Justia Insurance Law Opinion Summaries

Curtis Diblin and Monee Gagliardo were housemates when Diblin attacked Gagliardo with a rubber mallet, causing significant injuries. Diblin was criminally prosecuted and pled guilty to assault with intent to commit a sexual crime. Gagliardo then filed a civil suit against Diblin, alleging several intentional torts and negligence, all based on the attack. The operative complaint at trial did not allege any facts suggesting accidental conduct or negligence unrelated to the assault. Diblin’s homeowners insurance policy with State Farm covered injuries arising from an “occurrence,” defined as an “accident,” and excluded coverage for intentional or willful acts.In the San Diego County Superior Court, a jury found Diblin liable for gender violence (an intentional tort) and negligence, awarding Gagliardo over $2.5 million in compensatory damages. The jury also found Diblin acted with malice and oppression, supporting punitive damages, though Gagliardo later waived her right to punitive damages. State Farm, having defended Diblin under a reservation of rights, filed a declaratory relief action seeking a determination that it owed no duty to indemnify Diblin for the judgment.The California Court of Appeal, Fourth Appellate District, Division One, reviewed the trial court’s judgment in favor of State Farm. The appellate court held that the jury’s findings in the underlying action established Diblin’s conduct was intentional, not accidental, and therefore not a covered “occurrence” under the policy. The court rejected arguments that the negligence finding mandated coverage or that the concurrent independent causes doctrine applied, finding the injury-producing conduct was not independent of the intentional act. The court also found no need for a new jury to determine intent for exclusion purposes. The judgment in favor of State Farm was affirmed. View "State Farm Fire and Casualty Co. v. Diblin" on Justia Law

A chemical company sought a declaratory judgment to establish its right to insurance coverage for environmental damage resulting from its operation of a DDT plant. The company’s insurers denied coverage based on “qualified pollution exclusions” (QPEs) in their comprehensive general liability policies, which excluded coverage for pollution unless the discharge was “sudden and accidental” or, in some policies, “sudden, unintended and unexpected.” The company argued that “sudden” could reasonably be interpreted to include gradual, unintended pollution events, and sought to introduce extrinsic evidence, including drafting history and industry statements, to support this interpretation.The Superior Court of Los Angeles County, at the parties’ suggestion, divided the case into phases and, in Phase II-A, addressed the interpretation of the QPEs. The parties stipulated to the use of exemplar QPEs for interpretation. The trial court excluded the company’s proffered extrinsic evidence, reasoning that California appellate courts had uniformly held that “sudden” in this context unambiguously does not mean gradual, and that it was bound by this precedent. The court certified a question of law for appellate review regarding whether prior judicial construction of an insurance policy term precludes consideration of extrinsic evidence to determine ambiguity.The California Court of Appeal, Second Appellate District, Division Three, reviewed the case. The court held that, as a general rule, prior judicial construction of a policy term does not categorically preclude a trial court from considering extrinsic evidence to expose a latent ambiguity. However, in this case, the court found that California appellate decisions have uniformly and specifically rejected the interpretation that “sudden” can mean “gradual” in the context of these pollution exclusions. Therefore, the trial court correctly excluded the extrinsic evidence as irrelevant, and the petition for writ of mandate was denied. View "Montrose Chemical Corp. of California v. Superior Ct." on Justia Law

Adir International, LLC operates a chain of retail stores, Curacao, which primarily serves low-income, Spanish-speaking immigrants in California, Nevada, and Arizona. Curacao offers store credit to customers, with over 90 percent of sales made on store credit. Since at least 2012, Curacao has offered optional “account protection” services (AGP Basic and AGP Plus) to credit customers, with AGP Plus including a credit property insurance component. Curacao was licensed as a credit insurance agent, but its sales associates, who were not licensed or endorsed, received bonuses for selling these insurance products. The AGP program allowed customers to defer payments under certain circumstances, but the fees for AGP often exceeded finance charges, and the program was highly profitable for Curacao.The People of the State of California filed a civil enforcement action in the Superior Court of Los Angeles County, alleging that Adir and its owner, Ron Azarkman, violated the Unfair Competition Law (UCL) through predicate violations of the Insurance Code and the Unruh Retail Installment Sales Act (Unruh Act). After a bench trial, the Superior Court found that Adir and Azarkman violated the Insurance Code by selling insurance through unlicensed employees, failing to use approved training materials, and providing required disclosures only after enrollment. The court held Azarkman personally liable due to his control and knowledge of the practices. However, the court ruled that the sale of account protection services did not violate the Unruh Act.On appeal, the California Court of Appeal, Second Appellate District, Division Eight, affirmed the trial court’s findings regarding the Insurance Code violations and Azarkman’s personal liability, rejecting arguments about primary jurisdiction, statutory interpretation, and statute of limitations. The appellate court reversed the trial court’s ruling on the Unruh Act, holding that the Act limits all permissible fees to those specifically authorized, and remanded for further proceedings on that claim. In all other respects, the judgment was affirmed. View "P. v. Adir Internat., LLC" on Justia Law

