CHARLES HOWLEY, Plaintiff, v. BANKERS STANDARD INSURANCE COMPANY, Defendant.
Civil Action No. 3:19-cv-2477-L
IN THE UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF TEXAS DALLAS DIVISION
August 14, 2020
Sam A. Lindsay, United States District Judge
MEMORANDUM OPINION AND ORDER
Before the court is Defendant Bankers Standard Insurance Company (“Defendant” or “Bankers“)
I. Factual and Procedural Background
Plaintiff Charles Howley (“Plaintiff” or “Mr. Howley“) brought this action in Dallas County Court at Law No. 1 against Defendant for damages stemming from a claim for hail and wind damage to his insured home (the “Property“). Defendant removed this action to federal court on October 18, 2019, asserting that complete diversity of citizenship between the parties exists and that the amount in controversy, exclusive of interest and costs, exceeds $75,000. Bankers filed its first Motion to Dismiss (Doc. 5) on October 25, 2019. On November 8, 2019, Mr. Howley, filed his First Amended Complaint (“Amended Complaint“) (Doc. 7) against Bankers, which mooted the previous Motion to Dismiss.
Specifically, Mr. Howley alleges that the adjuster, Shawn Lopriore (“Mr. Lopriore“), denied his claim for hail and wind damage to his roof, “including any prospective contractors’ overhead and profit.” Id. ¶ 13. He also alleges that the adjuster handled the claim in a manner that would ultimately result in the “denial or underpayment” of the claim, and that Mr. Lopriore “misrepresented that the damage preexisted the storm.” Id. ¶¶ 13-14. Further, Mr. Howley alleges that Mr. Lopriore intentionally misrepresented the terms of the Policy to underpay his claim and that Bankers “failed to attempt in good faith to effectuate a prompt, fair, and equitable settlement of the claim after liability became reasonably clear.” Id. ¶¶ 15-17.
On November 20, 2019, Bankers filed its Motion to Dismiss the First Amended Complaint (Doc. 9), asserting that Mr. Howley has failed to state a claim upon which relief can be granted with respect to all six claims. Mr. Howley did not file a response.
II. Legal Standard for Motion to Dismiss
To defeat a motion to dismiss filed pursuant to
In reviewing a
The ultimate question in a
III. Analysis
A. Breach of Contract
In his Amended Complaint, Mr. Howley alleges that under the terms of the Policy, Bankers agreed to pay the cost to repair, rebuild, or replace his Property “in the event it was damaged in exchange for [him] paying his premiums.” Pl.‘s Am. Compl. ¶ 22. He further alleges that Bankers “breached the contract by denying or underpaying the claim.” Id. ¶ 28. Additionally, Mr. Howley alleges that as a result of Bankers’ alleged breach of the insurance contract, he “has incurred damages” and “will continue to incur damages until the claim is paid.” Id. ¶ 29. Bankers, however, contends that Mr. Howley fails to identify any terms of the contract that Bankers breached by denying or underpaying the claim. Def.‘s Br. 7. Additionally, Bankers contends that Mr. Howley‘s allegations are conclusory and “insufficient to support a finding” that he may recover damages for his breach of contract claim. Id.
To prevail on a breach of contract claim and survive a
Accepting the facts alleged by Plaintiff as true, Mr. Howley‘s scant assertions of Bankers’ liability, without more, fail to meet the factual pleading standard to overcome Bankers’ Motion to Dismiss. First, Mr. Howley fails to identify which provisions of the contract Defendant allegedly breached that would impose liability against Bankers. He does not reference any specific policy statement, provision of the contract, or any documentation that obligated Bankers to pay his claim. Notably, Mr. Howley alleges that he submitted a valid claim, and Bankers “breached the contract by denying or underpaying the claim.” Pl.‘s Am. Compl. ¶ 28. This allegation is conclusory and fails to show how denial or underpayment of his claim constitutes a breach of the contract. Id. Additionally, it is unclear which action—denial or underpayment—is the basis of the alleged breach. Mr. Howley asserts that his claim was denied or underpaid; however, he has not pleaded sufficient allegations to warrant recovery under either theory, which ultimately fails to allow the court to make “the reasonable inference that the defendant is liable for the misconduct alleged.” Iqbal, 556 U.S. at 678.
