AUGUST 2018 BAD FAITH CASES: PLAINTIFF MUST SPECIFICALLY INCLUDE FACTS TO ADDRESS WHO, WHAT, WHERE, WHEN, AND HOW THE ALLEGED BAD FAITH CONDUCT OCCURRED; 13 EXAMPLES OF CONCLUSORY ALLEGATIONS (Western District)

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The court found the following allegations all conclusory in nature, and therefore insufficient to make out a bad faith claim. However, the plaintiff was given leave to amend to file an Amended Complaint. The court made clear that “Plaintiff must specifically include facts to address who, what, where, when, and how the alleged bad faith conduct occurred.”

The conclusory allegations are:

  1. by sending correspondence falsely representing that Plaintiff’s loss caused by a peril insured against under the Policy was not entitled to benefits due and owing under the Policy;

  2. in failing to complete a prompt and thorough investigation of Plaintiff’s claim before representing that such claim is not covered under the Policy;

  3. in failing to pay Plaintiff’s covered loss in a prompt and timely manner;

  4. in failing to objectively and fairly evaluate Plaintiff’s claim;

  5. in conducting an unfair and unreasonable investigation of Plaintiff’s claim;

  6. in asserting Policy defenses without a reasonable basis in fact;

  7. in flatly misrepresenting pertinent facts or policy provisions relating to coverages at issue and placing unduly restrictive interpretations on the Policy and/or claim forms;

  8. in failing to keep Plaintiff or their representatives fairly and adequately advised as to the status of the claim;

  9. in unreasonably valuing the loss and failing to fairly negotiate the amount of the loss with Plaintiff or their representatives;

  10. in failing to promptly provide a reasonable factual explanation of the basis for the denial of Plaintiff’s claims;

  11. in unreasonably withholding policy benefits;

  12. in acting unreasonably and unfairly in response to Plaintiff’s claim;

  13. in unnecessarily and unreasonably compelling Plaintiff to institute this lawsuit to obtain policy benefits for a covered loss, that Defendant should have paid promptly and without the necessity of litigation.

Dates of Decision: July 12, 2018 (Report and Recommendation) July 30, 2018 (Order adopting Report and Recommendation as Opinion of the Court)

Rosenberg v. Amica Mutual Ins. Co., Civil Action No. 18-406, 2018 U.S. Dist. LEXIS 117116 (W.D. Pa. July 12, 2018) (Kelly, M.J.) (Report and Recommendation), adopted as Opinion of District Court on July 30, 2018 (Fischer, J.)

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