Insurance

Over a vigorous dissent, the majority holds that the adult daughter of the insureds under this homeowner's insurance policy does not have standing to sue the insurer for bad faith in regard to coverage for damage to the daughter's personal property that was damaged while in the insured premises.  Only the parents were named insureds under the policy, which expressly… Read More

Kaiser adequately proved that Kuntz's decedent enrolled with Kaiser under a CalPERS medical insurance plan which included an arbitration clause.  Kaiser showed that CalPERS keeps the individual enrollment forms, just sending Kaiser electronic enrollment information.  Kaiser's electronic enrollment information showed that Kuntz's decedent had been enrolled in the Kaiser health plan continuously since 1983.  Kaiser was not required to show… Read More

For purposes of unemployment insurance, the test set forth in G. Borello & Sons, Inc. v. Department of Industrial Relations (1989) 48 Cal.3d 341 governs the determination whether a worker is an employee or an independent contractor, not the more employee-friendly ABC test of Dynamex Operations West, Inc. v. Superior Court (2018) 4 Cal.5th 903.  Nevertheless, in this case, substantial… Read More

An insurer may be liable in bad faith if it fails to settle within policy limits when given the opportunity to do so.  This decision holds that to pursue a bad faith claim on that basis, it is not necessary for the insured to show that the claimant actually make a demand for settlement at or under policy limits.  Following… Read More

Ins. Code 12414.26 does not immunize a title insurer from liability with respect to rates it has not filed with the Insurance Commissioner.  The section provides:  “No act done, action taken, or agreement made pursuant to the authority conferred by Article 5.5 [dealing with rate filing and regulation] . . . of this chapter shall constitute a violation of or… Read More

It is not per se a breach of the insurer's duty of good faith for it to fail to accept a reasonable settlement offer within policy limits.  Accordingly, to support a bad faith judgment against the insurer, the jury must find that the insurer acted unreasonably in rejecting (or failing to accept) even a reasonable settlement offer within policy limits. … Read More

Following Lippitt v. Nationstar Mortgage, LLC (C.D.Cal. 2020) 2020 U.S. Dist. Lexis 122881, this decision holds that Civ. Code 2954.8 does not apply to (or require payment of interest on) hazard insurance proceeds that a lender or loan servicer holds pending the borrower/insured's rebulding or repairing the premises that secures his loan.  Section 2954.8 “applies to common escrows maintained to… Read More

Having secured a default judgment against the contractor that build a retaining wall on adjacent property which collapsed damaging plaintiff's property, plaintiff sued the contractor's general liability insurer.  This decision holds that the trial court erred in entering summary judgment in the insurer's favor.  The insurance policy was an occurrence policy.  With a continuing loss, coverage attaches when the damage… Read More

The State of California is the real party in interest in a qui tam action brought by a private party under the Insurance Fraud Protection Act (Ins. Code 1871 et seq.).  The state is not bound by an arbitration provision in a contract signed by the private party bringing the qui tam action.  Accordingly, arbitration of the qui tam action… Read More

After plaintiff sustained a loss that its insurer contended was excluded from coverage, plaintiff and insurer entered into a loan receipt agreement under which the insurer lent plaintiff the funds needed to repair the damage to its property.  The plaintiff was not personally liable to repay the loan but agreed to repay out of any proceeds it received from suing… Read More

Plaintiff, a Coptic church, bought a residence to serve as the Coptic pope's western US residence and a residence for visiting bishops.  Its insurance broker arranged for it to obtain a commercial property insurance policy which had an exclusion for loss due to water damage if the property had been vacant for 60 days or more before the loss.  This… Read More

While an insured cannot expand the scope of an existing insurance policy's coverage by waiver or estoppel, a would-be insured can rely on waiver or estoppel to show that the insurer agreed to provide the insurance despite the insured's failure to perform a condition precedent to issuance of the policy, such as submission of medical forms or, in this case,… Read More

An excess insurer may not challenge an underlying insurer’s payment decision as outside the scope of coverage and thus as improperly eroding the primary insurer's coverage and prematurely triggering the excess insurer's coverage—unless there is an indication that the payments were motivated by fraud or bad faith or the excess policy contains specific language reserving the excess insurer's right to… Read More

Generally, an insurance agent owes only a regular agent's duties of reasonable care, diligence, and judgment in procuring the insurance requested by an insured.  However, an insurance agent may assume a greater duty to the insured when one of the following three exceptions arise: “(a) the agent misrepresents the nature, extent or scope of the coverage being offered or provided,… Read More

The trial court wrongly granted a health insurer summary judgment on the insured's bad faith and UCL claims.  The insured's son was autistic and, before he turned 7 was given 157 hours a month of insured treatments.  When he turned 7, Magellan reduced the monthly allotment to 57 hours.  On the insured's appeal to the Department of Managed Health Care,… Read More

Under Ins. Code, § 11580.2(f), disputes between insureds and insurers over the amount due under the uninsured or underinsured motorist coverage in an auto policy must be submitted to arbitration, which, however, is limited to the questions of whether the insured is entitled to recover damages from the uninsured or underinsured motorist and the amount of the insured's damages.  CCP… Read More

Travelers insured several subcontractors who worked on two subdivisions developed by Pulte.  As required by their subcontracts, Pulte was made an additional insured under their Travelers policy.  When Pulte was sued for construction defects in the two subdivisions, Travelers provided a defense.  Later, it intervened to sue other subcontractors to recover its defense costs on an equitable subordination theory.  This… Read More

Following the Supreme Court's interpretation of excess insurance policies' other insurance clauses in Montrose Chemical Corp. v. Superior Court (2020) 9 Cal.5th 215, this decision holds that in a case involving coverage for injuries occurring over multiple coverage periods, the insured can reach an excess policy after "vertically" exhausting any primary insurance policies for the same period, but need not… Read More

This decision affirms a judgment against Anthem for violating the Cartwright Act by a vertical boycott.  Anthem announced that it would not accept "wrapped" health insurance plans of the type that Ben-E-Lect offered to small employers, and Anthem said it would terminate any of its agents who attempted to offer Anthem insurance plans in a "wrapped" package, such as those… Read More

The litigation privilege did not immunize coverage counsel's transmission of the claimant's tax returns to the insurer and its forensic accountant, which enabled the claimant to state a viable invasion of privacy claim on the basis that tax returns are privileged. Read More