SAN FRANCISCO — A district court did not err in applying an abuse-of-discretion standard of review in a disability suit because the plan administrator’s conduct did not rise to the level of requiring a de novo review of the plan’s denial of benefits, the Ninth Circuit U.S. Court of Appeals said Dec. 10 in affirming the lower court’s finding that the plan did not abuse its discretion in terminating the disability claimant’s benefits (Olga Gorbacheva v. Abbott Laboratories Extended Disability Plan, et al., Nos. 18-15400, 18-16178, 9th Cir., 2019 U.S. App. LEXIS 36542).
SAN FRANCISCO — A California federal judge on Nov. 27 granted a disability claimant’s motion for judgment on the administrative record after determining that the claimant met his burden of proving that he remained disabled from performing the duties of his sedentary occupation as a project manager (Steven S. Garretson v. Metropolitan Life Insurance Co., No. 17-7052, N.D. Calif., 2019 U.S. Dist. LEXIS 206700).
REDWOOD CITY, Calif. — A California judge on Nov. 4 appointed the state’s insurance commissioner as conservator of California Insurance Co. (CIC) and enjoined all litigation involving the insurer (Insurance Commissioner of the State of California v. California Insurance Co., No. 19CIV06531, Calif. Super., San Mateo Co.).
SAN JOSE, Calif. — A California federal judge on Nov. 25 denied a commercial general liability insurer's renewed motion for judgment as a matter of law on Yahoo! Inc.'s bad faith and bad faith damages claims, finding that the insurer has failed to present any new evidence or new argument since the original motion was denied in May (Yahoo! Inc. v. National Union Fire Insurance Company of Pittsburgh, PA, No. 17-00489, N.D. Calif., 2019 U.S. Dist. LEXIS 204411).
SAN FRANCISCO — An additional insured contractor alleges in a Nov. 7 complaint filed in a California federal court that a builders risk insurer breached its policy, acted in bad faith and violated California Business and Professions Code Section 17200 et seq., regarding its claim handling of water and mold-related damage in a construction project (Build Group, Inc. v. Liberty Surplus Insurance Corp., No. 19-07359, N.D. Calif.).
OAKLAND, Calif. — A California federal judge on Nov. 25 denied a disability claimant’s request to conduct discovery after determining that the claimant failed to prove that additional evidence is necessary to conduct an adequate de novo review (Natalya Vigdorchik v. Liberty Life Assurance Company of Boston, et al., No. 19-3891, N.D. Calif., 2019 U.S. Dist. LEXIS 204512).
SACRAMENTO, Calif. — A disability claimant failed to prove that a disability insurer breached its contract or acted in bad faith in denying any-occupation disability benefits, a California federal judge said Nov. 21 in granting summary judgment in favor of the insurer (Loretta Bruce v. Hartford Life & Accident Insurance Co., No. 17-2201, E.D. Calif., 2019 U.S. Dist. LEXIS 202511).
PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals on Nov. 19 remanded a long-term disability (LTD) benefits claim to the plan administrator after determining that the plan administrator abused its discretion in denying benefits based on the one-week waiting period required by the plan (Michael Alves v. Hewlett-Packard Comprehensive Welfare Benefits Plan, et al., No. 18-55819, 9th Cir., 2019 U.S. App. LEXIS 34362).
SAN FRANCISCO — An appellant recently asked a California appeals court to reverse a lower court’s ruling that stayed his declaratory judgment lawsuit disputing the validity of a professional liability insurer’s subrogation claim against his family trust, arguing that the stay “has no legal basis” (John Berman v. Minnesota Lawyers Mutual Insurance Company, No. A155394, Calif. App., 1st Dist., Div. 3).
PORTLAND, Ore. — The Ninth Circuit U.S. Court of Appeals on Nov. 18 affirmed a lower federal court’s finding that a hotel insured’s failure to file a signed and sworn proof of loss defeats its claim for flood damage (Surfsand Resort LLC v. Nationwide Mutual Fire Insurance Co., et al., No. 18-35607, 9th Cir., 2019 U.S. App. LEXIS 34258).
SAN FRANCISCO — A California federal magistrate judge on Nov. 15 remanded a disability claimant’s suit after determining that diversity of jurisdiction does not exist because a negligence claim asserted against the insurance agency that sold the disability policies to the claimant may not be time-barred under California law (Mark Bennett, D.D.S. v. Ohio National Life Assurance Corp., et al., No. 19-5774, N.D. Calif., 2019 U.S. Dist. LEXIS 198719).
