LEHMAN v. VICTORIA FIRE & CASUALTY INSURANCE COMPANY - Document 34
Court Description:
MEMORANDUM OPINION re: 22 Partial MOTION for Summary Judgment filed by VICTORIA FIRE & CASUALTY INSURANCE COMPANY. Signed by Judge William L. Standish on 6/16/2011. (md)
Loading PDF...
IN THE UNITED STATES DISTRICT COURT
FOR THE WESTERN DISTRICT OF PENNSYLVANIA
EARL LEHMAN,
Plaintiff,
vs.
Civil Action No. 09-1542
VICTORIA FIRE & CASUALTY
INSURANCE COMPANY,
Defendant.
MEMORANDUM OPINION
Pending before the
Court
is
a
motion
judgment brought by Defendant Victoria
Company ("Victoria H
),
partial
summary
re & Casualty Insurance
pursuant to Fed. R. Civ. P. 56 (Doc. No. 22.)
For the reasons discussed below,
Moreover,
for
Defendant's motion is granted.
inasmuch as the Court concludes that with dismissal of
Plaintiff's
bad
faith
aim
it
no
longer
has
subject
matter
jurisdiction, the case is remanded to the Court of Common Pleas of
Allegheny County.
I.
BACKGROUND
A.
Factual Background l
1.
Events occurring on the night of November 15 16, 2008:
Plaintiff Earl Lehman, a resident of the Hazelwood neighborhood of
Pittsburgh,
Pennsylvania, worked as an independent contractor for
a company called Halbleib' s Auto Body and Service ("Halbleib/l), also
located in Hazelwood.
Under a lease agreement with Mr. Lehman, the
repair shop purchased a 2007 GMC pickup truck which Mr. Lehman used
in his tow-truck business.
Mr. Lehman attached his own vehicle bed
to the truck and provided at his own expense a variety of equipment
commonly used in the business, e.g., lockout equipment, jacks, tow
chains, and emergency equipment.
Mr. Lehman was responsible for
maintenance of the truck, including insurance coverage.
In October
2008, Mr. Lehman purchased a vehicle insurance policy from Defendant
which the parties agree was in effect on November 15-16, 2008 ("the
Policy;/I see Exh. A to the Complaint.)
About two o'clock on the afternoon of Saturday, November 15,
2008, Mr. Lehman drove the truck to a wedding reception for a member
of his motorcycle riding club.
He and several other members of the
When considering a motion for summary judgment, the Court generally
summarizes the facts as they are agreed upon by the parties. Here, the
discrepancies between Plaintiff's accounts of the events precipitating
this claim and the results of Defendant's investigation are the crux of
Plaintiff's bad faith claim.
The facts in this section are summarized
primarily from Plaintiff's point of view.
Defendant's distinctions are
discussed in the analysis in Section IV. below.
1
2
club left the reception shortly before 11: 00 p.m., intending to meet
at a bar or back at their clubhouse to continue partying. 2
He then
drove to a bar located on Lebanon Road in West Mifflin, Pennsylvania,
called Spencer's Down Under ("Spencer's.")
Mr. Lehman testified at
his deposition that as he turned into Spencer's from Lebanon Road,
another pickup was coming out of the parking lot and blocked his
access.
Plaintiff and the other driver first exchanged words while
still in their trucks, then both drivers got out and began a physical
altercation.
Mr. Lehman knocked down the driver, then turned around
to confront the passengers in the other pickup.
lights went out."
As he did, "the
(Plaintiff's Appendix to Brief in Oppos
ion to
Motion for Partial Summary Judgment, Doc. No. 27, "PI£. , s App.," Exh.
11, Statement by Earl Lehman to Mary Egleton.)
The next thing Mr. Lehman remembers was waking up as his friend
Carl Cordero, known to Plaintiff as "Chico," slapped him in the face.
Whether they discussed the location of Mr. Lehman's truck at that
point is not clear.
Mr.
Cordero then drove Mr.
clubhouse where both continued to drink.
Lehman to the
Sometime between 4:00 and
5:00 a.m., when they decided to leave, Mr. Lehman asked his friend
to take him back to his truck.
Mr. Cordero told PI
ntiff his truck
The location where Mr. Lehman planned to meet other members of his riding
club is a little vague. This is not surprising since he admitted to the
investigating police officers, to the insurance company investigator, and
at his deposi tion that even before he went to the reception, he was "totally
drunk." See Def.'s App., Exh. A, Deposition of Earl Lehman, at 25.
2
3
was not in sight when he found Mr. Lehman at Spencer's and
asked him to take him home.
iff
While en route, they saw Mr. Lehman's
truck sitting on Second Avenue; the lights were on and the truck was
running.
Mr. Lehman got out of Mr. Cordero's vehicle, drove the
tow-truck to Halbleib's parking lot, then walked a few blocks home.
Sometime the next morning, that is, Sunday, November 16, Mr.
Lehman's roommate, Michael O'Malley, saw Mr. Lehman's truck as he
walked past Halbleib's.
He went home, woke Mr. Lehman, and asked
him, "Do you know your truck is wrecked?"
Mr. Lehman replied that
the truck was not "wrecked," but did have a flat tire on the right
front.
went to Halblieb's, however, he realized
When
entire
front right wheel was missing and the lower portion of the fender
was bent in.
He then called the Pittsburgh City Police.
Meanwhile,
Officer Kather
earlier
Sunday morning,
Pittsburgh
City
Police
Logue had responded to a report of a hit-and-run
accident on Almeda Street,
also in Hazelwood.
According to her
report, about 5:00 that morning, a resident heard a crash but did
not get up to investigate.
that morning,
When he did go out to the street later
discovered that a Chevy Tahoe, along with an adjacent
dumpster, had apparently been sideswiped.
He also found an entire
wheel which appeared to have been broken off the other vehicle.
Officer Logue noticed a white scrape mark on the pavement that went
from Almeda Street to Second Avenue and turned left.
4
was
familiar with the area and thought perhaps the damaged vehicle had
been taken to a nearby repair shop.
As she drove to that location,
however, she again noticed the scrape marks on the street and followed
them to Halbleib's.
