Archive for October, 2009

CA Department of Industrial Relations To Update WC Information System

The California Department of Industrial Relations has released a proposed update for the Workers’ Compensation Information System.  The 12-point plan includes regulations recently enacted, regulations in the process of enactment, and a set of new proposals to be put into place in 2010.  The proposed regulations increase the time for filing of the first report [...]

October 30, 2009   Posted in: Blog  Comments Closed

Fourth Appellate District Addresses Defense Attorney Fee Allocation Issues

In the unpublished case of National Continental Insurance Company v. National Union Fire Insurance Company, No. D053234 (October 29), Campbell Industries, a shipyard operator, was confronted with contribution and indemnity claims from Exxon Mobil Corporation arising out environmental contamination at the Port District of San Diego.  Campbell hired Latham & Watkins to defend itself and [...]

October 29, 2009   Posted in: Blog  Comments Closed

Absent Agency, Self-Funded Health Plan Not Liable On Contract Between Blue Cross and Hospital

In the unpublished case of Fresno Community Hospital and Medical Center v. UFCW Northern California Health and Welfare Trust, et al, No. F056444 (October 28), the Fifth Appellate District  considered the hospital’s challenge to a trial court’s decision sustaining the health plan’s demurrer to a breach of contract claim premised on a contract the hospital [...]

October 29, 2009   Posted in: Blog  Comments Closed

Fourth Appellate District Panel, Disagreeing With Sister Panel, Says Fraudulent Insurer Conduct Connected With Conduct Prohibited Under Unfair Insurance Practices Act Can Also Give Rise to Private UCL Claim

In Zhang v. Superior Court (California Capital Insurance Company), No. E047207 (October 29), Division Two of the Fourth Appellate District, ruling on a petition for writ of mandate challenging the sustaining of an insurer’s demurrer, held that the trial court had erroneously concluded that an insurer’s fraudulent conduct — connected to conduct that would violate [...]

October 29, 2009   Posted in: Blog  Comments Closed

Department of Insurance Schedules Hearing On Fee Schedule For Processing Documents

Commissioner Poizner has scheduled a public hearing in San Francisco on December 17 to adopt amendments to CCR Sections 2202 (b), 2202 (c), and 2203 (b) to adjust the fees he charges insurance providers for processing, indexing, and maintaining copies of documents defined in CCR Section 2201 (a).  In addition, the Commissioner proposes to amend [...]

October 29, 2009   Posted in: Blog  Comments Closed

California Workers’ Compensation Institute Reports On 2004 Reforms

The Oakland-based California Workers’ Compensation Institute has issued a report ascribing a 6 percent reduction in attorney involvement and in the average amount paid on claims at 36 months to SB 899, the landmark workers’ compensation reform law enacted at the outset of the Schwarzenegger Administration.  The report also found that there was an increase [...]

October 29, 2009   Posted in: Blog  Comments Closed

Intervenor Entitled To Defend Against Insurer’s Declaratory Relief Action Despite Default of Insured

In Westchester Fire Insurance Co., Northwest Airlines, Inc. (Intervenor) v. Mendez, No. 07-17383 (October 28), Westchester brought a declaratory relief action against Mendez, its insured, under a CGL insurance policy.  Westchester, claiming Mendez failed to provide notice, asserted it had no obligation to defend or indemnify Mendez.  The injured party, Northwest, whose airplane was allegedly [...]

October 28, 2009   Posted in: Blog  Comments Closed

Mediation Confidentiality Trumps Tortious Conduct Claims Arising From Mediation

In the unpublished case of  Kausch v. Wimsatt, No. B208724 (October 28), Division Three of the Second Appellate District, affirming a trial court judgment in favor of Kausch’s attorneys, restated its holding in Wimsatt v. Superior Court (2007) 152 Cal. App. 4th 137 that the strict rules of mediation confidentiality (Evidence Code Section 1115 et [...]

