Archive for February, 2010

Afro-American Icon Golden State Mutual Life To Pass Into History

Commissioner Poizner today announced that Golden State Mutual Life Insurance Company has entered into a letter of intent with IA American Life Insurance Company to negotiate a reinsurance agreement to transfer all in-force insurance policies of Golden State Mutual.  As this blog reported on September 30, Golden State Mutual, the largest minority-owned life insurance company [...]

February 26, 2010   Posted in: Blog  Comments Closed

Fourth Appellate District Upholds Dismissal Of Fraud, Bad Faith, And Emotional Distress Claims Against Interinsurance Exchange

In the unpublished case of Cohen, et al v. Automobile Club of Southern California, et al, No. D053900 (February 26), Division One of the Fourth Appellate District upheld a trial court’s dismissal of fraud, bad faith, and intentional infliction of emotional distress claims against the Interinsurance Exchange of the Auto Club.  The Cohens’ home was [...]

February 26, 2010   Posted in: Blog  Comments Closed

Truth In Lending Errors and Omissions Liability Endorsement Held To Potentially Cover Credit Union Claims

In the unpublished case of Mid-Century Insurance Co. v. Vinci Investment Company, Inc., No. G040815 (February 25), Division Three of the Fourth Appellate District reversed a trial court’s summary judgment in favor of Mid-Century, finding that there was a potential for coverage and therefore Vinci was entitled to a defense.  Vinci, doing business as Honda [...]

February 25, 2010   Posted in: Blog  Comments Closed

Second Appellate District Determines Gardener Not Employee For Workers’ Compensation Coverage Purposes

In Lara v. WCAB and Bratiff Home Corp., No. B214234 (February 25), Division Three of the Second Appellate District considered whether a gardener hired twice in the space of twelve months to prune bushes for a diner was an employee at the time he sustained injury.  The WCAB had held that he was an independent [...]

February 25, 2010   Posted in: Blog  Comments Closed

First Appellate District Holds That Employer Failed To Follow Prescribed Procedures For Resolving Conflict Between Employee’s Treating Physician And Employer’s Utilization Review Process

An employer faced with a treating physician’s recommendation must conduct a utilization review before denying treatment.  See State Compensation Insurance Fund v. WCAB (2008) 44 Cal. 4th 230, 233-234.  And it cannot, as an alternative to utilization review, avail itself of the general dispute resolution framework set forth in Labor Code Section 4062 (a).  In [...]

February 25, 2010   Posted in: Blog  Comments Closed

Negligent Entrustment Claim Held To Survive Admission Of Respondeat Superior Liability

Diaz v. Carcamo, et al, No. B211127 (February 25), is a decision from Division Six of the Second Appellate District dealing with these facts: Diaz was seriously injured when she was struck by a car that had jumped a freeway center divider following its collision with a truck.  She sued Tagliaferri, the driver of the [...]

February 25, 2010   Posted in: Blog  Comments Closed

Required Vehicle Exception to Going and Coming Rule Applies Even When Use of Personal Vehicle Infrequent

Lobo v. Tamco, Lobo v. Tamco, No. E047593 (February 24), is an opinion from Division Two of the Fourth Appellate District dealing with an employer’s liability for a serious automobile accident causing death.  It was uncontested that at the time of the accident the employee was going home, thereby potentially invoking the going and coming [...]

February 24, 2010   Posted in: Blog  Comments Closed

Insurance Law Principles Held To Require Enforcement Of Subrogation Rights Despite Lack of Resolution Of Non-Insurance Contractual Indemnity Issues

The unpublished case of Great American Insurance Company v. Fidelity and Guaranty Insurance Company, No. A122722 (February 24), arose out a partial collapse of a roof during construction of a commercial warehouse.  Two employees of the roofing subcontractor were injured, and a third was killed.  Personal injury and wrongful death actions ensued and were then [...]