She saw the tow-truck sitting in the lot,
identified its registration, and noted that the front wheel on the
passenger side was missing.
The tire on the wheel found at the site
of the hit-and-run on Almeda Street was the same make of tire as those
on the truck parked at Halbleib's.
She consequently concluded that
the tow-truck in the parking lot was the vehicle involved in the
hit-and-run.
Later that same Sunday, Mr. Lehman returned to Spencer's Down
Under and spoke with Thomas Exacustides, one of the owners of the
bar.
He told Mr. Exacustides that he had been beaten up in the bar's
parking lot "by a bunch of bikers u and asked if there were a camera
on the front of the building that might help him identify the men
with whom he had been fighting.
After determining the time of the
fight, the bar owner told Mr. Lehman there were cameras covering both
the inside of the bar and the parking lot.
They went to the parking
lot where Mr. Lehman showed Mr. Exacustides where he had parked and
where the altercation had taken place.
Mr. Exacustides explained
that his security cameras would cover those locations so they could
look at the tapes to determine exactly what had happened.
At that
point, Mr. Lehman responded, "Oh, maybe I was at a different bar on
5
Brownsville Road,N and left.
According to Mr. Exacustides' later
testimony at his deposition,
his security cameras that film the
parking lot and the entrance to the bar did not show any altercation
on the night of November 15, 2008, nor did they show any bikers.
2.
a
The police investigation and related events:
Shortly
er 1:00 p.m. on November 16, Officer Richard Petak interviewed
Mr. Lehman at his home and inspected the truck.
According to the
investigati ve report completed by Mr. Petak, Mr. Lehman told him that
after leaving the reception, he had gone to a bar called Doug's Den
on Lebanon Road in West Mifflin.
As he entered the bar, three white
males, apparently bikers, had made comments about a motorcycle vest
Mr. Lehman was wearing, and a
knocked uncons
ous.
ght ensued in which Plaintiff was
He was awakened by Mr. Cordero who told him
his truck was missing.
They then left Doug's Den and went to the
clubhouse to have a few more beers.
While driving home about 5:00
Sunday morning, they discovered his truck on Second Avenue, which
he drove to Halbleib's.
After Officer Petak completed his report, the case was assigned
to
Detective
Edward
Synkowski,
who
interviewed
Halblieb's shop on Tuesday, November 18, 2008.
Mr.
Lehman
at
In his deposition,
Mr. Synkowski testified that Plaintiff's report to him was somewhat
dif
rent from his original statement to Officer Petak.
is,
Mr. Lehman told Detective Synkowski he went to Spencer's Down Under
6
about 11: 00 p. m. on the night of November 15, had an altercation with
three people as he was pulling into the parking lot, was knocked out,
went to the bikers' clubhouse for several hours with Mr. Cordero,
returned to the bar to discover his truck was missing, discovered
the truck on Second Avenue while Mr. Cordero was driving him horne,
then drove the truck to Halbleib's.
Mr. Lehman returned to Spencer's a few days later and again asked
if there were securi ty cameras on the side of the building which would
show
the
driveway
area
where
the
Exacustides told him there were not.
altercation
took
place;
Mr.
After the police had reviewed
the surveillance tapes, Mr. Synkowski told Mr. Lehman he was unable
to
nd anyone who could verify that Plaintiff had been at Spencer's
Down Under on the night of the incident.
Mr.
Lehman responded,
"Maybe it wasn't that bar."
3.
December 3,
Vic
2008,
a's
investigation;
John Halbleib,
submi tted an insurance
the
subsequent events:
On
legal owner of the truck,
aim to Victoria.
3
Mary
eton, a Victoria
claims representative, interviewed Mr. Lehman two days later.
his statement to Ms. Egleton, Plaintiff indicat
In
that the incident
had occurred in the parking lot at Spencer's and that Mr. Cordero
Victoria Insurance is a member of the Nationwide chain of insurance
companies and it appears that Ms. Egleton, Mr. Balsomico, and Mr. Harper
are actually Nationwide employees.
For ease of reference, the Court has
substituted "Victoria" or "Defendant" when discussing actions taken by
Nationwide.
3
7
had found him at the "entrance as you come in."
his truck was there when he regained cons
He did not know if
ousness, but they went
to the clubhouse and partied until sometime around 4:00 or 5:00 in
the morning.
When Mr. Lehman asked Mr. Cordero to take him back to
his truck, his friend asked him where it was.
Mr. Lehman asked if
the truck was not at Spencer's, and when told it was not, Mr. Lehman
told Mr. Cordero to just drive him home.
Ms. Egleton referred the claim to the Special Investigative Uni t
("SIU") where agent Jason Balsomico was assigned to make a more
detailed investigation.
Between December 7 and December 9, 2008,
Mr. Balsomico spoke with Mr. Halbleib, reviewed the initial police
report prepared by Mr. Petak, and spoke wi th Detective Synkowski who
said he had reviewed the security tapes and there was no evidence
of a fight or of anyone matching the description of Mr. Lehman at
Spencer's that night.
Balsomico
a
fax
Also on December 9, Mr. Synkowski sent Mr.
telling
him
the
case
was
an
ongoing
police
investigation and noted "We believe Lehman is not telling the truth. "
Mr. Balsomico visited Spencer's where he interviewed Michelle
Beal who had been tending bar at the time of the alleged incident.
According to Ms. Beal, November 15 had been a normal Saturday evening,
and no one had alerted her or the doorman that there had been a fight
in the parking lot or that a truck had been stolen.
She also stated
that sometime after the incident, Mr. Lehman and some friends had
8
asked her about the location of the security cameras.
When she
replied that cameras were "everywhere," one of them said "Oh, sh-t.
II
Mr. Balsomico took a recorded statement from Mr. Exacustides who said
that when Mr. Lehman returned to the bar and talked with him about
the cameras, Plaintiff could not recall if he had actually been at
Doug's Den or Spencer's.
After some delays,
Mr.
Balsomico was
eventually able to get statements from Plaintiff and Mr. Cordero,
an affidavit of vehic
theft,
and a copy of the vehicle lease
agreement between Halbleib and Mr. Lehman.
