Insurance

An insurer is not required to appoint Cumis counsel when it accepts its insured's defense without a reservation of rights but, for premium purposes only, decides that the insured is the at-fault driver in the accident and so increases his premium for future years' coverage. Read More

This decision holds that an insurer's allegedly wrongful denial of an insurance claim or its claim handling leading to that denial cannot be the basis of a viable claim under the Insurance Fraud Pevention Act (Ins. Code 1871.7).  The Act was designed to prevent fraudulent insurance claims not impose added duties on or create new remedies against insurers in connection… Read More

This decision holds that losses due to COVID closures are not covered by the business income and extra expense coverage of a business insurance policy since to trigger coverage the loss must be due to an impairment of operations caused by direct physical loss or damage to property.  For there to be coverage under this policy language, some external force… Read More

Following Mudpie, Inc. v. Travelers Casualty Ins. Co. (9th Cir. 2021) 15 F.4th 885 and Inns-by-the-Sea v. California Mutual Ins. Co. (2021) 71 Cal.App.5th 688, this decision holds that business interruption insurance providing coverage for interruption due to physical loss or damage to property does not cover losses caused by the COVID pandemic or associated government-ordered shut downs of business… Read More

This decision affirms a judgment holding that Ins. Code 533 bars insurance coverage for a judgment against Conagra for the public nuisance caused by Fuller Paint's pre-1950 advertising promoting the use of lead-based paint for interior paint on residential units.  In the liability trial, the trial court found that Fuller had kwown at the time it made the advertisements that… Read More

The Court of Appeal initially reversed a judgment in the plaintiff's favor, finding that the insurance agent who fraudulently induced plaintiff to enter into unsuitable annuities rather than the life insurance he had requested was an insurance broker, not a true agent, and that the insurer defendant therefore was not liable for the agent's fraud.  The Supreme Court granted review… Read More

Hill's umbrella insurance did not provide coverage for bodily injuries Gardineer sustained in a car accident caused by Hill's niece while she was driving Hill's car with his permission.  The umbrella policy extended coverage only to "insureds" a term it defined to include only the named insured, his wife and other relative who resided in the named insured's house.  The… Read More

A hospital cannot recover more for its emergency care of patients injured in car accidents than the amounts it has agreed with the patients' medical insurers to charge for those services.  Here, the hospital tried to collect more by requiring the patients to sign conditions of admissions that contained assignments of the patients' underinsured motorist coverage and medical benefits coverage… Read More

Tricked by a hacker's sending emails purportedly from her boss, Ernst's accounts payable clerk wire transferred $200,000 to banks from which the money was swiftly withdrawn.  Ernst sued its insurer to recoup its losses.  This decision holds that the loss fell within the computer fraud coverage of loss “resulting directly from the use of any computer to fraudulently cause a… Read More

Under former Ins. Code 2051.5, an insurer's liability under a replacement cost policy was the lesser of (a) the amount it would cost to replace the damaged structure at the insured location (without regard to depreciation), or (b) the policy's limits.  If the insurer requires the insured to repair the structure before claiming replacement cost, the insurer must first pay… Read More