February 24, 2010   Posted in: Blog  Comments Closed

Third Appellate District Hands Down Post-In Re Tobacco Cases II Analysis of UCL and CLRA Class Requirements

McAdams v. Monier, Inc., No. CO51841 (February 24), is a decision from the Third Appellate District regarding the certification of a class action under the CLRA and the UCL.  It is instructive on how post- In Re Tobacco Cases II (2009) 46 Cal. 4th 298 class certifications will be handled. The factual context is defendant’s [...]

February 24, 2010   Posted in: Blog  Comments Closed

Summary Adjudication Reversed Where Trial Court Acted On Superseded Pleading

In the case of State Compensation Insurance Fund (SCIF)  v. Superior Court (Onvoi Business Solutions, Inc.), No. A125834 (February 23; ordered published May 20), Division Five of the First Appellate District granted SCIF writ relief where the trial court had entered a summary adjudication against it on a superseded complaint.  SCIF had sued Onvoi to [...]

February 23, 2010   Posted in: Blog  Comments Closed

Fourth Appellate District Grants Writ Petition Overturning Trial Court Order Compelling Interim Payment of Defense Costs

The unpublished opinion of Division Two of the Fourth Appellate District in Wausau Underwriters Insurance Company, et al v. Superior Court (Atlantic Mutual Insurance Company), No. E049323 (February 23), involved a petition for writ of mandate by Wausau.  The body of the opinion is two pages in length and not entirely self-explanatory.  However, what is [...]

February 23, 2010   Posted in: Blog  Comments Closed

Fire Insurance Exchange HO Claims Denial Upheld Based On Failure To Cooperate

Abdelhamid v. Fire Insurance Exchange, No. C059098 (February 22; ordered published March 9), is a decision from the Third Appellate District upholding a summary judgment in favor of Fire Insurance Exchange after its denial of a homeowners’  insurance claim after fire destroyed Abdelhamid’s home.  Fire Insurance Exchange’s denial was based on plaintiff’s failure to produce [...]

February 22, 2010   Posted in: Blog  Comments Closed

Where Insured Not Provided Notice of Nonrenewal, Policy Term Automatically Extended By Operation Of Law

Norcal Mutual Insurance Company v. Certain Underwriters at Lloyd’s of London, et al, No. B213122 (February 22), is an unpublished case from Division Four of the Second Appellate District founded on a statutory interpretation of Insurance Code Section 678.1.  The defendants reinsured Norcal for its liability under a managed health care professional liability insurance policy.  [...]

February 22, 2010   Posted in: Blog  Comments Closed

Contractual Indemnification Claim To Which Insurer Subrogated Not Barred By Good Faith Settlment

In Interstate Fire and Casualty Insurance Company v. Cleveland Wrecking Company, No. A124920 (February 22), Division Five of the First Appellate District ruled on an appeal by Interstate after the trial court sustained, without leave to amend, Cleveland’s demurrer to its subrogation complaint.  Cleveland was a subcontractor.  Interstate insured Cleveland’s principal.  Although Cleveland was contractually [...]

February 22, 2010   Posted in: Blog  Comments Closed

Commissioner Charges Anthem Blue Cross With More Than 700 Claims Violations

Escalating his ongoing battle with Anthem Blue Cross over its planned rate increases, Commissioner Poizner announced today an enforcement action against the health insurer alleging more than 700 claims-handling violations.  The charges are based on consumer complaints between 2006 and 2009, and include 277 alleged improper failures to pay within 30 days, 143 alleged failures [...]

February 22, 2010   Posted in: Blog  Comments Closed

Three Major Brokers Reach Agreements To Reinstate Contingent Commission

Marsh & McLennan Cos., Inc., Aon Corp., and Willis Group Holdings, P.L.C., the three largest insurance brokers in the United States, have announced that they have reached agreements with state insurance regulators in New York, Connecticut, and Illinois which will amend their 2005 settlement agreements with those states to allow them once again to receive [...]