Based on its investigation, Victoria sent Mr. Lehman a letter
on April 24, 2009.
letter quoted the provision of the Policy
which precluded coverage in cases of concealment, misrepresentation
or fraud, and then outlined several facts which Victoria believed
supported its decision to deny coverage of the claim.
In the letter,
Ms. Egleton stated:
The facts include, but are not limited to, the following:
Per your recorded interview on 11/5/08 [sic], you advised
SIU Jason Balsomic [sic] you were at a wedding all day and
you arrived at Spence's [sic] around 11: 00 p.m.
When
pulling in, you got into a verbal argument with a truck
driver, and you got out and starting [sic] fighting with
the driver. The other two occupants knocked you out and
you did not recall how long you were out but your friend,
Chico woke you up. You both left Spence's and went to your
riding clubs [sic] "clubhouse". You advised that you left
the clubhouse between 4: 00 and 5: 00 am and on the way home
you spotted your vehicle in the street running.
9
1.
SIU spoke to your roommate Mike 0' Malley and he
advised he was walking home from his son's house on
11/16/08 and saw extensive damage to insured's truck that
was parked at Halbleib's and advised you of same when he
got home.
2.
On 12/9/08, SIU spoke to Spence's owner Thomas
Exacustides and he advised that he reviewed the security
tapes with the police department and you were never in the
bar on 11/5/08 [sic] and he never saw a tow truck in the
parking lot.
Also, On[sic] 12/9/08 we received a copy of
the Pittsburgh Police Report and spoke to Detective
Synkowski who also reviewed the tapes, and advised there
was no fight and he also did not see your vehicle in the
parking lot.
3.
On 12/9/08, SIU, Jason Balsomic [sic] interviewed
Spence's bartender Michelle Beal who advised on 11/5/08
[sic] she never heard of any fight or a stolen vehicle and
also never saw you in the bar that night.
(Plf.'s App., Exh. 3, Deposition of Jason Balsomico, Exh. 2.)
On May 5, 2009, a preliminary criminal hearing was held in the
matter of Pennsylvania v. Lehman and Cordero.
Plaintiff and Mr.
Cordero were charged with making a false report to law enforcement
author
fraud,
Exh.
2,
ies, leaving the scene of a h
-and-run accident, insurance
and conspiracy to commit insurance fraud.
Criminal
Docket.)
Officers
Petak and Logue,
Synkowski, and Mr. Balsomico testified.
of Preliminary Criminal Hearing.)
( PI f . ' s App.,
Detective
(Id., Exh. 1, Transcript
On March 18, 2010,
all claims
brought in the criminal action against Mr. Lehman and Mr. Cordero
were dismissed.
(Id., Exh. 2.)
10
B.
Procedural Background
Mr. Lehman filed suit on October 16, 2009, in the Court
of Common Pleas of Allegheny County, asserting claims for breach of
an insurance contract and
C.S. § 8371.
r bad faith by an insurer under 42 Pa.
Pursuant to 28 U.S.C. § 1446, Defendant timely removed
the case to this Court on November 19,
2009,
based on complete
diversity of the parties and an amount in controversy greater than
the statutory minimum.
Following
Plaintiff did not object to removal.
unsuccessful
mediation
and
extensive
discovery,
Victoria filed the now-pending motion for summary judgment on the
bad faith claim only, contending that Plaintiff has failed to produce
the evidence required to support the elements of this cause of action.
The question has been fully briefed and is now ripe for decision.
II .
JURISDICTION AND VENUE
The parties agree this Court has subject matter jurisdiction
pursuant to 28 U.S.C. § 1332(a), based on comp
e diversity of the
parties 4 and an amount in controversy greater than the statutory
minimum.
Venue
Pennsylvania
is
inasmuch
properly
as
the
laid
events
in
l:he
giving
Western
rise
occurred primarily in Hazelwood, Allegheny County,
within this district.
District
to
the
of
claims
Pennsylvania,
See 28 U.S.C. § 1391(a).
Mr. Lehman is a citizen and resident of Pennsylvania; Victoria is an
Ohio corporation with its principal place of business in Columbus, Ohio.
(Not
of Removal, Doc. No. I, ~~ 5, 7.)
11
III.
STANDARD FOR SUMMARY JUDGMENT
A court may grant summary judgment if the party so moving can
show "there is no genuine issue as to any material fact and that the
moving
party
is
entitled
to
judgment
as
a
matter
of
law."
Fed.R.Civ.P. 56(a); Sollon v. Ohio Cas. Ins. Co., 396 F. Supp.2d 560,
568 (W.D. Pa. 2005). If a reasonable jury could return a verdict for
the non-movant, the dispute is genuine and if, under substantive law,
the dispute would affect the outcome of the suit, it is material.
A factual dispute between the parties that
is both genuine and
material will defeat a motion for summary judgment.
Liberty Lobby,
Inc.,
477
u.s.
242, 247-248
Anderson v.
(1986).
In considering a motion for summary judgment, the court must
ew all evidence in the light most favorable to the non-movant,
accept the non-movant's version of the facts as true, and draw all
reasonable
inferences
and
resolve
any
conflicts
in
its
favor.
Sollon, id., citing Matsushita Elec. Indus. Co. Ltd. v. Zenith Radio
---"-
, 475
u.s.
574, 587 (1986), and Big Apple BMW, Inc. v. BMW of
974 F.2d 1358, 1363 (3d Cir. 1992).
In short,
the movant must show that if the pleadings, depositions and other
evidentiary material were admissible at trial, the other party could
not carry its burden of proof based on that evidence and a reasonable
jury would thus decide all genuine material disputes in the movant's
favor.
Celotex Corp. v. Catrett, 477
12
u.s.
317, 318
(1986).
Once the movant has demonstrated that there are no genuine
issues of material fact, the burden shifts to the non-moving party
to "make a showing sufficient to establish the existence of every
element
depos
essential
to
his
case,
based on
ions and admissions on file.
Sollon,
id.
Fed.R.Civ.P.
56(c).
the
affidavits
Celotex,
If
The
sum
of
or
by
id.
at 322-323:
the
affirmative
evidence to be presented by the non-moving party must be such that
a reasonable jury could find in its favor,
and it cannot simply
reiterate unsupported assertions, conclusory allegations, or mere
suspicious beliefs.
