Justia Insurance Law Opinion Summaries

Brian Prahl filed a petition to compel arbitration of an uninsured motorist claim, alleging he was involved in a multiple vehicle accident in March 2016 while insured by Allstate Northbrook Indemnity Company. The insurance proceeds from the at-fault drivers were insufficient to cover his damages, leading him to seek arbitration for his underinsured motorist claim. Allstate agreed to arbitration in May 2018, but the arbitration was delayed and not concluded within the five-year deadline set by Insurance Code section 11580.2, subdivision (i). Prahl argued that Judicial Council Emergency Rule 10 extended this deadline by six months due to the COVID-19 pandemic.The Superior Court of Sacramento County denied Prahl's petition, concluding that the five-year deadline had expired and that Emergency Rule 10 did not apply to extend the deadline for arbitration. Prahl also contended that the court should have granted his petition because Allstate's opposition was not filed timely. However, the court found good cause to consider the late opposition, noting that Prahl had filed a reply on the merits.The California Court of Appeal, Third Appellate District, reviewed the case de novo and affirmed the lower court's decision. The appellate court held that Emergency Rule 10, which extends the time to bring a civil action to trial by six months, did not apply to arbitration proceedings. The court reasoned that the term "civil action" refers to court actions and does not include arbitration, which is an alternative to a civil action. Consequently, Prahl's failure to conclude the arbitration within the statutory five-year period resulted in the loss of his right to compel arbitration. The appellate court also upheld the lower court's decision to consider Allstate's late opposition, finding no undue prejudice to Prahl. View "Prahl v. Allstate Northbrook Indemnity Co." on Justia Law

In 2021, the 11640 Woodbridge Condominium Homeowners’ Association (HOA) experienced significant interior damage to their building due to two rainstorms while the roof was being replaced. The HOA filed a claim under their condominium policy with Farmers Insurance Exchange (Farmers), which was denied on the grounds that the damage resulted from nonaccidental faulty workmanship, not covered by the policy. The HOA then sued Farmers for breach of contract and breach of the implied covenant of good faith and fair dealing.The Superior Court of Los Angeles County granted summary judgment in favor of Farmers, concluding that the policy did not cover the HOA’s losses due to the water damage exclusion and the faulty workmanship exclusion. The HOA appealed the decision.The California Court of Appeal, Second Appellate District, Division Three, reviewed the case and reversed the summary judgment. The court found that the condominium policy was an “all-risks” policy, covering all damage unless specifically excluded. The court determined that there were triable issues of material fact regarding whether the exclusions cited by Farmers—the water damage exclusion and the faulty workmanship exclusion—precluded coverage. The court noted that the property had a “roof” during the repairs and that the damage could have been caused by both the rain and the alleged faulty workmanship. Therefore, the court concluded that Farmers did not establish that the damage was solely caused by faulty workmanship and that the HOA’s losses might be covered under the policy.The court reversed the summary judgment and remanded the case for further proceedings, allowing the HOA to pursue its claims against Farmers. The HOA was awarded its appellate costs. View "11640 Woodbridge Condominium Homeowners' Assn. v. Farmers Ins. Exchange" on Justia Law

Following a wildfire near their home, plaintiffs Hovik Gharibian and Caroline Minasian submitted a claim to their property insurer, Wawanesa General Insurance Company. Wawanesa paid the plaintiffs over $20,000 for professional cleaning services that were never used. Dissatisfied with the resolution, the plaintiffs filed a lawsuit against Wawanesa for breach of contract and breach of the implied covenant of good faith and fair dealing.The Superior Court of Los Angeles County granted Wawanesa’s motion for summary judgment, finding that the plaintiffs' insurance policy did not provide coverage for the claimed loss. The court determined that there was no evidence of "physical loss" as required by the policy. Plaintiffs appealed the decision.The California Court of Appeal, Second Appellate District, reviewed the case. The court held that the plaintiffs did not demonstrate a "direct physical loss to property" as required by their insurance policy. The court referenced the California Supreme Court's decision in Another Planet Entertainment, LLC v. Vigilant Ins. Co., which clarified that "direct physical loss" requires a distinct, demonstrable, physical alteration to property. The court found that the wildfire debris did not cause such an alteration and could be easily cleaned or removed. Consequently, the court affirmed the trial court's decision, concluding that Wawanesa did not breach the insurance policy since the plaintiffs' claim was not covered. All remaining arguments were deemed moot. View "Gharibian v. Wawanesa Gen. Ins. Co." on Justia Law

