The insured’s complaint sufficiently pled breach of contract and bad faith to survive the insurer’s motion to dismiss. Macias v. Am. Family Ins. Co., 2025 U.S. Dist. LEXIS 148628 (D. Colo. Aug. 1, 2025).

A hailstorm damaged the insureds’ property, including the roof. The insureds filed a claim (Claim One) with American Family. An adjuster assigned by American Family found storm-related damage to the gutters, window screens and lattice work, but only non-storm-related damage to other items, such as the roof. American Family determined the losses amounted to $1,104.97, which was below the deductible.

The insureds hired a public adjuster who found “widespread hail damage” to the roof shingles. The insureds submitted the public adjuster’s photos and estimate, but American Family continued to deny coverage for the roof as non-storm related.

The policy also covered losses caused by water. The home sustained interior water damage. The insureds filed a second claim (Claim Two) and again hired a public adjuster. American Family failed to render full payment for Claim Two.

The insureds filed suit alleging breach of contract and bad faith. American Family moved to dismiss. American Family argued that the complaint contained only conclusory statements and insufficient factual allegations to render their claims plausibly pleaded. The court concluded that the complaint alleged sufficient factual content to state plausible claims for relief.

On Claim One, the complaint included the following well-pleaded allegations:

The policy contained specific coverage for damage to shingled roofs caused by hail damage.

The public adjuster produced an estimate that showed “widespread hail damage to the shingled roof.”

The public adjuster’s estimate was provided to American Family, but benefits were denied in violation of the policy’s terms.

These factual allegations were sufficient to plausibly allege that American Family breached the policy.

The same analysis applied to Claim Two. The complaint alleged as follows:

The property suffered water damage.

The policy had several specific provisions that covered water damage.

American Family refused to render full payment for Claim Two despite the public adjuster’s estimate.

Finally, the insureds plausibly pleaded a bad faith claim because the complaint alleged that American Family denied payemnt wihotut a reasonable basis, The motion to dismiss was denied.