Archive for September, 2009

Denial of Class Certification Upheld In “Vanishing Premium” Life Insurance Case

In the case of Kaldenbach v. Mutual of Omaha Life Insurance Company, et al, No. G038539 (September 30; modified and ordered published October 26), Division Three of the Fourth Appellate District affirmed a trial court’s decision to deny class certification in a “vanishing premium” life insurance case founded on the Unfair Competition Law and the [...]

September 30, 2009   Posted in: Blog  Comments Closed

Oravecz v. New York Life Insurance Co. Reissued After Rehearing

In our June 9 blog post, we discussed the case of Oravecz v. New York Life Insurance Co., et al, No. B206066 (May 11; ordered published June 9).  The case deals with an insurer’s responsibility for an agent’s acts as an independent contractor.  Today, September 30, the ruling was reissued after rehearing as an unpublished [...]

September 30, 2009   Posted in: Blog  Comments Closed

Farmers’ Successful Defense Of Wrongful Termination Case Provides Helpful Insight Into Repair Estimating Practices

Yeakel v. Farmers Group of Companies, et al, No. B204115 (September 30), is an unpublished opinion from Division Seven of the Second Appellate District upholding a summary judgment in favor of Farmers on Yeakel’s assertion that he was relieved of his position as an auto physical damage claims representative in violation of Labor Code Section [...]

September 30, 2009   Posted in: Blog  Comments Closed

Golden State Mutual Life Insurance Company Ordered Into Conservation

Commissioner Poizner announced today that Los Angeles-based Golden State Mutual Life Insurance Company, an 84-year-old icon of African-American entrepreneurship, has been served an order of conservation and will discontinue selling policies immediately.  The company is not opposing the Commissioner’s action.  Golden State operates in twelve states;  California, Texas, Michigan, Illinois, North Carolina, and Louisiana are [...]

September 30, 2009   Posted in: Blog  Comments Closed

Trial Court Judgment Modified When Damages Award Included Costs Plaintiff Did Not Actually Incur

In the unpublished case of Mina Shin v. Tuyetmy N. Bui, et al, No. B207772 (September 29), Division One of the Second Appellate District was called upon to review a $272,273 judgment awarded Shin, who was injured in a motor vehicle accident while riding in a car driven by Bui and owned by Bui’s mother.  [...]

September 29, 2009   Posted in: Blog, Uncategorized  Comments Closed

Life Insurance Company of North America Agrees To Pay $600,000 For Claims-Handling Violations

Commissioner Poizner announced today that the Department of Insurance has reached a $600,000 settlement agreement with Life Insurance Company of North America to resolve alleged disability insurance claims-handling violations in 2005-2006.  The company has agreed to make changes in its internal procedures and to review closed claims to determine if additional benefits are due.  The [...]

September 29, 2009   Posted in: Blog  Comments Closed

Dermatologists Removed From Preferred Provider Lists Not Entitled To Common Law Fair Procedure

In the unpublished case of California Dermatology Center, Inc., et al v. United Healthcare Services, Inc., et al, No. B207028 (September 29), Division One of the Second Appellate District upheld a trial court’s decision that plaintiff dermatologists were not entitled to common law fair procedure before being removed from preferred provider lists and, alternatively, that [...]

September 29, 2009   Posted in: Blog  Comments Closed

Order Awarding Costs of Suit, Including $50,000 In Expert Witness Fees, Upheld After Jury Finds Defendant’s Negligence Not Substantial Factor in Causing Plaintiff’s Injuries

The unpublished case of Dutta v. Coker, No. C056023 (September 28), from the Third Appellate District is a textbook study of the potential impact of Code of Civil Procedure Section 998 and persuasive expert testimony and is well worth reading for those purposes.  Coker very lightly rear-ended Dutta’s vehicle, traveling, according to her expert, at [...]

September 28, 2009   Posted in: Blog  Comments Closed

California Insurance Policymakers Take Note: Dual Agency Making Its Way Back and It’s Time To Get On Board

In its September 19 edition, The Wall Street Journal reports that the major insurance brokers adversely affected by decisions taken in the wake of former New York Attorney General Eliot Spitzer’s attack on so-called broker “bid-rigging”  — industry leaders Aon, Marsh, and Willis — are now in negotiation with state regulators to reinstate “contingent commission.”  [...]

September 20, 2009   Posted in: Blog  Comments Closed

State Farm Nonsuit Following Opening Statement Reversed Where State Farm Allegedly Promised to Preserve Damaged Tire

In Cooper v. State Farm Mutual Automobile Insurance Company, No. E047002 (September 17), Division Two of the Fourth Appellate District reversed a nonsuit State Farm obtained after plaintiff’s opening statement in a suit based on State Farm’s alleged destruction of evidence plaintiff, a State Farm insured, needed to pursue his case against Continental Tire North [...]

September 17, 2009   Posted in: Blog  Comments Closed

Public Adjuster’s Cross-Complaint Against HO Association Subject To Summary Judgment When Evidence Showed Adjuster Did Not Rely On Alleged Misrepresentations of Claims Administrator’s Employee

Kapilow & Sons, Inc., et al v. Shaw, et al, No. B209519 (September 17), is an unpublished decision from Division Three of the Second Appellate District involving cross-actions between a homeowners association and its public insurance adjuster in which the adjuster, Kapilow, also named the association’s insurers, the insurers’ claims administrator, and one of its [...]

September 17, 2009   Posted in: Blog  Comments Closed

District Court Decision Reversed Where ERISA Plan Administrator’s Benefits Decision Not Reviewed Sufficiently Skeptically In Light of Plan Administrator’s Conflict Of Interest

Montour, et al v. Hartford Life & Accident Insurance Company, No. 08-55803 (September 14; opinion amended and petition for rehearing en banc denied, November 19), is a decision from the Ninth Circuit reversing a district court determination that an ERISA plan administrator did not abuse its discretion in terminating Montour’s long-term disability benefits.  The Court [...]

