Insurance

The trial court correctly denied defendant's Anti-SLAPP motion in this qui tam insurance fraud action against a doctor for preparing fraudulent patient medical reports and billing statements in support of insurance claims.  The billing statements and medical reports were prepared in the ordinary course of the doctor's business and not in serious contemplation of lawsuits, so they were not protected… Read More

The anti-suit and other injunctions entered when Castlepoint was placed in receivership under the California Insurance Commissioner did not prevent suit by shareholders of a related entity against other related entities and their controlling officers and directors on claims of breach of contract (to which Castlepoint was not a party), tortious interference with that same contract, and breach of fiduciary… Read More

An independent insurance agent that transacts business with many insurance companies is an agent of the insured, not any of the insurance companies, more akin to an insurance broker than a true insurance agent.  The insurer owes no duty of care to supervise such an agent and is not liable for the agent's torts.  In determining whether an applicant meets… Read More

Under 11580.2(f), insured and insurer must arbitrate any dispute about whether the insured is entitled to recover damages from an uninsured motorist and the amount of those damages.  While the insured is not required to arbitrate a bad faith claim arising from the same accident, the fact that the insured has alleged such a claim is not grounds for avoiding… Read More

An insurer may waive the insured's forfeiture of the policy through non-payment of the premium even though a loss has occurred during the period between lapse of the policy due to non-payment and reinstatement upon late payment of the premium.  The loss-in-progress rule (Ins. Code 22, 250) does not prevent the insurer from waiving the forfeiture in this situation because… Read More

Ins. Code 533.5 provides that no insurer (no matter what the insurance policy says) owes any duty to indemnify or defend a suit by the Attorney General, a district attorney or city or county counsel to recover a fine, penalty or restitution for a violation of B&P Code 17200 or 17500.  This decision holds that the statute does not violate… Read More

Over a vigorous dissent, the majority holds that the adult daughter of the insureds under this homeowner's insurance policy does not have standing to sue the insurer for bad faith in regard to coverage for damage to the daughter's personal property that was damaged while in the insured premises.  Only the parents were named insureds under the policy, which expressly… Read More

Kaiser adequately proved that Kuntz's decedent enrolled with Kaiser under a CalPERS medical insurance plan which included an arbitration clause.  Kaiser showed that CalPERS keeps the individual enrollment forms, just sending Kaiser electronic enrollment information.  Kaiser's electronic enrollment information showed that Kuntz's decedent had been enrolled in the Kaiser health plan continuously since 1983.  Kaiser was not required to show… Read More

For purposes of unemployment insurance, the test set forth in G. Borello & Sons, Inc. v. Department of Industrial Relations (1989) 48 Cal.3d 341 governs the determination whether a worker is an employee or an independent contractor, not the more employee-friendly ABC test of Dynamex Operations West, Inc. v. Superior Court (2018) 4 Cal.5th 903.  Nevertheless, in this case, substantial… Read More

An insurer may be liable in bad faith if it fails to settle within policy limits when given the opportunity to do so.  This decision holds that to pursue a bad faith claim on that basis, it is not necessary for the insured to show that the claimant actually make a demand for settlement at or under policy limits.  Following… Read More