Justia Insurance Law Opinion Summaries

Articles Posted in California Courts of Appeal
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Travelers won summary judgment in this duty-to-defend insurance dispute with its insured, KLA. The superior court concluded that the language of the commercial liability insurance policies, which covered claims for “malicious prosecution,” could not have created an objectively reasonable expectation that Travelers would defend a “Walker Process claim” against KLA. The Walker Process claim that KLA tendered to Travelers alleged that KLA had fraudulently procured a patent and used that patent to attempt to monopolize the market for a product. KLA argued that it was objectively reasonable for it to expect the “malicious prosecution” coverage in its policies to extend to this Walker Process claim. The court of appeal affirmed. Coverage language is construed as of the time of issuance of the policy, so the construction of that language cannot depend on the precise allegations made in a subsequent complaint. The history of prior litigation between the parties did not change the basis for this claim into one for malicious prosecution because there were no allegations of any legal proceedings involving the patent. View "Travelers Property Casualty Co. of America v. KLA-Tencor Corp." on Justia Law

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The issue this case presented for the Court of Appeal's review centered on whether a binding arbitration clause in an insurance policy issued by plaintiff Philadelphia Indemnity Ins. Co., applied to a third party, defendant SMG Holdings, Inc. The policy had been issued to Future Farmers of America, which was holding an event inside the Fresno Convention Center. Future Farmers had licensed the use of the convention center from its property manager, SMG. As part of the license, Future Farmers agreed to obtain coverage for itself and to name SMG as an additional insured. Thereafter, Future Farmers obtained a policy from Philadelphia Indemnity, which provided coverage for “managers, landlords, or lessors of premises” as well as for any organization “as required by contract.” The policy also contained an arbitration clause for coverage disputes. During the Future Farmers event, an attendee was injured in the convention center parking lot. When the injured man sued SMG, which also managed the parking lot, SMG tendered its defense to Philadelphia under the policy. Philadelphia refused, believing SMG was not covered under the policy for an injury occurring in the parking lot. After two years, Philadelphia petitioned the trial court to compel arbitration against SMG. The trial court denied the petition, concluding no evidence was presented that the parties to the policy intended to benefit SMG, and Philadelphia was equitably estopped from claiming SMG was required to arbitrate the dispute. Philadelphia contended: (1) the trial court erred in determining SMG was neither a third party beneficiary of the policy, nor equitably estopped from avoiding the policy’s arbitration clause; (2) alternatively, the court erred in finding Philadelphia estopped from compelling SMG to arbitrate; and (3) the coverage dispute was encompassed by the arbitration clause and arbitration should be ordered. The Court of Appeal agreed SMG could be compelled to arbitrate. Judgment was reversed, the trial court's order vacated, and the trial court directed to order arbitration of the coverage dispute. View "Philadelphia Indemnity Ins. Co. v. SMG Holdings, Inc." on Justia Law

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In a case of first impression, the Court of Appeal was asked to determine whether insurers have the right to appeal a small claims default judgment entered against their insureds. Vanessa Gonzalez sued Jonathan Johnson in small claims court after an auto accident in Orange, California. Johnson did not show up for the small claims hearing, and the small claims court entered a default judgment against him for $10,000, plus $140 in costs. Johnson’s auto insurer was Pacific Pioneer Insurance Company. Pacific Pioneer filed a timely notice of appeal. The trial court struck the notice of appeal, and Pacific Pioneer sought to set aside that order. This prompted the trial court to compose a minute order explaining why it had struck the notice: Code of Civil Procedure 116.710(d) precluded a non-appearing “defendant” - which the court equated with Pacific Pioneer - from appealing a small claims judgment. Pacific Pioneer then filed this writ petition, challenging the trial court’s reading of the relevant statutes. The Court of Appeal concluded the insured’s failure to appear in small claims court did not annul the appeal right conferred upon the insurer by Code of Civil Procedure section 116.710(c). The trial court thus erred in striking Pacific Pioneer’s notice of appeal. The Court issued a writ to direct the trial court to vacate its order striking Pacific Pioneer’s notice of appeal, and to reinstate its appeal of the small claims judgment in favor of Gonzalez. View "Pacific Pioneer Ins. Co. v. Super. Ct." on Justia Law

