Justia Insurance Law Opinion Summaries
Articles Posted in Supreme Court of California
John’s Grill, Inc. v. The Hartford Financial Services Group, Inc.
John’s Grill, Inc., a restaurant in San Francisco, suffered significant financial losses during the COVID-19 pandemic and sought compensation from its property insurer, Sentinel Insurance Company, Ltd. Sentinel denied the claim, stating that the losses did not fall under the policy’s “Limited Fungi, Bacteria or Virus Coverage” endorsement, which only covers virus-related losses if the virus results from specific causes like windstorms or water damage. John’s Grill argued that this limitation made the virus-related coverage illusory and unenforceable.The San Francisco City and County Superior Court sustained Sentinel’s demurrer, finding the policy language clear and enforceable. The court reasoned that the specified causes of loss could potentially cause virus damage, thus the coverage was not illusory. The Court of Appeal reversed, agreeing with John’s Grill that the specified cause of loss limitation rendered the virus coverage illusory, as the listed causes were not realistically related to virus transmission. The appellate court held that the policy’s promise of virus-related coverage was illusory and allowed John’s Grill’s claims to proceed.The Supreme Court of California reversed the Court of Appeal’s decision. The court held that the policy’s specified cause of loss limitation was clear and unambiguous, and thus enforceable. It concluded that John’s Grill did not have a reasonable expectation of coverage for pandemic-related losses under the policy. The court also determined that the illusory coverage doctrine, as articulated by John’s Grill, did not apply because the policy did offer a realistic prospect for virus-related coverage under certain conditions. The case was remanded for further proceedings consistent with this opinion. View "John's Grill, Inc. v. The Hartford Financial Services Group, Inc." on Justia Law
Posted in:
Insurance Law, Supreme Court of California
Rosenberg-Wohl v. State Farm Fire & Casualty Co.
Plaintiff Katherine Rosenberg-Wohl procured a homeowners insurance policy from State Farm Fire and Casualty Company, which covered various risks including fire. After her neighbor fell on her staircase, she discovered the stairs needed replacement and filed a claim with State Farm. The insurer denied her claim, citing policy exclusions. Rosenberg-Wohl then filed two lawsuits: one for breach of contract and another under the Unfair Competition Law (UCL), seeking declaratory and injunctive relief regarding State Farm’s general claims-handling practices.The San Francisco City and County Superior Court sustained State Farm’s demurrer, concluding that the one-year limitations period in the insurance policy applied to all of Rosenberg-Wohl’s claims, including her UCL claim. The court reasoned that her claims were essentially “on the policy” because they were grounded in the denial of her insurance claim. The Court of Appeal affirmed this decision, with a majority agreeing that the one-year limitations period applied, while a dissenting justice argued that the UCL’s four-year limitations period should govern.The Supreme Court of California reviewed the case and concluded that the one-year limitations period in section 2071 of the Insurance Code and the insurance policy did not apply to Rosenberg-Wohl’s UCL cause of action. The court determined that her lawsuit was not a “suit or action on [the] policy for the recovery of any claim” because she sought only declaratory and injunctive relief, not a financial recovery under the policy. The court emphasized that the UCL’s four-year statute of limitations governed her claim. Consequently, the Supreme Court reversed the judgment of the Court of Appeal and remanded the matter for further proceedings consistent with its opinion. View "Rosenberg-Wohl v. State Farm Fire & Casualty Co." on Justia Law
Truck Ins. Exchange v. Kaiser Cement & Gypsum Corp.
This case involves a dispute over insurance coverage for continuous injury claims. The plaintiff, Truck Insurance Exchange, was a primary insurer for Kaiser Cement and Gypsum Corporation. Truck filed an equitable contribution claim against several insurers that had issued first-level excess policies to Kaiser for policy years where the directly underlying primary policy had been exhausted. Truck argued that the excess insurers’ indemnity obligations were triggered immediately upon exhaustion of the directly underlying primary policies. The excess insurers, however, argued that they had no duty to indemnify Kaiser until it had exhausted every primary policy issued during the period of continuous damage. The trial court and the Court of Appeal agreed with the excess insurers, interpreting the excess policies as requiring horizontal exhaustion of all primary insurance.The Supreme Court of California disagreed, concluding that the language of the first-level excess policies at issue in this case is essentially identical to the policy language in the higher-level excess policies that it considered in a previous case, Montrose III. The Court held that the first-level excess policies are most reasonably construed as requiring only vertical exhaustion. However, the Court also noted that its conclusion does not fully resolve the questions presented in this appeal, which involves a contribution claim between coinsurers. The Court remanded the matter to allow the Court of Appeal to address these alternative arguments in the first instance. View "Truck Ins. Exchange v. Kaiser Cement & Gypsum Corp." on Justia Law
Another Planet Entertainment, LLC v. Vigilant Insurance Co.