September 14, 2009   Posted in: Blog  Comments Closed

Employee Covered For WC Insurance When On “Special Mission” Even Though Following Normal Commute Route

In our September 3 blog post, we discussed the “special errand” doctrine as applied to an employer’s liability for an employee’s automobile accident.  As part of that discussion, we noted that the employer had attempted unsuccessfully  to invoke parallel workers’ compensation insurance law in order to escape liability.  In American Home Assurance v. Workers’ Compensation [...]

September 13, 2009   Posted in: Blog  Comments Closed

Failure to Provide Notice To Surety Precludes Liability On Payment and Performance Bonds

In the unpublished case of Podsiadlo v. Western Insurance Company, et al, No. C056936 (September 10), the Third Appellate District dealt with a suit against Bridge Bank alleging breach of a construction loan agreement and Western Insurance Company seeking enforcement of performance and payment bonds issued by Western with respect to the loan agreement.  The [...]

September 11, 2009   Posted in: Blog  Comments Closed

AB 2 (De La Torre) Health Rescission Legislation Sent to Governor

Rescissions in both the health care service plan and individual health insurance markets have become a hot issue.  Although existing statutory language, as interpreted by the courts and administrative agencies, seems to us clear enough, this year has seen a heightened effort to add new language to the mix.  As we reported in our June [...]

September 11, 2009   Posted in: Blog  Comments Closed

Assembly Concurs In Senate Amendments To AB 1200 (Hayashi) and Law Sent To Enrollment

On September 9, the Assembly concurred in the Senate amendments to AB 1200 (Hayashi), on which we last reported in our September 4 blog post, and the bill and has now been sent to enrollment.

September 10, 2009   Posted in: Blog  Comments Closed

Plaintiff’s Attorney Who Entered Into Lien Agreement With Chiropractor Providing Services To Client Liable When Failed To Interplead Settlement Funds

Phillips Chiropractic, Inc. v. Ennix, No. E045043 (September 10), is an unpublished opinion from Division Two of the Fourth Appellate District holding that an attorney, who received settlement funds from a personal injury lawsuit, wrongfully failed to disburse them to a proper claimant when he failed to interplead the funds following a disagreement about the [...]

September 10, 2009   Posted in: Blog  Comments Closed

State Law Claims Not Completely Preempted By ERISA Held Improperly Removed To Federal Court

In Marin General Hospital v. Modesto Empire Traction Company, et al, No. 07-16158 (September 10), the Ninth Circuit considered whether Section 502 (a) (1) (B) of ERISA completely preempts a state law action for breach of contract, negligent misrepresentation, quantum meruit and estoppel.  The case arose out of a lumbar fusion procedure Marin General performed [...]

September 10, 2009   Posted in: Blog  Comments Closed

Insurance Agency Held Liable For Not Procuring and Maintaining An Insurance Package Including Workers’ Compensation Insurance

John Daniel Williams, et al v. Hilb, Rogal & Hobbs Insurance Services of California, Inc., No. B203961 (September 9), is a decision from Division Eight of the Second Appellate District setting forth the legal principles applicable to an insurance agent’s obligations to her clients to procure insurance meeting their needs when the agent has held [...]

September 9, 2009   Posted in: Blog  Comments Closed

SCIF-Blue Cross PPO Arrangement Does Not Violate Cartwright Act or UCL

In an unpublished opinion in Henstorf v. State Compensation Insurance Fund (SCIF), No. B210843 (September 4), Division Five of the Second Appellate District upheld a demurrer sustained by the trial court and rejected claims by individual physicians and California Orthopaedic Institute Medical Associates, Inc. that an agreement between SCIF and Blue Cross of California to [...]

September 6, 2009   Posted in: Blog  Comments Closed

AB 1200 (Hayashi) Passes Senate And Sent Back To Assembly

As we reported in our August 30 blog post, AB 1200 (Hayashi) was amended in a way which dealt with our reservations and then failed on the Senate floor on August 24.  However, that proved only a temporary set-back.  The bill passed 21-17 on September 4, and has now been sent back, in its amended [...]

September 4, 2009   Posted in: Blog  Comments Closed

Commissioner Issues Final Pay-As-You-Drive Regulations

Commissioner Poizner issued today his final Pay-As-You-Drive automobile insurance rate regulations.  The final version reflects the changes we discussed in our August 4 blog post.  The primary changes in the regulations from their initial release, discussed also in our June 25 blog post, include prepaid miles options for drivers; an allowance for selling mileage verification [...]

September 3, 2009   Posted in: Blog  Comments Closed

Special Errand Doctrine Applies to Employee Driving Home Even When Route Taken Overlaps Regular Commute Route

In Chuenchomporn Jeewarat, et al v. Warner Brothers Entertainment, Inc., No. B212323 (September 3), Division Five of the Second Appellate District reversed a summary judgment awarded Warner Brothers after one of its vice-presidents was involved in an automobile accident while returning from a three-day out-of-town business conference.  Upon his return, he drove from the airport [...]

September 3, 2009   Posted in: Blog  Comments Closed

Second Appellate District Holds Summary Forfeiture of Bond Not Precluded By Earlier Exercise of Discretion Not To Order Forfeiture Following Earlier Failure To Appear

In the unpublished case of County of Los Angeles v. Indiana Lumbermens Mutual Insurance Co., No. B21033 (September 2), Division Eight of the Second District Court of Appeal held that a trial court’s earlier decision to not order immediate forfeiture following a failure to appear did not deprive it of jurisdiction to order forfeiture following [...]

September 2, 2009   Posted in: Blog  Comments Closed