February 18, 2010   Posted in: Blog  Comments Closed

Wall Street Journal Hits Commissioner Poizner For “Political Opportunism”

The Wall Street Journal editorializes today against federal and state government officials’ use of Anthem Blue Cross’ announced individual insurance rate hikes as “a new insurance pinata.”  The editorial points out that the increases are largely due to excessive California insurance regulation and mandated coverage requirements far beyond those elsewhere in the country.  Commissioner Poizner, [...]

February 18, 2010   Posted in: Blog  Comments Closed

Second Appellate District Hands Down Another Post-Delgado Intentional Act Case Reconsideration

In the unpublished case of Sutton v. Interinsurance Exchange of the Automobile Club of Southern California, No. B198855 (February 16), Division Four of the Second Appellate District had been faced with the question of whether an intentional act by an insured, taken in self-defense, may qualify as an “accident” for purposes of defense and indemnification [...]

February 16, 2010   Posted in: Blog  Comments Closed

Release Language Upheld Despite Claim It Did Not Cover Later Discovered Bodily Injury And Was Unclear

In the unpublished case of Law v. Corral, No. A120738 (February 16), Division One of the First Appellate District was faced with the claim that the plaintiff should not be foreclosed from pursuing an underlying personal injury claim based on an automobile accident because of previously signed settlement documents releasing the defendants from all liability.  [...]

February 16, 2010   Posted in: Blog  Comments Closed

California Supreme Court Grants Review of Zhang v. Superior Court (Cal. Cap. Ins. Co.)

The Supreme Court has granted review of Zhang v. Superior Court (Cal. Cap.Ins. Co.), No. S178542, discussed in our October 29 blog post.  The Court will address the extent to which, if any, Moradi-Shalal v. Fireman’s Fund Companies (1988) 46 Cal. 3rd 287 bars UCL-based misrepresentation and false advertising causes of action alleging that an [...]

February 16, 2010   Posted in: Blog  Comments Closed

Anthem Blue Cross, Responding to Pressure, Delays Individual Health Insurance Rate Hike

Responding to pressure from Insurance Commissioner Poizner and U.S. Health & Human Services Secretary Kathleen Sebelius, health insurer Anthem Blue Cross has postponed rate increases for Californians buying individual health insurance policies on their own.  The planned hike, which would have affected about 700,000 customers, averaged 25 percent and reached as high as 39 percent [...]

February 13, 2010   Posted in: Blog  Comments Closed

Commissioner Schedules Public Hearing On Insurer Names Regulations

The Commissioner will hold a public hearing in San Francisco on April 20 to consider proposed regulations governing insurer names.  The proposed language specifies, among other things, words and phrases which must be used, language which cannot be used, rules governing similar names and affiliate names, use of names by foreign or alien insurers, and [...]

February 12, 2010   Posted in: Blog  Comments Closed

Commissioner Comes To $399,000 Settlement With Old Republic Title Over Alleged Rate Inducements To Lenders

Commissioner Poizner announced today that he has settled allegations of failing to follow the companies’ filed rate plans with Old Republic Title Company and Old Republic National Title Insurance Company.  The Department had alleged that Old Republic charged lenders rates different from the rating that had been approved for certain residential refinance title insurance policies [...]

February 12, 2010   Posted in: Blog  Comments Closed

Genuine Dispute Doctrine Invoked In Support of Summary Judgment On Bad Faith Claim

In the unpublished case of Bridal Images, Inc. v. Truck Insurance Exchange, No. B213083 (February 10),  Division Five of the Second Appellate District upheld a summary judgment of a bad faith claim in favor of Truck on the basis that Truck reasonably and in good faith had a genuine dispute as to whether Bridal Images [...]

February 10, 2010   Posted in: Blog  Comments Closed

Commissioner Moves Forward On Iranian Investment Policy

Commissioner Poizner has released a list of 50 companies doing business in the Iranian oil and natural gas, nuclear and defense sectors and announced that as of March 31, 2010, no investments that an insurer holds in any of those companies will be recognized on its financial statements in California. “The deteriorating situation in Iran [...]

February 10, 2010   Posted in: Blog  Comments Closed