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In September 2014, a driver was rear-ended by an SUV driven by a Union Pacific employee. The motorist lost control of her car, spinning off the freeway and onto the dirt shoulder, where it struck a roadside light pole. The light pole, which was manufactured by Ameron Pole Products, was designed to “break away” on impact, causing the pole to pass over the impacting vehicle, thereby reducing the force of the collision and concomitant risk of injury. On this occasion, however, the light pole did not break away, but instead remained standing. The driver sustained multiple injuries, including skull fractures, injuries to her brain and face, a fracture of the right scapula, and bilateral chest trauma. The driver sued Union Pacific Railroad Comapny and Ameron. Union Pacific cross-complained against Ameron for equitable indemnity and apportionment. Ameron moved for summary judgment, arguing the driver would be unable to prove causation as a matter of law. Union Pacific opposed the motion, arguing Ameron failed to carry its initial burden or showing judgment as a matter of law. Alternatively, Union Pacific argued the evidence submitted raised triable issues of fact as to whether Ameron’s negligence was a substantial factor in causing the driver’s injuries. The trial court entered judgment in Ameron’s favor. The Court of Appeal reversed, concurring with Union Pacific’s alternate grounds. Summary judgment was reversed and the matter remanded for further proceedings. View "Union Pacific Railroad Co. v. Ameron Pole Products LLC" on Justia Law

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Fireman’s Fund issued insurance covering property damage at Stephens's warehouse. Three days after the policy became effective, Stephens discovered that burglars stripped the property of all electrical and conductive material. Stephens filed an insurance coverage suit, retaining attorney O’Reilly who had a first lien to assure payment of fees. The trial court entered judgment NOV, awarding Stephens nothing. O’Reilly withdrew from the case and was the subject of an involuntary bankruptcy petition. Following a remand, Stephens and Fund settled for $5.8 million. The bankruptcy estate claimed 40% of the settlement. Danko, the largest creditor, bought the claim and obtained the Stephens's files from the trustee. Based on O’Reilly’s failure to sign the retainer agreement, Stephens sent Danko a letter voiding the retainer agreement and sought declaratory relief. The court ordered Danko to return Stephens’s client file and granted a special motion to strike (anti-SLAPP) a claim for breach of trust against Fund based on the theory that Fund breached a fiduciary duty to O’Reilly and/or the bankruptcy estate by failing to advise the bankruptcy court of the Stephens-Fund settlement and “secretly disbursing” the proceeds and a claim for interference with prospective business advantage against Fund based on the same acts. The court of appeal affirmed the trial court’s denial of Stephens’s motion to disqualify the Danko from representing the corporate entity to which Danko assigned the claim; a protective discovery order regarding Stephens’s client file; and the anti-SLAPP order. View "O&C Creditors Group, LLC v. Stephens & Stephens XII, LLC" on Justia Law

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In separate incidents, claimants Miguel Velazquez and Servando Velazquez suffered injuries within the scope of their employment, and each required Spanish language interpreting services in connection with their medical care. Meadowbrook Insurance Company was the workers’ compensation carrier for the claimants’ employers and accepted both claims and administered benefits. DFS Interpreting (“DFS”), which provided interpreter services to each claimant, timely submitted invoices to Meadowbrook for the services provided. Meadowbrook refused to pay the invoices DFS submitted. DFS objected to the insurance company’s explanations of review, but did not request a second review pursuant to Labor Code section 4603.2 (e) or California Code of Regulations, title 8, section 9792.5.5. Meadowbrook petitioned for writ of review of the Workers’ Compensation Appeal Board’s (WCAB) decision on reconsideration that liens held by DFS Interpreting (DFS) against Meadowbrook regarding unpaid invoices for interpreter services DFS provided to Meadowbrook’s insureds were not foreclosed by DFS’s failure to follow procedural rules. The Court of Appeal issued the writ, and held that DFS’s failure to comply with required procedures resulted in DFS’s bills being deemed satisfied. This result meant Meadowbrook was not liable for further payment. The Court annulled the WCAB’s decision to the contrary and remanded for further proceedings. View "Meadowbrook Ins. Co. v. Workers' Comp. Appeals Bd." on Justia Law