As Mr. Howley has failed to plead sufficient facts necessary to support his allegations that Bankers breached the contract, the court need not address whether he suffered any damages. The court, therefore, determines that Mr. Howley failed to plead sufficiently an essential element of his breach of contract claim and, thus, it will grant Bankers’ Motion to Dismiss.
B. Unfair or Deceptive Acts or Trade Practices
Mr. Howley alleges that during the underwriting and negotiation of his Policy, Bankers made misleading and misrepresentative statements regarding the extent of coverage provided under the Policy. Pl.‘s Am. Compl. ¶ 31. He also alleges that during the investigation of his claim, Bankers misrepresented the extent of the damage to his home and made additional misleading statements regarding the scope of his coverage under the Policy. Id. ¶¶ 32-33. Additionally, Mr. Howley alleges that Bankers refused to pay his claim without conducting a reasonable investigation, and, as a result, he incurred damages.2 Id. ¶¶ 36-37.
In its Motion to Dismiss, Bankers contends that Mr. Howley has only recited “word for word” the statutory language of
To state a claim under the Texas Deceptive Trade Practices Act (“DTPA“) and survive a
The court determines that Mr. Howley has failed to state sufficiently a claim under the Texas Insurance Code or the DTPA. Specifically, Plaintiff‘s Amended Complaint states that Defendant allegedly misrepresented the terms of the Policy and the extent of the damage to the Property, but these allegations are devoid of any specific facts detailing Defendant‘s alleged misrepresentations. As Bankers correctly observes, Mr. Howley has only recited, word for word,
Moreover, claims arising under the DTPA and the Texas Insurance Code require a heightened pleading standard under
Mr. Howley‘s account of the alleged misrepresentation or deceptive acts by Bankers is too attenuated, general, and conclusory, and, ultimately, fails to demonstrate that Bankers committed a violation of the DTPA or the Texas Insurance Code. Accordingly, the court determines that Mr.
C. Breach of Common Law Duty of Good Faith and Fair Dealing
Mr. Howley alleges that Bankers breached the common law duty of good faith and fair dealing because it had no reasonable basis for denying the full benefits of his roof claim. Pl.‘s Am. Compl. ¶ 41. Specifically, he alleges that Bankers “orchestrated the investigation of his claim in a manner calculated to construct a pretextual basis for denial or underpayment” of the claim. Id. ¶ 42. Bankers contends that Mr. Howley has not alleged any specific facts showing how it breached its duty of good faith “once liability became reasonably clear,” and thus, his claim should be dismissed. Def.‘s Br. 11. Additionally, it contends that Mr. Howley “provides only conclusory statements” of the legal standard without any factual support. Id. The court agrees.
Under Texas law, a cause of action for breach of the duty of good faith and fair dealing exists when an insurer has no reasonable basis for denying or delaying payment of a claim, or when an insurer fails to determine, or delays in determining, whether there is any reasonable basis for denial. Higginbotham v. State Farm Mut. Auto. Ins. Co., 103 F.3d 456, 459 (5th Cir. 1997). To prevail on such a claim, the insured must set forth allegations to demonstrate the absence of a reasonable basis for denying or delaying payment of the claim and that the insurer knew, or should have known, that there was no reasonable basis for denying or delaying payment. Id.
Upon review of the Amended Complaint, the court determines that Mr. Howley has failed to plead sufficient facts to support his breach of the duty of good faith claim. While it is true that Texas law has imposed a duty on the insurer to act in good faith and deal fairly with the insured, “there is no duty beyond the contract itself.” Higginbotham, 103 F.3d at 460. In other words, absent
Additionally, while it unclear as to whether this cause of action is premised in contract or tort law based on Plaintiff‘s inartful pleading, “if a defendant‘s conduct is actionable only because it breaches the parties’ agreement, the claim is solely contractual in nature.” Higginbotham, 103 F.3d at 460. Without more, the court cannot determine whether Mr. Howley is attempting to plead this claim in contract or tort law.
