Allegations Of Fraud Against Adjusters – Insurance Lawsuits

When suing an adjuster, the requirements are very specific to keep a case out of Federal Court. This is illustrated in a U.S. Northern District, Fort Worth Division, opinion. The case is styled Southlake Campus, Inc. v. Allstate Insurance Company, et al.
This action arises from a dispute over insurance coverage of a property damaged during a storm. Southlake alleges various causes of action which are specifically asserted against Allstate only. The only part of the petition that includes allegations against the adjuster is the section requesting a declaratory judgment.
This case was removed to Federal Court by Allstate under 28 U.S.C. 1332, for reason of diversity of citizenship and the amount in controversy exceeding $75,000.00. Allstate contends the adjuster was not properly joined as a defendant.
Southlake contends the adjuster was properly joined by the allegations of fraud.
The 5th Circuit has held a Rule 12(b)(6) type of analysis is required in these claims. Also, that the new Texas Civil Rule 91a applies.
The Texas rule is substantially the same as the federal rule. This new rule now allows a state court to do what a federal court can do.
The rule requires that a complaint contain “a short and plain statement of the claim showing that the pleader is entitled to relief in order to give the defendant fair notice of what the claim is and the grounds upon which it rests.” Although a complaint need not contain detailed factual allegations, the “showing” contemplated by Rule 8 requires the plaintiff do more than simply allege legal conclusions or recite the elements of a cause of action. Thus, while a court must accept all of the factual allegations in the complaint as true, it need not credit bare legal conclusions that are unsupported by any factual underpinnings.
To survive a motion to dismiss for failure to state a claim, the facts pleaded must allow the court to infer that plaintiff’s right to relief is plausible. 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.
For a pleading of fraud to be sufficient, the plaintiff must set forth in the complaint the “who, what, when, where, and how” of any alleged fraud. A plaintiff pleading fraud must specify the statements contended to be fraudulent, identify the speaker, state when and where the statements were made, and explain why the statements are fraudulent.
In this case, all of Southlake’s six claims list only Allstate as defendant. In the motion to remand and reply, Southlake appears to contend that it has alleged a claim for fraud against Oliver. The court was perplexed by this because Southlake’s complaint explicitly states that the claim for fraud is asserted against Allstate only.
While it is true that the section of Southlake’s complaint includes some factual allegations related to the adjuster, a close analysis discloses that they are nothing more than mere conclusions. No facts are alleged that would plausibly lead to the conclusion that Southlake suffered any damage by reason of the conduct of the adjuster, bearing in mind that ultimately Allstate, not the adjuster, was responsible for insurance coverage.
This court found that Southlake failed to state a claim against the adjuster and thus found the joinder of the adjuster was without basis and Southlake’s motion to remand to state court was denied.