NEEDREPLACE, Civil Action No. 3:13–CV–00716 (VLB).

CourtNew York District Court
Writing for the CourtVANESSA L. BRYANT
Citation7 F.Supp.3d 182
Docket NumberCivil Action No. 3:13–CV–00716 (VLB).
Decision Date21 March 2014
PartiesAMICA MUTUAL INSURANCE COMPANY, Plaintiff, v. Susan B. LEVINE, Defendant.

7 F.Supp.3d 182

Susan B. LEVINE, Defendant.

Civil Action No. 3:13–CV–00716 (VLB).

United States District Court, D. Connecticut.

Signed March 21, 2014

Motion granted.

[7 F.Supp.3d 184]

Philip T. Newbury, Jr., Howd & Ludorf, Hartford, CT, for Plaintiff.

Jennifer Beth Levine, Law Offices of Harvey L. Levine, New Britain, CT, for Defendant.


VANESSA L. BRYANT, District Judge.
I. Introduction

The Plaintiff, Amica Mutual Insurance Company (“Amica”), a Rhode Island corporation with its principal place of business in Lincoln, Rhode Island, brings this action for a declaratory judgment pursuant to 28 U.S.C. § 2201 against the Defendant, Susan B. Levine, a Connecticut resident, related to an insurance claim dispute. The Defendant filed this motion to dismiss for

[7 F.Supp.3d 185]

failure to state a claim upon which relief may be granted pursuant to Fed. R. Civ. P. 12(b)(6) and for lack of subject matter jurisdiction pursuant to Fed.R.Civ.P. 12(b)(1) and Local Rule 7. For the reasons that follow, Defendant's Motion to Dismiss is GRANTED.

II. Background

The following facts and allegations are taken from the Plaintiff's complaint (the “Complaint”) and supporting materials. [Dkt. 1, Complaint]. Amica issued an automobile insurance policy with the number 911206–22PV (the “Policy”) to the Defendant for the period between December 1, 2010 and December 1, 2011. [Dkt. 1, ¶ 6]. The Policy provides, among other things, “Medical Payments Coverage.” [ Id. at ¶ 7]. On or about September 6, 2011, the Defendant was involved in a motor vehicle accident in which she claims to have sustained personal injuries. [ Id. at ¶ 8]. As a result, she made a claim for medical payments coverage under the Policy. [ Id. at ¶ 9]. The Policy provides, in relevant part:


We have no duty to provide coverage under this policy if the failure to comply with the following duties is prejudicial to us:


B. A Person seeking any coverage must:

1. Cooperate with us in the investigation, settlement or defense of any claim or suit.

2. Promptly send us copies of any notices or legal papers received in connection with the accident or loss.

3. Submit, as often as we reasonably require:

a. To physical exams by physicians we select. We will pay for these exams.

b. To examination under oath and subscribe the same.

4. Authorize us to obtain:

a. Medical reports; and

b. Other pertinent records.

5. Submit proof of claim when required by us.

Id. at ¶ 10]. In accordance with the Policy conditions, Amica requested that the Defendant undergo a medical examination, but the Defendant refused. [ Id. at ¶¶ 11, 12]. As a result, Amica claims to have been prejudiced in its ability to properly evaluate the Defendant's claim for medical payments benefits (“med pay”). [ Id. at ¶ 13]. Amica further alleges that since the Defendant breached the Policy by refusing to undergo the requested medical examination, Amica has no duty to provide coverage for her claim. [ Id. at ¶ 14] III. Legal Standard

“ ‘To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to state a claim to relief that is plausible on its face.’ ” Sarmiento v. United States, 678 F.3d 147 (2d Cir.2012) (quoting Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009)). While Rule 8 does not require detailed factual allegations, “[a] pleading that offers ‘labels and conclusions' or ‘formulaic recitation of the elements of a cause of action will not do.’ Nor does a complaint suffice if it tenders ‘naked assertion[s]’ devoid of ‘further factual enhancement.’ ” Iqbal, 556 U.S. at 678, 129 S.Ct. 1937 (citations omitted). “Where a complaint pleads facts that are ‘merely consistent with’ a defendant's liability, it ‘stops short of the line between possibility and plausibility of ‘entitlement to relief.’ ' ” Id. (quoting

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Bell Atl. Corp. v. Twombly, 550 U.S. 544, 557, 127 S.Ct. 1955, 167 L.Ed.2d 929 (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.” Id. (citations and internal quotation marks omitted).

In considering a motion to dismiss for failure to state a claim, the Court should follow a “two-pronged approach” to evaluate the sufficiency of the complaint. Hayden v. Paterson, 594 F.3d 150, 161 (2d Cir.2010). “A court ‘can choose to begin by identifying pleadings that, because they are no more than conclusions, are not entitled to the assumption of truth.’ ” Id. (quoting Iqbal, 556 U.S. at 679, 129 S.Ct. 1937). “At the second step, a court should determine whether the ‘well-pleaded factual allegations,’ assumed to be true, ‘plausibly give rise to an entitlement to relief.’ ” Id. (quoting Iqbal, 556 U.S. at 679, 129 S.Ct. 1937). “The plausibility standard is not akin to a probability requirement, but it asks for more than a sheer possibility that a defendant has acted unlawfully.” Iqbal, 556 U.S. at 678, 129 S.Ct. 1937 (internal quotations omitted).