Liberty Lobby,
Township of Manalapan,
id.
at
250-252;
Groman v.
47 F.3d 628, 633 (3d Cir. 1995).
A special burden of proof
Ils on the plaintiff in cases
involving a claim brought under the Pennsylvania bad faith statute.
That is, at trial the insured must prove the elements of the claim
by clear and convincing evidence.
Co.
v.
Babayan,
430 F.3d 121,
Prudential Property
&
137
See Northwestern Mut. Life Ins.
(3d Cir.
2005):
Terletsky v.
Casualty Ins. Co., 649 A. 2d 680, 688 (Pa. Super.
Ct. 1994), citing Cowden v. Aetna Casualty & Surety Co., 124 A.2d
223, 229
(Pa.
1957).
Under Pennsylvania law,
"[t]he standard of
clear and convincing evidence means testimony that is so clear,
direct, weighty, and convincing as to enable the trier of fact to
corne to a clear conviction, without hesitancy, of the truth of the
precise facts in issue."
In re Sylvester, 555 A.2d 1202, 1203-1204
13
(Pa. 1989) (citations omitted); see also Lockhart v. State Farm Mut.
Auto. Ins. Co., CA No. 08-993, 2010 U.S. Dist. LEXIS 12992, *17 (W.D.
Pa. Feb. 16, 2010), and Polselli v. Nationwide Mut. Fi
23 F.3d 747,
judgment
752
stage,
(3d Cir.
the
1994).
Consequently,
plaintiff's burden
is
Ins. Co.
at the summary
"commensurately high
because the court must view the evidence presented in light of the
substantive evidentiary burden at trial."
Babayan, 430 F.3d at 137
(internal quotation omitted); Williams v. Hartford Cas. In
83 F. Supp.2d 567, 571 (E.D. Pa. 2000); see also Terletsky, 649 A.2d
at 688
IV.
(bad faith must be proven, "not merely insinuated.")
ANALYSIS
A.
Relevant Law 5
Bad
faith
claims
against
insurance
companies
in
Pennsylvania are governed by a statute which provides:
In an action arising under an insurance policy, if the
court finds that the insurer has acted in bad faith toward
the insured, the court may take all of the following
actions:
(1) Award interest on the amount of the claim from the date
the claim was made by the insured in an amount equal to
the prime rate of interest plus 3%.
(2) Award punitive damages against the insurer.
5 The parties assume, and the Court agrees, that a court si tting in di versi ty
applies the substantive law of the state in which it sits. See Erie R.R.
Co. v. Tompkins, 304 U.S. 64 (1938); Edwards v. HOVENSA, LLC, 497 F.3d 355,
361 (3d Cir. 2007).
14
(3) Assess
insurer.
court
costs and attorney fees
against the
42 Pa. C.S. § 8371.
Under Pennsylvania law, "[b]ad faith claims are fact-specific
and depend on the conduct of the insurer vis-a-vis its insured."
Williams v. Nationwide Mut. Ins. Co., 750 A.2d 881, 887 (Pa. Super.
Ct. 2000).
phrase
in
The statute itself does not define bad faith, but the
the
insurance
context
universally acknowledged meaning."
has
acquired
a
"peculiar
Polselli, 23 F.3d at 751.
and
The
more common description of bad faith is that the insurer indulged
a " volous or unfounded refusal to pay proceeds of a policy."
~-=--=--=-----"-
where
, 649 A.2d at 688}.
the
insurer
failed
Alternatively, bad faith can be shown
to
investigate
the
claim
fairly
and
objectively, or where it did not conduct a reasonable investigation
based on available information.
See Giangreco v. United States Life
Ins. Co., 168 F. Supp.2d 417,423 (E.D. Pa. 2001), and Diamon v. Penn
Mut. Fire Ins. Co., 372 A.2d 1218, 1226 (Pa. Super. Ct. 1977)
insured
is
entitled
to
expect
that
the
insurer
will
(an
exercise
reasonable care in investigating the claim and reject it only for
good cause.)
In short, "the crux of a bad faith claim under § 8371
is denial of coverage by an insurer when it has no good reason to
do so."
Jung v. Nationwide Mut. Fire. Ins., Co., 949 F.Supp. 353,
360 (E.D. Pa. 1997).
15
To succeed on a claim for bad fai th, the plaintiff must establish
by clear and convincing evidence that:
(1) the insurer did not have
a reasonable basis for denying coverage, and (2) the insurer knew
or recklessly disregarded its lack of reasonable basis.
See Klinger
v. State Farm Mut. Auto. Ins. Co., 115 F.3d 230, 233 (3d Cir. 1997),
adopting the test set out in Terletsky, 649 A.2d at 688.
Further,
it is insufficient to establish "mere negligence or an incorrect
analysis of the law;" rather, evidence of recklessness is required
to support a finding of bad faith.
Jung, 949 F.Supp. at 356, citing
Polselli, 23 F.3d at 751.
B.
The Parties' Arguments
1.
Defendant's arguments:
Victoria argues that because
Mr. Lehman cannot establish by clear and convincing evidence that
its
decision
to
deny
coverage
under
the
Policy
was
less
than
reasonable, this Court must find as a matter of law that it could
not have acted in bad faith.
Support
Memo,
II
(Defendant's Memorandum of Law in
Motion for Partial Summary Judgment, Doc. No. 23, "Def.' s
at 9.)
The Policy in effect at the time of the incident
states in relevant part:
CONCEALMENT, MISREPRESENTATION OR FRAUD
This coverage form is void in any case of fraud by you at
any time before or after a loss, as it relates to this
coverage form.
It is void if you or any other insured,
at any time, intentionally conceal or misrepresent any
material fact concerning:
16
a.
this coverage form;
b.
this covered auto;
c.
your interest in the covered auto;
d.
a claim under this coverage form.
(Def.'s Memo at 9.)
According to Victoria,
the evidence supports its conclusion
that Mr. Lehman had made material misrepresentations as to the facts
surrounding the events of November 15-16,
misrepresentations
violated
the
above
2008,
and that
provision.
those
Under
Pennsylvania law, violation of such a fraud and concealment provision
is a total bar to recovery.
