You Win Some, You Lose Some

You Win Some, You Lose Some

See the full video at https://rumble.com/v3japk2-you-win-some-you-lose-some.html  and at https://youtu.be/awbewsSCtZM

Loann T. Phan-Kramer and Jonerik Kramer sued American States Insurance Company for underinsured motorist coverage, won, and collected. Then, they sued American States again asserting statutory bad faith, breach of contract/good faith and fair dealing, and loss of consortium.

In Loann T. Phan-Kramer and Jonerik Kramer v. American States Insurance Company, No. 2:23-cv-01867-JDW, United States District Court, E.D. Pennsylvania (September 14, 2023) the USDC took away part of plaintiffs claim and allowed the rest to proceed in a Solomon like decision.

BACKGROUND FACTS

On April 15, 2016, an underinsured motorist rear-ended Loann T. Phan-Kramer. She suffered a full thickness tear of her rotator cuff, as well as other neck and back injuries. At the time of the accident, American States Insurance Company insured Ms. Phan-Kramer, including underinsured motorist (“UIM”) benefits. After suing then settling with the other driver, Plaintiffs filed their UIM insurance claim with American States. American States denied that claim and Plaintiffs sued. At trial, the jury returned a verdict in Plaintiffs’ favor and the insurer satisfied the verdict.

DISCUSSION

The Tort of Bad Faith

The statute of limitations bars Plaintiffs’ claim. The statute of limitations on a bad faith claim is two years in Pennsylvania. The statute begins to run when the insurer first refuses to pay the claim. When the court denied Plaintiffs’ motion for leave to file a second amended complaint, the court concluded that the statute of limitations began to run on June 28, 2019, when American States denied their claim. Plaintiffs’ time to file this claim expired on June 28, 2021. Therefore, American States’s Motion on the bad faith claim was granted because it was barred by the statute of limitations.

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Breach of Contract/Loss of Consortium

The Third Circuit has adopted a bright-line rule that res judicata cannot bar claims that are predicated on events that postdate the filing of the initial complaint. Because Plaintiffs’ breach of contract and loss consortium claims both rely (at least in part) on American States’s conduct following the filing of the initial lawsuit, res judicata cannot preclude these claims.

American States acknowledged that the Amended Complaint “focus[es] . . . on the ways that American States supposedly acted in bad faith during the litigation and trial of the underlying UIM/consortium case.”

Because the bright-line rule bars the application of res judicata, American States’s Motion on the breach of contract and loss of consortium claims was denied.

Insurance companies, like every person and corporation, are imperfect. American States decided it did not owe UIM benefits to its insured, took the issue to trial and lost. It paid the judgment only to be sued for defending the original suit. The court found that the insured/plaintiffs filed their bad faith claim too late and dismissed that action only to allow the breach of contract and loss of consortium claims to proceed. The decision is a Pyrrhic victory for the plaintiffs since they already recovered in the initial suit the contract damages.

(c) 2023 Barry Zalma & ClaimSchool, Inc.

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About Barry Zalma

An insurance coverage and claims handling author, consultant and expert witness with more than 48 years of practical and court room experience.