Archive for June, 2010

Prudential Sales Representative Not Responsible For Insured’s Purchase of Life Insurance Policy With Suicide Exclusion

In the unpublished case of Petrulis v. Prudential Insurance Company of America, No. B212058 (June 30), Division Two of the Second Appellate District considered for a second time a life insurance claim.  In the first appeal in the case, the court reversed a $6 million judgment against Prudential based on the applicability of the policy’s [...]

June 30, 2010   Posted in: Blog  Comments Closed

Anthem Blue Cross Files New Rate Filing; Further Increases Expected In 2011

Anthem Blue Cross has filed with the Department of Insurance  to raise rates for tens of thousands of California policyholders, some of whom could see their premiums rise as much as 20%. The filed rates, however, are significantly lower than those proposed earlier this year. Anthem, California’s largest for-profit health insurer, had sought premium increases [...]

June 30, 2010   Posted in: Blog  Comments Closed

Commissioner Announces $11 Million Multi-State Settlement With Conseco Life

Commissioner Poizner announced today a multi-state, multi-million dollar settlement with Conseco Life Insurance Company. The settlement requires the establishment of a $10 million fund for certain owners of its Lifetrend life insurance policies, and provides policyholders with significant options for maintaining coverage. Participation in the settlement is voluntary. “Insurers have to know that we are [...]

June 30, 2010   Posted in: Blog  Comments Closed

Second Insurer Submits Pay-As-You-Drive Program To DOI

Commissioner Poizner announced today that the Automobile Club of Southern California has submitted an application to offer a new program that rewards California drivers who voluntarily drive fewer miles with lower auto insurance rates. “The voluntary pay-as-you-drive initiative is a cutting-edge program that will allow insurers to offer plans based on more accurate mileage, so [...]

June 29, 2010   Posted in: Blog  Comments Closed

Minority Status Does Not Justify Noncompliance With UM Limitations Period

Blankenship, a Minor, etc. v. Allstate Insurance Company, No. C059423 (June 29) addresses a minor’s right to pursue an uninsured motorist claim after the two-year limitations period has expired.  Insurance Code Section 11580.2 (d) (i) provides that an insured may not pursue a UM claim against his insurer unless, within two years of the date [...]

June 29, 2010   Posted in: Blog  Comments Closed

Independent Contractor May Not Hold Hiring Party Vicariously Liable For Injuries Resulting From Its Own Failure to Guard Against Inherent Risks

The Supreme Court granted review in Tverberg v. Fillner Construction, Inc., No. S169753 (June 28), to resolve a district split on the implications of Privette v. Superior Court (1993) 5 Cal. 4th 689.  That case holds that the hirer of an independent contractor is not vicariously liable to the contractor’s employee who sustains on-the-job injuries [...]

June 28, 2010   Posted in: Blog  Comments Closed

Tree Service Employee’s Injury When Trunk Fell “Extraordinary” Under Labor Code Section 3208.3 (d)

In the unpublished case of Campos v. Workers’ Compensation Appeals Board, No. A125998 (June 25), Division Three of the First Appellate District considered whether an injury that occurred to a worker suspended half way up an 80-foot tree that he was cutting when the trunk of the tree fell, causing him serious physical and psychiatric [...]

June 25, 2010   Posted in: Blog  Comments Closed

Health Care Rate Regulation Scheme Moves Forward

AB 2578 (Jones-Sacramento and Feuer-Los Angeles) passed the Senate Health Committee. The bill would impose a Proposition 103-style rate regulation scheme on health insurance and health care providers.

June 25, 2010   Posted in: Blog  Comments Closed

Health Insurance Rescission Measure Passes Senate Health Committee

AB 2470 (De La Torre -South Gate) passed the Senate Health Committee. The bill, like previous bills AB 1945 of 2008 and AB 2 of 2009, would create an independent review panel to review decisions by health plans to rescind individual health care contracts.

June 25, 2010   Posted in: Blog  Comments Closed

Surety’s Subjective Belief In Increased Flight Risk Does Not Justify Exonerating Bond When Bond’s Language Covers Specific Objective Factual Circumstances

In The People v. International Fidelity Insurance Company, No. G042328 (June 24), Division Three of the Fourth Appellate District affirmed a trial court order denying International Fidelity’s motion to vacate the forfeiture of a bail bond and exonerate bail.  Under the objective language of the bond it issued, International Fidelity undertook to ensure a defendant’s [...]

June 24, 2010   Posted in: Blog  Comments Closed

Mathematical Errors Found In Another Health Insurer Rate Filing; Future Rate Filings Will Be Made Available On Department Website

Commissioner Poizner announced today that Aetna has withdrawn its rate filing that would have increased rates by an average of 19 percent on its 65,000 policyholders after substantial mathematical errors were uncovered during the process of conducting an additional actuarial review. “First, we found major problems with the Anthem Blue Cross rate filing,” said Commissioner [...]

June 24, 2010   Posted in: Blog  Comments Closed

First Appellate District Follows Fourth District’s Howell Rationale That Tort Victims Should Recover Fully For Medical Expenses Without Regard To Reduced Charges Paid By Their Insurers

In Yanez v. SOMA Environmental Enginneering Company, No. A123894 (June 24), Division One of the First Appellate District held that the trial court had erred in reducing a negligence award in an automobile accident case from $150,000 to about $18,000 based on a reduction in the award for past medical expenses.  The amount awarded by [...]

June 24, 2010   Posted in: Blog  Comments Closed

Bail Forfeiture Upheld Where Court Had Jurisdiction To Act And No Proof Defendant Outside Country

In the unpublished case of The People v. Bankers Insurance Company, No. A125077 (June 22), Division One of the First Appellate District upheld a trial court’s order denying relief from forfeiture of a bail bond and from the summary judgment underlying the forfeiture.  The Court rejected Bankers’ reliance on California Rule of Court Section 8.104 [...]