(Def.'s Memo at 9, citing,
ter alia,
Millard v. Shelby Cas. Ins. Co., CA No. 02-1902, 2005 U.S. Dist. LEXIS
45502, *11 (M.D. Pa. Aug 24, 2005).)
In its memorandum, Victoria identifies eight specific reasons
why its claims managers decided certain statements Mr. Lehman had
made were misrepresentations that precluded coverage:
The
Pittsburgh
police
investigation
conducted
by
Detective Synkowski found the incident to be suspicious
and, as he advised Victoria, the police believed Lehman
was lying.
There were no eyewitnesses to the alleged fight in the
parking lot at Spencer's Down Under or to the theft of the
truck,
and the security cameras did not show the
altercation, the theft, or the bikers who allegedly
attacked Mr. Lehman.
17
Mr. Lehman appeared to have changed the details of his
story between the time he gave his initial statement to
Officer Petak and when he spoke to Detective Synkowski,
perhaps because in the interim, he had learned from
Spencer's owner that had the altercation occurred as he
initially reported, it would have been recorded on the
surveillance tapes.
Mr. Lehman made several contradictory statements to police
and Victoria during the course of the investigation,
specifically, the name of the bar where the altercation
occurred, the location of the fight (i. e., at the entrance
to the bar or at the entrance to the parking lot), the
subject which sparked the altercation, and when he
realized his truck was missing.
The statements of independent witnesses
the bartender,
Michelle Beal, and the owner of the bar, Thomas Exacustides
- undermined Mr. Lehman's credibility.
The hit-and-run accident only a few streets away from the
place where Mr. Lehman allegedly discovered his truck
provided a motive for someone driving under the influence
of alcohol to lie about his vehicle being stolen.
According to Detective Synkowski, when he inspected the
interior of the tow truck, it appeared nothing had been
disturbed as one might expect if the vehicle had been
stolen, e.g., the glove box was closed, its contents were
not disturbed, a few dollars were found in the center
console, and a police radio was still in place.
Victoria's investigation was through and included site
visits to Spencer's and the location where Plaintiff's
vehicle was found, interviews with Mr. Lehman, Mr.
Cordero,
Ms.
Beal,
Mr.
Exacustides,
and
several
indi viduals who lived in the neighborhood where the
vehicle was found.
(Def.'s Memo at 12-13.)
According to Defendant, many of Mr. Lehman's statements were
material
in that
they concerned subjects germane
18
to Victoria's
investigation
or
were
facts
decision-making process.
important
to
Victoria
in
its
(Def.'s Memo at 13-14, citing Hepps v.
General Am. Life Ins., CA No. 95-5508, 1998 U.S. Dist. LEXIS 13795,
*10 (E.D. Pa. Sept. 2, 1998).)
of
those
coverage.
misrepresentations
The cumulative, reasonable result
was
Victoria's
Moreover, Plaintiff has
breach
of
the
duty
of
to
deny
led to elicit any evidence
whatsoever that Victoria's decision was characte
purpose,
decision
good
faith
zed by a dishonest
and
fair
dealing,
self-interest or ill will, and thus has failed to satisfy the second
prong of the test set out in Terletsky.
2.
Plaintiff's arguments:
the motion for
summary
judgment,
In his brief in opposition to
Mr.
Lehman contends that the
deposition testimony of Jason Balsomico, the Victoria investigator,
and of Christian Harper, one of the Victoria claims managers who made
the decision to deny coverage, supports his version of the events
on November 15-16, 2008, and provides clear and convincing evidence
that Victoria's investigation was neither complete nor reasonable.
(Doc. No. 26, "PIt.' s
ef,
/I
at 1-2.)
Mr. Lehman points to numerous
instances where contrary to Defendant's argument that he mate
ally
misrepresented facts about what occurred that night, Mr. Balsomico
and Mr. Harper conceded in their depositions that there were no
inconsistencies either between what Plaintiff told the police and
the insurance company or between his statements to the insurance
19
company on various occasions.
(Plf.'s Brief at 2-6.)
Moreover,
Messrs. Balsomico and Harper conceded that Victoria failed to take
numerous actions which could have confirmed Mr. Lehman's reports.
Id. at 7-17.)
Plaintiff attacks each of the eight subject areas
about which he allegedly made misrepresentations and concludes that
at a minimum, his evidence raises genuine issues of material fact
about Victoria's investigation.
C.
(Id. at 19-25.)
Discussion
1.
investigation:
Vict
a's
ilure
to
conduct
a
reasonable
Mr. Lehman provides a litany of investigative steps
Mr. Balsomico conceded Victoria did not take during its investigation
of his claim.
For example, he did not:
ask Mr. Exacustides or Detective Synkowski if the
surveillance tapes showed the area where Mr. Lehman stated
the incident occurred or ask to look at the surveillance
tapes himself;
discover the names of any patrons who were at Spencer's
on the night of November 15 or ask any of them if they
recognized someone going in or out of the bar;
interview the doorman on duty at Spencer's that night to
confirm that he had not seen or heard the events described
by Mr. Lehman;
verify that Mr. Lehman was at the wedding all day;
interview anyone who could have confirmed that Plaintiff
and Mr. Cordero went to the motorcycle clubhouse after they
left Spencer's;
discover any information to contradict Mr. Lehman's
statement that he left the clubhouse between 4 and 5 a.m. ;
20
discover any information to contradict the statements by
Plaintiff and Mr. Cordero that they found the truck on
Second Avenue or that Mr. Lehman drove the truck to
Halbleib's; or
speak
to
Officer
Petak
to
clarify
the
apparent
inconsistencies between his initial report and the
statements Mr. Lehman later made to Detective Synkowski
and to Victoria representatives.
(Plf.'s Brief at 11-12, 21, 25.)
In short, Plaintiff argues, Mr. Balsomico's investigation was
inadequate because he never investigated the facts as Mr. Lehman
reported them to the police and to Victoria, but instead investigated
something Plaintiff never said happened.
Taken as a whole,
Mr.
Balsomico's investigation "confirms every aspect" of what Mr. Lehman
told Victoria about the incident.
(Plf.'s Brief at 25.)
