Landon v. Am. Family Mut. Ins. Co.
Opinion of the Court
On April 25, 2017, plaintiffs, Stephen and Dianne Landon, filed a complaint alleging breach of contract, bad faith, punitive damages, and vexatious refusal to pay against defendant, American Family Mutual Insurance Company. Docket 1. American Family moves to dismiss Count II (bad faith) and Count III (punitive damages) of the complaint for failure to state a claim under Federal Rule of Civil Procedure 12(b)(6). Docket 5. Plaintiffs oppose the motion. Docket 9. For the reasons that follow, the court denies American Family's motion to dismiss.
BACKGROUND
The facts alleged in the complaint, accepted as true, are as follows:
In June 2014, a hailstorm damaged plaintiffs' home and numerous other homes in their Sioux Falls, South Dakota, neighborhood. The hailstorm caused extensive *881damage to plaintiffs' shake shingle roof. At the time of the hailstorm, plaintiffs had in effect a homeowner's insurance policy with American Family that listed hail damage as a covered loss. After the hailstorm, plaintiffs timely filed a claim to American Family for the damage caused to their home.
Sometime after the plaintiffs submitted their claim, an authorized agent of American Family inspected plaintiffs' home and determined that the roof, gutters, and downspouts were damaged by the hailstorm. Based on that inspection, American Family determined that $2,810.75 was a reasonable amount to repair the damage. American Family had notice that the homes adjacent to plaintiffs' home as well as other homes in the neighborhood also suffered extensive hail damage. These homes, some of which were insured by American Family, were compensated for the full replacement value of the damage caused to the homes by the hailstorm.
Plaintiffs repeatedly told American Family that $2,810.75 was insufficient to fix the damage caused to their home by the hailstorm. Despite plaintiffs' numerous requests that American Family cover the full replacement value of the damage caused to their home, American Family continued to rely on its initial investigation when assessing the value of the damage to plaintiffs' home.
LEGAL STANDARD
A court may dismiss a complaint "for failure to state a claim upon which relief can be granted." Fed. R. Civ. P. 12(b)(6). "To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to 'state a claim to relief that is plausible on its face.' " Ashcroft v. Iqbal ,
The court determines plausibility by considering only the materials in the pleadings and exhibits attached to the complaint, drawing on experience and common sense, and viewing the plaintiff's claim as a whole. Whitney v. Guys, Inc. ,
A heightened pleading standard applies when a complaint alleges fraud or mistake. See Fed. R. Civ. P. 9(b). Under Federal Rule of Civil Procedure 9(b), a party alleging fraud or mistake "must state with particularity the circumstances constituting fraud or mistake." Thus, to satisfy Rule 9(b), the party alleging fraud "must typically identify the 'who, what, where, when, and how' of the alleged fraud."
*882BJC Health Sys. v. Columbia Cas. Co. ,
As described by the Eighth Circuit Court of Appeals, the particularity requirement of Rule 9(b) serves three important purposes:
First, it deters the use of complaints as a pretext for fishing expeditions of unknown wrongs designed to compel in terrorem settlements. Second, it protects against damage to professional reputations resulting from allegations of moral turpitude. Third, it ensures that a defendant is given sufficient notice of the allegations against him to permit the preparation of an effective defense.
Streambend Props. II, LLC v. Ivy Tower Minneapolis, LLC ,
DISCUSSION
American Family presents two primary arguments in support of its motion to dismiss. American Family first argues that plaintiffs' claims for bad faith and punitive damages are subject to dismissal because they fail to meet the heightened pleading standard of Rule 9(b). American Family next argues that even if plaintiffs' claims for bad faith and punitive damages are not subject to a heightened pleading requirement, the claims are still subject to dismissal because they fail to satisfy the notice pleading requirement of Rule 8(a)(2). Because this case is before the court on diversity jurisdiction, the court will apply South Dakota's substantive law and federal procedural law to resolve American Family's motion to dismiss. Gasperini v. Ctr. for Humanities, Inc. ,
I. Count II: Bad Faith
Bad faith litigation arises in either the first- or third-party context. Hein v. Acuity ,
In Dakota, Minnesota & Eastern Railroad Corp. v. Acuity ,
*883[F]or proof of bad faith, there must be an absence of a reasonable basis for denial of policy benefits [or failure to comply with a duty under the insurance contract] and the knowledge or reckless disregard [of the lack] of a reasonable basis for denial, implicit in that test is our conclusion that the knowledge of the lack of a reasonable basis may be inferred and imputed to an insurance company where there is a reckless disregard of a lack of reasonable basis for denial or a reckless indifference to facts or to proofs submitted by the insured.
Under these tests of the tort of bad faith, an insurance company, however, may challenge claims which are fairly debatable and will be found liable only where it has intentionally denied (or failed to process or pay) a claim without a reasonable basis.