During the COVID-19 pandemic, two individuals who held automobile insurance policies with a major insurer in California alleged that the insurer’s rates became excessive due to a significant reduction in driving and traffic accidents. They claimed that the insurer was required by statute to refund a portion of the premiums collected during this period, even though the rates had previously been approved by the state’s insurance commissioner. The insurer did provide partial refunds in response to directives from the insurance commissioner, but the plaintiffs argued these refunds were insufficient and sought further restitution on behalf of a class of similarly situated policyholders.The Superior Court of Alameda County initially allowed the plaintiffs to amend their complaint after sustaining a demurrer. In their amended complaint, the plaintiffs continued to assert claims under California’s Unfair Competition Law and for unjust enrichment, maintaining that the insurer’s failure to provide full refunds violated Insurance Code section 1861.05(a). The trial court, however, sustained the insurer’s subsequent demurrer without leave to amend, holding that the statutory scheme did not require insurers to retroactively refund premiums collected under previously approved rates, even if those rates later became excessive due to changed circumstances.The California Court of Appeal, First Appellate District, Division One, reviewed the case on appeal. The court held that Insurance Code section 1861.05(a) does not impose an independent obligation on insurers to retroactively refund premiums collected under rates approved by the insurance commissioner, even if those rates later become excessive. The court reasoned that the statutory scheme provides for prospective rate adjustments through the commissioner’s review process, not retroactive modifications. The court also found that the insurer’s conduct was affirmatively permitted under the statutory “prior approval” system, and thus not actionable under the Unfair Competition Law. The judgment in favor of the insurer was affirmed. View "Davis v. CSAA Insurance Exchange" on Justia Law

Plaintiffs initiated a class action against National General Insurance Company and Integon National Insurance Company, alleging that the defendants improperly denied their car accident claims and rescinded their automobile insurance policies. The plaintiffs claimed that the defendants retroactively denied insurance claims and rescinded policies based on the plaintiffs' failure to disclose household members. The plaintiffs sought class certification for 1,032 insureds who had their policies rescinded under similar circumstances.The Superior Court of San Bernardino County denied the plaintiffs' motion for class certification, citing the lack of a palpable trial plan for resolving damages. The court noted that the plaintiffs admitted most of the available damages were inherently individualized and expressed concern that the plaintiffs wanted to make the case more manageable by forfeiting certain categories of damages. The court concluded that class treatment would not be a substantial benefit to the litigants.The California Court of Appeal, Fourth Appellate District, Division Three, reviewed the case. The appellate court disagreed with the defendants' contention that common questions of law and fact did not predominate on the issue of liability. The court found that the trial court had relied on improper legal criteria by denying certification based on individualized damages and by not considering the potential benefits of class certification. The appellate court held that individualized proof of damages does not preclude class certification when common issues of liability predominate. The court reversed the order denying class certification and remanded the case, directing the trial court to certify, at minimum, a liability-only class and to consider whether any subclasses are necessary. View "Cobos v. National General Insurance Co." on Justia Law

