Mealey's California Insurance
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November 23, 2022
Judge Dismisses In Row Over LTC Insurance, Finds No Elder Abuse In Coverage Denial
SANTA ANA, Calif. — A California federal judge granted a long-term care (LTC) insurer’s dismissal motion in a breach of contract and elder abuse suit filed against it by an insured seeking coverage for his stay at a residential care facility for the elderly (RCFE), finding that the policy provisions were sufficient to provide the insured with notice of coverage limitations and that the elder abuse claim failed because the insured was not deprived of personal property since the insurer “properly” denied benefits.
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November 22, 2022
Pollution Exclusions Bar Coverage For Underlying Contamination Judgment
LOS ANGELES — No coverage is afforded for an underlying judgment entered against an insured in an environmental contamination dispute because pollution exclusions included in the applicable policies clearly bar coverage, a California federal judge said in entering summary judgment for the insurers.
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November 21, 2022
Judge Conditionally Dismisses Insurer’s Tile Defects Coverage Suit
OAKLAND, Calif. — A federal judge in California issued a conditional order dismissing with prejudice a breach of contract insurance action filed by an insurer against additional insured subcontractors and others related to an underlying action against a general contractor alleging defective tile installation at a housing development after the remaining parties agreed to settle their claims.
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November 21, 2022
Insurer Acted In Bad Faith In Denying Claim For Water Damages, Insureds Say
LOS ANGELES — A homeowners insurer breached its contract and acted in bad faith by denying coverage for $200,000 worth of water damage sustained in an insured home and should be ordered to pay $2 million in punitive damages, the insureds maintain in a complaint filed in California state court.
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November 18, 2022
California High Court Answers Certified Question In Yahoo’s TCPA Coverage Suit
SAN FRANCISCO — The California Supreme Court on Nov. 17 answered a certified question from the Ninth Circuit U.S. Court of Appeals in a coverage dispute between Yahoo! Inc. and its commercial general liability insurer arising from claims brought under the Telephone Consumer Protection Act (TCPA), finding that the CGL policy language at issue can cover liability for right-of-seclusion violations assuming “such coverage is consistent with the insured's objectively reasonable expectations.”
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November 16, 2022
GEICO Seeks To Appeal UCL Class Certification In COVID Premium Credit Suit
SAN FRANCISCO — GEICO petitioned the Ninth Circuit U.S. Court of Appeals for permission to appeal a “deeply problematic” ruling certifying a class of automotive policy holders who say GEICO violated California’s unfair competition law (UCL) by profiting from a premium giveback program initiated during the COVID-19 pandemic, writing that certification was based on a flawed expert report that should have been excluded.
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November 16, 2022
Insurer Disputes Coverage For Cyberstalking Suit Against EBay, Directors And Officers
SAN JOSE, Calif. — A commercial umbrella liability insurer filed a declaratory judgment lawsuit in a California federal court, disputing coverage for an underlying lawsuit alleging that eBay and its directors and officers “engaged in a coordinated effort to intimidate, threaten to kill, torture, terrorize, stalk and silence” the underlying plaintiffs “in order to stifle their reporting on eBay.”
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November 15, 2022
Insurer Counterclaims In Administrator’s Suit Over Fee Calculation, Payment
LOS ANGELES — Answering a complaint by an administrative service provider that allegedly mistakenly underpaid itself by approximately $40 million, an insurer on Nov. 14 counterclaimed in California federal court for breach of contract and breach of fiduciary duty and argued in part that the provider is obligated to indemnify the insurer.
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November 14, 2022
Insureds Not Permitted To File Amended Complaint In Bad Faith, Wildfire Damage Suit
SAN FRANCISCO — A California federal judge denied a motion for leave to file a third-amended complaint to add a claim for injunctive relief by insureds who claim their insurer breached its contract and acted in bad faith by refusing to cover damages caused to their refrigerators by power outages during a California wildfire because the insureds have an adequate legal remedy for damages based on their contract claims.
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November 11, 2022
Claimant Met Burden Of Showing Own-Occupation Benefits Are Owed
SACRAMENTO, Calif. — A disability claimant is entitled to long-term disability (LTD) benefits under a plan’s own-occupation standard because the evidence supports a finding that the claimant was disabled from performing the duties of her own occupation; however, the disability insurer must determine on remand if the claimant qualifies for LTD benefits under the plan’s any-occupation standard, a California federal judge said.
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November 10, 2022
Disability Claimant Entitled To LTD Benefits For Heart Condition, Judge Says
LOS ANGELES — A disability claimant is entitled to long-term disability (LTD) benefits because the medical evidence supports a finding that the claimant was totally disabled and the disability insurer failed to consider how work-related stress could negatively contribute to the claimant’s heart condition, a California federal judge said.
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November 10, 2022
Heart Attack Patient’s UCL Fraud Claims Against Insurer Insufficient, Judge Says
SACRAMENTO, Calif. — A California federal judge dismissed with prejudice claims that a travel insurance policy provider committed promissory fraud and violated California’s unfair competition law (UCL) by not approving medical coverage for a heart attack patient on vacation to Chile for five days, finding that the plaintiff failed to plead intent to defraud but may pursue a breach of contract claim.
