MAY 2011 BAD FAITH CASES COURT GRANTS SUMMARY JUDGMENT ON BAD FAITH AND BREACH OF CONTRACT CLAIMS AFTER INSURED FAILS TO ASSERT DISPUTE OF MATERIAL FACT (Philadelphia Federal)
The insured was injured in a motor vehicle accident in 2007. She had a policy with the insurer, under which the insurer would cover personal injury losses if incurred within two years of the date of the injury. She applied for benefits approximately one month after the accident.
On her application, the insured listed the injuries she suffered. She stated that she was unsure of the amount of medical bills generated so far and did not know how many further costs she would endure. She also stated that she did not suffer any wage losses because she was looking for a new job at the time of the accident. For almost the first nine months after the accident, the insurer covered all of the insured’s medical bills, but after an independent medical examination was performed at the request of the insurer, the insurer informed the insured that it would discontinue paying for medical benefits.
Plaintiff had started working as an architect in January 2008, and she alleged that she suffered wage losses for a month due to injuries resulting from the accident. The insurer requested a disability note from her physician, but the insured never provided one, so the insurer never paid any wage loss claim.
The insured filed a Complaint in December 2008, which contained counts for breach of contract and bad faith. The court sided with the insurer on all counts. Concerning the breach of contract claim, the court stated that the insured provided no evidence that the insurer failed to pay any medical bills in the past that it was supposed to cover, and she did not demonstrate a dispute of material fact over coverage for any future medical treatment, so it granted the insurer’s Motion for Summary Judgment for that count.
With respect to the bad faith claim, the court noted that “the finding of a reasonable justification for [an insurer]’s action in terminating [an insured’s] benefits precludes, as a matter of law, a finding of bad faith.” Here, the court ruled that the insurer did not breach the contract concerning past medical expenses, wage loss, or any other area, so the court had to also grant the insurer’s Motion for Summary Judgment on the bad faith claim.
Date of Decision: May 5, 2011
D’Orazio v. Hartford Ins. Co., Civil Action No. 09-CV-0403, United States District Court for the Eastern District of Pennsylvania, 2011 U.S. Dist. LEXIS 49418, (May 5, 2011) (Joyner, J.)