Justia Insurance Law Opinion Summaries

The term "invasion of the right of private occupancy" is ambiguous and may include non-physical invasions of rights in real property. The Court of Appeal reversed the trial court's grant of summary judgment for the umbrella insurer in an action alleging claims for breach of contract and breach of the implied covenant of good faith and fair dealing. In this case, the personal injury provision of plaintiff's umbrella policy potentially covered the allegations in the underlying action and the umbrella insurer breached its duty to defend by not providing plaintiff with a defense. Accordingly, the court vacated the trial court's order and directed the trial court to enter a new order granting the motion. View "Albert v. Truck Insurance Exchange" on Justia Law

An insured plaintiff who has chosen to be treated with doctors and medical facility providers outside his insurance plan shall be considered uninsured, as opposed to insured, for the purpose of determining economic damages. The Court of Appeal held that the trial court properly allowed the plaintiff in this case, as a plaintiff who is treating outside his insurance plan, to introduce evidence of his medical bills. The trial court also permitted defendants to present expert testimony that the reasonable and customary value of the services provided by the various medical facilities was substantially less than the amounts actually billed. The jury rejected the expert evidence and awarded plaintiff the billed amounts. The court held that defendants have not demonstrated error except with respect to two charges regarding the amounts billed by Ventura County Medical Center and American Medical Response. Accordingly, the court reduced the damage award and affirmed the judgment as modified. View "Pebley v. Santa Clara Organics" on Justia Law

Nielsen Contracting, Inc. and T&M Framing, Inc. (collectively Nielsen) sued several entities (defendants) alleging these entities fraudulently provided workers' compensation policies to Nielsen that were illegal and contained unconscionable terms. Defendants moved to compel arbitration and stay the litigation under an arbitration provision in one defendant's contract, titled Reinsurance Participation Agreement (RPA). Nielsen opposed the motion, asserting the arbitration provision and the provision's delegation clause were unlawful and void. After briefing and a hearing, the trial court agreed and denied defendants' motion. Defendants appealed, arguing: (1) the arbitrator, and not the court, should decide the validity of the RPA's arbitration agreement under the agreement's delegation clause; and (2) if the court properly determined it was the appropriate entity to decide the validity of the delegation and arbitration provisions, the court erred in concluding these provisions are not enforceable. The Court of Appeal rejected these contentions and affirmed. View "Nielsen Contracting, Inc. v. Applied Underwriters, Inc." on Justia Law

The Court of Appeal reversed the trial court's entry of judgment for Gursey in an action alleging that plaintiffs had been damaged because they could not collect the additional money they would have been entitled to had Gursey purchased an insurance policy with the limits they had requested. The court held that plaintiffs did not incur actual damages until they became entitled to the benefits of the underinsured motorist policy. Consequently, plaintiffs' causes of action against Gursey accrued less than two years before they filed this action, and the trial court erred in holding that plaintiffs' claims were time-barred. View "Lederer v. Schneider" on Justia Law

In 2012, Dr. Jacobs hired All Green to perform electrical work for Jacobs’s MRI and X-ray facility, including a room in which a mammography unit was to be installed. Hologic installed that unit but discovered it was not operating correctly due to a magnetic field in the room. All Green ran power to another room but the magnetic field persisted; the unit continued to malfunction. The magnetic field continued to interfere with the unit's operation after installation of steel shielding. Jacobs then hired an electromagnetic field expert who determined that the problem was caused by a loose bolt in an electrical cabinet installed by All Green. When the bolt was tightened, the magnetic field instantly disappeared. Jacobs filed suit. All Green tendered defense of the lawsuit to its insurer, SNIC, under policies covering bodily injury and property damage liability. All Green denied the allegations of negligence, stating that all bolts had been properly tightened and that its work had passed two inspections. SNIC denied the claim citing the “impaired property” exclusion. The court of appeal affirmed summary judgment, holding that SNIC had no duty to defend. If Jacobs’s allegations were found true, SNIC would not have to indemnify, nor would SNIC have to indemnify if, as All Green contended, it was not responsible for the loose bolt. View "All Green Electric, Inc. v. Security National Insurance Co." on Justia Law