In the case before the Supreme Court of California, Another Planet Entertainment, LLC, a live entertainment venue operator, sued its insurer, Vigilant Insurance Company, for denying its claim for coverage of pandemic-related business losses. The plaintiff argued that the actual or potential presence of the COVID-19 virus at its venues constituted "direct physical loss or damage to property," triggering coverage under its insurance policy. The district court dismissed the case, and the plaintiff appealed. The Ninth Circuit Court of Appeals then asked the Supreme Court of California to clarify whether the presence of the COVID-19 virus could constitute "direct physical loss or damage to property" under California law.The Supreme Court of California concluded that allegations of the actual or potential presence of COVID-19 on an insured’s premises do not, without more, establish direct physical loss or damage to property within the meaning of a commercial property insurance policy. Under California law, direct physical loss or damage to property requires a distinct, demonstrable, physical alteration to property. The physical alteration need not be visible to the naked eye, nor must it be structural, but it must result in some injury to or impairment of the property as property. The court found that Another Planet’s allegations did not satisfy this standard. While Another Planet alleges that the COVID-19 virus alters property by bonding or interacting with it on a microscopic level, Another Planet does not allege that any such alteration results in injury to or impairment of the property itself. Its relevant physical characteristics are unaffected by the presence of the COVID-19 virus. View "Another Planet Entertainment, LLC v. Vigilant Insurance Co." on Justia Law
Allied Premier Insurance v. United Financial Casualty Co.
The Supreme Court held that under California's Motor Carriers of Property Permit Act, Cal. Veh. Code 34600 et seq., a commercial automobile insurance policy does not continue in full force and effect until the insurer cancels a corresponding certificate of insurance on file with the Department of Motor Vehicles (DMV).Insured was driving a truck covered by his policy with Insurer when he collided with a car, killing its driver. The driver's parents sued Insured for wrongful death, and Insured tendered his defense to Insurer. Insurer settled the claim for its policy limits and then sued Insured's former insurer (Defendant) for declaratory relief, equitable contribution, and equitable subrogation. The trial court held that Defendant's policy remained in effect on the date of the collision because one of Defendant's cancellation notices was rejected by the DMV as incomplete. The Court of Appeals for the Ninth Circuit certified a question of law to the Supreme Court, which answered that the Act does not require a commercial auto insurance policy to remain in effective indefinitely until the insurer cancels the certificate of insurance on file with the DMV. View "Allied Premier Insurance v. United Financial Casualty Co." on Justia Law
Cal. Medical Assn. v. Aetna Health of Cal., Inc.
