Mealey's California Insurance : Mealey's : Legal News & Analysis

Mealey's California Insurance

June 14, 2023
Vizio Tells 9th Circuit Its 4th Amended Complaint Is ‘More Than Sufficient’

SAN FRANCISCO — Responding to an insurer’s contention that its appeal “merely regurgitates the same failed arguments,” Vizio Inc. tells the Ninth Circuit U.S. Court of Appeals that the allegations in its fourth amended complaint are “more than sufficient” to permit it to proceed past the pleading stage in its lawsuit seeking coverage for an underlying $17 million settlement and defense costs arising from class claims alleging unauthorized collections of consumers’ television viewing data.
June 09, 2023
9th Circuit Partly Reverses Dismissal Of Disability Claims Against Insurers

SAN FRANCISCO — A Ninth Circuit U.S. Court of Appeals panel reversed in part and affirmed in part a California federal judge’s grant of summary judgment against an insured who accused two insurers of breach of contract and violation of California’s unfair competition law (UCL) for refusing to find her totally disabled since 1989 when she developed carpal tunnel syndrome and left her primary career, based on a claim she filed in 2020 after leaving a secondary job due to COVID-19-related health concerns.
June 09, 2023
Federal Judge: CGL Insurer Owes Defense For Tenants’ Suit Against Mutual Insured

OAKLAND, Calif. — A federal judge in California granted an insurer’s motion for summary judgment in its declaratory judgment lawsuit seeking defense from a commercial general liability insurer for an underlying lawsuit brought against their mutual insured, finding that there is no genuine dispute that the underlying lawsuit might fall within coverage under the CGL policy.
June 09, 2023
Panel Affirms Ruling In Insurers’ Favor In Aiding And Abetting Malpractice Suit

LOS ANGELES — A California appeals panel affirmed a lower court’s ruling in favor of insurers in a lawsuit alleging that they conspired with attorneys to force insureds to accept a $750,000 settlement of an underlying lawsuit arising from a failed partnership, finding that the insureds failed to plead any facts to support their contention that the insurers “had actual knowledge of the tortious conduct by the attorney defendants.”
June 08, 2023
Calif. Federal Judge Grants Motion To Compel Arbitration, Stays Bad Faith Claim

SAN FRANCISCO — A California federal judge granted an auto insurer’s motion to compel arbitration of its insured’s breach of contract claim because arbitration is required under California law and further stayed litigation of the insured’s bad faith claim because the result of the arbitration will impact the result of the bad faith claim.
June 06, 2023
California Judge Enters Judgment On Special Jury Verdict In Insurer’s Favor

LOS ANGELES — A Los Angeles County Superior Court judge entered judgment on a jury’s special verdict in favor of a commercial property insurer in the insureds’ breach of contract coverage lawsuit arising from the coronavirus pandemic after the jury found last month that SARS-CoV-2 did not cause any direct physical loss or damage to the insureds’ hotel on or before June 1, 2020.
June 06, 2023
Dismissal Granted In Row Over Medicare Payments Suspended Due To Alleged Fraud

SAN DIEGO — A California federal judge dismissed without prejudice a suit filed against employees of a Medicare contractor accused of violations of the California Insurance Frauds Prevention Act and California unfair competition law after the employees suspended Medicare payments to a pain management clinic for allegations of fraud, finding that dismissal is proper because the clinic failed to exhaust its administrative remedies pursuant to the Medicare Act.
June 06, 2023
Breach Of Fiduciary Duty Claim Against Disability Insurer Not Foreclosed

PASADENA, Calif. — A district court erred in entering judgment in favor of a disability insurer on a breach of fiduciary duty claim because the insurer was acting in a fiduciary function when it miscalculated the claimant’s long-term disability benefits, resulting in a more than $56,000 overpayment to the claimant, the Ninth Circuit U.S. Court of Appeals said in reversing the district court’s judgment.
May 31, 2023
California Panel: Insured’s Direct Physical Loss Claims Are ‘Mere Legal Conclusions’

SAN DIEGO — A California appeals panel on May 30 affirmed a lower court’s grant of a commercial property insurer’s motion for judgment on the pleadings in a coverage dispute arising from the coronavirus pandemic, finding that it is clear that the causes of the insured’s business losses are not attributable to the presence of the coronavirus on its premises but are the purported result of “certain government orders, community infection, and assumption that the virus is ubiquitous.”
May 30, 2023
Panel Affirms Conversion To Judgment In ‘The Starry Night’ Insurance Fraud Case

SACRAMENTO, Calif. — A California appellate court on May 26 affirmed a decision converting criminal restitution orders to civil judgments after homeowners pleaded guilty to insurance fraud in overstating their fire-related losses to include an original Vincent van Gogh “The Starry Night” painting, finding that the trial court correctly determined that it had statutory authority to convert restitution orders to civil money judgments.
May 26, 2023
Federal Judge Grants In Part Judgment For Insurer In Medical Coverage Dispute

SANTA ANA, Calif. — A California federal judge granted in part summary judgment to an insurer seeking a determination that a medical professions liability policy issued to its insured behavioral health provider provides no coverage in an underlying Oregon state court suit, finding that the provider breached the insurance contract by misrepresenting in a renewal application lack of awareness of a possible lawsuit following a former employee’s criminal conviction.
May 25, 2023
Judgment Denied In FCA Suit Against Pharmacy Accused Of Overcharging Medicare

