Insurance

After plaintiff sustained a loss that its insurer contended was excluded from coverage, plaintiff and insurer entered into a loan receipt agreement under which the insurer lent plaintiff the funds needed to repair the damage to its property.  The plaintiff was not personally liable to repay the loan but agreed to repay out of any proceeds it received from suing… Read More

Plaintiff, a Coptic church, bought a residence to serve as the Coptic pope's western US residence and a residence for visiting bishops.  Its insurance broker arranged for it to obtain a commercial property insurance policy which had an exclusion for loss due to water damage if the property had been vacant for 60 days or more before the loss.  This… Read More

While an insured cannot expand the scope of an existing insurance policy's coverage by waiver or estoppel, a would-be insured can rely on waiver or estoppel to show that the insurer agreed to provide the insurance despite the insured's failure to perform a condition precedent to issuance of the policy, such as submission of medical forms or, in this case,… Read More

An excess insurer may not challenge an underlying insurer’s payment decision as outside the scope of coverage and thus as improperly eroding the primary insurer's coverage and prematurely triggering the excess insurer's coverage—unless there is an indication that the payments were motivated by fraud or bad faith or the excess policy contains specific language reserving the excess insurer's right to… Read More

Generally, an insurance agent owes only a regular agent's duties of reasonable care, diligence, and judgment in procuring the insurance requested by an insured.  However, an insurance agent may assume a greater duty to the insured when one of the following three exceptions arise: “(a) the agent misrepresents the nature, extent or scope of the coverage being offered or provided,… Read More

The trial court wrongly granted a health insurer summary judgment on the insured's bad faith and UCL claims.  The insured's son was autistic and, before he turned 7 was given 157 hours a month of insured treatments.  When he turned 7, Magellan reduced the monthly allotment to 57 hours.  On the insured's appeal to the Department of Managed Health Care,… Read More

Under Ins. Code, § 11580.2(f), disputes between insureds and insurers over the amount due under the uninsured or underinsured motorist coverage in an auto policy must be submitted to arbitration, which, however, is limited to the questions of whether the insured is entitled to recover damages from the uninsured or underinsured motorist and the amount of the insured's damages.  CCP… Read More

Travelers insured several subcontractors who worked on two subdivisions developed by Pulte.  As required by their subcontracts, Pulte was made an additional insured under their Travelers policy.  When Pulte was sued for construction defects in the two subdivisions, Travelers provided a defense.  Later, it intervened to sue other subcontractors to recover its defense costs on an equitable subordination theory.  This… Read More

Following the Supreme Court's interpretation of excess insurance policies' other insurance clauses in Montrose Chemical Corp. v. Superior Court (2020) 9 Cal.5th 215, this decision holds that in a case involving coverage for injuries occurring over multiple coverage periods, the insured can reach an excess policy after "vertically" exhausting any primary insurance policies for the same period, but need not… Read More

This decision affirms a judgment against Anthem for violating the Cartwright Act by a vertical boycott.  Anthem announced that it would not accept "wrapped" health insurance plans of the type that Ben-E-Lect offered to small employers, and Anthem said it would terminate any of its agents who attempted to offer Anthem insurance plans in a "wrapped" package, such as those… Read More