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Defendant was charged with driving under the influence of alcohol and obtained a $35,000 bond for his release from custody. The surety promised to assure Defendant’s appearance for arraignment. The contract stated that, if Defendant left the jurisdiction, he would “voluntarily return” and “waive extradition.” On the day of the arraignment, Defendant's indemnitor informed the surety Defendant told her he was in Mexico. The court forfeited the bail bond. Under Penal Code 1305(c), the court was required to vacate the forfeiture if Defendant appeared in court, either voluntarily or in custody, within 180 days. The court extended the appearance period by six months. The surety then moved to vacate the forfeiture and exonerate the bond or to toll or extend time, arguing that Defendant was located in Mexico and “subject to “constructive custody,” having obtained a Mexican passport and applied for a U.S. visa. The surety contended the People were imposing improper conditions, including a requirement that the surety pay for extradition ($50,000). The surety argued Defendant was in effect detained as a result of immigration laws that precluded his reentry. The People argued they could not extradite Defendant on a misdemeanor charge and that he was not detained but left the country voluntarily. The court of appeal affirmed summary judgment against the surety, rejecting an argument that Defendant suffered from a “temporary disability” under Penal Code 1305(e), View "People v. The North River Insurance Co." on Justia Law

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After a customer purchased a pharmaceutical product from Target (the retailer) which was distributed by McKesson (the supplier), she experienced an adverse reaction to the product that resulted in serious bodily injury. The customer filed suit against Target, and McKesson and Golden State Insurance (the carrier) refused to defend it. Target then filed suit against McKesson and Golden State, seeking to compel them to defend it. The trial court granted McKesson and Golden State's motion for summary adjudication. The Court of Appeal affirmed, holding that the indemnification/defense clause in McKesson's contract with Target and the additional insured endorsement did not require McKesson and Golden State to defend Target against the customer's lawsuit. In this case, the customer's claim was based on Target's mislabeling of a product that was not defective. Therefore, Target's actions came within the exclusions of the additional insured endorsement for repackaging and labeling and relabeling. Furthermore, the additional insured endorsement did not impose on McKesson a duty to provide additional insured coverage that would protect Target from the customer's claim that it had mislabeled the medication and had failed to warn of possible adverse reactions and side effects. View "Target Corp. v. Golden State Insurance Co. Ltd." on Justia Law

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In 2005, Protective Life Insurance Company (Protective Life) issued William McHugh a 60-year term life policy (the policy) that provided for a 31-day grace period before it could be terminated for failure to pay the premium. McHugh failed to pay the premium due on January 9, 2013, and his policy lapsed 31 days later. McHugh passed away in June 2013. This appeal raised one fundamental issue: whether Insurance Code sections 10113.71 and 10113.72 ("the statutes"), which came into effect on January 1, 2013, applied to term life insurance policies issued before the statutes' effective date. Mchugh's daughter, Blakely McHugh, the designated beneficiary under the policy, and Trysta Henselmeier (appellants) sued Protective Life for breach of contract and breach of the implied covenant of good faith and fair dealing, claiming Protective Life failed to comply with the statutes' requirement that it provide a 60-day grace period before it terminated the policy for nonpayment of premium. The parties filed various trial court motions, and Protective Life, relying largely on interpretations of the Department of Insurance (the Department) argued that the statutes did not apply retroactively to McHugh's policy and the claim. The court rejected Protective Life's arguments and ruled that the statutes applied to the claim. The matter proceeded to jury trial and Protective Life prevailed. Appellants appealed both a special verdict in favor of Protective Life and an order denying their motion for judgment notwithstanding the verdict (JNOV). Pursuant to Code of Civil Procedure section 906, Protective Life requested that the Court of Appeal affirm the verdict on the additional ground that the statutes did not apply to the policy and the trial court erred by ruling to the contrary when it denied Protective Life's motion for a directed verdict. The Court of Appeal concurred with Protective Life, finding the trial court should have granted the company’s motion for a directed verdict. View "McHugh v. Protective Life Insurance" on Justia Law

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The Court of Appeal annulled the decision of the appeals board and remanded with directions to find that the special employer had a valid endorsement in its workers' compensation insurance policy excluding coverage for special employees. The court held that while the appeals board was correct that the limiting endorsement had not been signed by the special employer, the written affirmation required by the regulation then in effect is not limited to a signature. Taking into account the circumstances of the entire transaction and its history, the court held that there was substantial compliance with the requirement of a written affirmation. Therefore, the court held that CIGNA was liable for the claim as a covered claim within the meaning of Insurance Code section 1063.1. View "Travelers Property Casualty Co. v. Workers' Compensation Appeals Board" on Justia Law