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Carmona v. Travelers Casualty Insurance Company of America

Court of Appeals of Utah

June 28, 2018

Fabiola Carmona, Appellant,
v.
Travelers Casualty Insurance Company of America, Appellee.

          Third District Court, Salt Lake Department The Honorable Royal I. Hansen No. 150906577

          Daniel F. Bertch, Attorney for Appellant

          Andrew D. Wright and Jennifer R. Carrizal, Attorneys for Appellee

          Judge Michele M. Christiansen authored this Opinion, in which Judges Gregory K. Orme and Kate A. Toomey concurred.

          OPINION

          CHRISTIANSEN, Judge

         ¶1 Appellant Fabiola Carmona appeals from the district court's grant of Travelers Casualty Insurance Company of America's (Travelers) motion to dismiss. We affirm.

         BACKGROUND

         ¶2 Carmona sued Badger Creek Associates LLC (Badger Creek) for personal injuries she sustained when she slipped and fell on ice in a common stairway at the Badger Creek Apartments in Salt Lake City.[1]

         ¶3 Badger Creek carried liability insurance through Travelers. The insurance policy included an indemnity provision (the Coverage C provision), which stated that Travelers would "pay medical expenses" up to $5, 000 "for 'bodily injury' caused by an accident" on Badger Creek's premises and that it would "make these payments regardless of fault." This provision explicitly excluded payments to "any insured."

         ¶4 When Carmona learned of this provision, she moved to amend her complaint to add Travelers as an additional defendant. In her proposed amended complaint, Carmona alleged that "Travelers owed [her] a contractual duty to pay medical bills" for her injuries, that Travelers knew about her injuries and had "failed to disclose the coverage to [her]," and that Travelers had "failed to pay those [medical] bills, without justification." The district court found that Carmona's motion to amend was futile and denied the motion. Specifically, the court determined that "Utah case law is clear regarding parties seeking to sue a tortfeasor's insurer" and that "'a plaintiff must direct his action against the actual tortfeasor, not the [tortfeasor's] insurer.'" (Alteration in original) (quoting Campbell v. Stagg, 596 P.2d 1037, 1039 (Utah 1979)).

         ¶5 Thereafter, Carmona filed a second lawsuit against Travelers alone.[2] Carmona claimed that, because she suffered bodily injury as a result of the accident on Badger Creek's premises, she was "a third-party or intended beneficiary" under the Coverage C provision. According to Carmona, "Travelers owed [her] a contractual duty to pay medical bills" for her injuries, and "Travelers had refused to investigate and/or pay the claim." Carmona also asserted that Travelers had breached the Coverage C provision and the implied covenant of good faith and fair dealing "by failing to investigate or pay the claim."

         ¶6 Travelers moved to dismiss for failure to state a claim upon which relief could be granted, see Utah R. Civ. P. 12(b)(6), arguing that Carmona's claims were barred by res judicata and that Carmona lacked standing to pursue claims for breach of contract and breach of the implied covenant of good faith and fair dealing because she was not a party to the insurance contract. The district court granted Travelers' motion, finding that Carmona "is not an intended third-party beneficiary to the insurance contract between Travelers and Badger Creek." The court stated that "there is no statute and nothing about the insurance contract that would give [Carmona] privity of contract and standing to sue Travelers directly." In addition, the court granted Travelers' motion on res judicata grounds, finding that "the elements of claim[] preclusion and issue preclusion have been met in this case."

         ¶7 Carmona now appeals from the district court's grant of ...


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