Justia California Court of Appeals Opinion Summaries

Plaintiffs filed suit against Scottsdale for breach of its insurance contract and tortious breach of the implied covenant of good faith and fair dealing. At issue was whether plaintiffs can pursue a claim for preforeclosure damage to the property at issue deliberately caused by the purchaser under an insurance policy issued by Scottsdale containing a mortgage coverage provision. The court concluded that plaintiffs' full faith and credit bid at the foreclosure sale under the second deed of trust precluded them from making a claim on the insurance proceeds. Further, the trial court did not abuse its discretion in finding that a defense offer to compromise under Code of Civil Procedure section 998 was reasonable. Accordingly, the court affirmed the judgment of the trial court.View "Najah v. Scottsdale Ins. Co." on Justia Law

Mercury Casualty Company filed an action seeking declaratory relief regarding its obligation to students Hung Chu and his roommate Tu Pham. Mercury issued an automobile policy to Chu insuring his 1995 Honda Accord. Chu was driving, and Pham was a passenger, when Chu collided with a vehicle driven by Krystal Nguyen Hoang. Pham filed a personal injury action against Chu and Hoang and obtained a $333,300 judgment against Chu. Mercury sought a judicial determination confirming Mercury’s decision Chu’s policy excluded coverage for Pham’s judgment under a “resident exclusion.” Mercury also sought an order requiring Chu to reimburse Mercury the fees and costs it incurred in defending him against Pham’s lawsuit. Chu cross-complained against Mercury for breach of contract, bad faith, and general negligence. Mercury prevailed on the issue of whether the policy provided coverage for Pham’s judgment. The court determined Mercury had no duty to indemnify Chu with respect to the judgment. It granted Mercury’s motion for judgment on the pleadings (JOP) on Chu’s cross-complaint but determined Mercury could not seek reimbursement of its attorney fees and costs in defending Chu because such damages were not sought in the JOP. Both parties appealed. Chu and Pham appealed the determination that Mercury’s policy excluded coverage for Pham’s personal injury lawsuit against Chu. Mercury appealed the court’s ruling Chu was not required to reimburse Mercury for the defense fees and costs. After its review of the record, the Court of Appeal reversed, concluding the policy provision excluding Pham from coverage was an overbroad expansion of the statutorily permitted exclusion and was also contrary to public policy. Based on this ruling, the Court did not address the issue raised in Mercury’s cross-appeal regarding its entitlement to defense costs and fees.View "Mercury Casualty v. Chu" on Justia Law

Manuel Lainez had been independently driving commercial vehicles for eight and a half years. He owned his own truck and his own business, Lainez Trucking. He purchased a trucker’s liability policy from Scottsdale Indemnity Company with a $1 million liability limit. Lainez entered into a motor carrier agreement with Western Transportation Services. Western did not own tractors or trailers, but contracted with owner/operators or drivers. The agreement provided that Lainez was an independent contractor and was responsible for all costs and expenses incidental to the performance of transportation services. He agreed to maintain liability insurance and to name Western Transport as an additional insured. Western Transport, through the California Automobile Assigned Risk Plan (CAARP), purchased a commercial assigned risk policy from National Continental Insurance Company (NCI), which stated "'Named Insured’s Business: 1 Trucker for Hire-Excess'" and named Lainez as a driver. It did not list, describe, or rate any vehicle. It was rated on an excess cost of hire basis at a premium that was 4 to 10 percent of the cost of a policy rated on a primary cost of hire basis. The issue this case presented for the Court of Appeal's review was whether the two insurance companies were coprimary insurers or whether NCI was an excess insurer for an underlying fatality involving Lainez. The trial court granted NCI’s motion for a summary judgment, concluding that Scottsdale was the primary insurer pursuant to California Insurance Code section 11580.9, subdivisions (d) and (h). The Court of Appeal agreed that Scottsdale was the primary insurer and NCI was the excess insurer and affirmed the judgment. View "Scottsdale Indemnity v. National Continental Insurance Co." on Justia Law