A. Subject Matter Jurisdiction

“A case is properly dismissed for lack of subject matter jurisdiction under Rule 12(b)(1) when the district court lacks the statutory or constitutional power to adjudicate it.” Makarova v. United States, 201 F.3d 110, 113 (2d Cir.2000). “A plaintiff asserting subject matter jurisdiction has the burden of proving by a preponderance of the evidence that it exists.” Id. (citing Malik v. Meissner, 82 F.3d 560, 562 (2d Cir.1996)). On a Rule 12(b)(1) motion, “ ‘the court must take all facts alleged in the complaint as true and draw all reasonable inferences in favor of plaintiff.’ ” Natural Res. Def. Council v. Johnson, 461 F.3d 164, 171 (2d Cir.2006) (quoting Sweet v. Sheahan, 235 F.3d 80, 83 (2d Cir.2000)). “However, where jurisdictional facts are placed in dispute, the court has the power and obligation to decide issues of fact by reference to evidence outside the pleadings, such as affidavits.” LeBlanc v. Cleveland, 198 F.3d 353, 356 (2d Cir.1999).

This action was filed in this Court pursuant to its diversity jurisdiction. Diversity jurisdiction is conferred on a district court in all civil actions between citizens of different states “where the matter in controversy exceeds the sum or value of $75,000, exclusive of interest and costs.” 28 U.S.C. § 1332(a). Neither party contests the residency prong of the statute, but the parties disagree as to whether the amount-in-controversy requirement is met.

The court measures “the amount in controversy as of the date of the complaint.” Scherer v. Equitable Life Assurance Soc'y of U.S., 347 F.3d 394, 397 (2d Cir.2003). Moreover, “[a] party invoking the jurisdiction of the federal court has the burden of proving that it appears to a reasonable probability that the claim is in excess of the statutory jurisdictional amount.” Id. (citations and internal quotation marks omitted). “This burden is hardly onerous, however, for we recognize a rebuttable presumption that the face of the complaint is a good faith representation of the actual amount in controversy.” Id. (citations and internal quotation marks omitted). “To overcome the face-of-the-complaint presumption, the party opposing jurisdiction must show to a legal certainty that the amount recoverable does not meet the jurisdictional threshold.” Id. (citations and internal quotation marks omitted). “Our cases have set a high bar for overcoming this presumption. The legal impossibility of recovery must be so certain as virtually to negative the plaintiff's good faith in asserting the claim.” Id. (citations and internal quotation marks omitted).

[7 F.Supp.3d 187]

In declaratory judgment actions based on diversity jurisdiction, “the amount in controversy is measured by the value of the object of the litigation.” Hunt v. Wash. State Apple Adver. Comm'n, 432 U.S. 333, 347, 97 S.Ct. 2434, 53 L.Ed.2d 383 (1977); Garanti Finansal Kiralama A.S. v. Aqua Marine and Trading Inc., 697 F.3d 59, 68 (2d Cir.2012). In declaratory judgment cases involving “the applicability of an insurance policy to a particular occurrence, the jurisdictional amount in controversy is measured by the value of the underlying claim—not the face amount of the policy.” Hartford Ins. Group v. Lou–Con, Inc., 293 F.3d 908, 911 (5th Cir.2002); see also Budget Rent–A–Car, Inc. v. Higashiguchi, 109 F.3d 1471, 1473 (9th Cir.1997) (“Because the applicability of Budget's liability coverage to a particular occurrence is at issue, the amount in controversy is the value of the underlying potential tort action.”); Infinity Ins. Co. v. Sevilla Guerrero, No. CIV F 07–583(AWI)(TAG), 2007 WL 2288324, at *3 (E.D.Cal. Aug. 8, 2007) (citing several cases from various jurisdictions for the same proposition); 14B Charles Alan Wright, Arthur R. Miller & Edward H. Cooper, Federal Practice & Procedure § 3710 (3d ed.1998) (hereinafter “Wright & Miller”) (same). However, if the “substance of the declaratory judgment action seeks to determine the validity of an insurance policy, then the policy limit is the amount in controversy.” Infinity Ins. Co., 2007 WL 2288324, at *3; see also Hawkins v. Aid Ass'n for Lutherans, 338 F.3d 801, 805 (7th Cir.2003) (“when the validity of a policy (as opposed to the insurer's obligation to pay) is in dispute, the face value of that policy is a proper measure of the amount-in-controversy.”); Mass. Cas. Ins. Co. v. Harmon, 88 F.3d 415, 416–17 (6th Cir.1996) (“the clear federal rule is that where the validity of an insurance policy containing disability benefit provisions is involved in a diversity action in a federal district court, future potential benefits may be considered in computing the requisite jurisdiction amount.... In contrast, future potential benefits may not be taken into consideration in the...

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