When determining whether an insurer had a fairly debatable reason to deny a claim or whether the insurer acted unreasonably when denying a claim, courts view the decision "at the time the insurer made the decision to deny or litigate the claim, rather than pay it."
A. Whether plaintiffs' first-party bad faith claim is subject to heightened pleading requirements under Federal Rule of Civil Procedure 9(b) ?
Irrespective of the above-described substantive law of first-party bad faith in South Dakota, American Family argues that the substance and construction of plaintiffs' bad faith allegations here requires plaintiffs to plead their allegations with particularity under Rule 9(b). See Docket 6 at 6-7; Docket 11 at 2-4. Plaintiffs disagree and instead contend that the notice pleading under Rule 8(a)(2) is the applicable pleading standard. Docket 9 at 4-6. Central to the parties' arguments regarding the applicable pleading standard for plaintiffs' claims is the court's recent decision in Haney v. American Family Mutual Ins. Co. ,
The facts of Haney are as follows: In June 2014, Haney's roof was damaged in a hailstorm that hit Sioux Falls, South Dakota.
Based on American Family's refusal to pay more than $3,890.15 on his claim, Haney filed a federal lawsuit against American Family alleging breach of contract, bad faith, punitive damages, and vexatious refusal to pay.
As observed by the court in Haney , the South Dakota Supreme Court "has not directly addressed whether first-party bad faith is akin to fraud and thus subject to the heightened pleading requirements of Rule 9(b)." Id at 925. Thus, in order to determine whether first-party bad faith claims are grounded in fraud, the Haney court examined the foundation of South Dakota's law regarding third-party bad faith claims for guidance. See
Because the South Dakota Supreme Court had not explicitly determined whether first-party bad faith claims were grounded in fraud, the Haney court also analyzed whether other federal courts had applied Rule 9(b)'s particularity requirement to first-party bad faith claims. See id. at 926-27. The court's review revealed no case that had applied Rule 9(b) to a first-party bad faith case. Id. Thus, given the lack of authority supporting American Family's argument, the Haney court found "that the heightened pleading standards of Rule 9(b) do not apply to first-party bad faith claims under South Dakota law." Id. at 927. The Haney court then evaluated Haney's complaint using Rule 8(a)(2) and concluded that the complaint stated a plausible claim for relief sufficient to defeat American Family's motion to dismiss. Id. at 927-28.
Here, plaintiffs urge the court to adopt the rationale from Haney and deny American Family's motion to dismiss. Docket 9 at 4-6. American Family argues that Haney -if the decision is correct-is distinguishable from the plaintiffs' case. See Docket 6 at 6. The distinguishing fact, according to American Family, is that unlike the plaintiff in Haney , plaintiffs here have "erased any distinctions that may exist between bad faith and fraud by asserting a theory of bad faith that is inescapably grounded in fraud." Docket 11 at 2. Thus, because plaintiffs "proceed on a theory of fraudulent bad faith," American Family argues that Rule 9(b) is the applicable pleading standard. Id. at 4 (emphasis omitted).
To support its argument that plaintiffs are required to comply with Rule 9(b), American Family notes that plaintiffs' complaint explicitly alleges fraud by statin *885g that "American Family's actions, including its claims-handling process, were undertaken with oppression, fraud, and malice." Docket 1 ¶ 45.
Plaintiffs vehemently disagree with American Family's interpretation of their theory of bad faith as well as with American Family's attempt to distinguish the court's decision in Haney . Docket 9 at 4-6. Plaintiffs contend that their single use of the word "fraud"-which is located in the punitive damages count of the complaint-does not require them to meet Rule 9(b)'s particularity requirement. Id. at 5. Plaintiffs further contend that American Family's failure to cite a single case where a court required a party to allege a first-party bad faith claim with particularity undermines American Family's entire argument. See id. at 5-6. Plaintiffs also note that while their use of the word "fraud" in the complaint was intentional, the term was not used in isolation. See id. at 5 (citing Docket 1 ¶ 45) (stating that the word fraud was used as a part of the string of terms "oppression, fraud, and malice"). Instead, plaintiffs argue that their sole purpose in using the word "fraud" in their complaint, was to mirror SDCL § 21-3-2,
Having reviewed the various arguments presented by the parties, the court concludes that plaintiffs are not required to plead their allegations with particularity under Rule 9(b). Several considerations inform the court's conclusion. First, because " Rule 9(b) is a special pleading requirement, contrary to the general approach of Rule 8, 'its scope of application should be construed narrowly and not extended to other legal theories or defenses.' " Haney ,
