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Legal Updates for Insurance Agents & Brokers

Can a Claim Against an Agent Be Limited Under the Gist of the Action Doctrine In Pennsylvania?

Legal Update for Insurance Agents & Brokers – August 2022

August 22, 2022

Residential real estate sales are governed by the terms of the sales agreement. The contract for the sale of real estate establishes the legal rights and obligations of both the buyer and the seller in regard to the property itself and the transaction. When courts are confronted with disputes between a buyer and seller, and the seller’s agent, over a real estate transaction, the sales agreement along with the seller’s disclosure statement are the bases for the claims and defenses asserted. Despite real estate sales being a fundamentally contract matter, legal disputes between a buyer, a seller and an agent are not limited to breach of the contract upon which the transaction is based.

In the case of Josaphs v. Lacy, 2022 WL 474715 (E.D. Pa. Feb. 16, 2022), the court addressed a claim made by the buyer of residential property that the seller failed to complete repairs as required under the terms of the Agreement for Sale of Real Estate. The sellers then brought suit, alleging not only a claim for breach of the contract, but also separate tort claims for misrepresentation and fraud, and violations of the Real Estate Seller Disclosure Law and Unfair Trade Practices. The buyers sought to dismiss the claims on the basis of the legal doctrine that the “gist of the action” is in contract.

In its analysis, the court in Josaphs noted that the gist of the action doctrine precludes a plaintiff from bringing what is actually a breach of contract claim as a tort claim when the parties’ actions are defined by the terms of a contract and the claim is based on a breach of a specific promise in the contract. However, under established Pennsylvania law, the fact that a contract governs the parties’ actions does not limit a claim for damages to a breach of the contract where the wrong complained of arises from a violation of a broader social duty. Thus, fraud or misrepresentation claims not related to the performance of the contract are not precluded by the gist of the action doctrine.

Applying the principle of the gist of the action doctrine to the real estate dispute, the court held that the claim, based on the failure to make repairs to the property, was one of breach of the contract terms under the sales agreement. The plaintiffs’ claims of fraud, misrepresentation and violation of the Unfair Trade Practices law were barred as a result. A separate claim, that the defendants violated the disclosure statement by misrepresenting that the property had been vacant, was not barred by the gist of the action doctrine. The court reasoned that the disclosure statement was collateral to the sales agreement and the misrepresentation did not relate to the performance of a provision of the statement itself.

That the gist of the action doctrine was found to apply at all, even in a limited fashion, by the court in Josaphs is noteworthy as other courts have narrowed its application to cases involving disputes over insurance coverage under a contract. In two recent rulings, federal courts have held that this doctrine does not preclude misrepresentation claims against the insurer and the sales agent based on breach of a life insurance policy. In Rosenberg v. Nassau Life Insurance Company, 2022 WL 2718607 (E.D. Pa. Jul. 13, 2022), the Trust owner claimed that the insurer and the agent misrepresented the availability of an option to convert to another policy. The court found that the plaintiff’s fraud claim was premised not on the defendants’ obligations under the conversion provision of the contract, but on the defendants’ “broader social duty ... to refrain from defrauding” the Trust during the conversion process. In Vliet v. Liberty Mutual Insurance Company, 2022 WL 2109203 (E.D. Pa. Jun. 10, 2022), the plaintiff claimed the insurer did not fully cover property damage under its policy and had misled her into purchasing an inadequate insurance policy. The court found that this claim was not barred where the alleged misrepresentation was not based on following the terms of the policy but, rather, the inducement by the sales agent to purchase the insurance.

The importance of these decisions in the context of the defense of a real estate seller or agent is that, while the gist of the action doctrine may still be asserted to challenge a tort claim that is fundamentally based on the terms or conditions of the sales agreement or other contract between buyer and seller, courts are limiting the application of this principle where the claims involve alleged misrepresentations in the sales transaction separate from the terms of the agreement.

 

Legal Update for Insurance Agents & Brokers – August 2022, has been prepared for our readers by Marshall Dennehey. It is solely intended to provide information on recent legal developments, and is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. We welcome the opportunity to provide such legal assistance as you require on this and other subjects. If you receive the alerts in error, please send a note tgventura@mdwcg.com. ATTORNEY ADVERTISING pursuant to New York RPC 7.1. © 2022 Marshall Dennehey. All Rights Reserved.

