United States District Court, W.D. Oklahoma
JOHN T. LINTHICUM dba LINTHICUM ANGUS RANCH, Plaintiff,
PRAETORIAN INSURANCE COMPANY, Defendant.
TIMOTHY D. DEGIUSTI UNITED STATES DISTRICT JUDGE.
the Court is Defendant's Motion to Dismiss [Doc. No. 9],
filed pursuant to Fed.R.Civ.P. 12(b)(6). Plaintiff has filed
a response [Doc. No. 14] in opposition to the Motion, and
Defendant has replied [Doc. No. 15]. The Motion is fully
briefed and ripe for decision.
brings this diversity action to recover damages under
Oklahoma law for breach of contract, insurer's bad faith,
and fraud. Plaintiff alleges Defendant wrongly denied
his insurance claim for payment due under a livestock
mortality policy, and breached its duty of good faith and
fair dealing by failing to properly investigate, adjust, and
pay the claim. Plaintiff also alleges Defendant's
soliciting agent, Troy Alexander, misrepresented the
valuation process for insured animals worth more than $100,
000 and falsely stated the insured value of the covered
animal (payable in the event of a covered loss) would be the
amount stated in the policy once it was approved by the
underwriting department and issued. According to Plaintiff,
only after the covered animal died did he learn that
Defendant would actually conduct a valuation process during
the investigation of the loss, and this process caused
payment of his claim to be delayed and ultimately denied.
Motion, Defendant asserts that Plaintiff's pleading fails
to state any plausible claim. Defendant contends
Plaintiff's contract claim is time barred, his bad faith
claim fails for lack of a viable contract claim, and the
fraud claim fails because Plaintiff's factual allegations
are inconsistent with the terms of the written
survive a motion to dismiss [under Rule 12(b)(6)], a
complaint must contain sufficient factual matter, accepted as
true, to ‘state a claim to relief that is plausible on
its face.'” Ashcroft v. Iqbal, 556 U.S.
662, 678 (2009) (quoting Bell Atlantic Corp. v.
Twombly, 550 U.S. 544, 570 (2007)). “A claim has
facial plausibility when the plaintiff pleads factual content
that allows the court to draw the reasonable inference that
the defendant is liable for the misconduct alleged.”
Iqbal, 556 U.S. at 678. Determining whether a
complaint states a plausible claim for relief is a
“context-specific task that requires the reviewing
court to draw on its judicial experience and common
sense.” See id. at 679. The question to be
decided is “whether the complaint sufficiently alleges
facts supporting all the elements necessary to establish an
entitlement to relief under the legal theory proposed.”
Lane v. Simon, 495 F.3d 1182, 1186 (10th Cir. 2007)
(internal quotation omitted).
the allegations [of a complaint] show that relief is barred
by the applicable statutes of limitations, the complaint is
subject to dismissal for failure to state a
claim.'” Vasquez Arroyo v. Starks, 589
F.3d 1091, 1096-97 (10th Cir. 2009) (quoting Jones v.
Bock, 549 U.S. 199, 215 (2007)); accord Chance v.
Zinke, 898 F.3d 1025, 1034 (10th Cir. 2018). This is so
because “any party claiming the benefit of equitable
tolling of a limitations period . . . [bears] the burden of
[pleading and] proving justifiable circumstances.”
Olson v. Federal Mine Safety & Health Review
Comm'n, 381 F.3d 1007, 1014 (10th Cir. 2004);
see Aldrich v. McCulloch Prop., Inc., 627 F.2d 1036,
1044 n.4 (10th Cir. 1980).
the allegations of the Complaint as true, Defendant issued a
livestock mortality insurance policy to Plaintiff on November
11, 2016, for a registered angus cow, which died during the
term of the policy on July 20, 2017. Plaintiff timely submitted a
claim to Defendant for the loss and complied with
Defendant's instructions regarding handling and
inspecting the animal for coverage. Then, contrary to
representations made by Defendant's agent, Mr. Alexander,
during the sale of the policy, Defendant began a valuation
process to determine the coverage amount of the policy. In
selling the policy, Mr. Alexander had stated that, for
animals valued at more than $100, 000, Defendant required an
appraisal to establish an insured amount for the animal
during the underwriting and issuance of the policy, and once
the policy was issued this stated insured amount would be
payable upon a covered loss. The insured amount for
Plaintiff's covered animal was $500, 000. Mr. Alexander
repeatedly assured Plaintiff that the policy would provide
this amount of coverage if Defendant's underwriting
department approved it and issued the policy.
the loss, however, Defendant handled Plaintiff's claim in
a different way, by initiating a process to determine the
insured amount. Due to this process, payment due under the
policy was delayed and eventually denied because Plaintiff
failed to provide additional information and documentation
that Defendant required. Plaintiff contends Mr.
Alexander's misrepresentations and failure to disclose
the requirements later imposed by Defendant regarding
valuation of the animal “led to confusion, conflict and
denial of [Plaintiff's] claim which otherwise could have
been promptly paid upon verification of the covered death of
the covered animal.” See Compl. [Doc. No.
1-2], ¶ 20.
Plaintiff admits that he “did not complete a request
from the insurance company for his EUO [examination under
oath] and his claim was declined for failure to
comply.” Id. . ¶ 8. However, he alleges
the following facts:
In June 2018, [Plaintiff] offered to complete the EUO and
submit additional documentation, etc., and on July 11, 2018,
the insurance company indicated that they were considering
[Defendant's] prior declination of coverage and the
reopening of [Plaintiff's] claim. On July 27, 2018,
[Defendant] declined to go forward with the EUO's or to
further consider the claim.
Id. Plaintiff alleges that a final denial letter
issued on July 27, 2018, stated as the reasons for
Defendant's decision, Plaintiffs “continued failure
to produce [certain] documents” and “failure to
comply with Condition 10” of the policy, which requires
an EUO and the production of all records and receipts
requested by Defendant. Id. ¶ 12; see
Def.'s Mot, Ex. 1 [Doc. No. 9-1] (hereafter
“Policy”) at 3, ¶ 10. Plaintiff alleges that
if Defendant “had not refused to proceed with the
offered EUO” but, instead, had completed the
examination and an adequate investigation before denying
reconsideration of the claim, Defendant would have been aware
that the requested documentation that it “cited as
lacking . . . does not exist.” See Compl.
in apparent anticipation of a time-bar defense, Plaintiff
alleges that he was required by the policy to “comply
with Defendant's requested EUO prior to proceeding in
civil litigation” and “Defendant did not decline
to take his EUO until July 27, ...