Archive for April, 2010

Bad Faith Claim Properly Dismissed Where Plaintiffs Not Entitled To Coverage

In the unpublished case of The Housing Group, et al, v. Empire Indemnity Insurance Company, No. A124780 (April 30), Division Three of the First Appellate District upheld the dismissal of a bad faith case where the plaintiffs had sued Empire for failure to defend and indemnify in connection with a construction defect and product liability [...]

April 30, 2010   Posted in: Blog  Comments Closed

Injured Worker’s Treatment Outside WC System Reasonable And Necessary and Therefore Compensable In Permanent Disability Rating

In the unpublished case of Leprino Foods v. Workers’ Compensation Appeals Board, et al, No. F058809 (April 30), the Fifth Appellate District received a petition of review from a WCAB decision.  Leprino contended that the WCAB erred in awarding an injured employee a higher level of permanent disability after self-procuring a medical surgery legally denied [...]

April 30, 2010   Posted in: Blog  Comments Closed

Umbrella Coverage Held To Be Primary, Duty To Defend Arose Upon Potential For Coverage, And Self-Insured Retention Relieves Insurer Of Duty To Defend Only If Policy Expressly So Provides

In a very important insurance coverage case, Legacy Vulcan Corp. v. Superior Court (Transport Insurance Company), No. B215713 (April 30; reissued after rehearing June 11), Division Three of the Second Appellate District addressed the nature of an insurer’s defense obligations under a policy of liability insurance providing both “excess” and “umbrella” coverage.  The Court also [...]

April 30, 2010   Posted in: Blog  Comments Closed

Anthem Blue Cross Withdraws Proposed Rate Hike

Anthem Blue Cross has withdrawn its proposed rate increase –  projected to be as much as 39 percent for some policyholders — after being told by the Department of Insurance it would probably find the filing unacceptable.  It said it will refile in May.  The proposed increases would have affected some 800,000 individual market customers.  [...]

April 29, 2010   Posted in: Blog  Comments Closed

Experience Rating Formula Changes Have Not Affected Gross WC Premiums

According to a report from the Workers’ Compensation Insurance Rating Bureau, changes in the experience rating formula implemented late last year have not affected total statewide pure premium generated.  However, “approximately 64 percent of experience-rated policyholders are receiving a lower experience modification than would otherwise be the case as a result.”  Some 29 percent are [...]

April 29, 2010   Posted in: Blog  Comments Closed

Mello-Roos Special Tax Was An Encumbrance on Title Covered By Title Insurance

In the unpublished case of MBK Celamonte, LLC v. Lawyers Title Insurance Corporation, No. G041605 (April 28), Division Three of the Fourth Appellate District considered a case where a purchaser of undeveloped land believed the property was not subject to a special tax under the Mello-Roos Community Facilities Act of 1982 (Government Code Section 53311 [...]

April 28, 2010   Posted in: Blog  Comments Closed

Rescission, Once A Mainstay Of Health Insurance Litigation, Rapidly Fading Into History

WellPoint, Inc,, parent of Anthem Blue Cross of California and Blue Shield of California, has announced that it will no longer pursue post-claims rescissions of its policies.  Kaiser stopped rescinding in 2005, and Health Net presently has a moratorium on using it.  The practice is dying out.  Last year, only four such cancellations were reported [...]

April 28, 2010   Posted in: Blog  Comments Closed

Emergency Response Fund Surcharge Bill Moves Forward

SB 1258 (Kehoe-San Diego), which would impose a 4.8 percent premium surcharge on commercial and residential fire and multi-peril policies to fund an Emergency Response Fund, has passed through the Senate Banking, Finance and Insurance Committee and now moves to Appropriations.  The surcharge would apply to all policies issued or renewed after July 1.  The [...]

April 27, 2010   Posted in: Blog  Comments Closed

Defense Duty Not Triggered Without Some Evidence Showing Potential For Coverage

The unpublished case of Federal Insurance Company v. American Home Assurance Company, No. B216147 (April 27), involved a consideration by Division Four of the Second Appellate District of a subrogation action by Federal seeking reimbursement for defense costs it incurred in an underlying arbitration proceeding.  The core issue was the duty of American Home to [...]

