According to the Opinion, the insured was apparently dissatisfied with the carrier’s claim evaluation and alleged that the insured had failed to evaluate the claim fairly and objectively, failed to complete a prompt and thorough investigation, failed to remit benefits promptly, failed to reasonably evaluate medical documentation, and failed to keep the insured fairly advised as to the status of the claim.
The court noted that the Plaintiff offered no further detailed facts to support these conclusory allegations.
As such, the Eastern District Court granted the carrier’s Motion to Dismiss and held that “bare-bones” conclusory allegations that are not accompanied by factual allegations are insufficient to raise the claims to a level of plausibility required to survive a Rule 12(b)(6) Motion to Dismiss. The court further noted that a Plaintiff must provide additional facts to show how the insured’s conduct was allegedly unreasonable and reckless.
Despite granting the Motion to Dismissed filed by the Defendants, the court did grant the Plaintiff leave to file an Amended Complaint to correct the errors noted.
Anyone wishing to review a copy of this decision may click this LINK. The companion Order can be viewed HERE.
I
send thanks to Attorney Lee Applebaum, the writer of the excellent Pennsylvania
and New Jersey Insurance Bad Faith Case Law Blog and member of the Philadelphia
Law Firm of Fineman, Krekstein & Harris for bringing this case to my
attention.
Check out Attorney Applebaum's excellent Bad Faith Case Law Blog HERE. It is my go-to resource for the latest Pennsylvania and New Jersey Bad Faith cases of note.
Check out Attorney Applebaum's excellent Bad Faith Case Law Blog HERE. It is my go-to resource for the latest Pennsylvania and New Jersey Bad Faith cases of note.
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