Andrew Murphy, a delivery driver for Grassdoor, was involved in a collision while using his personal vehicle for work. He filed a claim with his insurer, Interinsurance Exchange of the Automobile Club (erroneously sued as AAA Auto Insurance of Southern California), which was denied based on a policy exclusion for transporting property for compensation. Murphy sued for breach of contract, arguing the exclusion was ambiguous and overly broad.The Superior Court of Orange County granted summary judgment in favor of the Exchange, finding the exclusion applied and was neither ambiguous nor against public policy. Murphy appealed, contending the exclusion should only apply to independent contractors and not employees, and that it was overly broad.The California Court of Appeal, Fourth Appellate District, Division Three, reviewed the case de novo. The court held that the policy language was clear and unambiguous, excluding coverage for vehicles used to transport property for compensation. The court found that Murphy's employment status did not affect the applicability of the exclusion and that the exclusion was not contrary to public policy, as employees like Murphy are protected under Labor Code section 2802, which requires employers to indemnify employees for necessary expenditures incurred in the course of their duties.The court affirmed the trial court's judgment, concluding that the Exchange properly denied Murphy's claim based on the compensated carrying exclusion. The court also rejected Murphy's hypothetical scenarios as irrelevant to the case at hand. The judgment was affirmed, and the Exchange was entitled to recover its costs on appeal. View "Murphy v. AAA Auto Insurance of Southern California" on Justia Law

In April 2013, Michael Riste applied for a bail bond for his son, Michael Peterson, and signed an Indemnity Agreement and a Premium Agreement with Bad Boys Bail Bonds (Bail Agent). The agreements required Riste to pay a $10,000 premium in installments. Peterson signed identical documents after his release. The Bail Agent executed a $100,000 bail bond on behalf of The North River Insurance Company (Surety), ensuring Peterson's appearance at future court proceedings. Peterson failed to appear, leading to the forfeiture of the bail bond and a summary judgment against the Surety in October 2015.The Superior Court of Los Angeles County denied appellants' previous motions to set aside the summary judgment, vacate the forfeiture, and exonerate the bond. Two different panels of the Court of Appeal affirmed these denials. In October 2020, a class action cross-claim was filed against BBBB Bonding Corporation (doing business as the Bail Agent), arguing that their bail bond premium financing agreements were subject to Civil Code section 1799.91 and thus unenforceable. The trial court agreed, and the Court of Appeal upheld this finding, affirming a preliminary injunction against BBBB.In September 2022, appellants filed a third motion to set aside the summary judgment, citing the Caldwell decision. They argued that the premium was part of the consideration for the bail bond, making the bond void and the summary judgment invalid. The trial court denied the motion.The California Court of Appeal, Second Appellate District, Division Three, affirmed the trial court's order. The court held that the bail bond was not void because the consideration for the bail bond was Peterson's release from custody, not the premium financing agreement. Therefore, the trial court had jurisdiction, and the summary judgment was valid. View "P. v. North River Ins. Co." on Justia Law

In this case, the plaintiff, David Yaffee, was awarded $3,299,455 in damages by a jury for past and future economic earnings and noneconomic loss due to injuries sustained when his vehicle was rear-ended by a truck driven by Joseph Skeen, who was employed by KLS Transportation, Inc. The accident occurred in 2015, and Yaffee experienced significant medical issues, including back pain and leg tingling, leading to multiple medical treatments and surgeries.The Superior Court of Sacramento County entered a judgment on the jury's verdict, which included awards for past and future medical expenses, lost earnings, and noneconomic damages. Defendants, including National Liability & Fire Insurance Company, challenged the awards on several grounds, including the reasonableness of past medical expenses, the speculative nature of future medical expenses, and the sufficiency of evidence supporting lost earnings.The Court of Appeal of the State of California, Third Appellate District, reviewed the case. The court found that the trial court had erred in its interpretation of the Hospital Lien Act (HLA) regarding the measure of past medical damages, leading to the improper admission of evidence on the reasonable value of services. The court concluded that the HLA only applies to services provided while the patient remains in the hospital or affiliated facility following emergency services. Consequently, the award for past medical expenses was reversed.The court also found that the award for future medical expenses was not supported by substantial evidence, particularly regarding the speculative nature of the need for a dorsal root ganglion stimulator. The court reversed the award for future medical expenses and remanded for a new trial on this issue.The awards for past and future lost earnings were upheld, as the court found sufficient evidence supporting the jury's findings. The award for future noneconomic damages was also upheld, as the evidence established a reasonable certainty of future pain and suffering.The court vacated the award for costs and prejudgment interest, as these were based on the reversed portions of the judgment. The case was remanded for a new trial on the issues of past and future medical expenses. View "Yaffee v. Skeen" on Justia Law

Erin Hughes, the plaintiff, obtained two homeowner’s insurance policies for her property in Malibu. One policy, through the California FAIR Plan Association (FAIR Plan), covered fire loss, while the other, issued by Farmers Insurance Exchange (Farmers), did not. After a fire caused significant damage to her property, Hughes filed a lawsuit against Farmers, alleging it was vicariously liable for the negligence of its agent, Maritza Hartnett, who assisted her in obtaining the FAIR Plan policy, resulting in underinsurance for fire loss.The Superior Court of Los Angeles County granted Farmers’ motion for summary judgment, ruling that Hartnett was not acting within the scope of her agency with Farmers when she assisted Hughes in obtaining the FAIR Plan policy. The court also denied Hughes’s motion for leave to amend her complaint.The Court of Appeal of the State of California, Second Appellate District, reviewed the case. The court affirmed the lower court’s decision, holding that Hartnett was not acting as Farmers’ actual or ostensible agent when she helped Hughes obtain the FAIR Plan policy. The court found that Hartnett’s agent appointment agreement with Farmers did not include authority to transact insurance business on behalf of Farmers for policies issued by unrelated carriers like FAIR Plan. Additionally, the court determined that Hughes failed to present evidence showing that Farmers’ conduct could have led her to reasonably believe Hartnett was acting as its agent in procuring the FAIR Plan policy. The court also upheld the trial court’s denial of Hughes’s motion for leave to amend her complaint, citing her failure to provide an excuse for the delay in filing the motion and the potential prejudice to Farmers. View "Hughes v. Farmers Insurance Exchange" on Justia Law

