Insurance

Defendant disability insurer wrote plaintiff insured in 2015 that it had determined his disability arose from illness rather than accident and so would stop paying benefits in 2018 when he turned 65 as the policy allowed for illness-caused disability.  Plaintiff sued for breach of contract and breach of implied covenant in 2019, more than four years after the 2015 letter,… Read More

Emphasizing the difference between the broad duty to defend and the narrower duty to indemnify, this decision holds that the defendant insurer breached its contractual duty to defend plaintiff homeowner against a suit for damages caused by two pit bull dogs that the complaint alleged were owned by the homeowner.  The homeowners insurance policy contained an express exclusion of coverage… Read More

The allegation of temporary loss of use of property resulting from pandemic-related government closure orders—without any physical loss of the property—is not sufficient to support a claim against an insurer for business income coverage under a policy that requires the suspension be caused by “direct physical loss of or damage to” insured property.  Instead some physical alteration of the premises… Read More

In this case, plaintiff obtained a UIM arbitration award for the entire $1 million umbrella policy limit due to emotional distress plaintiff suffered from seeing the underinsured motorist hit her mother who was crossing the street with her.  Before the arbitration award, plaintiff made a 998 offer for a penny less than the umbrella policy limits, which the insurer refused. … Read More

This decision affirms a summary judgment for the insurer against a business interruption insurance claim by a casino due to COVID-19.  The decision holds that while it may be enough to overcome a demurrer for the complaint to allege simply that COVID-19 altered the surfaces of the plaintiff's business property, at the summary judgment stage much more is required to… Read More

This decision holds that a restaurant established that its business losses incurred due to government closure orders during the COVID-19 pandemic were within the basic coverage of its business interruption coverage but also fell within the virus exclusion and the exclusion for loss caused directly or indirectly by enforcement of an ordinance or law.  Hence, judgment for the insurer is… Read More

The no voluntary payment clause in plaintiffs' insurance policies barred its recovery for costs it incurred in complying with a settlement agreement and consent order with the government to remediate mercury contamination of water supplies.  Plaintiff had notified defendant of its receiving a notice of the federal government's claim for natural resources damages from the contamination, but then failed to… Read More

One insurer may recover equitable contribution from another insurer only if the two insurers share the same level of liability on the same risk as to the same insured.  Here, a business' CGL insurer sought equitable contribution from the same business' workers compensation insurer.  Dismissal of the complaint was affirmed because the two insurers did not insure the same risk. … Read More

The court that wrote Inns-by-the-Sea v. California Mutual Ins. Co. (2021) 71 Cal.App.5th 688 affirms summary judgment for the defendant insurer in the COVID-19 case.  While the plaintiff introduced sufficient evidence to show that COVID-19 airborne particles might have caused physical damage to the motel, the plaintiff couldn't show that its business losses were due to that contamination rather than… Read More

Following Marina Pacific Hotel & Suites, LLC v. Fireman's Fund Ins. Co. (2022) 81 Cal.App.5th 96, this decision holds that a complaint alleging that COVID-19 physically changes the business premises by virus-infected droplets adhering to surfaces and transforming them into disease-spreading modalities states an actionable claim for coverage under standard CGL business interruption coverage language. Read More

The supplementary payments provision of this contractor's CGL policy provided that if the insured contractor faced liability for personal injury or property damage pursuant to an indemnity provision in one of the insured's contracts, the insurer would pay for the insured's defense but count any recovery by the indemnitee as damages against the $1 million limit on coverage.  The supplementary… Read More

Under a unique virus coverage endorsement that did not require physical loss of or damage to real property, this CGL policy's business interruption policy might provide coverage for COVID-19 caused business interruption losses. Read More

Under FRCivP 24(a), a would-be intervenor must show that it has a significant protectable interest as to the property or transaction involved in the dispute which may be impaired by resolution of the case as well as that the motion to intervene was timely and the existing parties don't or can't protect the intervenor's interest.  Here, the plaintiff sought a… Read More

Under a manuscript endorsement, Yahoo's insurance policy provided covereage for “injury . . . arising out of . . . [o]ral or written publication, in any manner, of material that violates a person’s right of privacy.”  This decision holds that the "restrictive relative phrase" "that violates a person's right of privacy" might under standard rules of English usage and the… Read More

A divorce decree required ex-husband to maintain wife as 25% owner of his life insurance policy and forfeited to her the entire ownerhip interest if he stopped paying the premiums and she took over that burden.  That's what happened, as defendant's agent knew.  The agent's knowledge was imputed to defendant.  The insurance policy’s requirements for changing ownership do not control… Read More

In 2004-2011, Travelers issued workers compensation policies to Adir Int'l, LLC which contained a reference to a side agreement allowing retroactive recalculation of the premiums.  The policies were filed with the Insurance Commissioner, as required; the side agreement was not.  When Travelers demanded retroactive premiums, Adir sued for a declaration that the side agreement was illegal and unenforceable since it… Read More

The communicable disease extension of the comprehensive property insurance policy that Fireman's issued to Amy's provided coverage for the costs of remediating, cleaning, disinfecting, etc. the premises after a communicable disease event, defined to mean  “an event in which a public health authority has ordered that a location be evacuated, decontaminated, or disinfected due to the outbreak of a communicable… Read More

This decision holds that the insured's original complaint failed to allege a covered business interruption loss due to COVID-19 stay-at-home orders.  However, it also holds that it was error to deny the insured leave to amend since the demurrer had been sustained to the insured's original complaint, the insured requested leave to amend and described in some detail what additional… Read More

Joining Inns-by-the-Sea v. California Mutual Ins. Co. (2021) 71 Cal.App.5th 688 and many later decisions, this case holds that COVID-19 and the accompanying stay at home orders did not cause physical loss or damage to the insured's business premises and so did not give rise to business interruption coverage under its CGL policy. Read More

The insured landlord's CGL policy excluded claims for claims arising out of actual or claimed uninhabitable conditions on the premises--and all other claims (whether or not otherwise covered) which were alleged in the same suit as claims for non-habitability.  This decision holds that the exclusion was plain, clear, conspicuous, and enforceable.  As a result, the exclusion relieved the insurer of… Read More