To the extent Mr. Howley alleges extra-contractual conduct by Bankers, he fails to plead sufficient facts supporting his claim. Instead, his claim appears to be rooted in his disagreement with Bankers’ ultimate decision on the claim, which is insufficient to satisfy the elements of a breach of common law duty of good faith claim. The court, therefore, determines that Plaintiff failed to plead sufficient allegations supporting his breach of common law duty and good faith claim and, accordingly, it will grant Defendant‘s Motion to Dismiss on this claim.
D. Breach of the Prompt Payment of Claims Act
Mr. Howley contends that Bankers breached the Prompt Payment of Claims Act (“PPCA“) by failing to notify him “in writing of the acceptance or rejection of his claim.” Pl.‘s Am. Compl. ¶¶ 45-46. Mr. Howley further alleges that as a result of Banker‘s breach of the PPCA, he is entitled to $220,628.92 in damages, which is the entire cost to restore his home with an additional 10% penalty interest. Id. ¶ 47. Bankers asserts, however, that Mr. Howley again only pleads conclusory allegations and has not alleged facts showing how it “delayed payment beyond the time permitted
Based on the pleadings, the court determines that Plaintiff has failed to provide sufficient factual allegations to support his claim for breach of the PPCA. Specifically, he has failed to identify any specific provision of the contract that would explicitly require Bankers to pay his claim, and does not offer any dates that would shed light on what day the claim was filed and subsequently rejected. Further, an insurer can only be liable under the PPCA when it has been “found liable for breach of contract.” Higginbotham, 103 F.3d at 461. Mr. Howley‘s allegations fail to establish that Bankers is liable for a claim under the Policy, as he has failed to direct the court to any contractual provision, or any conduct beyond a contractual breach, that would impose liability. See Weiser-Brown Operating Co. v. St. Paul Surplus Lines Ins. Co., 801 F.3d 512, 518 (5th Cir. 2015). His allegations are, once again, entirely conclusory.
Additionally, as Mr. Howley has failed to plead successfully a breach of contract claim, this same deficiency will preclude him in successfully pleading a breach of the PPCA. Id. Accordingly, Mr. Howley has failed to plead sufficient facts supporting his claim for violations of the PPCA, and the court, therefore, will grant Defendant‘s Motion to Dismiss regarding this claim.
E. Breach of Express or Implied Warranty
Mr. Howley asserts that Bankers made “express or implied warranties” that “hail and windstorm claims will be paid in full,” and “that claims will be processed promptly.” Pl.‘s Am. Compl. ¶ 51. Mr. Howley also contends that he relied on the express or implied warranties because the representations “became part of the basis of the bargain.” Id. ¶ 52. Bankers argues that Mr. Howley has failed to plead sufficiently the alleged misrepresentations that form the basis of this cause of action. Def.‘s Br. 13. The court agrees.
(1) an affirmation or promise made by the seller to the buyer; (2) that such affirmation or promise was part of the basis for the bargain, (e.g. that the buyer relied on such affirmation or promise in making the purchase;) (3) that the goods failed to comply with the affirmation or promise; (4) that there was financial injury; and (5) that the failure to comply was the proximate cause of the financial injury to the buyer.
Lindemann v. Eli Lilly & Co., 816 F.2d 199, 202 (5th Cir. 1987) (citation omitted).
Here, Mr. Howley has failed to plead sufficiently the existence of any express warranty. As the Fifth Circuit explained in Brooks, Tarlton, Gilbert, Douglas & Kressler v. U.S. Fire Ins. Co., 832 F.2d 1358, 1375 (5th Cir. 1987), there is a difference “between promises [that] are merely terms of the contract and promises [that] rise to the level of warranties.” Id.; Beauty Mfg. Sols. Corp. v. Ashland, Inc., 848 F. Supp. 2d 663, 671 (N.D. Tex. 2012). Mr. Howley has not directed the court to any provision of the contract or any separate warranty created by Bankers by which it was bound. Without more, Mr. Howley has failed to plead sufficiently the existence of an express warranty, and, thus, the court cannot reasonably infer that one exists.