Third, while plaintiffs' complaint does use the word "fraud," the purpose of using the word was to mirror the relevant statutory authority that allows plaintiffs to seek punitive damages. See SDCL § 21-3-2 (indicating that where a defendant acted with "oppression, fraud, or malice" a jury can award punitive damages). Thus, the court is unpersuaded by American Family's argument that plaintiffs' singular use of the word "fraud," with the intention of mirroring the applicable statutory authority, transforms their argument into one that should be subject to the heightened pleading under Rule 9(b). See Wheeler , 125 F.Supp.3d at 840 (citations omitted) (concluding that the "singular mention" of deception in plaintiff's breach of contract claim did not "require the imposition of a heightened pleading standard, as the claim exist[ed] independent of any allegations of fraud or deception contained in the complaint"); cf. Zebrowski ,
Fourth, although the Eighth Circuit has observed that "[c]laims 'grounded in fraud' must meet [ Rule 9(b)'s] heightened pleading requirement[,]" Streambend ,
And fifth, to the extent that American Family's briefing in support of its motion to dismiss can be read to argue that this court should reach the opposite decision as the court in Haney -meaning the court would find that first-party bad faith claims are akin to fraud and thus subject to heightened pleading under Rule 9(b) -the court's own review of South Dakota's substantive law regarding first-party bad faith, supra , at 882-83, leads the court to reach the same result as the court in Haney . Supporting this conclusion are prior decisions of the South Dakota Supreme Court indicating that insurers must give equal consideration to an insured's interests when evaluating an insured's claim, even if those interests are adverse to the insurer's own interests. See Trouten v. Heritage Mut. Ins. Co. ,
B. Whether plaintiffs' first-party bad faith claim satisfies the requirements of Federal Rule of Civil Procedure 8(a)(2) ?
American Family argues that even under the notice pleading standard of Rule 8(a)(2), a fatal deficiency of plaintiffs' complaint is that the complaint "liberally insists that [American Family] engaged in bad faith conduct without bothering to allege specific facts to support this legal conclusion." Docket 6 at 8. According to American Family, the non-legal conclusions from plaintiffs' complaint are boiled down to five facts that are insufficient to support plaintiffs' allegations of bad faith. See
Plaintiffs respond by arguing that American Family's insistence on requiring plaintiffs to allege their bad faith claim using "specific facts" is inappropriate at the motion to dismiss stage. Docket 9 at 6. This is because at the motion to dismiss stage, the court is required to accept plaintiffs' well-pleaded allegations as true and draw all reasonable inferences in the plaintiffs' favor. See, e.g. , Schriener v. Quicken Loans, Inc. ,
After accepting the well-pleaded allegations in plaintiffs' complaint as true and drawing all reasonable inferences in plaintiffs' favor, Schriener ,
II. Count III: Punitive Damages
American Family also moves to dismiss plaintiffs' request for punitive damages. Docket 6 at 12-15. As previously noted by this court, "punitive damages are a form of relief and not a 'claim' that is subject to a Rule 12(b)(6) motion to dismiss." Benedetto v. Delta Air Lines, Inc. ,
CONCLUSION
American Family moves to dismiss Count II (bad faith) and Count III (punitive damages) of plaintiffs' complaint for failure to state a claim under Federal Rule of Civil Procedure 12(b)(6). The court finds that plaintiffs have stated a plausible claim for relief under South Dakota's substantive law regarding first-party bad faith. Plaintiffs' allegations of bad faith are subject to review under the pleading standard for Federal Rule of Civil Procedure 8(a)(2), and are not subject to the heightened pleading requirements of Federal Rule of Civil Procedure 9(b). Because plaintiffs have stated a plausible first-party bad faith claim, their claim for punitive damages also survives American Family's motion to dismiss. Thus, it is
ORDERED that American Family's motion to dismiss Counts II and III (Docket 5) is denied.
The Kunkel case is recognized as the origin of South Dakota's third-party bad faith cause of action. Haney ,
Paragraph 45 contains the sole reference to "fraud" in plaintiffs' complaint.
SDCL § 21-3-2 provides: "In any action for the breach of an obligation not arising from contract, where the defendant has been guilty of oppression, fraud, or malice ... the jury, in addition to the actual damage, may give damages for the sake of example, and by way of punishing the defendant."
During the court's own review of bad faith cases in federal courts, the court was unable to find a case that dismissed a plaintiff's bad faith claim for failure to plead that claim with particularity under Rule 9(b). In fact, the court's review indicated that several courts have reached the same result as the court in Haney and declined to apply Rule 9(b)'s particularity requirement to a plaintiffs's bad faith claim. See, e.g. , Zebrowski v. Am. Standard Ins. Co. of Wis. , Civ. 16-5018-JLV,
Given American Family's briefing here, it appears to the court that American Family has formulated a defense to plaintiffs' bad faith claim and is able to articulate that defense. Further, in the event that the facts uncovered in discovery prove not to support plaintiffs' bad faith claim, American Family will have the chance to dispose of the case at the summary judgment stage.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.