In 2015, Zongwei Shen, owner of a massage spa, purchased a commercial insurance policy from Continental Casualty Company, which included an exclusion for abuse or molestation. In 2019, Toiah Gordon, Morganne Mersadie Root, and Karina Carrero sued Shen and his wife, Zhong Xin, alleging Shen sexually assaulted them during massage sessions. After Continental declined to provide a defense, Shen and Xin stipulated to liability, resulting in a $6.8 million judgment against them. Shen and Xin assigned their rights against Continental to the plaintiffs in exchange for a covenant not to execute the judgment. The plaintiffs then sued Continental for breach of contract and related claims.The Superior Court of Los Angeles County granted Continental's motion for summary judgment, finding that the abuse or molestation exclusion in the insurance policy applied. The court held that the exclusion's language was unambiguous and did not require Shen to have "exclusive or complete control" over the plaintiffs. The court also found that the claims against Xin for negligent training fell within the exclusion, as negligent training is a form of negligent employment or supervision.The California Court of Appeal, Second Appellate District, affirmed the trial court's decision. The appellate court held that the abuse or molestation exclusion applied to Shen's actions because the plaintiffs were under Shen's care and control during the massages. The court also held that the exclusion applied to Xin's alleged negligent training of Shen, as it fell within the scope of negligent employment or supervision. Consequently, Continental had no duty to defend Shen and Xin, and the summary judgment in favor of Continental was affirmed. View "Gordon v. Continental Casualty Co." on Justia Law

In 2015, Zongwei Shen, owner of a massage spa, purchased a commercial insurance policy from Continental Casualty Company, which included an exclusion for abuse or molestation. In 2019, Toiah Gordon, Morganne Mersadie Root, and Karina Carrero sued Shen and his wife, alleging Shen sexually assaulted them during massage sessions. After Continental declined to provide a defense, Shen and Xin stipulated to liability, resulting in a $6.8 million judgment against them. Shen and Xin assigned their rights against Continental to the plaintiffs in exchange for a covenant not to execute the judgment. The plaintiffs then sued Continental for breach of contract and related claims.The Superior Court of Los Angeles County granted Continental's motion for summary judgment, finding that the abuse or molestation exclusion in the insurance policy applied. The court concluded that Shen had care and control of Gordon during the massage, thus the exclusion applied to her injury. The court also found that the claims against Xin for negligent training fell within the exclusion, as negligent training is a form of negligent hiring, retention, or supervision.The California Court of Appeal, Second Appellate District, affirmed the trial court's decision. The appellate court held that the abuse or molestation exclusion applied to Shen's actions because Gordon was under Shen's care and control during the massage. The court also held that the exclusion applied to the claims against Xin, as negligent training is encompassed within negligent employment and supervision. Consequently, Continental had no duty to defend Shen and Xin, and the summary judgment in favor of Continental was affirmed. View "Gordon v. Continental Casualty Co." on Justia Law

Erin Hughes, the plaintiff, obtained two homeowner’s insurance policies for her property in Malibu. One policy, through the California FAIR Plan Association (FAIR Plan), covered fire loss, while the other, issued by Farmers Insurance Exchange (Farmers), did not. After a fire caused significant damage to her property, Hughes filed a lawsuit against Farmers, alleging it was vicariously liable for the negligence of its agent, Maritza Hartnett, who assisted her in obtaining the FAIR Plan policy, resulting in underinsurance for fire loss.The Superior Court of Los Angeles County granted Farmers’ motion for summary judgment, concluding that Hartnett was not acting within the scope of her agency with Farmers when she assisted Hughes in obtaining the FAIR Plan policy. The court also denied Hughes’s motion for leave to amend her complaint.The Court of Appeal of the State of California, Second Appellate District, reviewed the case. The court affirmed the lower court’s decision, holding that Hartnett was not acting as Farmers’ actual or ostensible agent when she helped Hughes obtain the FAIR Plan policy. The court found that Hartnett was acting as an independent broker for the FAIR Plan policy and not on behalf of Farmers. Additionally, the court determined that Hughes failed to present evidence that could establish a triable issue regarding Farmers’ vicarious liability for Hartnett’s actions.The court also upheld the trial court’s denial of Hughes’s motion for leave to amend her complaint, noting that Hughes offered no explanation for the delay in filing the motion and that allowing the amendment would have prejudiced Farmers and Hartnett. The judgment in favor of Farmers was affirmed, and Farmers was entitled to recover its costs on appeal. View "Hughes v. Farmers Insurance Exchange" on Justia Law