April 27, 2010   Posted in: Blog  Comments Closed

NPR Commentator Fact-Checks Commissioner Poizner’s Portrayal of Mt. Pleasant High School

Commissioner Poizner, on the gubernatorial campaign trail, has taken pride in not being an “NPR (National Public Radio) listener.”  Now he has one more reason to maintain that stance.  NPR commentator Ira Glass has released a devastating look at the Commissioner’s recent book about his semester experience as a teacher at San Jose’s Mt. Pleasant [...]

April 27, 2010   Posted in: Blog  Comments Closed

Summary Judgment For Life Insurer Upheld Where Premium Payments Inadvertently Not Made

In the unpublished case of Zakarian v. Fidelity & Guaranty Life Insurance Company, No. B214030, (April 26), Division Four of the Second Appellate District upheld a summary judgment in favor of Fidelity & Guaranty after a life insurance policy lapsed.  The Court of Appeal found that there was a suspension of automatic premium payments caused [...]

April 26, 2010   Posted in: Blog  Comments Closed

California Supreme Court Holds Deprivation Of Hearing On Merits of Unwaivable Statutory Claim Justifies Vacation of Arbitration Award

Courts are not ordinarily able to vacate arbitration awards based on errors of law.  Moncharsh v. Heily & Blase (1992) 3 Cal. 4th 1, 25, 28.   The scope of judicial review, however, may be somewhat broader in a case of a mandatory employment arbitration agreement encompassing an employee’s unwaivable statutory rights.  Armendariz v. Foundation Health [...]

April 26, 2010   Posted in: Blog  Comments Closed

Motion To Shift Costs Must Be Made Within Time-Frame When Costs May Be Awarded

In the unpublished case of Igma v. O’Rourke, No. G042685 (April 26), Division Three of the Fourth Appellate District addressed this question certified to it by the Orange County Superior Court: What, if any, time requirements apply to a defendant’s motion under Code of Civil Procedure Section 998 (e) to offset costs against a judgment [...]

April 26, 2010   Posted in: Blog  Comments Closed

Industry Groups Oppose Two Pending Workers’ Compensation Bills

AB 1994 (Skinner-Berkeley) and AB 2490 (Jones-Sacramento) are drawing workers’ compensation insurance industry opposition.  The first would create a rebuttable presumption of work-relatedness for some injuries suffered by hospital workers.  Currently only public sector workers such as public safety officers benefit from such a presumption.  This legislation would be the presumption’s first extension to a [...]

April 23, 2010   Posted in: Blog  Comments Closed

Bail Properly Forfeited Where Extradition Infeasible Due To Lack of Extradition Treaty

In the unpublished case of The People v. Indiana Lumbermens Mutual Insurance Company, No. B212340 (April 22), Division Three of the Second Appellate District upheld a trial court order denying Lumbermens’ motion to vacate forfeiture and exonerate bail.  The surety contended that it was entitled to relief because the criminal defendant had fled to Lebanon [...]

April 22, 2010   Posted in: Blog  Comments Closed

Bonding Company Contract Providing For Recovery Upon Failure To Appear Upheld

Absolute Bonding Corporation v. White-Watkins, No. B211609 (April 22), is an unpublished decision from Division Four of the Second Appellate District upholding a summary judgment in favor of Absolute in the amount of $185,334.99 after White-Watkins’ son failed to appear in court and the bail bond obtained in order to secure his release was forfeited.  [...]

April 22, 2010   Posted in: Blog  Comments Closed

Fourth Appellate District, Contrary To Current DOI Policy, Indicates Insurers Should Not Be Required To Insure Drivers With Unresolved FTAs As If Those FTAs Did Not Exist

In our April 14 blog post, we discussed the Department of Insurance’s refusal to treat Failures to Appear (FTAs) as the equivalent of convictions for purposes of insurance ratemaking.  Barton v. Commerce West Insurance Company, No. E048248 (April 19), an unpublished decision from Division Two of the Fourth Appellate District, sheds new light on that [...]