SAN FRANCISCO — An errors and omissions liability insurer’s failure to settle a consumer class action lawsuit against its insured for violating provisions of the Telephone Consumer Protection Action (TCPA) amounts to a bad faith breach of contract, an assignee argues in a Nov. 5 complaint filed in California federal court (Ignacio Perez v. Indian Harbor Insurance Co., et al., No. 19-7288, N.D. Calif.).
SANTA ANA, Calif. — An insurer’s lawsuit accusing a number of substance abuse treatment centers of common-law fraud, violation of California’ unfair competition law (UCL) and other claims can proceed in state court, a federal judge in California ruled Nov. 13, holding that the plaintiff company’s claims are not preempted by the Employee Retirement and Income Security Act (Health Net Life Insurance Co. v. Morningside Recovery LLC, et al., No. 19-cv-1342, C.D. Calif., 2019 U.S. Dist. LEXIS 197937).
LOS ANGELES — A California federal judge on Nov. 4 dismissed a breach of contract claim and a bad faith claim against a life insurer because the plaintiffs’ allegations, which arise out of the life insurer’s increase in policy premiums, do not support a claim for breach of contract or for bad faith (Brighton Trustees, et al. v. Transamerica Life Insurance Co., No. 19-4210, C.D. Calif., 2019 U.S. Dist. LEXIS 193359).
SAN FRANCISCO — A trial attorney’s failure to raise the youth factors argument in two U.S. Supreme Court rulings and one California Supreme Court case following a man’s conviction on two counts of insurance fraud did not constitute ineffective assistance of counsel, a California appeals panel ruled Nov. 13, finding that the contents of the presentence report prepared by the prosecution showed the defendant’s history of failing to comply with probation and post-sentence requirements (People v. Lamont James, Nos. A155627, A157772, Calif. App., 1st Dist., 2nd Div., 2019 Cal. App. Unpub. LEXIS 7507).
SANTA ANA, Calif. — A California appeals court panel on Nov. 8 found that while a trial court judge’s decision to admit evidence regarding a 2009 incident in which a police officer injured his right hand while on duty was erroneous, it does not warrant vacating the officer’s conviction for insurance fraud because the error was not prejudicial (People v. Ryan Patrick Natividad, No. G055248, Calif. App., 4th Dist., 3rd Div., 2019 Cal. App. Unpub. LEXIS 7451).
SAN JOSE, Calif. — A disability claimant failed to prove that he was disabled from his own occupation as a result of sickness or injury according to the plan’s terms, a California federal judge said Nov. 6 after applying a de novo standard of review based on a remand order issued by the Ninth Circuit U.S. Court of Appeals (Robert Gordon v. Metropolitan Insurance Co., No. 10-5399, N.D. Calif., 2019 U.S. Dist. LEXIS 193142).
SAN JOSE, Calif. — A California court erred in sustaining demurrers without leave to amend in a construction defects insurance lawsuit because the discovery that an insurer’s obligations to a subcontractor arose from fraudulent activity should not result in the general contractor’s insurers avoiding their obligations to their insured “in their entirety,” punishing the subcontractor’s insurer for fulfilling its obligations to it insurer, the subcontractor’s insurer argues in a Sept. 4 appellant brief filed in a California appellate court (The Travelers Indemnity Company of Connecticut v. Navigators Specialty Insurance Co., et al., No. H046784, Calif. App., 6th Dist.).
SACRAMENTO, Calif. — A California federal magistrate judge on Nov. 1 recommended that judgment be entered in favor of a disability claim because the denial of a claim for an extension of short-term disability (STD) benefits was not an abuse of discretion and is supported by the medical evidence (Jerome Clay v. AT&T Umbrella Benefit Plan No. 3, No. 17-749, E.D. Calif., 2019 U.S. Dist. LEXIS 190308).
SAN DIEGO — In a case of first impression in California, a state appeals panel on Oct. 30 found, for the purpose of excess insurance, that a trial court has jurisdiction to characterize an employee’s injury under an insolvent insurer’s excess policy differently than what was reflected in a stipulation by the Workers' Compensation Appeals Board (WCAB) (California Insurance Guarantee Association v. San Diego County Schools Risk Management Joint Powers Authority, et al., No. D074360, Calif. App., 4th Dist., Div. 1, 2019 Cal. App. LEXIS 1070).