Justia Insurance Law Opinion SummariesArticles Posted in California Courts of Appeal
Potter v. Alliance United Insurance Co.
Plaintiff filed suit against AUIC, alleging that the release it procured from the insured was fraudulent conveyance under statutory and common law. In this case, the insured was involved in a car accident that injured plaintiff. AUIC paid the insured to release any bad faith claim he had against the company for AUIC's failure to accept an earlier settlement offer. The Court of Appeal held that California's Uniform Voidable Transactions Act (UVTA) filing deadlines did not pose a bar to plaintiff's UVTA cause of action; the operative complaint stated a valid UVTA claim against the insured; and plaintiff waived any challenge to the demurrer ruling on the common law cause of action. Accordingly, the court reversed the judgment of dismissal and remanded for further proceedings. View "Potter v. Alliance United Insurance Co." on Justia Law
People ex rel. Allstate Insurance Co. v. Suh
Allstate filed suit under Insurance Code section 1871.7 on behalf of the People against defendant, her mother, and others for insurance fraud in violation of Penal Code section 550, which makes it unlawful to submit false or fraudulent claims to an insurance company. The jury found in favor of Allstate. The Court of Appeal affirmed, holding that the trial court did not abuse its discretion in denying defendant's ex parte application for a stay. The court also held that unlawful conduct under section 550 does not require a misstatement of fact in the insurance claim. In this case, defendant and her mother committed insurance fraud in violation of section 550 where they perpetrated a deceitful insurance scheme designed to acquire insurance proceeds illegally for personal gain. View "People ex rel. Allstate Insurance Co. v. Suh" on Justia Law
Samsky v. State Farm Mutual Automobile Insurance Co.
The Court of Appeal reversed the trial court's denial of plaintiff's motion for costs of proof after State Farm denied eight of his requests for admissions. The court held that the trial court incorrectly placed on plaintiff the burden to prove that none of the exceptions to an award of costs as set out in Code of Civil Procedure section 2033.420, subdivision (b) applied. Rather, State Farm should have carried the burden of proof and failed to do so. Therefore, the court remanded to the trial court to determine the reasonable costs of proof. View "Samsky v. State Farm Mutual Automobile Insurance Co." on Justia Law
McMillin Homes Construction v. Natl. Fire & Marine Ins. Co.
A general contractor was covered as an additional insured on a commercial general liability (CGL) policy issued to its roofing subcontractor. The insurer refused to defend the general contractor after it was sued by homeowners for construction defects concerning roofing, prompting this lawsuit. After a bench trial, the trial court concluded the insurer owed no duty to defend. It believed the exclusion in the additional insured endorsement for damage to "property in the care, custody or control of the additional insured" precluded any duty to defend the general contractor in construction defect litigation. The general contractor disputed the insurer's interpretation of the policy and contended there was a duty to defend. After review, the Court of Appeal agreed and reversed judgment: “the facts indicate only shared control between the general contractor and its roofing subcontractor. Because the insurer did not prove coverage for the underlying construction defect litigation was impossible, it owed the general contractor a duty to defend the homeowner claim.” View "McMillin Homes Construction v. Natl. Fire & Marine Ins. Co." on Justia Law
Jozefowicz v. Allstate Ins. Co.
Plaintiff Stanley Jozefowicz owned a mobilehome that was damaged in a fire. At the time, Jozefowicz’s mobilehome was insured under an Allstate homeowners policy. Jozefowicz submitted a claim to Allstate for the fire damage and retained Sunny Hills Restoration (Sunny Hills) to perform cleanup, repairs, and remediation of the mobile home. He told his insurer, defendant Allstate Insurance Company (Allstate), that Sunny Hills was to be named on all reimbursement checks and was permitted to deposit checks into its own account. The contractor then contacted Allstate for a check, Allstate sent it, and the contractor deposited it. At some point, Jozefowicz and the contractor were having a dispute over the scope and quality of the work. Jozefowicz sued Allstate under California Uniform Commercial Code section 3309, which provided a cause of action on a negotiable instrument where the payee has lost possession of the instrument. Allstate moved for summary judgment, contending section 3309 did not apply because Jozefowicz permitted Allstate to issue checks to the contractor. The trial court agreed. As did the Court of Appeals, which affirmed. View "Jozefowicz v. Allstate Ins. Co." on Justia Law
Mazik v. GEICO General Insurance Co.