Having considered the entirety of Mr. Balsomico's testimony at
the preliminary criminal hearing and his deposition testimony (see
P1f.'s App., Exhs. 1 and 3), the Court cannot dispute Plaintiff's
assertions about specific actions Mr. Balsomico did not take during
the course of his investigation.
However, they are irrelevant even
if Plaintiff is correct in every instance.
As another court has
held, an insurance company need not establish that its investigation
"yielded the correct conclusion or even that its conclusion more
likely than not was accurate."
Neither does it need to show that
the investigatory process was flawless or that the methods it used
21
eliminated all possibilities at odds with its conclusion.
Cantor
v. Equitable Life Assur. Socly of the United States, No. 97-5711,
1999 U.S. Dist. LEXIS 4805, *8 (E.D. Pa. Apr. 12, 1999).
"Rather,
an insurance company simply must show it conducted a review or
investigation sufficiently thorough to yield a reasonable foundation
for its action.
u
Id. at *9; see also Mann v. UNUM Li
Am., CA No. 02-1346, 2003 U.S. Dist. LEXIS 23993 (E.D. Pa. Nov. 25,
2003)
(although the investigation might have been more thorough if
the insurer had spoken directly to the plaintiff's physicians, there
was still a reasonable basis for denying coverage); McCrink v.
CA No. 04-1068, 2005 U.S. Dist. LEXIS
5072 (E.D. Pa. Mar. 29, 2005)
(failure to interview two witnesses
to an accident, inspect the motorcycle involved, and determine if
the vehicle was operating properly prior to denying the claim was
not bad faith where the insurer provided other evidence that its
investigation was complete and thorough); and Wedemeyer v. United
States Life Ins. Co., CA No. 05-6263, 2007 U.S. Dist. LEXIS 15742
(E. D. Pa. Mar. 6, 2007) (several omissions and oversights during the
course of the insurer's investigation did not defeat summary judgment
where there was ample record evidence showing the insurer conducted
a thorough investigation and had a reasonable basis for terminating
the plaintiff's disability benefits.)
22
According to the investigation log, between December 2, 2008,
when Victoria was first advised of the loss and April 24, 2009, when
it informed Mr. Lehman that it was denying coverage for the damage
to his vehi
e, Mr. Balsomico, the primary agent for Victo
a, took
the following steps during his investigation:
December 5, 2008 -- interviewed Mr. Lehman by telephone;
December 8, 2008 -- discussed the plan
action with Ms.
Egleton and ran several internet searches about possible
stolen vehicle claims and criminal records for Mr. Lehman;
December 9,
2008
went to Spencer's where he
interviewed Ms. Beal, Mr. Exacustides and his wife, and
took at least six photographs of the area where
theft
allegedly occurred;
December 9, 2008 -- received a copy of the police report
and spoke with Detective Synkowski about his review of the
surveillance tapes and Of cer Petak's report;
December 10-16, 2008 -- continued his research and spoke
with Mr. Lehman and his attorney about arranging a second
interview;
December 17, 2008 -- went to Second Avenue in Hazelwood
where the vehicle was recovered, photographed the area and
attempted unsuccessfully to find a resident who had seen
the vehi e in the area at that time;
January 26, 2009 6 -- took a second statement from Mr.
Lehman, reminded Mr. Lehman and his attorney that
Plaintiff had not yet completed the affidavit of theft
which had been previously sent to him, and spoke with
Detecti ve Synkowski about the interview, telling him that
in accord with the d e t e c t ' s previous request, he would
send a copy of the interview transcript to him;
Between mid-December 2008 and mid-January 2009, Mr. Balsomico attempted
several times to set a date for Mr. Lehman's interview after he was advised
on December 16, 2008, that Plaintiff had engaged legal counsel.
6
23
February 3 through at least February 17, 2009 -- tried
several times to interview Mr. Cordero who was either not
available at the time Mr. Balsomico called or did not
appear as scheduled;
February 5, 2009
interviewed Mr.
events of Sunday, November 16i
O'Malley about the
February 26, 2009 -- held a conference with other Victoria
agents during which it was suggested that Mr. Balsomico
contact Mr. Halbleib for policy information since it had
not been provided by Mr. Lehmani and
February 27, 2009 -- went to Halbleib's Automotive and
later talked with Mr. Halbleib who had no information
regarding the incident other than what Mr. Lehman told him.
(Appendix in Support of Motion for Partial Summary Judgment,
Doc.
No. 25, "Def.'s App.," Exh. E, Deposition of Christian Harper, Exh.
1.)
It is true Mr. Balsomico did not take several of the steps Mr.
Lehman suggests he should have taken as part of a
reasonable investigation.
surveillance
tapes
himself,
For example,
but
he did not
since Mr.
Lehman
comp
e and
look at the
told
him the
incident took place at the entrance to the parking lot and Mr.
Exacustides and Detective Synkowski both confirmed that cameras were
not positioned to photograph that area, such an action would have
been futile.
He did not interview anyone who could have confirmed
Mr. Lehman and Mr. Cordero went to the motorcycle clubhouse and
remained there until between 4: 00 and 5: 00 a .m. but at his deposition,
Mr. Lehman refused to provide the names
24
any members of
club,
so
there
is
no
reason
to
information to Victoria.
Lehman,
at 38.)
Mr.
believe
he
would have
provided
that
(Def.'s App., Exh. A, Deposition of Earl
Balsomico tried to find someone who could
confirm the statements by Plaintiff and Mr. Cordero that they found
the truck on Second Avenue by attempting to interview at least nine
residents of the area, but was unsuccessful.
In hindsight , although
these and the other so-called "inadequacies" in the investigation
could be considered negligent or indicative of poor judgment, they
are insufficient to sustain a bad faith claim.
See Luse v. Liberty
Mut. Fire Ins. Co., No. 10-3363, 2011 U.S. App. LEXIS 2725, *7 (3d
Cir.
Feb.
11,
2011),
citing Terletsky,
649 A.2d at
688 for the
principle that "mere negligence or bad judgment is not bad faith."