A wine dealer sold millions of dollars’ worth of counterfeit wine to an unsuspecting wine collector. When the collector discovered the fraud, he filed an insurance claim based on his “Valuable Possessions” property insurance policy. The insurance company denied the claim. The collector sued for breach of contract. The trial court ruled in favor of the insurance company, sustaining its demurrer. The Court of Appeal concurred with the trial court: the collector suffered a financial loss, but there was no loss to property that was covered by the property insurance policy. View "Doyle v. Fireman's Fund Insurance Co." on Justia Law

A wine dealer sold millions of dollars’ worth of counterfeit wine to an unsuspecting wine collector. When the collector discovered the fraud, he filed an insurance claim based on his “Valuable Possessions” property insurance policy. The insurance company denied the claim. The collector sued for breach of contract. The trial court ruled in favor of the insurance company, sustaining its demurrer. The Court of Appeal concurred with the trial court: the collector suffered a financial loss, but there was no loss to property that was covered by the property insurance policy. View "Doyle v. Fireman's Fund Insurance Co." on Justia Law

The Court of Appeal affirmed the confirmation of an appraisal award under homeowners insurance policies issued by Liberty Mutual. Plaintiffs claimed that the appraisers exceeded their authority regarding the award and that it was the product of fraud. In the published portion of this opinion, the court held that the trial court erred under Evidence Code section 703.5 in admitting part of an appraiser's declaration that plaintiffs offered in opposing confirmation of the award. View "Khorsand v. Liberty Mutual Fire Insurance Co." on Justia Law

Victaulic, a manufacturer, sued its insurers in connection with product liability claims that resulted in litigation. Following summary adjudication for Victaulic (duty to defend) and a declaratory ruling (duty to indemnify), the case proceeded to a jury trial on Victaulic’s bad faith claim. Numerous witnesses testified and over 100 exhibits were introduced. Reversing an in limine ruling, the court allowed Victaulic to interrogate Finberg, the examiner on most of the claims, who had verified the insurers’ responses to Victaulic’s requests for admissions (RFAs). The court concluded Finberg “made an admission that she perjured herself” and stopped Finberg’s testimony. When she resumed the stand the next day, represented by personal counsel, the court ruled that she could, on a blanket basis, claim the Fifth Amendment privilege against self-incrimination— in front of jury. Victaulic’s closing arguments focused on “Finberg,” “RFAs,” “lies,” and “penalty of perjury.” The jury awarded damages for breach of contract totaling $1,073,868.80, with attorney fee damages for bad faith of $8,259,712.31. The punitive damages trial resulted in an award of $46 million. The court of appeal reversed, finding prejudicial errors, beginning with the court’s allowance of the use of the RFA responses, compounded by the court’s intensive questioning of Finberg, and by several errors in handling Finberg’s invocation of the Fifth Amendment. View "Victaulic Co. v. American Home Assurance Co." on Justia Law

The underlying action was initiated by homeowners from two residential developments in Rocklin against appellants Centex Homes and Centex Real Estate Corporation (Centex) for alleged defects to their homes. Centex and cross-defendant and respondent St. Paul Fire and Marine Insurance Company (St. Paul) have a history of insurance coverage disputes. St. Paul was an insurer for subcontractor Ad Land Venture (Ad Land), and agreed to defend Centex as an additional insured subject to a reservation of rights. Centex filed a cross-complaint against its subcontractors and St. Paul that sought, as the seventh cause of action, a declaration that Centex was entitled to independent counsel under Civil Code section 28601 because St. Paul’s reservation of rights created significant conflicts of interest. Centex appealed after the trial court granted St. Paul’s motion for summary adjudication of Centex’s seventh cause of action. Centex argued any possible or potential conflict was legally sufficient to require St. Paul to provide independent counsel. The Court of Appeal disagreed. Alternatively, Centex contended independent counsel was required because counsel appointed by St. Paul could influence the outcome of the coverage dispute and St. Paul controlled both sides of the litigation. The Court of Appeal concluded that because Centex failed to establish a triable issue of material fact regarding these assertions, the Court affirmed the judgment. View "Centex Homes v. St. Paul Fire & Marine Ins. Co." on Justia Law