The case involves the California Insurance Company (CIC), which attempted to merge with a newly-formed New Mexico corporation, CIC II, without obtaining the required consent from the California Insurance Commissioner. As a result, the trial court appointed the commissioner as CIC’s conservator. The trial court later approved a rehabilitation plan proposed by the commissioner, which included terms for ending the conservatorship. CIC appealed, arguing that the conservatorship was unlawfully imposed and should be vacated, and that the rehabilitation plan was an abuse of discretion.The San Mateo County Superior Court initially granted the commissioner’s application to be appointed as CIC’s conservator due to the unauthorized merger attempt. CIC’s motion to vacate the conservatorship was denied, and their subsequent petition for writ of mandate was also denied by the California Court of Appeal. CIC II and an affiliate filed federal actions to vacate the conservatorship, but these were dismissed, and the dismissals were affirmed by the Ninth Circuit Court of Appeals.The California Court of Appeal, First Appellate District, reviewed the case and affirmed the trial court’s order. The court held that the conservatorship was lawfully imposed under Insurance Code section 1011(c) due to CIC’s unauthorized merger attempt. The court also found that the rehabilitation plan, which included reinsurance and assumption of CIC’s California policies and settlement options for pending litigation, was not an abuse of discretion. The court concluded that the plan was reasonably related to the public interest and necessary to address the issues that led to the conservatorship. View "Lara v. California Insurance Co." on Justia Law

Plaintiff purchased a rural property in Santa Cruz County, which was accessed via a private road crossing his neighbor's property. A dispute arose when the neighbor claimed an easement over the road, leading to increased traffic due to marijuana cultivation. The neighbor filed two lawsuits asserting an easement, both of which were dismissed without prejudice. Plaintiff then sued to quiet title, and the neighbor cross-complained, asserting an easement based on a 1971 deed. The trial court ruled in favor of the neighbor, finding an express easement, a decision affirmed on appeal.Plaintiff funded his defense using retirement savings after Chicago Title Insurance Company, his title insurer, denied his tender for defense, citing policy exclusions. Plaintiff sued Chicago Title for breach of contract and bad faith. The trial court found Chicago Title had a duty to defend from the initial tender but rejected Plaintiff's bad faith claim and request for punitive damages. The court awarded damages for the diminution in property value but denied damages for periods outside the litigation.On appeal, the California Court of Appeal, Sixth Appellate District, found that Chicago Title acted in bad faith by failing to defend Plaintiff despite the potential for coverage indicated by the 1971 deed. The court reversed the trial court's judgment on the bad faith claim and remanded for a determination of damages resulting from the breach of the implied covenant of good faith and fair dealing. The court affirmed the trial court's denial of punitive damages and its award of prejudgment interest on the additional diminution in value. The case was remanded for further proceedings consistent with the appellate court's findings. View "Bartel v. Chicago Title Insurance Co." on Justia Law

Truck Insurance Exchange (Truck) filed a lawsuit against Federal Insurance Company (Federal) alleging fraud, unjust enrichment, and seeking rescission of a settlement agreement. Truck claimed that Federal fraudulently misrepresented and concealed the voluntary nature of its decision to pay defense costs for Moldex-Metric, Inc. (Moldex) under an umbrella policy. Truck argued that it would not have agreed to pay $4.9 million in settlement had it known Federal contributed to Moldex’s defense voluntarily “at its own expense.”The Superior Court of Los Angeles County initially ruled in favor of Federal, granting summary judgment on the basis that Federal had no duty to defend Moldex under its umbrella policy. Truck appealed, and the Court of Appeal affirmed the trial court’s decision, rejecting Truck’s assertion that it reserved the right to recoup defense fees and indemnity costs after the settlement agreement. Truck then filed the current fraud action, alleging that Federal concealed its voluntary business decision to defend Moldex.The Court of Appeal of the State of California, Second Appellate District, reviewed the case. Truck contended that the trial court failed to address its claim for fraudulent concealment and only considered the misrepresentation theory. The appellate court agreed with Truck, finding that the trial court did not consider the fraudulent concealment claim despite Truck’s objection. The appellate court determined that Truck did not unreasonably neglect to protect itself against the alleged fraudulent concealment by Federal, rendering it extrinsic and not barred by the litigation privilege.The Court of Appeal reversed the judgment on Truck’s fraudulent concealment cause of action and remanded the matter to the trial court for a new trial to consider Truck’s fraudulent concealment claim and any other derivative causes of action. The judgment was otherwise affirmed, and Truck was awarded costs on appeal. View "Truck Ins. Exchange v. Fed. Ins. Co." on Justia Law

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