The Supreme Court reversed the judgment of the court of appeal affirming the judgment of the court of appeal granting summary judgment for the defense in this lawsuit brought by the California Medical Association (CMA), holding that the evidence was sufficient to create triable issues of fact precluding summary judgment.CMA, a nonprofit professional association representing California physicians, sued Aetna Health of California Inc. alleging that Aetna violated the unfair competition law (UCL), Cal. Bus. & Prof. Code 17200 et seq., by engaging in unlawful business practices. At issue was whether Aetna satisifed the UCL's standing requirements by diverting its resources to combat allegedly unfair competition. The Supreme Court held (1) the UCL’s standing requirements are satisfied when an organization, in furtherance of a bona fide, preexisting mission, incurs costs to respond to perceived unfair competition that threatens that mission, so long as those expenditures are independent of costs incurred in UCL litigation or preparations for such litigation; and (2) the trial court erred in granting summary judgment for Aetna on the ground that CMA lacked standing. View "Cal. Medical Assn. v. Aetna Health of Cal., Inc." on Justia Law
Yahoo Inc. v. National Union Fire Insurance Co. of Pittsburgh, PA
The Supreme Court held that the language in the insurance policy at issue in this case provided liability coverage for right-of-seclusion violations litigated under the Telephone Consumer Protection Act of 1991 (TCPA), 47 U.S.C. 227, assuming such coverage is consistent with the insured's reasonable expectations.Privacy injuries involving the right of seclusion are sometimes actionable under the TCPA provided that the violation involves the use of telephonic equipment. The insurance policy in this case provided liability coverage for injuries "arising out of...[o]ral or written publication...of material that violates a person's right of privacy." At issue before the Supreme Court was whether this language provided liability coverage for right-of-seclusion violations brought under the TCPA. The Court held that a commercial general liability insurance policy that provides coverage for "personal injury" defined in part as injury arising out of oral or written publication of material that violates a person's right of privacy can cover liability for violations of the right of seclusion if that coverage is consistent with the insured's reasonable expectations. View "Yahoo Inc. v. National Union Fire Insurance Co. of Pittsburgh, PA" on Justia Law
Posted in:
Insurance Law, Supreme Court of California
McHugh v. Protective Life Insurance Co.
The Supreme Court held that Defendant, which terminated one of the life insurance policies at issue in this case because the policy owner had failed to make a payment, had no right to terminate the policies without complying with the newly codified statutory protections against termination.In 2013, protections to shield consumers from losing life insurance coverage because of a missed premium payment went into effect. The protections were codified in Cal. Ins. Code 10113.71 and 10113.72. Thereafter, Defendant terminated the subject life insurance policy. Plaintiffs brought this action arguing that Defendant had no right to terminate the policies, which predated sections 10113.71 and 10113.72, without complying with the sections. The court of appeal concluded that the newly codified statutory protections against termination did not apply because they appeared to affect only policies issued or delivered after the sections' effective date. The Supreme Court reversed, holding that sections 10113.71 and 10113.72 apply to all life insurance policies in force when these two sections went into effect, regardless of when the policies were originally issued. View "McHugh v. Protective Life Insurance Co." on Justia Law
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Insurance Law, Supreme Court of California
Skidgel v. California Unemployment Insurance Appeals Board
In this case involving the In-Home Supportive Services (IHSS) program the Supreme Court affirmed the judgment of the court of appeal concluding that sections 631 and 683 of the Unemployment Insurance Code exclude from coverage a provider who is the recipient's minor child, parent, or spouse under the state's unemployment insurance program, holding that the court of appeal did not err.The IHSS program authorized certain Californias, who were disabled or elderly, to receive in-home services from third parties or family members paid for with public funds. Under one program option, service recipients hire their own providers and the providers are paid either by a public entity or by the recipients with funds they have received from a public entity. At issue was whether such a provider qualified for unemployment benefits. The Supreme Court answered the question in the negative, holding that provider who is the recipient's minor child, parent, or spouse is not covered by the state's unemployment insurance program. View "Skidgel v. California Unemployment Insurance Appeals Board" on Justia Law
Villanueva v. Fidelity National Title Co.
The Supreme Court reversed the judgment of the court of appeal reversing the judgment of the trial court granting a class injunctive relief, holding that Insurer was not entitled to immunity under the Insurance Code and that the Insurance Commission did not have exclusive jurisdiction.At issue was whether, if a title insurer charges rates without filing them with the Insurance Commissioner, a consumer can challenge the charges as unlawful in court. The trial court rejected Insurer's argument that it should be held immune from Plaintiff's putative class action under Cal. Ins. Code 12414.26, but the court of appeals reversed, concluding that the class claims were barred because Insurer was in fact immune and that the trial court lacked jurisdiction. The Supreme Court reversed, holding (1) the statutory immunity for "act[s] done...pursuant to the authority conferred" by the rate-filing statutes does not shield title insurers from suit for charging unauthorized rates; and (2) the Insurance Commissioner does not have exclusive jurisdiction over unfiled-rate claims. View "Villanueva v. Fidelity National Title Co." on Justia Law
Posted in:
Insurance Law, Supreme Court of California