Lindsay Potter v. Aetna Life Insurance Company (2013)

MEMORANDUM OF DECISION RE MOTION TO STRIKE # 103

On October 22, 2012, the plaintiff, Lindsay Potter, filed a two-count complaint sounding in breach of contract and breach of the covenant of good faith and fair dealing against the defendant, Aetna Life Insurance Company.   On March 6, 2013, the defendant filed a motion to strike count two along with the corresponding prayers of relief seeking punitive damages, attorneys fees, costs and interest on the grounds that the plaintiff's allegations are conclusory and fail to plead sufficient facts to support a claim for breach of the covenant of good faith and fair dealing.   The plaintiff filed a memorandum of law in opposition on March 15, 2013.   The matter was heard at short calendar on April 1, 2013.

BACKGROUND

This action arises as the result of a motor vehicle accident that occurred on May 15, 2011, in Madison, Connecticut.   In her complaint, the plaintiff alleges the following facts.   The plaintiff was a passenger in a motor vehicle driven by Derek Sweezy, who lost control of the vehicle causing it to leave the highway and collide into trees.   The plaintiff suffered serious injury and was taken by ambulance to Yale–New Haven Hospital, where she was treated.   The plaintiff had health insurance with the defendant who denied her coverage for medical bills claiming the plaintiff had taken a controlled substance.   Even though the defendant admits that the controlled substance had nothing to do with the collision or the treatment, it continues to deny coverage to the plaintiff for her injuries.   The plaintiff further alleges that Aetna's “intentional refusal to pay these contractual obligations has caused the plaintiff to unfairly be saddled with significant debt and caused the defendant to improperly profit from their actions.”

APPLICABLE LAW RE MOTION TO STRIKE

“[A] motion to strike challenges the legal sufficiency of a pleading, and, consequently, requires no factual findings by the trial court.”  (Internal quotation marks omitted.)  New London County Mutual Ins. Co. v. Nantes, 303 Conn. 737, 747, 36 A.3d 224 (2012).   This court takes “the facts to be those alleged in the complaint ․ and ․ construe[s] the complaint in the manner most favorable to sustaining its legal sufficiency.”  (Internal quotation marks omitted.)  Id. “Moreover [the court notes] that [w]hat is necessarily implied [in an allegation] need not be expressly alleged.”  (Internal quotation marks omitted.)   Connecticut Coalition for Justice in Education Funding, Inc. v. Rell, 295 Conn. 240, 252, 990 A.2d 206 (2010).

APPLICABLE LAW RE COVENANT OF GOOD FAITH AND FAIR DEALING

In the present case, the defendant moves to strike count two of the plaintiff's complaint and the corresponding prayers for relief on grounds that the allegations are conclusory and fail to sufficiently plead facts necessary to sustain a claim for breach of the covenant of good faith and fair dealing.   The plaintiff counters that she has sufficiently alleged facts to support her claim.

“[E]very contract carries an implied duty requiring that neither party do anything that will injure the right of the other to receive the benefits of the agreement ․ The covenant of good faith and fair dealing presupposes that the terms and purpose of the contract are agreed upon by the parties and that what is in the dispute is a party's discretionary application or interpretation of a contract term ․ To constitute a breach of [the implied covenant of good faith and fair dealing], the acts by which a defendant allegedly impedes the plaintiff's right to receive benefits that he or she reasonably expected to receive under the contract must have been taken in bad faith.”  (Internal quotation marks omitted.)  Renaissance Management Co. v. Connecticut Housing Finance Authority, 281 Conn. 227, 240, 915 A.2d 290 (2007).

“There is no Connecticut Appellate or Supreme Court case setting forth exactly what allegations are required to set forth a viable claim for bad faith.”   Mamudi v. State Farm Fire & Casualty Co., Superior Court, judicial district of Waterbury, Docket No. CV 12 6016785 (December 20, 2012, Roche, J.).  “[T]here is a split of authority among Superior Courts as to what factual allegations are sufficient to constitute a finding of bad faith ․ Some courts have required that allegations establishing a dishonest purpose or malice be specifically [pleaded] ․ Other courts have ruled that a plaintiff need only allege sufficient facts or allegations from which a reasonable inference of sinister motive can be made ․ For instance, bad faith may be inferred by repetitive, knowing or deliberate conduct as such allegations are unlikely to be attributable to an honest mistake or mere negligence.”   Metcalf v. Hartford Casualty Ins. Co., Superior Court, judicial district of Litchfield, Docket No. CV 09 6000686 (January 21, 2010, Roche, J.).

ANALYSIS

In the present case, the defendant relies on Ryan v. Allstate Indemnity Co., Superior Court, judicial district of Stamford–Norwalk, Docket No. CV 95 0142573 (September 22, 1998, D'Andrea, J.).   In that case, the court held in granting the defendant's motion to strike, that allegations the “defendant ․ acted in bad faith, and with a dishonest purpose” were legally insufficient to support a claim for breach of the covenant of good faith.   In the present case, the defendant argues that the plaintiff alleged the elements of breach of the covenant of good faith and fair dealing, but her claim is legally insufficient because she failed to plead the necessary facts to sustain her claim.   In response the plaintiff relies on Panamsat Corp. v. Millennium Television Network, Superior Court, judicial district of Stamford–Norwalk, Docket No. CV 01 0181722 (July 20, 2001, D'Andrea, J.).   In that case the court held, in denying the defendant's motion to strike, that allegations the defendant “acted in concert to reject valid claims” along with allegations that the defendant acted in “bad faith, and intentionally, willfully and/or in reckless disregard and in derogation of the plaintiff's rights” were legally sufficient to sustain a claim of bad faith.   The plaintiff argues that her claim is legally sufficient because she has alleged that the defendant is using a claim of narcotic use as a dishonest pretense to deny paying benefits to the plaintiff, and that the defendant denied her claim to improperly profit, which resulted in her being unfairly saddled with significant medical bills even though she paid her insurance premiums.

In the present case, the plaintiff alleges in count two of her complaint that the defendant's conduct in denying her insurance claim is intentional, unfairly saddled her with medical bills and caused the defendant to improperly profit from its actions.   Our superior Court is divided regarding the level of factual detail necessary to allege bad faith, however, in addressing a motion to strike the court construes the allegations broadly in a manner most favorable to sustaining the legal sufficiency.   Additionally, allegations in a complaint need not be expressly alleged.   See e.g. Connecticut Coalition for Justice in Education Funding, Inc. v. Rell, supra, 295 Conn. 252 (allegations can be implied).   The cases permitting reasonable inferences as to allegations of bad faith are persuasive and this court will follow their line of reasoning.   Viewing the complaint in the light most favorable to the plaintiff, and pursuant to the line of Superior Court cases permitting reasonable inferences of bad faith, this court finds the plaintiff's allegations of bad faith in count two of the complaint are legally sufficient and the defendant's motion to strike must be denied.

ORDER

As a result of the foregoing, the defendant's motion to strike count two of the plaintiff's complaint and the corresponding prayers for relief is hereby denied.

Devine, J.

Devine, James J., J.