Moreover, while Texas has recognized the existence of an implied warranty that accompanies a contract for the repair or modification of goods or property, Plaintiff‘s pleadings offer no clarity as to whether he is asserting a claim for breach of an implied warranty of merchantability, or a claim for breach of an implied warranty of fitness for a particular purpose. See
F. Fraud
Plaintiff alleges that he was “duped” into purchasing the Policy because Bankers failed to disclose that “it will never pay claims absent a lawsuit,” and that Bankers also failed to disclose this material fact with the intent to induce him into purchasing insurance. Pl.‘s Am. Compl. ¶ 55. Bankers counters Mr. Howley‘s allegations by highlighting that his pleading fails to allege facts showing that it knew that any alleged misrepresentations were false. Def.‘s Br. 13. Defendant also contends that Mr. Howley does not allege sufficient facts showing that it intended him to act and rely upon its alleged misrepresentations, and that he failed to plead sufficient facts for his fraud claim with the particularity required by
Under Texas Law, the elements of fraud are:
(1) that a material representation was made; (2) the representation was false; (3) when the representation was made, the speaker knew it was false or made it recklessly without any knowledge of the truth and as a positive assertion; (4) the speaker made the representation with the intent that the other party should act upon it; (5) the party acted in reliance on the representation; and (6) the party thereby suffered injury.
Allstate Ins. Co. v. Receivable Fin. Co., 501 F.3d 398, 406 (5th Cir. 2007) (quoting In re FirstMerit Bank, N.A., 52 S.W.3d 749, 758 (Tex. 2001)). To satisfy
Based upon the allegations in Plaintiff‘s Amended Complaint, Mr. Howley has once again failed to plead allegations with particularity in support of his fraud claim. First, his Amended Complaint fails to meet the heightened pleading requirements of
Additionally, even assuming that Mr. Howley could set forth the factual basis to adequately plead that Bankers intended for him to rely on their misrepresentation, the allegations in his Amended Complaint still fall short. Plaintiff‘s pleadings fail to allege facts showing that Defendant knew that any alleged misrepresentations were false. Further, Mr. Howley has not identified which specific facts, if any, would allow this court to reasonably infer the basis of Bankers’ alleged intent to induce him to act on their misrepresentations. In sum, the allegations of fraud in Plaintiff‘s Amended Complaint are vague and fail to meet the heightened pleading requirements of
IV. Amendment of Pleadings
Mr. Howley did not respond to Defendant‘s Motion to Dismiss and, thus, did not request to amend his pleadings in the event the court determined that he failed to state a claim. The provision of
Based upon the applicable legal standard, the court determines that Plaintiff should not be permitted to replead his claims. Mr. Howley‘s Amended Complaint, which is nearly identical to his state court petition (Doc. 1-2), does not offer any clarity or expansion regarding the claims he brings before the court. Although Plaintiff amended his complaint, he did not respond to Defendant‘s Motion to Dismiss. For these reasons, the court determines that Plaintiff has stated his best case and determines that any further attempts at amendment would be futile and needlessly delay resolution of this action. Schiller, 342 F.3d at 567 (quoting Jacquez v. Procunier, 801 F.2d 789, 792 (5th Cir. 1986)). Moreover, as Plaintiff has not requested that this court allow amendment of his pleadings, he cannot expect such dispensation on appeal. Accordingly, the court will not allow any further amendment of Plaintiff‘s pleadings.
V. Conclusion
For the reasons herein stated, the court determines that Plaintiff has failed to plead sufficient allegations to support his claims for: (1) breach of contract; (2) unfair or deceptive acts or trade practices; (3) breach of common law duty of good faith and fair dealing; (4) breach of the
It is so ordered this 14th day of August, 2020.
Sam A. Lindsay
United States District Judge