GEICO appealed a judgment awarding punitive damages to plaintiff for GEICO's bad faith breach of an insurance contract. The Court of Appeal affirmed the punitive damages award and held that there was sufficient evidence in the record to show that GEICO's managing agent ratified conduct warranting punitive damages. In this case, GEICO concluded that plaintiff's claim was worth far less than the policy limits by disregarding information provided by plaintiff showing that he had a permanent, painful injury, and instead selectively relied on portions of medical records that supported GEICO's position that plaintiff had fully recovered. Furthermore, the $1 million in punitive damages was within the constitutionally permitted range in view of the degree of reprehensibility of GEICO's conduct. View "Mazik v. GEICO General Insurance Co." on Justia Law
Mercury Insurance Co. v. Lara
Defendant-appellant Ricardo Lara, the California Insurance Commissioner, filed a notice of noncompliance against plaintiffs-respondents Mercury Insurance Company, Mercury Casualty Company, and California Automobile Insurance Company (collectively Mercury) alleging Mercury charged rates not approved by the California Department of Insurance (CDI) and that the rates were unfairly discriminatory in violation of Insurance Code sections 1861.01 (c) and 1861.05 (b). The allegedly unapproved rates were in the form of broker fees charged by Mercury agents, which should have been disclosed as premium. After prevailing at an administrative hearing, the Commissioner imposed civil penalties against Mercury totaling $27,593,550 for almost 184,000 unlawful acts. Mercury filed a petition for writ of mandate, which the court granted, reversing the Commissioner’s decision. The court found the “broker fees” were not premium because they were charged for separate services. The court also rejected the Commissioner’s interpretation of the term premium under the Insurance Code and regulations. In addition, the court ruled Mercury did not have proper notice it was subject to penalties, in violation of due process, and the action was barred by laches because CDI had unduly delayed in bringing the action. Commissioner and intervener-appellant, Consumer Watchdog (CWD), appealed on several grounds, among them: (1) the trial court did not use the proper standard of review; (2) failed to give the Commissioner’s findings a strong presumption of correctness and failed to put the burden of proof on Mercury to show the findings were against the weight of the evidence; (3) the trial court’s finding the fees were charged for separate services was precluded by collateral estoppel; (4) Mercury received proper notice of the potential imposition of a penalty; and (5) laches did not bar the action. The Court of Appeal agreed with Commissioner and CWD the writ was issued in error and reversed the judgment. View "Mercury Insurance Co. v. Lara" on Justia Law
Posted in: California Courts of Appeal, Civil Procedure, Government & Administrative Law, Insurance Law
Western Heritage Insurance Co. v. Frances Todd, Inc.
The Covenants for Berkeley’s East Shore Commercial Condominiums Owners’ Association require it to maintain a master policy of all risk property insurance coverage, naming as insured the Association, the owners and all mortgagees. “Any insurance maintained by the Association shall contain [a] ‘waiver of subrogation’ as to the Association, its officers, Owners and the occupants of the Units and Mortgagees.” Article 13.4 prohibits an individual owner from obtaining fire insurance while allowing an owner to obtain individual liability insurance. The defendants leased a Commercial Condominium for a furniture manufacturing business. The Lease required the Lessee to maintain liability insurance, naming Lessor as an additional insured but did not specify which party would carry fire insurance. Western issued an insurance policy to Eastshore for the commercial properties; each owner was a named insured. A fire erupted in the condominium leased by defendants, damaging that and other units. Western paid for the fire damage then filed a subrogation complaint against defendants, alleging the fire was caused by their negligence. The trial court concluded that the Lease contemplated that the Western policy would be for defendants’ benefit so that subrogation was inappropriate. The court of appeal affirmed, concluding that defendants reasonably expected their landlord, an insured under the policy, to procure fire insurance. Western was barred from suing its own insured for negligently causing a fire, and the defendants were implied insureds under the policy, even if defendants were negligent. View "Western Heritage Insurance Co. v. Frances Todd, Inc." on Justia Law
Komorsky v. Farmers Insurance Exchange
Plaintiff appealed a judgment in favor of Farmers Insurance Exchange and Truck Insurance Exchange after the trial court determined that she was entitled to coverage under the Farmers policy as an heir of an insured under Insurance Code section 11580.2, subdivision (a)(1), but was not entitled to coverage under the Truck umbrella policy. The Court of Appeal affirmed the trial court's judgment and held that it properly ruled that plaintiff was not entitled to the uninsured motorist coverage under the Truck umbrella policy, because section 11580.2, subdivision (a)(1) did not modify the language of the Truck uninsured motorist endorsement and the endorsement governed who would be paid by Truck. The court also held that the trial court properly denied leave to file a second amended complaint; plaintiff was not entitled to coverage by estoppel; and the complaint failed to allege facts sufficient to justify reformation. View "Komorsky v. Farmers Insurance Exchange" on Justia Law
Jackpot Harvesting, Inc. v. Applied Underwriters, Inc.
After its workers’ compensation insurance premiums rapidly increased, Jackpot believed that Applied Underwriters had mishandled its claims and had wrongfully failed to disclose how it calculated premiums. Jackpot filed suit. Applied sought to compel arbitration based on the arbitration agreement contained in a Request to Bind. Jackpot argued that the arbitration agreement was invalid. Applied contended that, under the Federal Arbitration Act, only the arbitrator could decide the threshold question of whether the arbitration agreement was enforceable. The trial court held that the arbitration agreement was invalid. The court of appeal affirmed. In light of Jackson’s specific arguments that the arbitration provision was unenforceable due to fraud, ambiguity, and unconscionability, the trial court was obligated to consider its validity. Allied violated California law in issuing the Request to Bind without first submitting it for regulatory approval. The policy does not provide for arbitration but allows for administrative review by the Insurance Commissioner for certain disputes and otherwise leaves Jackpot’s rights to judicial review intact. The Request to Bind’s arbitration agreement, which compels arbitration in Nebraska for a wide array of disputes, materially changes the policy's dispute-resolution terms and constituted “a collateral agreement that should have been filed and endorsed to the Policy” under Insurance Code section 11658. View "Jackpot Harvesting, Inc. v. Applied Underwriters, Inc." on Justia Law