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November 09, 2022
Assignee Tells 9th Circuit It Stepped In Provider’s Shoes, Has Viable ERISA Claim
PASADENA, Calif. — A district court judge ignored precedent the Ninth Circuit U.S. Court of Appeals cited in reversing a previous dismissal on standing grounds and then changed its mind for unknown reasons and found the claims insufficient, a group assigned the rights of a now-defunct health and substance abuse care provider argues.
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November 07, 2022
Reports Accidentally Produced By Insurer In Contamination Suit Are Not Discoverable
RIVERSIDE, Calif. — An insured seeking coverage for groundwater contamination at a county airport is not entitled to three reports regarding the contamination and prepared at the insurer’s request because the reports, which were inadvertently produced by the insurer during discovery, are clearly protected by the attorney-client privilege and the insurer did not waive its right to assert that privilege, a California federal magistrate judge said in denying insured’s motion seeking a determination that the reports are not subject to privilege or immunity.
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November 07, 2022
No Certiorari For Discovery, Deposition, Questions In Uninsured Motorist Suit
WASHINGTON, D.C. — A pro se petitioner who raised four questions regarding depositions, discovery and the statute of limitations over uninsured motorist (UM) insurance coverage for a 2009 auto accident saw his petition for certiorari denied without comment by the U.S. Supreme Court on Nov. 7.
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November 07, 2022
Bad Faith Claim Against Disability Insurer To Proceed Under California Law
SAN DIEGO — A bad faith claim against a disability insurer will proceed because applying Illinois law would be contrary to California’s fundamental policy of providing a remedy for insurance bad faith, a California federal judge said in denying the insurer’s motion to dismiss the bad faith claim.
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November 07, 2022
Bad Faith Claim Against Rental Property Insurer Must Be Dismissed, Judge Says
SAN FRANCISCO — A bad faith claim alleged against a rental property insurer must be dismissed because the insured’s tenants who filed the suit failed to allege any bad faith conduct by the insurer after the tenants became judgment creditors of the insured, a California federal judge said in granting the insurer’s motion to dismiss the bad faith claim.
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November 07, 2022
Bad Faith Claim Is Duplicative Of Breach Of Contract Claim Against Auto Insurer
SACRAMENTO, Calif. — A bad faith claim against an auto insurer cannot proceed, a California federal judge said, because the claim is duplicative of the insured’s breach of contract claim in a dispute over the auto insurer’s handling of the insured’s claim for underinsured motorist benefits.
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November 01, 2022
Judge Certifies Class In Suit Alleging GEICO Profited From Premium Giveback Program
SAN JOSE, Calif. — A California federal judge on Oct. 31 granted an insured’s motion for class certification in a lawsuit alleging that GEICO profited from a premium giveback program initiated by the insurer during the COVD-19 pandemic and ordered the parties to submit briefing on supplemental authority that was submitted by the insurer.
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October 31, 2022
Calif. Suit Accuses Sister Of Fraudulently Using Brother’s Life Insurance Proceeds
SANTA ANA, Calif. — A California woman violated the California Insurance Frauds Prevention Act (IFPA) when she allegedly had her mentally disabled relative who was incapable of entering into contracts sign a power of attorney allowing her to access life insurance proceeds left to him, alleges a complaint filed in a California court by the people of the state of California for the benefit of the relator, the employer who paid the premiums on the two policies.
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October 31, 2022
Jury Awards Health Insurer $2.4M On Claim That Employer Fraudulently Insured Father
SANTA ANA, Calif. — A federal jury in California found that an employer and his California limited liability company committed fraud when the man’s father was presented as an employee and insured under the company’s small group health plan and awarded the insurer more than $2.4 million in damages.
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October 28, 2022
On Reconsideration, Judge Affirms Refusal To Dismiss Lakers’ COVID Coverage Suit
LOS ANGELES — Granting an insurer’s motion for reconsideration, a federal judge in California again affirmed the court’s refusal to dismiss the Los Angeles Lakers’ first amended complaint to the extent that the claims are based on a commercial property insurance policy’s property damage clause, finding the court lacks the scientific expertise necessary to determine, based solely on the Lakers’ amended complaint, that it is not plausible for the insured’s property to have been physically altered by the coronavirus.
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October 26, 2022
California Rulings ‘Directly Undermine’ Insured’s Appeal Of COVID-19 Coverage Suit
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Oct. 25 affirmed a lower federal court’s dismissal of a California restaurant owner insured’s lawsuit seeking coverage for its business interruption arising from the coronavirus pandemic, finding that the coronavirus did not cause “direct physical loss or physical damage” or “risks of physical loss.”
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October 25, 2022
Jury Finds Insurance Agent Negligent, Awards $4.5M To Insureds In Wildfire Suit
NAPA, Calif. — Finding that an insurance agent was professionally negligent and was acting in the scope of her agency with State Farm General Insurance Co. when she harmed Napa County insureds, a California jury awarded the insureds $4,349,800 for their economic losses arising from the Atlas Peak wildfire.
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October 24, 2022
Panel Affirms Finding That Auto Insurer Abandoned Arbitration Proceeding
LOS ANGELES — A trial court did not err in finding that an auto insurer abandoned an arbitration proceeding after its insured filed a breach of contract and bad faith suit because the insurer did not move to compel arbitration until more than a year after the insured filed suit.