Anderson v. The Standard Insurance Company
3:14-cv-00051
W.D. Ky.Oct 21, 2014Background
- Jo Anderson, former art teacher for Jefferson County Public Schools, held a disability policy issued to her employer by Standard.
- Anderson claimed she was disabled under the policy and submitted a claim; Standard denied coverage after an investigation.
- Anderson’s Amended Complaint asserts five counts, including UCSPA-based Count C, which Standard moved to dismiss.
- Standard used its own medical experts (not Kentucky-licensed) to evaluate Anderson’s claim during the investigation.
- The court analyzes whether Anderson pleads a plausible UCSPA claim and whether use of unlicensed experts violates Kentucky law.
- The court grants dismissal of Count C without prejudice and denies Standard’s motion to strike portions of the complaint.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether UCSPA claim is pled with specificity | Anderson says UCSPA violations occurred under listed acts. | Count C merely lists acts; lacks factual support for intentional misconduct. | Count C dismissed for lack of specific facts. |
| Whether use of unlicensed medical professionals violates Kentucky law and supports bad-faith claim | Standard’s reliance on unlicensed experts constitutes bad faith and licensing violation. | Use of unlicensed experts for investigation does not constitute practicing medicine; not a license violation. | No Kentucky Medical Practice Act violation; bad-faith claim fails. |
| Whether the complaint’s pleadings should be struck under Rule 12(f) | Introductory and procedural paragraphs are relevant pleadings. | Some sections are redundant or immaterial; should be stricken. | Strike motion denied for these sections; other arguments rejected as moot. |
Key Cases Cited
- Phelps v. State Farm Mut. Auto. Ins. Co., 736 F.3d 697 (6th Cir. 2012) (high threshold for punitive damages under UCSPA)
- Wittmer v. Jones, 864 S.W.2d 885 (Ky. 1993) (requires showing intentional misconduct or reckless disregard for UCSPA)
- Columbia Natural Res., Inc. v. Tatum, 58 F.3d 1101 (6th Cir. 1995) (pleading standards for civil actions under Twombly/Iqbal framework)