF No. 19 at p. 5 n.2. However, the S.C. Supreme Court has explained that "the first-party cause of action [recognized in Nichols, supra ] is in reality merely a different aspect of the duty first identified by this Court in Tyger River"; that "[i]n Tyger River , we held an insurer's unreasonable refusal to settle within policy limits subjects the insurer to liability"; and that "[t]he application of the Tyger River Doctrine to an insurer's handling of a claim for first-party benefits was a natural extension of the policy behind the doctrine." Charleston Cty. Sch. Dist. v. State Budget & Control Bd. ,
The Court notes Defendant makes strong, compelling arguments regarding whether its refusal to pay the $ 50,000 property damage liability limit was reasonable or not. As Defendant points out, Plaintiff initially accepted the two checks for $ 7,547, and it was over six months later that her counsel sent the Tyger River demand letter seeking the full $ 50,000 property damage liability limit (in addition to the $ 50,000 bodily injury liability limit) but only identifying a lost phone and outfit as the sole additional property damage. When Defendant's attorney logically sent Plaintiff's counsel subsequent correspondence seeking clarification as to the additional property damage, Plaintiff's counsel refused to budge on the demand for the full policy limits. The case may very well be that Plaintiff's/her counsel's conduct was unreasonable-not Defendant's-but the Court is constrained by the legal standard for a Rule 12(b)(6) motion, which merely "tests the sufficiency of a complaint" but does not "resolve contests surrounding the facts, the merits of a claim, or the applicability of defenses." See King ,
In short, the strong arguments in Defendant's motion to dismiss are better raised and addressed by the Court via a motion for summary judgment. See, e.g. , Tucker v. Peerless Ins. Co. , No. 4:13-cv-01809-BHH,
On a related note, the Court cautions the parties that the five-million dollar verdict amount likely cannot be considered in determining whether Defendant's actions were unreasonable. See Howard v. State Farm Mut. Auto. Ins. Co. ,
In Nichols , the South Carolina Supreme Court explained: "Under our view of the bad faith cause of action, ... the jury is entitled to consider negligence on the issue of unreasonable refusal to pay benefits."
Section 38-47-10 addresses licensing requirements for insurance adjusters.
Reference
- Full Case Name
- Annie SKINNER, as Assignee of Andrew Poston v. HORACE MANN INSURANCE COMPANY
- Cited By
- 4 cases
- Status
- Published