Archive for the ‘Blog’ Category

DOI To Clarify That Prepared Direct Testimony Requirement Does Not Apply to Adverse Witnesses and Witnesses Not Controlled By Party

The Commissioner will hold a public hearing on October 25 in San Francisco to consider amendments to the regulations governing hearings conducted pursuant to Insurance Code Sections 1858, 1858.01, 1858.1 and 1858.2.  In addition to a technical amendment, the purpose of the new language is to clarify that the prepared direct testimony requirement applies “only [...]

September 3, 2010   Posted in: Blog  Comments Closed

Surplus Lines Reforms Go To Governor

The legislature has sent to the Governor AB 1708 (Villines-Fresno), sponsored by the Department of Insurance.  The bill would require the total capital and surplus requirements for nonadmitted insurers in California to be at least $45 million.  The current amount is  $15 million. The bill would also require $25 million of this amount to be [...]

September 3, 2010   Posted in: Blog  Comments Closed

No Defense Duty For Motorcycle Accident Where Automobile Accident Exclusion Barred Coverage Under CGL Policy

Sprinkles v. Associated Indemnity Corporation, et al, No. B218417 (September 1) is a decision from Division Five of the Second Appellate District arising out of motorcycle accident caused by an employee of Sinco, Inc.  Sinco had a number of liability policies, including a CGL policy issued by Fireman’s Fund.  Fireman’s Fund denied coverage under that [...]

September 1, 2010   Posted in: Blog  Comments Closed

One Health Insurance Regulatory Measure Advances, Another Stalls

The Assembly has passed SB 1163 (Leno-San Francisco), which would require insurers to get an independent review of proposed rate increases aimed at establishing they correspond to the reasonable cost of health care.  The legislation would also require public disclosure of proposed rate increases and their justification, and require that insurers provide 60 days notice [...]

August 31, 2010   Posted in: Blog  Comments Closed

Commissioner Reaches Enforcement Settlement With Corinthian Title

Commissioner  Poizner today announced that he has reached an agreement with an underwritten title company to resolve an enforcement action taken against the company by the Department of Insurance. Corinthian Title Company, Inc., licensed to transact title business in San Diego county, allegedly failed to file escrow rates between October 2008 and November 2009 despite [...]

August 30, 2010   Posted in: Blog  Comments Closed

Insurer Had No Obligation To Defend Where There Was No Accident

Pacific Specialty Insurance Company v. Mercury Casualty Company, No. A127389 (August 30) involves  a coverage dispute between two insurers.  Mercury was the primary carrier and Pacific Specialty was excess.  Mercury declined to defend its insured, Belinda St. Andrews, and Pacific Specialty picked up the defense.  Pacific Specialty then brought this declaratory relief action.  The trial [...]

August 30, 2010   Posted in: Blog  Comments Closed

Despite Optional Relief Under Pennsylvania Law, California Time Limit Strictly Enforced In Ancillary Liquidation

HCM Healthcare, Inc., et al v. California Insurance Guarantee Association, No. B213373 (August 30) is an affirmance by Division Eight of the Second Appellate District of a trial court decision rejecting HCM’s and Madera Convalescent Hospital, Inc.’s ancillary liquidation claims as untimely.  Between 1997 and 2001, three insurers issued nursing home liability policies to the [...]

August 30, 2010   Posted in: Blog  Comments Closed

Insured Cannot Retain Benefits of Settlement And Sue For Fraudulent Inducement To Settle

In Village Northridge Homeowners Association v. State Farm Fire and Casualty Company, No. S161008 (August 30), an insured who suffered damage in the 1994 Northridge earthquake settled a disputed insurance claim with its first party insurer, executed a full release of the claim, kept the money the insurer paid in the settlement without rescinding the [...]