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Thought Leadership

Commonwealth Court Reaffirms the Constitutionality of Act 111's IRE Provisions

In this case, the claimant sustained a work injury of January 6, 1994, which was acknowledged by Notice of Compensation Payable (NCP). After the claimant’s receipt of 104 weeks of temporary total disability benefits, the employer filed a Request for an Impairment Rating Examination (IRE). The IRE was performed in May 2023 and the IRE physician found that the claimant had a 5% whole person impairment, under the AMA Guides. The employer filed a Petition based on the IRE results, and the Petition was granted by the WCJ. During litigation, the claimant argued that the IRE provisions of Act 111 (Section 306(a.3) of the Act) were not applicable to her injury, since it predated June 24, 1996, the date Act 57 went into effect, and that the IRE provisions were unconstitutional. The Workers’ Compensation Judge (WCJ)) granted the Petition and the Board affirmed. On appeal to the Commonwealth Court, the claimant argued that Act 111 violated the nondelegation doctrine and that its retroactive application to the claimant’s injury was unconstitutional. The court rejected the arguments on the basis that they had already found the same arguments without merit in multiple, prior cases. The court also addressed an argument made by the claimant that Act 111 was procedurally defective under the Pennsylvania Constitution because it was only considered on two days in each House after having undergone amendments and reassignments. The court noted that the Pennsylvania Constitution requires every bill to be considered on three different days in each House. The claimant maintained that, according to the legislative history, the bill did not receive three separate days of consideration from each House when it was assigned a new bill number. The court pointed out, however, that the bill number, H.B. 1840 remained constant and was considered on three occasions by the House. Further, the court concluded that minor amendments to the bill were germane to its original subject, which was to modify the Act’s IRE process, in accordance with Protz II.

Thought Leadership

Florida Supreme Court Rules Florida Statute §627.70152 Does not Apply Retroactively

In a decision that resolves years of appellate uncertainty and confirms that insurers and insureds alike can rely on the legal framework in place when a policy is issued, the Supreme Court of Florida last week found that Florida Statute §627.70152, which involves an insured’s requirement to provide an insurer with pre-suit notice before filing a suit, cannot be applied retroactively. In Universal Property & Casualty Insurance Company v. Hughes, the Court was presented with the issue of whether the statutory pre-suit notice requirement applied retroactively and whether it would apply to a breach of contract of an insurance policy that was issued before the statute went into effect. Before the Court was an appeal from a homeowner, Ms. Hughes, who sued her insurance carrier, Universal Property & Casualty Insurance Company (Universal) for breach of contract under an insurance policy that was in effect from April 24, 2019 through April 24, 2020. During the policy period, Ms. Hughes suffered a loss and, on May 29, 2019, made a claim for water damage. The carrier investigated the loss and issued payment; Ms. Hughes disputed the payment, finding the amount insufficient for repairs. On July 1, 2021, Florida Statute §627.70152 went into effect, which required insureds to provide notice of intent to initiate litigation against the carrier prior to filing a lawsuit; if an insured filed the lawsuit without complying with §627.70152, a court must dismiss the case without prejudice. On August 4, 2021, Ms. Hughes filed her lawsuit against Universal for breach of contract. Universal moved to dismiss based on her failure to comply with §627.70152. Ms. Hughes contended the notice requirement could not be applied retroactively. The trial court disagreed and dismissed the lawsuit without prejudice, and Ms. Hughes appealed. During the appeal, the Fourth District Court of Appeal, in Cole v. Universal Property & Casualty, 363 So. 3d 1089 (Fla. 4th DCA 2023), ruled that Florida Statute §627.70152 did apply retroactively to policies issued before the effective date of §627.70152. However, the Sixth District Court agreed with Ms. Hughes and overturned the trial court’s ruling, finding the statute could not retroactively apply to policies issued prior to the statute effective date. Thereafter, the other district courts weighed in, with the Third District Court agreeing with the Fourth District Court, and the First, Second and Fifth District Courts agreeing with the Sixth District Court. In resolving the conflict amongst the district courts, the Supreme Court advised “as a general rule, ‘the statute in effect at the time an insurance contract is executed governs substantive issues arising in connection with that contract.’ Hassen v. State Farm Mut. Auto. Ins. Co., 674 So. 2d 106, 108 (Fla. 1996). The Court applied the two-step test when deciding whether a statute has retroactive application: “First, the Court must ascertain whether the Legislature intended for the statute to apply retroactively. Second, if such an intent is clearly expressed, the Court must determine whether retroactive application would violate any constitutional principles.” Menendez v. Progressive Exp. Ins. Co., 35 So. 3d 873, 877 (Fla. 2010). In analyzing the Legislature’s intent, the Court must determine whether the Legislature has manifested a clear command for retroactivity in the statutory text.  In review of the statutory text, the Court found nothing in the language of the statute to indicate that the phrase “all suits” was serving another purpose of expanding its reach to suits based on policies that both predate and postdate the enactment of the statute. Buis v. Universal Prop. & Cas. Ins. Co., 394 So. 3d 738, 741 (Fla. 2d DCA 2024). Further, the Court noted the statute has an effective date, which has long been considered to be evidence against retroactive application of a statute. The Court concluded that, on its face, no provision of §627.70152 speaks to application of the statute to insurance policies issued before the statute’s effective date and therefore, the Legislature did not clearly command retroactivity of the statute to include insurance policies issued prior to the enactment of the statute. The Court briefly reviewed Universal’s argument that the presuit notice requirement was procedural, not substantive, and therefore should be applied retroactively; however, the Court agreed with the Sixth District Court’s finding that, in its entirety, §627.70152 transformed an insured’s ability to sue an insurance company under a property insurance policy and an insurer’s obligations to respond to and pay insurance claims, thus making the requirement a substantive change. The Court thereby upheld the decision of the Sixth District and disapproved the decision of the Fourth District in Cole.