To defeat a bad faith claim based on the failure to investigate
properly, the insurer can show it conducted a review or investigation
sufficiently thorough
action.
to yield a
foundation
for
its
J.C. Penney Life Ins. Co. v. Pilosi, 393 F.3d 356, 367 (3d
Cir. 2004)
("A reasonable basis is all that is required to defeat
a claim of bad faith.")
forward
reasonable
with
clear
We conclude that Plaintiff has not come
and
convincing
investigation was not suffi
evidence
that
Victoria's
ently thorough to support its ultimate
conclusion to deny coverage.
2.
Victoria's erroneous conclusion that Plainti
inconsistent statements:
ma
We turn to Plaintiff's second argument,
25
i.e.,
there were no material misrepresentations in Mr.
Lehman's
various reports and the testimony of Mr. Balsomico and Mr. Harper
confirms that fact.
Again, we agree with Defendant that several
inconsistencies in
s reports about the incident support Victoria's
decision to deny coverage pursuant to the concealment provision of
the Policy quoted above.
To point out the inconsistencies in the statements, we compare
the details of Mr. Lehman's first report to the police on November
16, 2008, with those of his later reports to Detective Synkowski,
Ms. Egleton, and Mr.
somico.
The Court has used bold typeface
to highlight the subjects of the inconsistencies.
According
afternoon
to
the
of November
statement
taken by Of
16,
"sometime around 1:00 a.m.
2008,
cer
Petak on
the
on
November 16, 2008, Mr. Lehman "entered Doug's Den on Lebanon Road
in West Mifflin.
/I
As he "entered the bar three wh
e males in [their]
30' s walked [past] him and began making comments about the motorcycle
vest that Lehman was wearing. II
they began fighting.
by Mr. Cordero.
He told the three men "F-k you,
/I
and
He was knocked unconscious and was awakened
He asked what had happened and Mr. Cordero explained
he was knocked out and his truck was missing.
They Ie
Doug's Den
and began to drive horne, but decided to stop at the clubhouse and
have a few more beers.
Plaintiff and Mr. Cordero left the clubhouse
26
at
approx~ately
5:30 a.m. and found his truck on Second Avenue.
(Def.'s App., Exh. B, Deposition of Richard Petak, Exh. A.)
When speaking with Detective Synkowski on the afternoon of
Tuesday, November 18, 2008, Mr. Lehman stated that he left the wedding
about 11 p.m. and went to Spencer's Down Under.
"Out in the [parkingJ
lot as he was coming in, a truck was pulling out with three people
in it.
'thanks'
.Since they were in the middle of the road, he yelled
and the guys got out of the truck and started saying
something about Greenfield boys."
He got out of his truck and struck
one of them but was knocked out.
The next thing he remembered was
Mr. Cordero picking him up and taking him to the motorcyc
They continued to party until between 4:00 and 5:00 a.m.
clubhouse.
Be asked
Mr. Cordero to take him back to Spencer's for his truck, but it was
not there.
"While going home from Spencer's," they saw the truck
(Def. 's App.,
on Second Avenue.
Exh.
C,
Deposition of Edward
Synkowski, Exh. A.)
Ms.
Egel ton
interviewed
Mr.
Lehman
on
December
5,
2008.
Plaintiff stated that after the wedding reception, "I was supposed
to meet a friend . . . [at] Spencer's Down Under."
somet~e
about 11
0'
clock,
gentlemen in another truck.
he got
into an
He was
As he "pulled in,"
argument with three
knocked unconscious.
Mr.
Cordero saw him lying "in their driveway," i. e., "right there in the
entrance as you come in," picked him up,
27
and put him in his own
vehicle.
When he came to (apparently after he was in the truck) he
said to Mr. Cordero, "Get me out of here."
He also stated to Ms.
Egleton, "I assume my truck was there, I don' t even know."
to the clubhouse.
They went
As Mr. Lehman reported the conversation, sometime
around 4: 00 or 5: 00 a.m., he said, "Hey, take me to my truck and [Mr.
Cordero] said where's it at and [Mr. Lehman] said wasn't it there
where you got me and he said no."
me home."
Mr. Lehman responded, "Just take
(Plf.'s App., Exh. 11, Transcript of telephone interview
between Mary Egleton and Earl Lehman.)
Finally,
on January 26,
Lehman for the second time.
2009,
Mr. Balsomico interviewed Mr.
During that conversation, Mr. Lehman
stated that the vehicle had to have been stolen "somewhere around
11
0'
clock" and occurred, "to the best of [his] knowledge at Spencer's
Down Under right there as you're pulling in."
The argument started
whi Ie he was attempting to enter the parking lot.
Mr. Lehman stated
that the other pickup truck "took up most of the driveway, I had to
stop."
When asked what the verbal argument was about, he stated,
"It was two drunk people yelling at each other.
precisely what it was.
I don't remember
Something about I say hey, thanks for taking
up the whole room, you know,
something on that line and he said
something, I said something and it just escalated."
The next thing
he remembers was Mr. Cordero slapping him in the face.
He said to
his f
He did not
end, "Just get me out of here," and they left.
28
think to look for his truck.
They got to the clubhouse sometime
between 11:00 and 11:45 p.m. and stayed there until about 4:00 or
5: 00 a.m. when Mr. Lehman said to Mr. Cordero, "Take me to my truck.
He said where is [it] at, I said wasn't it there where you got me.
He said no.
I thought okay maybe I didn't take the truck there, I
don't know.
. Well, maybe [Mr. Cordero] had somebody take it
home or whatever you know.
I don't know and I really can't tell you
exactly why I didn't [call the police from the club] other than I've
been drinking at that point for about 14 hours."
( P1 f . ' s App., Exh.
11, Transcript of telephone interview between Jason Balsomico and
Earl Lehman.)
We agree with Plaintiff that his reports to Detective Synkowski,
Ms. Egleton, and Mr. Balsomico are, for the most part, consistent.
In
each
of
them he
stated
that
the
altercation
took place
at
approximately 11 p.m. in the driveway or entrance to the parking lot
at Spencer's Down Under; 7 that Mr. Cordero found him sometime later;
We have given little weight to the fact that in Officer Petak's report,
the bar in question is identified as "Doug's Down Under," or "Doug's Den,"
rather than "Spencer's Down Under."