August 30, 2010   Posted in: Blog  Comments Closed

Failure To Investigate Public Records Created No Enforeceable Rights Against Insurer

In the unpublished case of Colony Insurance Company v. Crusader Insurance Company, No. B215274 (August 27), both Colony and Crusader insured a building in Los Angeles that was the subject of tenant litigation.  Colony sought a declaration that Crusader had improperly refused to defend and an equitable share of its legal costs in conducting the [...]

August 27, 2010   Posted in: Blog  Comments Closed

Commissioner To Hold Hearing On WC Claims Cost Benchmark and Pure Premium Rates

The Commissioner will hold a public hearing on October 12 in San Francisco to consider the Workers’ Compensation Insurance Rating Bureau’s proposed 29.6 percent increase.  The hearing will also consider proposed amendments to the Statistical Rating Plan, to regulations governing recording and reporting of data, and to the Experience Rating Plan.

August 26, 2010   Posted in: Blog  Comments Closed

Blue Shield Obtains DOI Concurrence On 18.2 Percent Rate Hike

Blue Shield’s 247,000 individual certificate holders will soon face a rate increase averaging 18.2 percent — with some insureds’ increases, depending on age, hitting 50 percent.  As with Anthem Blue Cross’ recently approved rate hike, the Department of Insurance is not standing in the way of Blue Shield’s action.

August 26, 2010   Posted in: Blog  Comments Closed

Title Insurer Owed Defense and Indemnity For Title Claim Asserted By Archbishop

In the unpublished case of Cohn v. First American Title Insurance Company, No. A126228 (August 26), Division Four of the First Appellate District considered an issue of coverage under a title insurance policy.  Daniel Cohn and Annette Goggio owned property within a subdivision adjacent to land owned by the Roman Catholic Archbishop of San Francisco.  [...]

August 26, 2010   Posted in: Blog  Comments Closed

Second Appellate District Upholds Arbitration Agreement Applicable To Coverage And Valuation Issues

In the unpublished case of Tutor-Saliba-Perini, J.V. v. Allianz Global Risks US Insurance Company, No. B219231 (August 26), TSP appealed from a summary judgment in favor of Allianz in an insurance bad faith case.  TSP argued that the arbitration agreement into which it had entered with Allianz did not waive TSP’s right to pursue claims [...]

August 26, 2010   Posted in: Blog  Comments Closed

Scaled-Back Anthem Blue Cross Rate Hikes Approved

Anthem Blue Cross’ scaled-back individual health insurance rate hikes have been approved, and the company said it intends to put the new rates — averaging 14 percent and as high as 20 percent — into effect Oct. 1 for nearly 800,000 individual California policyholders.  The company’s disapproved prior filing would have allowed rate hikes as [...]

August 25, 2010   Posted in: Blog  Comments Closed

Fraudulent Slip and Fall Claims Appear To Be On Rise

The National Underwriter reports that insurance crime experts are warning that “slip and fall” claims are on the upswing, and as a result, such claims are increasing reviewed for potential fraud by both insurers and investigators. The Des Plaines, Ill.-based National Insurance Crime Bureau (NICB) said yesterday that an analysis of questionable slip and fall [...]

August 25, 2010   Posted in: Blog  Comments Closed

First Appellate District Finds Title Insurer Not A Guarantor And Applies Buss Holding To Reimbursement Issues

Bar-K, Inc. v. Security Title Corp., First American Title Insurance Company, No. A115199 (August 25), is a very complex opinion from Division Two of the First Appellate District arising out of a 1997 transaction in which Bar-K, a lender, paid $4.1 million to purchase certain notes and mortgages, thereby refinancing a third party’s debt related [...]

August 25, 2010   Posted in: Blog  Comments Closed

Anti-SLAPP Motion Granted Where Third-Party Claimant Seeks to Evade Moradi-Shalal

In the unpublished case of Rolla v. Cheldin, et al, No. 55614 (August 25), Division One of the Fourth Appellate District upheld the trial court’s grant of a special motion to strike under Code of Civil Procedure Section 425.16 brought by Crusader Insurance Company and its chief executive officer, Cary Cheldin.  Rolla was a third-party [...]

