Neither an insurance agent nor an insurance company owes an insured or prospective insured a duty to tell the insured he needs other or additional insurance coverage unless (1) the agent misrepresents the nature, extent or scope of the coverage being offered or provided; (2) there is a request or inquiry by the insured for a particular type or extent… Read More
The insureds were not entitled to Cumis counsel in the underlying personal injury case. The insurer settled the case within policy limits and had reserved its rights only with respect to damages in excess of policy limits and punitive damages, both of which were clearly not covered--and nothing in the underlying action concerning those damages placed insurance defense counsel in… Read More
While the presumption against retroactive application of new statutes is strong, figuring out what constitutes retroactive application may be difficult. Here, the statute required a grace period and notice before terminating a life insurance policy for nonpayment of the premium. Though it changed the terms of the policy, it governed only the insurer's actions after the effective date of the… Read More
Ins. Code 10113.71 and 10113.72 became effective on January 1, 2013. They require life insurance companies to grant the insured a 60 day grace period after the due date of a premium payment in which to make up the payment and reinstate the policy. The statutes also require the insurance company to notify the insured of an impending lapse or… Read More
Following Howell v. Hamilton Meats & Provisions, Inc. (2011) 52 Cal.4th 541 and Pebley v. Santa Clara Organics, LLC (2018) 22 Cal.App.5th 1266, this decision holds that a plaintiff who has medical insurance but chooses to use out-of-plan doctors for his care is treated for damage purposes as if he were uninsured and may submit the doctors' bills as evidence… Read More
Under Idaho law, a title insurance policy that excluded coverage for claims that were "not shown by the public record" did not exclude coverage of claims that arose from the county's official road maps that described a road through the insured's property. "Public records" was undefined in the policy and could be reasonably be construed to include official documents brought… Read More
The International Convention on the Recognition and Enforcement of Foreign Arbitral Awards contains a self-executing direction for the courts of the signatory states to compel arbitration of agreements falling within the Convention's scope. Since that provision is self-executing and not an "Act of Congress," the McCarran-Ferguson Act does not reverse preempt it. Accordingly, the Convention preempts Washington state law that… Read More
This decision reverses a summary judgment, finding that a question of fact exists as to whether defendant insurer acted reasonably to settle this catastrophic injury case within the insured's $25,000 policy limits. During the week the plaintiff's policy limits demand remained open, defendant did not transmit the offer to its insured for his consent. Defendant also repeatedly failed to send… Read More
Disagreeing with Pulte Home Corp. v. CBR Electric, Inc. (2020) 50 Cal.App.5th 216, this decision holds that while an insurer's right to proceed on its insured's claim under the doctrine of equitable subrogation is an equitable claim as to which there is no right to a jury trial, if the claim to which the insurer successfully becomes subrogated is a… Read More
After the Court of Appeal decided in Hollingsworth v. Superior Court (2019) 37 Cal.App.5th 927 that the trial court, having first acquired jurisdiction, should decide whether the Workers Compensation Appeals Board had exclusive jurisdiction over this worker's injury suit--a question that turned on whether the employer had workers compensation insurance coverage at the time plaintiff was injured. The plaintiff had… Read More
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
