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Hackbarth v. Nationwide Mutual Insurance Co.

United States District Court, W.D. Pennsylvania

July 9, 2014

ROBERTD D. HACKBARTH, Plaintiff,
v.
NATIONWIDE MUTUAL INSURANCE COMPANY, Defendant.

OPINION AND ORDER

MAURICE B. COHILL, Jr., Senior District Judge.

In his Complaint, Plaintiff Robert D. Hackbarth ("Hackbarth") is seeking a declaratory judgment that he is entitled to payment from Defendant Nationwide Mutual Insurance Company ("Nationwide") for first party medical benefits pursuant to a motor vehicle insurance Policy he purchased from Nationwide. Plaintiff is also asserting a state law bad faith claim pursuant to 42 Pa.C.S.A. § 8371. In response, Defendant has filed a Motion to Dismiss Plaintiffs Complaint pursuant to Fed.R.Civ.P. 12(b)(6) for failure to state a claim upon which relief can be granted [ECF #9].

I. Standard of Review.

In Thompson v. Real Estate Mortgage Network, No. 12-3828, 2014 WL 1317137 (3d Cir. April 3, 2014), the appellate court recently stated that in ruling on a Rule 12(b)(6) Motion to Dismiss for failure to state a claim upon which relief can be granted:

Under the "notice pleading" standard embodied in Rule 8 of the Federal Rules of Civil Procedure, a plaintiff must come forward with "a short and plain statement of the claim showing that the pleader is entitled to relief." As explicated in Ashcroft v. Iqbal , 556 U.S. 662, 678 (2009), a claimant must state a "plausible" claim for relief, and "[a] claim has facial plausibility when the pleaded factual content allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged." Although "[f]actual allegations must be enough to raise a right to relief above the speculative level, " Bell Atlantic Corp. v. Twombly , 550 U.S. 544, 555 (2007), a plaintiff "need only put forth allegations that raise a reasonable expectation that discovery will reveal evidence of the necessary element." Flower, 578 F.3d at 213 (quotation marks and citations omitted); see also Covington v. Int'l Ass'n of Approved Basketball Officials , 710 F.3d 114, 117-18 (3d Cir. 2013).

Id. at *2. Further, in ruling on a Rule 12(b)(6) Motion to Dismiss for failure to state a claim upon which relief can be granted, a court must "accept all factual allegations as true, construe the complaint in the light most favorable to the plaintiff, and determine whether, under any reasonable reading of the complaint, the plaintiff may be entitled to relief." Phillips v. Cnty. of Allegheny , 515 F.3d 224, 233 (3d Cir. 2008) (quoting Pinker v. Roche Holdings Ltd. , 292 F.3d 361, 374 n. 7 (3d Cir. 2002)); see also Bell Atlantic Corp. v. Twombly , 550 U.S. 544, 563, n.8 (2007). Additionally, where, as here, exhibits are attached to the Complaint by the plaintiff, when deciding a motion to dismiss, courts can consider these exhibits in addition to the allegations contained in the complaint. Pension Ben. Guar. Corp. v. White Consol. Indus., Inc. , 998 F.2d 1192, 1196 (3d Cir.1993).

Further, if the court decides to grant a motion to dismiss for failure to state a claim upon which relief can be granted pursuant to Fed.R.Civ.P. 12(b)(6), the court must next decide whether leave to amend the complaint must be granted. As explained in Phillips, "[w]e have instructed that if a complaint is vulnerable to 12(b)(6) dismissal, a district court must permit a curative amendment, unless an amendment would be inequitable or futile." Phillips , 515 F.3d at 236 (citing Grayson v. Mayview State Hosp. , 293 F.3d 103, 108 (3d Cir.2002)).

II. Relevant Facts Alleged in Plaintiff's Complaint and exhibits attached to Complaint.

Plaintiffs 2001 GMC Sierra pick-up truck is insured through Nationwide under policy number 5437A752054 ("the Policy"). On February 2, 2013, Plaintiff had driven the truck to a Wal-Mart located in Grove City, Pennsylvania. Complaint, ¶ 6. The "weather conditions preceding Plaintiffs trip to Wal-Mart caused a significant buildup of ice and snow on the parking lot surface." Id. at ¶ 7.

After finishing his shopping, Plaintiff loaded items into the passenger side of the insured truck, walked around to the driver side of the vehicle, and opened the driver side door and began to step into the truck, holding onto the door with his left hand and the handle of the door with his right hand. Complaint, ¶¶ 5-8; April 4, 2103 Transcript of Recorded Statement attached to Complaint, p. 3. Then, "while in physical contact with the GMC Truck for purposes of entering the same to operate it, Plaintiff slipped and fell from partially within the vehicle to the ground, sustaining serious and permanent injuries, including but not limited to a fractured left femur." Complaint, ¶ 9. Plaintiff further explained in a recorded statement he made for Defendant that "I opened up the driver's door and [was] in the process of stepping onto the running board, and when I lifted my right leg to step up on the running board, uh, being the parking lot was slippery, slipped and I fell." Transcript of Recorded Statement, p. 3. At the time Plaintiff slipped, his foot was not yet on the running board; "I was stepping to put it up on, getting ready onto the running board." Id . Plaintiff further explained that one foot was on the ground. Id.

On March 20, 2013, Plaintiff filed a claim with Defendant for first party medical benefits under the Policy as a result of the injuries he suffered on February 2, 2013. Id. at ¶ 15.

The Policy, which was attached to Plaintiffs Complaint, first explains under the title "INSURING AGREEMENT, " that "we agree to provide the coverages the policyholder has selected. These selections are shown in the enclosed Declarations, which are part of this policy contract." Policy, D1. The Policy then explains under "DEFINITIONS" that "[t]his policy uses certain common words for easy reading. They are defined as follows." Id . Relevant to this case, the terms "OCCUPYING" and "BODILY INJURY" are then defined. Id . "OCCUPYING' means in, upon, entering, or alighting from." Id . "BODILY INJURY' means: a) physical injury, b) sickness; c) disease; or d) resultant death." Id.

Thereafter, the Policy contains a section entitled "FIRST PARTY BENEFITS." Id. at F1. Under "Coverage Agreement, " the Policy states:

This coverage provides First Party Benefit options in accordance with the Pennsylvania Motor Vehicle Financial Responsibility Law. The options and limits which the policyholder has selected are shown in the Declarations.
We will pay First Party Benefits for the bodily injury of an insured as a result of an accident that arises out of the maintenance or use of a motor vehicle as a motor vehicle.

Id. The Policy then states "INSUREDS" and explains that "the policyholder and relatives are covered while occupying or injured by any motor vehicle." Id.

At Defendant's request, on April 4, 2013, Plaintiff gave a recorded statement regarding the accident; the transcript of the statement was attached to Plaintiffs Complaint. Complaint, ¶¶ 18-19. He described the accident as occurring as follows:

A: "I opened up the driver's door and in the process of stepping onto the running board, and when I lifted my right leg to step up on the running board, uh, being the parking lot was slippery, slipped and I fell."
Q: "Okay, So did you have, uh, where were your feet placed then? Did you have, you said you had one foot one the ...

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