October 28, 2009   Posted in: Blog  Comments Closed

ERISA Does Not Preempt Insurance Department’s Disapproval of Disability Policy’s Discretionary Clause

In Standard Insurance Company v. John Morrison, No. 08-35246 (October 27), the Ninth Circuit considered whether the Montana Insurance Commissioner’s practice of disapproving discretionary clauses in disability insurance policies runs afoul of  ERISA.  Discretionary clauses limit the review of an insurer’s benefits decision under ERISA to an abuse of discretion standard; otherwise, benefits decisions are [...]

October 27, 2009   Posted in: Blog  Comments Closed

Farmers Secures En Banc Review of Ojo Credit-Scoring Case

The Ninth Circuit ordered that Ojo v. Farmers Group, Inc., et al, No. 06-55522, be reheard en banc.  In the 2-1 decision by the three-judge panel, the Court ruled that the trial court’s dismissal of a prospective class action asserting that Farmers violated the Fair Housing Act by allegedly charging minorities more for homeowners insurance [...]

October 26, 2009   Posted in: Blog  Comments Closed

NY Insurance Department Elaborates On Commission Disclosure Regulations

Matthew Gaul, special counsel to the New York Insurance Department, has elaborated on the Department’s decision to reject different degrees of disclosure for different categories of insurance producer.  Former Superintendent Eric Dinallo has suggested there could be different disclosure requirements depending on whether a producer is a captive agent, independent agent, or broker.  Mr. Gaul [...]

October 26, 2009   Posted in: Blog  Comments Closed

New York Continues To Refine Producer Compensation Disclosure Regulations

The current draft of the proposed New York producer compensation regulations says, in part, that, upon request, a producer must provide “a description of the nature, amount and source of any compensation to be received by the producer or any parent, subsidiary or affiliate based in whole or in part on the sale.”  Although New [...]

October 24, 2009   Posted in: Blog  Comments Closed

DOI Schedules Public Discussion On Proposed Regulations Regarding Standards For Approval Of Insurer Names

The Commissioner has scheduled a pre-notice public discussion in San Francisco on December 8 to consider contemplated new regulations establishing standards for insurer names.  The new regulations would prescribe written applications for insurer names, list prohibited words and phrases, mandate the use of certain words and phrases for different types of insurer entities, prescribe standards [...]

October 23, 2009   Posted in: Blog  Comments Closed

Surety Fails To Obtain Recovery Against Co-Signer Of Estate Joint Control Agreement Despite Failure To Abide By Agreement’s Terms

In the unpublished case of American Contractors Indemnity Company v. Sirkin, No. B202129 (October 22), Division Four of the Second Appellate District reversed a trial court judgment against Sirkin based on a breach of contract claim brought against her by American Contractors.  Sirkin was the attorney for the administrator of an estate.  Because the administrator [...]

October 23, 2009   Posted in: Blog  Comments Closed

PRMA, Ex-New York Superintendent Dinallo Weigh In On Compensation Disclosure Issues

The Public Risk Management Association has issued a statement calling for full and mandatory disclosure of all forms of broker remuneration.  It said that was the only way to maintain trust in the insurance purchasing process.  At the same time, former New York Insurance Superintendent Eric Dinallo told National Underwriter Online that he believes broker [...]

October 21, 2009   Posted in: Blog  Comments Closed

Second Appellate District Drives Big Stake Through California Binding Arbitration Law

In a 2-1 decision it is almost impossible to believe the California Supreme Court won’t take up,  Division Six of the Second Appellate District drove a stake today through the heart of California arbitration law in Burlage v. Superior Court (Spencer), No. B211431 (October 20).  The current lodestar of California arbitration law, Moncharsh v. Heily [...]

October 20, 2009   Posted in: Blog  Comments Closed

Pay-As-You-Drive Regulations Approved By Office of Administrative Law

Commissioner Poizner announced today that his final pay-as-you-drive regulations, which we last discussed in our September 3 blog post, have now been approved by the Office of Administrative Law.