April 19, 2010   Posted in: Blog  Comments Closed

Pick-Off Doctrine Protects Named Plaintiff’s Continued Viability As Class Representative

In Wallace v. GEICO General Insurance Company, et al, No. D055305 (April 19), Division One of the Fourth Appellate District considered an appeal from Carolyn Wallace striking class allegations from a proposed class action lawsuit she filed against various GEICO companies.  Wallace sued under the UCL, alleging, among other theories, that GEICO wrongfully denied coverage [...]

April 19, 2010   Posted in: Blog  Comments Closed

Fourth Appellate District Upholds UCL and CLRA Causes Of Action Where Reliance Adequately Pled

Hale v. Sharp Healthcare, et al, No. D054637 (April 19) is a decision from Division One of the Fourth Appellate District based on facts similar to those set forth in the blog post immediately below.  The case concerns a putative class action against Sharp Healthcare and Sharp Grossmont Hospital under the same causes of action [...]

April 19, 2010   Posted in: Blog  Comments Closed

Fourth Appellate District Relies On In Re Tobacco Cases II To Uphold Dismissal of UCL Claim

Durell v. Sharp Healthcare, No. D054261 (April 19), is a putative class action by Durell alleging violations of the UCL and the CLRA as well as breach of contract, bad faith, and unjust enrichment.  The theory of the case is that Sharp engaged in deceptive practices by billing uninsured patients its full standard rates for [...]

April 19, 2010   Posted in: Blog  Comments Closed

Insurer Entiled To Recover Settlement Payments Made Under Malpractice Policy

In the case of Carolina Casualty Insurance Company v. L. M. Ross Law Group, LLP, No. B215668 (April 19; ordered published April 29), Carolina had issued a malpractice policy to a two-person law firm.  Following the settlement of a malpractice action against the firm, Carolina sought to recover the $175,000 it had paid.  The law [...]

April 19, 2010   Posted in: Blog  Comments Closed

London Market Servicing Companies Lacked Sufficient Jurisdictional Contacts With California

In the unpublished case of Hollander v. XL London Market LTD. et al, No. B213864 (April 16), plaintiffs appealed the trial court’s order quashing service of their summons and complaint for lack of personal jurisdiction against three United Kingdom corporations arising from an insurance claim made relating to damage to the Hollanders’ insured fine art.  [...]

April 16, 2010   Posted in: Blog  Comments Closed

Summary Judgment Reversed Where Insurer Failed To Shift Burden of Proof As To Most Causes of Action

In the unpublished case of Woffinden v. Mid-West National Life Insurance Company of Tennessee, et al, No. B212443 (April 15), Division Five of the Second Appellate District overturned the bulk of a summary judgment/judgment on the pleadings in a case involving alleged misrepresentations about the nature and scope of health insurance coverage purchased by the [...]

April 15, 2010   Posted in: Blog  Comments Closed

Commissioner Poizner, Not Able to Find Support Elsewhere, Rallies the Scofflaw Vote

In our May 20 blog post, we wrote at length about how scofflaws — cited traffic violators who decline to pay their bail or show up in court — can go years without paying any legal penalty or having their driving records affected.  The rest of us subsidize these offenders because they are never convicted [...]

April 14, 2010   Posted in: Blog  Comments Closed

Mercury Take Heart: Read Here What They Are Saying About Him In The Water Business

As a follow-up to the Department of Insurance’s latest charges against Mercury Insurance Group we discussed yesterday, today’s Los Angeles Times was enlivened by supercharged exchanges between Mercury and the Department over their merits.  A Mercury spokesman attributed the Department’s actions to the Commissioner’s gubernatorial aspirations; the Department advised  Mercury to spend “less time imagining [...]

April 13, 2010   Posted in: Blog  Comments Closed