SACRAMENTO, Calif. — A California federal judge denied summary judgment in a whistleblower’s suit against a pharmacy, alleging that it violated the federal False Claims Act (FCA) and the California False Claims Act (CFCA) by overcharging the state of California and federal government for Medi-Cal and Medicare Part D nursing home patients, finding that fact disputes remain as to the actual reason for firing the whistleblower.
May 22, 2023
Insurers Resolve Equitable Indemnity, Subrogation Action Over Sinking High-Rise

SAN FRANCISCO — An excess insurer and two insurers it had sued for equitable indemnity and/or equitable subrogation related to damages they paid to settle lawsuits stemming from the sinking of a residential high-rise stipulated to the dismissal with prejudice of all claims in the suit after notifying the court in March that they had reached a confidential settlement.
May 22, 2023
Magistrate: Suit Against HOA Insured Fails To Allege ‘Loss’ To Trigger Coverage

SACRAMENTO, Calif. — A federal magistrate judge in California on May 18 granted a professional liability insurer’s motion to dismiss a homeowners’ association insured’s breach of contract and bad faith lawsuit, finding that an underlying lawsuit against the HOA did not seek a “loss” to trigger coverage under the policy.
May 19, 2023
Excess Insurer’s Policies Provide Only Duty To Indemnify, Not Defend, Judge Says

RIVERSIDE, Calif. — An excess insurer’s policies only require the insurer to indemnify its insured for covered claims and does not require the insurer to defend against claims, a California federal judge said in partly granting the excess insurer’s motion for summary judgment in a groundwater contamination coverage suit.
May 19, 2023
Judge: Triable Issues Exist As To When Subcontractor Knew Property Damage Occurred

LOS ANGELES — A California judge denied an insurer’s motion for summary judgment in a building owner and general contractor’s lawsuit seeking payments of an underlying $1.1 million default judgment entered against a subcontractor insured, finding that there are triable issues as to when the subcontractor “knew” that the property damage occurred and whether the subcontractor’s conduct qualifies as an “occurrence” under the business owners insurance policy.
May 18, 2023
California Panel Affirms JNOV For Auto Parts Retailer In Indemnification Dispute

RIVERSIDE, Calif. — A California appeals panel on May 17 affirmed a lower court’s ruling granting an auto parts retailer’s judgment notwithstanding the verdict in an indemnification dispute over an underlying $29.9 million negligence and product liability settlement, finding that neither a cross-complainant nor its insurer was entitled to recover half of the underlying settlement.
May 16, 2023
Judgment Properly Entered For Disability Plan, 9th Circuit Panel Determines

SAN FRANCISCO — A district court did not err in granting judgment in favor of a disability plan and against a disability claimant because the claimant failed to show that he is unable to perform the duties of any occupation and the plan identified at least one sedentary occupation that the claimant could become qualified to perform even with his current physical restrictions, the Ninth Circuit U.S. Court of Appeals said.
May 15, 2023
Parties Propose Trial Dates On Remaining Claims In Reinsurance Billings Suit

LOS ANGELES — In a May 12 joint statement in California federal court, parties in a reinsurance billings suit involving dozens of claims outline the remaining claims and disputes to be tried, estimating that a jury trial will take 10 days.
May 15, 2023
Parties Reach Settlement In Coverage Dispute Over Wildfire Damage To Napa Wineries

SAN FRANCISCO — An insured and its insurer filed a notice in a California federal court indicating that they have settled the insured’s lawsuit seeking coverage for property damage to its Napa County wineries caused by two wildfires.
May 15, 2023
Insurer Dismisses Coverage Suit Arising From Cyberstalking Claims Against EBay

SAN JOSE, Calif. — A commercial umbrella liability insurer voluntarily dismissed without prejudice its suit in a California federal court disputing coverage for allegations that eBay and its directors and officers “engaged in a coordinated effort to intimidate, threaten to kill, torture, terrorize, stalk and silence” the underlying plaintiffs “to stifle their reporting on eBay.”
May 12, 2023
California Panel: Insurer Did Not Act In Bad Faith In Windstorm Coverage Dispute

SANTA ANA, Calif. — A California appeals court on May 11 held that an insurer did not act in bad faith in its handling of an insured’s windstorm damage claim, rejecting the insured’s arguments on appeal that the insurer failed to thoroughly investigate his property damage and misrepresented his rental coverage.
May 11, 2023
Parties Dispute Coverage Issues In Groundwater Contamination Suit

RIVERSIDE, Calif. — In reply briefs filed in support of competing motions for summary judgment in a groundwater contamination coverage suit, an insured and its excess insurer seek a ruling from a California federal court on whether judgment should be entered on the insured’s breach of contract claim arising out of the insurer’s termination of coverage based on the insurer’s position that coverage is owed for only one occurrence under the applicable policies.
May 11, 2023
Calif. High Court Declines Review Of Relator Appeal In IFPA Suit Against Hospital

SAN FRANCISCO — The California Supreme Court denied review of an appellate court decision affirming a lower court’s judgment for a hospital in the state of California’s qui tam lawsuit alleging that the hospital participated in kickbacks, patient steering and billing fraud schemes.
May 09, 2023
California Jury Returns Verdict In Insurer’s Favor In COVID-19 Coverage Suit

LOS ANGELES — A California jury returned a special verdict in favor of a commercial property insurer in insureds’ breach of contract coverage lawsuit arising from the coronavirus pandemic, finding that SARS-CoV-2 did not cause any direct physical loss or damage to the insureds’ hotel on or before June 1, 2020.