October 16, 2009   Posted in: Blog  Comments Closed

Commissioner Schedules Hearing On Community Service Statement Reporting

Commissioner Poizner has scheduled a hearing on December 2 in Los Angeles to consider amendments to CCR Section 2646.6 to (1) reduce the frequency of reporting Community Service Statement data from annually to every two years; (2) reduce the frequency of the issuance of the Commissioner’s Report on Underserved Communities from annually to every two [...]

October 16, 2009   Posted in: Blog  Comments Closed

California Now Regulates Life Settlement Market

Governor Schwarzenegger has signed into law SB 98 (Calderon), which provides for the licensing of anyone handling so-called life settlements.  The new law also prohibits the sale of an existing life insurance policy to a third party for more than its cash surrender value but less than its death benefit for two years after issuance, [...]

October 16, 2009   Posted in: Blog  Comments Closed

RIMS Issues Report Advocating Full Disclosure Of All Income Brokers and Agents Receive

The Risk & Insurance Management Society, Inc. (RIMS) issued yesterday a new executive report that reiterates its prior position that agents and brokers should disclose to consumers all forms of compensation they receive.   The report comes as the New York Insurance Department prepares to issue new broker compensation disclosure regulations.  The last draft of those [...]

October 15, 2009   Posted in: Blog  Comments Closed

Intentional Acts Exclusion Upheld in Assault and Battery Coverage Case

In the unpublished case of Martin v. Pacific Specialty Insurance Company, No. B208734 (October 14), Division Eight of the Second Appellate District dealt with the application of an intentional acts exclusion to a homeowner’s insurance policy issued by Pacific Specialty.  Christopher Martin, the insured, brutally assaulted Ricardo Zenon Gutierrez, who recovered $176,667.71 after a bench [...]

October 14, 2009   Posted in: Blog  Comments Closed

Three Workers’ Compensation Bills Signed Into Law

Among the bills Governor Schwarzenegger has now signed into law are AB 361 (Lowenthal), which provides that employers authorizing workers’ compensation medical care cannot rescind or modify the authorization for treatment already provided; AB 483 (Buchanan), which requires the Workers’ Compensation Rating Bureau to establish a web site identifying whether an employer is insured for [...]

October 14, 2009   Posted in: Blog  Comments Closed

Fourth Appellate District Addresses WC Geographic Limitation Issues When Employee Suffers New Injuries En Route To Medical Appointment

In Esquivel v. Workers’ Compensation Appeals Board and Corrections Corporation of America San Diego Detention, et al, No. D054197 (October 13), the Fourth Appellate District addressed what, if any, geographic limitation applies to an employer’s risk of incurring compensable workers’ compensation liability with respect to new injuries an employee suffers while traveling to or from [...]

October 13, 2009   Posted in: Blog  Comments Closed

Governor Vetoes Bill to Extend Low-Cost Automobile Insurance Program

Governor Schwarzenegger vetoed yesterday AB 725 (Jones), which would extend the life of the low-cost automobile insurance program to 2016 from its presently-scheduled January, 2011 expiration.  The Governor questioned the effectiveness of the program given the number of policies in effect and low participation rate among the insured, but did suggest that Assembly Member Jones [...]

October 13, 2009   Posted in: Blog  Comments Closed

AB 1093 (Yamada) Legislation Banning WC Denials In Racial Attacks Signed Into Law

Governor Schwarzenegger signed yesterday  AB 1093 (Yamada), legislation which prohibits the denial of a workers’ compensation claim filed by an employee because of circumstances relating to the employee’s  race, national origin, age, disability, gender, sexual orientation, or religious creed.  Known as “Taneka Talley’s Law,” the bill was introduced after the death of a black employee [...]

October 13, 2009   Posted in: Blog  Comments Closed