Green v. Holm

• Decision Date: 12 January 1981
• Docket Number: No. 8087-3-I,8087-3-I
• Citation: 28 Wn.App. 135,622 P.2d 869
• Parties: Cindy GREEN, a single woman; and Laurie Woloszyn, a single woman, Appellants, v. Ralph R. HOLM, Jr. and Jane Doe Holm, husband and wife, individually and the marital community composed thereof, Respondents, v. FEDERATED AMERICAN INSURANCE COMPANY, Respondent.
• Court: Washington Court of Appeals

Page 135

28 Wn.App. 135

622 P.2d 869

Cindy GREEN, a single woman; and Laurie Woloszyn, a single

woman, Appellants, v. Ralph R. HOLM, Jr. and Jane Doe Holm, husband and wife,

individually and the marital community composed

thereof, Respondents, v. FEDERATED AMERICAN INSURANCE COMPANY, Respondent.

No. 8087-3-I.

Court of Appeals of Washington, Division 1.

Jan. 12, 1981.

Gerald B. Netzky, Redmond, for appellants.

Wayne Murray, Seattle, for respondents.

DURHAM, Judge.

This action arises out of an automobile accident occurring on February 24, 1979, involving appellants Laurie Woloszyn and Cindy Green, and respondent Ralph R. Holm, Jr. Holm admits that he negligently struck the vehicle in which Woloszyn and Green were riding. Appellants allege that Holm's insurer, Federated American Insurance Company (Federated), has never questioned Holm's liability. Appellants further allege that before Woloszyn obtained an attorney, Federated paid some of her medical bills, but that afterwards Federated "categorically refused" to pay any more of her medical bills.

In their complaint for damages brought against Holm, his wife, and Federated, appellants claim that Federated committed an unfair trade practice under the Consumer Protection Act, RCW 19.86, and WAC 284-30-300 et seq., by refusing to pay Woloszyn's medical bills. Specifically, they allege:

XI

Plaintiff, Wolosyzn (sic ), is therefore put in an improper position of being penalized for obtaining counsel and her credit is being impaired because she cannot pay her hospital and medical bills.

XII

In addition, plaintiff, Wolosyzn (sic ), is in the unfair position of being pressured to settle her claim at a figure that may be less than just in order to obtain money to salvage her credit rating and avoid lawsuits and collections.

The trial court granted respondents' motion for summary judgment, and dismissed the claim against Federated with prejudice for its failure to state a cause of action.

Initially, we note that even though the matter before us is a summary judgment in form, it is a CR 12(b)(6) motion to dismiss in substance, and we must review it as such. Corrigal v. Ball & Dodd Funeral Home, Inc., 89 Wash.2d 959, 577 P.2d 580 (1978). Such a motion may be granted only when, after accepting the appellants' allegations as true, the court can say beyond doubt that no set of facts consistent with the complaint could be proven which would entitle the appellants to relief. Corrigal at 961, 577 P.2d 580.

Appellants first argue that they have shown that Federated engaged in a per se violation of the Consumer Protection Act, RCW 19.86. They contend that if their allegations are taken as true, then they have satisfied the requirements enunciated in State v. Reader's Digest Ass'n, 81 Wash.2d 259, 501 P.2d 290 (1972), appeal dismissed, 411 U.S. 945, 93 S.Ct. 1927, 36 L.Ed.2d 406 (1973) and Salois v. Mutual of Omaha Ins. Co., 90 Wash.2d 355, 581 P.2d 1349 (1978); the unlawful act here being Federated's alleged violation of RCW 48.01.030. ¹ A Consumer Protection Act claim against an insurance company for breach of its duty to exercise good faith under RCW 48.01.030 is limited to the insured. Rice v. Life Ins. Co., 25 Wash.App. 479, 609 P.2d 1387 (1980). Here, Federated is Holm's insurer, not the appellants'. They cannot assert a claim under the Act because it does not apply to a relationship that is adversarial in nature. Marsh v. General Adjustment Bureau, Inc., 22 Wash.App. 933, 592 P.2d 676 (1979).

Appellants next contend that their complaint states a claim under WAC 284-30-300 et seq. and that Federated's violation of these administrative regulations constitutes negligence per se under the rule of Bayne v. Todd Shipyards Corp., 88 Wash.2d 917, 568 P.2d 771 (1977). Appellants suggest that the purpose of these regulations is to avoid exactly the type of conduct that transpired here, i. e., Woloszyn was forced to choose between settling her claim for a lesser amount or jeopardizing her financial future. Federated responds that the specific regulations cited are inapplicable and cannot serve as the basis for an action against the company.

WAC 284-30 is authorized by RCW 48.30.010. ² The purpose of WAC 284-30 is to "define certain minimum standards which, if violated with such frequency as to indicate a general business practice, will be deemed to constitute unfair claims settlement practices." WAC 284-30-300. The regulations define certain unfair or deceptive acts or practices. WAC 284-30-330. The regulations, however, are not exclusive. WAC 284-30-310. Other acts may also be deemed to be violations of the insurance code or other regulations. WAC 284-30-310.

Appellants argue that Federated violated WAC 284-30 in general, and WAC 284-30-330(6), (7), (12), and (16) in particular. No cases have yet interpreted any of these regulations, which became effective on September 1, 1978. We have reviewed the entire chapter, and conclude that the only regulation that possibly applies here is WAC 284-30- 330(6). ³ That regulation defines as an unfair or deceptive act or practice in the business of insurance: "Not attempting in good faith to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonably clear." WAC 284-30-330(6). Even though appellants' complaint did not use these precise words, their complaint could be construed to allege a violation of subparagraph (6), and we will construe it as such. CR 8(f).

Woloszyn's status is that of a third party claimant, which the regulations define as "any individual, ... asserting a claim against any individual, ... insured under an insurance policy or insurance contract of an insurer." WAC 284-30-320(8). Because WAC 284-30-330 does not distinguish between first and third party claimants, Woloszyn's status as a third party claimant does not prevent her from asserting a claim under that regulation. Assuming without deciding that a private cause of action may be based upon a violation of WAC 284-30-330, the appellants' complaint still fails to state a claim upon which relief can be granted.

Woloszyn's claim against Federated may be broken down into three parts. First, she claims her credit was impaired. Federated cannot be held legally responsible for any impairment of her credit, however, because Federated had no legal duty to pay any of her medical bills before she formally settled, or adjudicated, her claim. See Bowe v. Eaton, 17 Wash.App. 840, 565 P.2d 826 (1977). Next, she claims she was penalized for obtaining counsel. If Woloszyn was in fact being penalized for obtaining counsel, then her complaint might have been legally sufficient; e. g., if Federated had first offered her $100,000, but after obtaining counsel reduced its offer to $50,000. Federated's mere discontinuance of paying medical bills that it had no legal duty to pay,...