Trustees of the Western Asbestos Settlement Trust, charged with paying bodily injury claims against companies that distributed asbestos-containing building materials, sought coverage under the companies’ insurance policies. In 2004, after the insurer was declared insolvent, the trust sought declaratory relief against the California Insurance Guarantee Association (CIGA). CIGA filed an answer denying any obligation to pay claims against the insolvent insurer. The proceedings remained dormant for six years. In 2011, the Western Trust dismissed its complaint without prejudice. The present declaratory relief action by the Western Trust against CIGA was filed in 2013. The trial court dismissed, citing the three-year statute of limitations. Western Trust argued that the limitations period does not begin to run until CIGA denies a specific claim for payment and that no such claim has yet been submitted. The appeals court reversed, holding that a cause of action against CIGA for breach of statutory duties does not accrue until all of the events necessary to create a covered claim have occurred, giving rise to the insured’s right to demand payment from CIGA. The complaint alleged no facts indicating that all those events occurred more than three years before the complaint was filed, if they have occurred. View "Snyder v. CA Ins. Guar. Ass'n" on Justia Law

After Arch denied coverage to its insured, Jon Davler, Inc., based on an employment-related practices exclusion, Jon Davler filed suit seeking coverage. In the underlying action, employees filed suit against their employer, Jon Davler, for various employment claims, including sexual harassment, invasion of privacy, and false imprisonment. The trial court sustained Arch's demurrer to the complaint without leave to amend. The court concluded that the employment-related practices exclusion applies to the underlying claims and rejected Jon Davler's contention that the exclusion is ambiguous. The court concluded that the employment-related practices exclusion is plain and clear and "understandable to a layperson." Jon Davler is not entitled to leave to amend and the court affirmed the judgment of the trial court.View "Davler, Inc. v. Arch Ins. Co." on Justia Law

Kaiser Permanente covered three patients who received care at an emergency room operated by Dameron Hospital Association. The patients were injured due to the negligence of third party tortfeasors who had automobile liability insurance with California Automobile Association Inter-insurance Bureau (AAA) and Allstate Insurance Company. Unlike Kaiser, neither AAA nor Allstate had contracts with Dameron. In the absence of an agreement for negotiated billing rates, Dameron sought to collect from AAA and Allstate its customary billing rates by asserting liens filed under the Hospital Lien Act (HLA). AAA and Allstate ignored Dameron’s HLA liens when paying settlements to the three Kaiser patients. Upon learning of the settlements, Dameron sued AAA and Allstate to recover on its liens. The trial court granted the automobile liability insurers’ motions for summary judgment on grounds the patients’ debts had already been fully satisfied by their health care service plans. Reasoning the HLA liens were extinguished for lack of any underlying debt, the trial court dismissed the case. The trial court further found dismissal was warranted because Dameron failed to timely file some of its HLA liens against AAA. The issue this case presented for the Court of Appeal was whether a heath care service plan’s payment of a previously negotiated rate for emergency room services insulate the tortfeasor’s automobile liability insurer from having to pay the customary rate for medical care rendered? AAA and Allstate contended they were not responsible for any amount after Kaiser paid in full the bill for the emergency room services provided by Dameron. Dameron contended that it contracted with Kaiser to preserve its rights to recover the customary billing rates from tortfeasors and their automobile liability insurers. Dameron argued the tortfeasors and their liability insurers were responsible for the entire bill for medical services at the customary rate, not just the difference between the reimbursement received from Kaiser and the customary billing rate. Although Dameron claimed it should benefit from the California Supreme Court’s holding that it may avoid extinguishment of its HLA liens upon receiving payments from health insurers, the contract in this case preceded that case by 10 years. The Court of Appeal concluded that the Dameron/Kaiser contract did not preserve the right to recover the customary billing rate for emergency room services from third party tortfeasors: "[I]f Dameron wishes to preserve its right to recover its customary billing rates through an HLA lien, it is free to contract for this right. But Dameron must actually contract for this right. A history of voluntary cooperation with Kaiser does not suffice to avail Dameron of the [Supreme Court's] guidance on reservation of contractual rights under the HLA." Consequently, the trial court properly granted summary judgment in favor of AAA and Allstate. As to Dameron’s argument that it filed a timely claim relating to patient Rita H.’s HLA lien, the Court of Appeal affirmed the trial court’s dismissal based on the statute of limitations. Dameron has not made a sufficient showing of diligence to toll the claim under the discovery rule. View "Dameron Hospital Assn. v. AAA etc. Ins. Exchange" on Justia Law

