Carmona v. Travelers Casualty Insurance Company
Carmona v. Travelers Casualty Insurance Company
Opinion
¶1 Appellant Fabiola Carmona appeals from the district court's grant of Travelers Casualty Insurance Company of America's (Travelers) motion to dismiss. We affirm.
BACKGROUND
¶2 Carmona sued Badger Creek Associates LLC (Badger Creek) for personal injuries she sustained when she slipped and fell on ice in a common stairway at the Badger Creek Apartments in Salt Lake City. 1
¶3 Badger Creek carried liability insurance through Travelers. The insurance policy included an indemnity provision (the Coverage C provision), which stated that Travelers would "pay medical expenses" up to $5,000 "for 'bodily injury' caused by an accident" on Badger Creek's premises and that it would "make these payments regardless of fault." This provision explicitly excluded payments to "any insured."
¶4 When Carmona learned of this provision, she moved to amend her complaint to add Travelers as an additional defendant. In her proposed amended complaint, Carmona alleged that "Travelers owed [her] a contractual duty to pay medical bills" for her injuries, that Travelers knew about her injuries and had "failed to disclose the coverage to [her]," and that Travelers had "failed to pay those [medical] bills, without justification." The district court found that Carmona's motion to amend was futile and denied the motion. Specifically, the court determined that "Utah case law is
clear
regarding parties seeking to sue a tortfeasor's insurer" and that " 'a plaintiff
must
direct his action against the actual tortfeasor, not the [tortfeasor's] insurer.' " (Alteration in original) (quoting
Campbell v. Stagg
,
¶5 Thereafter, Carmona filed a second lawsuit against Travelers alone. 2 Carmona claimed that, because she suffered bodily injury as a result of the accident on Badger Creek's premises, she was "a third-party or intended beneficiary" under the Coverage C provision. According to Carmona, "Travelers owed [her] a contractual duty to pay medical bills" for her injuries, and "Travelers had refused to investigate and/or pay the claim." Carmona also asserted that Travelers had breached the Coverage C provision and the implied covenant of good faith and fair dealing "by failing to investigate or pay the claim."
¶6 Travelers moved to dismiss for failure to state a claim upon which relief could be granted, see Utah R. Civ. P. 12(b)(6), arguing that Carmona's claims were barred by res judicata and that Carmona lacked standing to pursue claims for breach of contract and breach of the implied covenant of good faith and fair dealing because she was not a party to the insurance contract. The district court granted Travelers' motion, finding that Carmona "is not an intended third-party beneficiary to the insurance contract between Travelers and Badger Creek." The court stated that "there is no statute and nothing about the insurance contract that would give [Carmona] privity of contract and standing to sue Travelers directly." In addition, the court granted Travelers' motion on res judicata grounds, finding that "the elements of claim[ ] preclusion and issue preclusion have been met in this case."
¶7 Carmona now appeals from the district court's grant of Travelers' motion to dismiss.
ISSUES AND STANDARDS OF REVIEW
¶8 Carmona raises two issues on appeal. First, she contends that the district court erred when it ruled that her claims against Travelers were barred by res judicata. Second, Carmona contends that the district court erred when it ruled that she was not an intended third-party beneficiary to the insurance contract between Travelers and Badger Creek. Because we agree with the district court that Carmona was not an intended third-party beneficiary to the contract, we need not rule on the district court's resolution of the res judicata issue. 3
¶9 We review the grant of a motion to dismiss for correctness, giving no deference to the district court's decision.
Lilley v. JP Morgan Chase
,
ANALYSIS
¶10 Carmona contends that she "is a third party beneficiary of Coverage 'C' of the Travelers insurance policy" and that Travelers was therefore required "to pay [her] medical bills directly." "Third-party beneficiaries are persons who are recognized as having enforceable rights created in them by a contract to which they are not parties and for which they give no consideration."
SME Indus., Inc. v. Thompson, Ventulett, Stainback & Assocs., Inc.
,
¶11 Carmona relies on case law from several other jurisdictions to assert her right to sue Travelers directly. Indeed, other jurisdictions have determined that plaintiffs in Carmona's position may qualify as third-party beneficiaries to insurance contracts.
See, e.g.
,
Donald v. Liberty Mutual Ins. Co.
,
¶12 However, that proposition is not consistent with Utah law on the subject. Under Utah law, "it is not enough that the parties to the contract know, expect or even intend that others will benefit from the contract. The contract must be undertaken for the plaintiff's direct benefit and the contract itself must affirmatively make this intention clear."
SME Indus.
,
¶13 Carmona is not explicitly mentioned in the contract and, consequently, falls into a very broad class of people that may be incidentally benefited from the contract. And, importantly, there is nothing in the Coverage C provision affirmatively suggesting that Travelers and Badger Creek intended that the contract directly benefit people injured on Badger Creek's property. Rather, the provision provides for limited coverage in favor of Badger Creek for certain small claims.
Cf.
Ron Case Roofing & Asphalt Paving, Inc. v. Blomquist
,
¶14 Carmona asserts that the Coverage C provision cannot be read as merely an indemnification clause, because it provides for payment regardless of the insured's fault.
See
Donald
,
¶15 Carmona also asserts that Travelers violated its duty of good faith and fair dealing by denying her claim. The district court does not appear to have directly addressed this claim, but we nevertheless conclude that it fails as a matter of law. "Utah law clearly limits the duty of good faith to first parties to insurance contracts. Consequently, only a first party can sue for breach of that duty."
Sperry v. Sperry
,
CONCLUSION
¶16 Because we determine that Carmona is not an intended third-party beneficiary to the contract between Badger Creek and Travelers, we agree with the district court that she has failed to state a claim for breach of the contract terms or breach of the covenant of good faith and fair dealing. Accordingly, we affirm the district court's dismissal.
Badger Creek is not a party to this case.
Judge William W. Barrett presided over the portions of the suit between Carmona and Badger Creek relevant to our review. Judge Royal I. Hansen presided over the suit between Carmona and Travelers.
At first blush, the district court's res judicata analysis does seem problematic.
See generally
Snyder v. Murray City Corp.
,
Case-law data current through December 31, 2025. Source: CourtListener bulk data.