Thought Leadership

The Tolling Trap: Filing Alone Will Not Toll the Statute Without Good-Faith Service

The Eastern District of Pennsylvania recently reinforced a critical limitation on bad faith claims, holding that a timely filing alone will not preserve a cause of action absent a good-faith effort to serve the original process. The plaintiff had presented a claim for underinsured motorist benefits to his auto insurer. The insurer evaluated the claim and determined that the plaintiff’s accident-related damages did not exceed the bodily injury liability insurance limits of the at-fault driver and denied his claim. Among other claims, the plaintiff sought to present a claim for insurance bad faith under 42 Pa. C.S.A. § 8371, to which a two year statute of limitation applies. He first filed a praecipe for writ of summons before the expiration of the statute of limitation. However, the plaintiff did not attempt to serve the praecipe or writ until after the statute of limitations had expired. Additionally, the service failed as the plaintiff had mailed the original process to an incorrect address. Despite receipt of the Postal Service’s failure to deliver the original process, the plaintiff did not attempt to re-serve the writ. Two months later, the plaintiff filed a complaint and then successfully served that complaint. The insurer sought to dismiss the plaintiff’s bad faith claim as time-barred by the statute of limitations. The district court agreed. Though the plaintiff had filed a praecipe for a writ of summons prior to the expiration of the statute of limitations, the statute is only tolled if there is a good faith effort to serve that original process. In this case, the court determined that the plaintiff had failed to perform a “good faith effort to serve the original process”. Additionally, though the filing and service of a complaint can serve as alternative original process when the lawsuit is commenced by the filing of a praecipe for a writ of summons, the plaintiff filed his complaint after the statute of limitations had expired. The plaintiff’s bad faith claim was therefore determined to be barred by the statute of limitations and dismissed by the court, with prejudice. A key takeaway for the defense is not to assume that the statute of limitations has been successfully tolled by a plaintiff merely because a praecipe for a writ of summons or complaint has been filed prior to the expiration of the statute. A filed complaint or writ is only part of the equation. The defense should carefully review the docket and filings to confirm that the plaintiff also performed the requisite good faith effort to serve that original process. A thorough review of the docket may reveal that the plaintiff failed to make the good-faith service efforts necessary to toll the statute of limitations.