June 22, 2010   Posted in: Blog  Comments Closed

California WC Benefits Up $138 Million Despite Fall In Claims Volume

Although the number of workers’ compensation insurance claims in California fell more than 5 percent in 2007, big jumps in the average costs incurred for total disability and minor permanent disability workers’ compensation insurance claims have fueled a $138 million increase in total incurred workers’ compensation benefits, according to the California Workers’ Compensation Institute. In [...]

June 22, 2010   Posted in: Blog  Comments Closed

Overcharge Not Necessary To Assert RESPA Violation Against Title Insurer

In Edwards v. The First American Title Corporation, et al, Nos. 08-56536 and 08-56538 (June 21), the Ninth Circuit addressed a prospective class representative’s standing to pursue a violation of the Real Estate Settlement Procedures Act of 1974 (RESPA), 12 U.S.C. Section 2607.  The issue arose out of First American’s ownership of title insurance agencies [...]

June 21, 2010   Posted in: Blog  Comments Closed

Prop. 103-Style Health Care Rate Legislation To Be Heard In Senate Insurance Committee

AB 2578 (Jones-Sacramento and Feuer-Los Angeles) is set for hearing in the Senate Health Committee next week. The bill would impose a Prop. 103-style rate regulation regime on health plans regarding the rates they may charge.

June 18, 2010   Posted in: Blog  Comments Closed

Health Plan Rescission Legislation Now Before Senate Health Committee

AB 2470 (De La Torre -South Gate) is set for hearing next week in the Senate Health Committee. The bill, like previous bills AB 1945 of 2008 and AB 2 of 2009, would create an independent review panel to review decisions by health plans to rescind individual health care contracts.

June 18, 2010   Posted in: Blog  Comments Closed

Jones WC Choice of Law/Choice Of Forum Legislation Passes Senate Committee

AB2490 (Jones-Sacramento) has  passed the Senate Banking, Finance and Insurance Committee. This bill, authored by Assembly Member Dave Jones, the likely next Insurance Commissioner,  would prevent employers and their workers’ compensation insurance providers from agreeing to resolve future disputes under a choice of law or choice of forum other than California. Meanwhile, with absentee ballots [...]

June 18, 2010   Posted in: Blog  Comments Closed

Insurer’s Failure To Establish Elements Of Open Book Account Requires Reversal Of Judgment

In the unpublished case of National Continental Insurance Company v. Stanley, No. B217138 (June 17), Division Four of the Second Appellate District reversed a judgment in favor of National Continental on an alleged open book account with a policyholder.  The dispute arose when Stanley’s commercial auto liability policy was uprated due to alleged inaccuracies in [...]

June 17, 2010   Posted in: Blog  Comments Closed

Heading Of Policy Provision Does Not Establish Ambiguity When Term Fully Explained

In Hervey v. Mercury Casualty Company, No. B215470 (June 17), Division Five of the Second Appellate District, affirming a trial court dismissal, held that there was nothing ambiguous about a Mercury automobile insurance policy provision that differentiated between the insurer’s surrender of any right to reimbursement of medical expense payments made as a result of [...]

June 17, 2010   Posted in: Blog  Comments Closed

Supreme Court Finds That Intentional Acts Exclusion, Read In Conjunction With Severability Clause, Creates Ambiguity That Must Be Construed In Favor Of Coverage

In Minkler v. Safeco Insurance Company of America, No. S174016 (June 17), the Supreme Court answered a question certified to it by the Ninth Circuit.  The case concerned a suit brought by Minkler against David Schwartz and his mother alleging sexual molestation of Minkler.  The complaint alleged some of the acts occurred in Minkler’s mother’s [...]

June 17, 2010   Posted in: Blog  Comments Closed

Commissioner Announces New Level Of Rate Review For Major Health Carriers

In order to ensure that health insurers are charging accurate rates to their individual customers, Commissioner Poizner announced today that any rate change filings by top health insurers will undergo an additional level of actuarial analysis as part of the Department of Insurance’s regulatory review. “My job as Insurance Commissioner is to ensure that consumers [...]

June 16, 2010   Posted in: Blog  Comments Closed

Summary Judgment Not “Void” And Therefore Not Subject To Attack At Any Time

In the unpublished case of County of Los Angeles v. American Contractors Indemnity Company, No. B210625 (June 15),  Division Eight of the Second Appellate District analyzed the difference between “void” and “voidable” judgments.  The surety on a bail bond moved to set aside a summary judgment forfeiting  the bond issued for a criminal defendant.  American [...]

June 15, 2010   Posted in: Blog  Comments Closed

Potential For Coverage Exists Where Insured May Have Had Reasonable Expectation of Coverage Based On SIR Applying Only Once

In the case of Clarendon America Insurance Company v. North American Capacity Insurance Company, No. E048176 (June 15; ordered published July 7), Clarendon sought contribution and equitable indemnity from North American for sums it had expended in defending Tanamera Homes and Resort Communities, Inc. in a construction defect action.  Clarendon had defended Tanamera in a [...]

June 15, 2010   Posted in: Blog  Comments Closed

Taxi Cab Altercation Not Covered Under Checker Cab’s Liability Policy

In the case of L.A. Checker Cab Cooperative, Inc. v. First Specialty Insurance Co., No. B213948 (June 14; ordered published July 13), Division One of the Second Appellate District dealt with an altercation that occurred between a taxi cab driver and a prospective passenger.  The cab driver, Terminassian, got into a dispute with a would-be [...]

June 14, 2010   Posted in: Blog  Comments Closed