This is because, according to the
statements of both Mr. Exacustides and Mr. Lehman, Plaintiff returned to
Spencer's sometime on November 16, 2008.
By contrast, there is no evidence
he went to Doug's Den to check if that had been where the incident actually
occurred, even after Detective Synkowski told him the surveillance tapes
did not show any altercation in the parking lot at Spencer's that night,
to which Mr. Lehman responded that perhaps he had been at another bar.
See
Def.'s App., Exh. A, Deposition of Earl Lehman at 39-40; Plf.'s App., Exh.
10, Deposition of Thomas Exacustides at 4-5; and Def.'s App., Exh. C,
Deposition of Edward Synkowski, Exh. A.
7
29
they went
to the
ubhouse
clubhouse somet
for more drinks;
and they I
the
between 4:00 and 5:00 a.m.
But, the more telling discrepancies are between what Mr. Lehman
told Officer Petak in the initial interview on the a
ernoon of
November 16, immediately after the incident occurred, and what he
told
Detective
Synkowski
and
the
Victoria
agents
beginning
on
November 18, after he had returned to Spencer's and learned from Mr.
Exacustides that the surveillance cameras would have photographed
the entrance to the bar and the parking lot,
recorded events whi
the parking lot.
but would not have
happened near Lebanon Road at the entrance to
Speci
cally:
Mr. Lehman told officer Petak that the events began around
1: 00 a. m. ; he told everyone else that they occurred shortly
after he Ie
the wedding reception about 11:00 p.m.
According to the report to Officer Petak, Mr. Lehman was
entering the bar and three men walked past him; he told
the other investigators that the incident began while he
and the other men were still in their vehicles at the point
where the driveway and Lebanon Road intersect.
Mr. Lehman told
cer Petak that the precipi tating event
was the
that the men commented about his motorcycle
vest; he told Detective Synkowski that the incident began
when he obj
to the fact that the truck coming out of
the parking lot was blocking his entrance, but told Mr.
Balsomico he did not remember the event exactly, but it
was "two drunk people yelling at each other."
According to Of ce Petak's report, Mr. Cordero told Mr.
Lehman immediately upon restoring him to consciousness
that his truck was missing, but Mr. Lehman told Detective
Synkowski that they went to the motorcycle club apparently
without discussing the location of his truck, told Ms.
30
Egleton that he "assumed" his truck was still at the bar
when Mr. Cordero revived him, and told Mr. Balsomico that
he "did not think to look for his truck."8
Plaintiff told Officer Petak he and Mr. Cordero Ie
the
clubhouse and headed directly to his home; he told
Detective Synkowski he and Mr. Cordero had gone back to
Spencer's to pick up his truck, but it was not there; and
he told Ms. Egleton and Mr. Balsomico that Mr. Cordero had
told him at the club that his truck had been missing when
he picked him up at Spencer's.
We conclude that the inconsistencies between what Plaintiff
told Officer Petak within a few hours of the incident and his reports
to
Detective
reasonably
be
Synkowski,
considered
Mr.
Balsomico
material.
We
and
Ms.
Egleton
recognize
that
could
"[t]he
question of materiality is generally considered one of fact and law,
but if the facts misrepresented are so obviously important that
reasonable minds cannot differ on the question of materiality, then
the question becomes one of law that the court can decide at the
summary judgment stage."
Parasco v.
Pacific Indemnity Co.,
920
Further inconsistencies on this point were introduced by Mr. Cordero.
In his statement to Detective Synkowski on March 5, 2009, he said he found
Mr. Lehman at Spencer's sometime between 4: 00 and 5: 00 a.m., the truck was
gone, and as they drove from Spencer's toward Mr. Lehman's home, they found
the vehicle on Second Avenue.
(Def.'s App., Exh. 3, Deposition of Edward
Synkowski, Exh. A.) At his deposition, Mr. Cordero said he had no plans
to meet Mr. Lehman or go to Spencer's; he just happened to see Mr. Lehman
standing in front of the bar as Mr. Cordero drove toward the riding club
where everyone was supposed to meet. He picked up Mr. Lehman and as they
drove to the clubhouse, he asked Mr. Lehman what had happened; Plaintiff
told him he had been mugged but did not elaborate on the cause of the
altercation. He did not see Mr. Lehman's vehicle at Spencer's and did not
look for it. When they left the club, they went headed to Mr. Lehman's
house and found the truck on Second Avenue.
(Def. 's App., Exh. I,
Deposition of Carl Cordero at 9-12.)
31
F.Supp. 647, 654 (E.D. Pa. 1996) (internal quotation omitted.)
The
most important facts - the location where the confrontation began
(parking lot or entrance to the bar),
what Mr.
Lehman did upon
regaining consciousness, and when he discovered the vehicle was not
at Spencer's are all germane and important to Victoria's decision
making process and, as Mr. Harper testified, the inconsistencies in
Mr. Lehman's reports were the basis of Defendant's decision to deny
coverage.
We conclude that Mr. Lehman has failed to es
clear and convincing evidence that Victoria acted in bad
ish by
ith by
doing so.
V.
CONCLUSION
This Court has an "ever-present obligation" throughout the
course of the litigation to assure itself that it has subj ect matter
ju
sdiction, even if the parties do not raise the issue.
Mut. Ins. Co. v. Ward Trucking Corp., 48 F.3d 742, 750 (3d Cir. 1995) .
Under Fed. R. Civ. P. 12 (h) (3), a federal court must dismiss an action
if
determines at any time it lacks jurisdiction.
As the Rule
indicates by use of the word "must," this action is mandatory.
Moreover, dismissal under Rule 12(h) (3) does not require a motion
by a party, but may be entered sua span te by the Court.
~--~~~~~----~-----
Pfi zer, Inc. ,
, 525 F. Supp.2d 680, 684 (D. Del. 2007).
In his Complaint, Plaintiff raises two causes of action, breach
of contract and the bad faith claim on which Victoria has just been
32
granted summary judgment.
Under the breach of contract claim, Mr.
Lehman seeks the amount Victoria would be obligated to pay under the
Policy for damage to his vehicle, that is, $18,000.
9-11. )
(Complaint,