In December 2010, Cost-U-Less Insurance assisted plaintiffs by telephone, through an InsZone Insurance Services employee, in obtaining a homeowner’s insurance policy with Fidelity. In 2011, a fire damaged plaintiffs’ home. They made a claim with Fidelity. Fidelity property claims representative Fowler sent a letter advising that Fidelity was investigating coverage for the fire incident, indicating that Fidelity had obtained information suggesting plaintiff did not live in the home and that the property had been used and operated as a residential care facility. After an investigation, Fidelity rescinded the homeowner’s policy on the grounds that plaintiffs’ insurance application contained material misrepresentations about various facts concerning plaintiffs’ and their home. The trial court entered judgment in favor of plaintiffs in the amount of $807,058.10, plus interest and costs of suit. Plaintiffs appealed the trial court’s decision to strike the jury’s $1.9 million punitive damages award. Fidelity appealed that the court committed jury instructional error. The appeals court remanded, holding that the trial court prejudicially erred in refusing to give certain jury instructions concerning whether the application formed an insurance contract.View "Douglas v. Fidelity Nat' Ins.Co." on Justia Law

The City sought a writ of mandate challenging the trial court's order denying summary adjudication with respect to Mercury's inverse condemnation and nuisance claims based on damages to Mercury's insured's house caused by a tree the City owned. The court concluded that the trial court properly denied summary adjudication as to the inverse condemnation cause of action because there were triable issues of material fact as to whether the tree was part of a work of public improvement. Further the City failed to meet its burden on summary adjudication of establishing that Mercury could not show nuisance. Accordingly, the court denied the petition. View "City of Pasadena v. Super. Ct." on Justia Law

The health care service plan in this case, Kaiser Permanente, covered three patients who received care at an emergency room operated by Dameron Hospital Association. The patients were injured due to the negligence of third party tortfeasors who had automobile liability insurance with California Automobile Association Inter-insurance Bureau (AAA) and Allstate Insurance Company. Unlike Kaiser, neither AAA nor Allstate had contracts with Dameron. In the absence of an agreement for negotiated billing rates, Dameron sought to collect from AAA and Allstate its customary billing rates by asserting liens filed under the Hospital Lien Act (HLA). AAA and Allstate, however, ignored Dameron’s HLA liens when paying settlements to the three Kaiser patients. Upon learning of the settlements, Dameron sued AAA and Allstate to recover on its HLA liens. The trial court granted insurers’ motions for summary judgment on grounds the patients’ debts had already been fully satisfied by their health care service plans. Reasoning the HLA liens were extinguished for lack of any underlying debt, the trial court dismissed the case. The trial court further found dismissal was warranted because Dameron failed to timely file some of its HLA liens against AAA. The question this case presented to the Court of Appeal was whether the health care service plan’s payment of a previously negotiated rate for emergency room services insulated the tortfeasor’s automobile liability insurer from having to pay the customary rate for medical care rendered. AAA and Allstate argued they were not responsible for any amount after Kaiser paid in full the bill for the emergency room services provided by Dameron. Dameron argued that it contracted with Kaiser to preserve its rights to recover the customary billing rates from tortfeasors and their automobile liability insurers, and that the tortfeasors and their liability insurers were responsible for the entire bill for medical services at the customary rate - not just the difference between the reimbursement received from Kaiser and the customary billing rate. The Court of Appeal concluded that the Dameron/Kaiser contract did not contain the term described by case law as sufficient to preserve the right to recover the customary billing rate for emergency room services from third party tortfeasors. Consequently, the trial court properly granted summary judgment in favor of AAA and Allstate. View "Dameron Hosp. Assn. v. AAA Nor. Cal., Nev. & Utah Ins. Exc." on Justia Law

The Eastern Municipal Water District (EMWD) hired general contractor S.J. and Burkhardt, Inc. (SJB) for a public works construction project in 2006. Safeco Insurance Company (Safeco) executed performance and payment bonds for the project. Plaintiff Golden State Boring & Pipe Jacking, Inc. (GSB) was a subcontractor for the project, completing its work by September 2006, but it did not receive payment. In March 2008, SJB sent a voluntary default letter to Safeco. In July 2008, GSB sued SJB, EMWD, and Safeco for the unpaid amounts under the contract, separately seeking payment from Safeco under its payment bond. EMWD filed a cross-complaint to interplead retained sums. Safeco made a motion for summary judgment on the cause of action for payment under the bond on the ground that GSB’s claim was untimely. The trial court granted the motion, finding that there had been three cessations of labor that triggered GSB’s duty to file a stop notice in order to secure payment under Safeco's payment bond. At a subsequent court trial on the contract claims, GSB was awarded judgment against SJB, and Safeco was awarded judgment on the interpleader action. GSB appealed the summary judgment ruling, arguing: (1) the trial court erroneously overruled its objections to evidentiary matters presented in support of Safeco’s summary judgment; and (2) the court erred in finding the action was untimely. Finding no reversible error, the Court of Appeal affirmed. View "Golden State v. Eastern Municipal Water Dist." on Justia Law