August 25, 2010   Posted in: Blog  Comments Closed

Legislature Passes Bill To Bar Health Rate Hikes More Than Once Each Year

AB 2042 (Feuer-Los Angeles) has cleared the legislature.  The bill prohibits a health care service plan or health insurer from altering the rates that apply to individual health care contracts more than once each year, except as specified.  Among those exceptions, the bill provides that if a brand name drug becomes available as a generic [...]

August 24, 2010   Posted in: Blog  Comments Closed

Second Appellate District Upholds Thing Limits On Dillon v. Legg

In Thing v. La Chusa (1989) 48 Cal. 3rd 644, the Supreme Court narrowed its holding in Dillon v. Legg (1968) 68 Cal. 2nd 728, limiting the scope of claims for negligent infliction of emotional distress.  Its stated purpose was to “avoid limitless liability out of all proportion to the degree of a defendant’s negligence, [...]

August 23, 2010   Posted in: Blog  Comments Closed

Supreme Court Holds That Wrongful Death Claims Are Subject To Medical Malpractice Arbitration Agreements

In Ruiz v. Podolsky, No. S175204 (August 23), the Supreme Court was faced with this issue: when a person seeking medical care contracts with a health care provider to resolve all medical malpractice claims through arbitration, does that agreement apply to the resolution of wrongful death claims, when the claimants are not themselves signatory to [...]

August 23, 2010   Posted in: Blog  Comments Closed

Spitzer Era Contingent Commission Case Revived By Third Circuit

Eliot Spitzer has risen again: the Third Circuit has revived a number of the racketeering and antitrust claims against insurers and brokers, dismissed three years ago by a New Jersey federal district court, asserting the defendants participated in a bid-rigging scheme with  Marsh. The federal class action case filed by numerous businesses, municipalities and others [...]

August 20, 2010   Posted in: Blog  Comments Closed

Commissioner Promulgates Updated Minimum Reserving Requirements For Life Insurance

The Commissioner will hold a public hearing on October 5 in San Francisco to consider new regulations setting forth updated minimum reserving requirements for life insurance.  The regulations will supersede Ins. Bull. 2009-2, which currently governs.  The regulations draw from, but also differ from, the NAIC Model in several respects.  The regulations will also apply [...]

August 19, 2010   Posted in: Blog  Comments Closed

WCAB Held To Have Failed To Consider That Claimant Was An Excluded Employee

In the unpublished case of Duenas and Fire Insurance Exchange v. Workers’ Compensation Appeals Board and Juan Jose Ayala, No. B215894 (August 19), Division Two of the Second Appellate District agreed that Ayala, hired to do landscaping work at a private residence, was presumptively an employee of Duenas.  However, it went on to determine that [...]

August 19, 2010   Posted in: Blog  Comments Closed

Summary Judgment Against Surety Upheld Where Trial Court Allowed Plenty Of Time To Locate Defendant

In the unpublished case of County of Los Angeles v. Lexington National Insurance Corp., No. B214084 (August 19), Division Three of the Second Appellate District affirmed the trial court’s summary judgment against the surety after it denied the surety’s motion to vacate the forfeiture and exonerate the bond.  The surety contended that the defendant had [...]

August 19, 2010   Posted in: Blog  Comments Closed

WCAB Reliance On, And Understanding Of, Permanent Impairment Guide To Rebut Rating Upheld

In Milpitas Unified School District v. Workers’ Compensation Appeals Board and Joyce Guzman, No. H0343853 (August 19), the Sixth Appellate District was faced with a challenge by the School District to a decision by the WCAB applying Labor Code Section 4660 to the disability evaluation of a District employee.  The Board ruled that an employee’s [...]

August 19, 2010   Posted in: Blog  Comments Closed