United States District Court, W.D. Pennsylvania
WADE A. SCHAUER, Plaintiff,
FIDELITY SECURITY LIFE INSURANCE COMPANY, Defendant.
ARTHUR J. SCHWAB, District Judge.
This is an insurance bad faith case under Pa.C.S.A. § 8371. This Court has diversity jurisdiction over the matter.
Presently before the Court are two motions: Defendant's Motion for Partial Judgment on the Pleadings (doc. no. 34) and Plaintiff's Motion for Judgment on the Pleadings. Doc. no. 36. Plaintiff filed a Brief in Opposition to Defendant's Partial Motion (doc. no. 37), and Defendant filed a Reply Brief in support its own Motion for Partial Judgment (doc. no. 34), which also included a Brief in Opposition to Plaintiff's Motion (doc. no. 36). See doc. no. 38. Plaintiff filed a Brief in support of his own Motion. Doc. no. 39. Counsel contacted the Court and represented that these matters are fully briefed and thus, ripe for adjudication.
After careful consideration of all the aforementioned submissions, the Court will DENY Defendant's Partial Motion (doc. no. 34), and will GRANT Plaintiff's Motion (doc. no. 36) by way of an Order filed contemporaneously with this Opinion. The Court's reasons for entering this Order will be discussed in detail below.
I. STANDARD OF REVIEW
Both Parties have filed a Motions for Judgment on the Pleadings pursuant to Federal Rule of Civil Procedure 12(c). Defendant filed a Motion for Partial Judgment on the Pleadings (doc. no. 34), while Plaintiff filed a Motion for Judgment on the Pleadings. Doc. no. 36.
Under Rule 12(c), judgment will not be granted unless the movant clearly establishes that no material issue of fact remains to be resolved and that he is entitled to judgment as a matter of law. See also Minnesota Lawyers Mut. Ins. Co. v. Ahrens, 432 Fed.Appx. 143, 147 (3d Cir. 2011).
Rule 12(b)(6), provides the standard of review applicable to motions for judgment on the pleadings and motions to dismiss. The Court is permitted to consider, in addition to the allegations of the Complaint, "documents that are attached or submitted with the complaint, ... and any matters incorporated by reference or integral to the claim, items subject to judicial notice, matters of public record, orders, [and] items appearing in the record of the case." Buck v. Hampton Twp. Sch. Dist., 452 F.3d 256, 260 (3d Cir. 2006).
Thus, when deciding a motion filed in accordance with Rule 12(c), a Court must accept the factual allegations as true and draw all reasonable inferences presented in the pleadings in the light most favorable to the plaintiff. Erickson v. Pardus, 554 U.S. 89, 93-94 (2007); Lum v. Bank of America, 361 F.3d 217, 223 (3d Cir.2004). If the facts alleged by the plaintiff are sufficient to "raise a right to relief above the speculative level" such that the plaintiff's claim is "plausible on its fact, " a complaint will survive a motion to dismiss, Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 570 (2007), or a motion for judgment on the pleadings, Turbe v. Gov't of Virgin Islands, 938 F.2d 427, 428 (3d Cir. 1991).
II. Factual Background
The following facts are undisputed (unless indicated otherwise) and material to this Court's analysis and decision.
Plaintiff purchased an Insurance Policy, number 71312N, from Defendant. Doc. nos., 27 and 30, ¶ 6. This Policy was attached to the Amended Complaint. Doc no. 27-1. The policy contains a page that bears the following heading:
OUTLINE OF COVERAGE INDVIDUAL DISABILITY INCOME INSURANCE Policy Form M-4025PA
Doc. no. 27-1, p. 2. The Court will therefore refer to this insurance policy as a "disability insurance policy."
The disability insurance policy indicates that Defendant will pay benefits to Plaintiff if six criteria are met. Id. The policy also notes that amount payable "will be to a maximum of 60% of [Plaintiff's] Monthly Earned Income on the date [Plaintiff] becomes Totally Disabled due to Injury or Sickness, not to exceed the Maximum Monthly Benefit Amount shown in the Schedule of Benefits." Id.
The disability insurance policy further indicates that Defendant "will not pay for a Disability caused by a Pre-existing Condition until after [Plaintiff] has been covered under this Policy for 24 months." Id., p. 5. With respect to a reduction of disability benefits, the disability insurance policy indicates: there will be a 50% reduction in benefits for individuals who are age 65 and older; benefits can be reduced for benefits payable under Workers' Compensation Law, Occupational Disease Law, the 4800 Time Benefit Plan, or similar ...