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Mealey's California Insurance

  • December 10, 2018

    Bad Faith Dispute Over Denial Of Health Insurance Coverage Remanded

    LOS ANGELES — A federal judge in California on Nov. 29 remanded an insurance breach of contract and bad faith lawsuit to state court, ruling that an insured’s state law claims do not arise under the Medicare Act and that the insured failed to show that federal question jurisdiction exists (Rosalie Vaccarino v. Aetna Inc., et al., No. 18-2349, C.D. Calif., 2018 U.S. Dist. LEXIS 202672).

  • December 6, 2018

    Denial Of Disability Benefits Not Supported By Medical Evidence, Judge Says

    OAKLAND, Calif. — A California federal judge on Dec. 5 granted a disability claimant’s motion for summary judgment after determining that the disability insurer’s denial of long-term disability (LTD) benefits is not supported by the medical evidence (Dale Holmgren v. Sun Life and Health Insurance Co., No. 17-3028, N.D. Calif., 2018 U.S. Dist. LEXIS 205649).

  • December 6, 2018

    Disability Insurer Conducted Full, Fair Review, Judge Says Following Bench Trial

    LOS ANGELES — Following a bench trial in a short-term disability (STD) benefits dispute, a California federal judge on Nov. 26 granted judgment in favor of the disability insurer after determining that the insurer conducted a full and fair review of the disability claim and did not abuse its discretion in denying the claim for benefits (Yvette Williby v. Aetna Life Insurance Co., No. 14-4203, C.D. Calif., 2018 U.S. Dist. LEXIS 201708).

  • December 6, 2018

    No Coverage Owed For Underlying Judgment Entered Against Insured, Panel Says

    LOS ANGELES — No coverage is owed for a judgment entered against an insured for breach of warranty of habitability claims alleged by the insured’s tenants because the insured failed to comply with the policy’s condition that required working smoke detectors in the insured building, the Second District California Court of Appeal said Dec. 3 in affirming the trial court’s decision to sustain the insurer’s demurrer to the tenants’ breach of contract and bad faith complaint (Debra Gray v. American Safety Indemnity Co., No. B289323, Calif. App., 2nd Dist., Div. 4, 2018 Cal. App. Unpub. LEXIS 8160).

  • December 6, 2018

    Panel Upholds Denial Of Arbitration Under Reinsurance Participation Agreement

    SAN FRANCISCO — Citing “persuasive prior decisions,” the First District California Court of Appeal, Division Four, on Dec. 4 affirmed the denial of a reinsurer’s motion to compel arbitration under a reinsurance participation agreement (RPA) (Luxor Cabs Inc., et al. v. Applied Underwriters Captive Risk Assurance Co., et al., No. A147962, Calif. App., 4th Dist., Div. 4, 2018 Cal. App. Unpub. LEXIS 8223).

  • December 5, 2018

    Judge Rejects Consolidation, Tells Reinsurer, Insurer To Appoint Umpires To Dispute

    LOS ANGELES — Rejecting an insurer’s petition to proceed with a single arbitrator and a single umpire, a California federal judge on Dec. 3 ordered a reinsurer and the insurer to name umpires in accordance with a reinsurance treaty’s arbitration clause (Employers Insurance Company of Wausau v. The Hartford, No. 18-07240, C.D. Calif., 2018 U.S. Dist. LEXIS 205345).

  • December 5, 2018

    Statute Of Limitations Bars Breach Of Contract, Bad Faith Claims In Disability Suit

    SAN FRANCISCO — A disability claimant cannot maintain claims for breach of contract and bad faith based on a 2013 denial of benefits because the applicable statute of limitations for breach of contract and bad faith allegations bars the claims, a California federal judge said Dec. 4 (Theresa Hong v. AXA Equitable Life Insurance Co., No. 18-4039, N.D. Calif., 2018 U.S. Dist. LEXIS 205336).

  • December 5, 2018

    Auto Insurer Promptly Paid Insured’s Claim After Receiving All Information

    LOS ANGELES — Judgment in favor of an auto insurer on an insured’s bad faith claim was proper because the insurer promptly paid the insured’s claim after learning how much of the insured’s medical expenses would be covered by workers’ compensation insurance, the Second District California Court of Appeal said Nov. 21 (Melissa Case v. State Farm Mutual Auto Insurance Co. No. B281732, Calif. App., 2nd Dist., Div. 4, 2018 Cal. App. Unpub. LEXIS 7887).

  • December 4, 2018

    9th Circuit Remands Disability Suit To Reconsider Source Of Disability

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Dec. 3 remanded a disability claimant’s suit after determining that the district court must determine the whether the source of a claimant’s disability is physical or mental (Miae Decovich v. Anthem Life Insurance Co., No. 17-15324, 9th Cir., 2018 U.S. App. LEXIS 33890).

  • December 4, 2018

    Insurance Commissioner Seeks To Liquidate Insurer Following California Fires

    MERCED, Calif. — As a result of the fires in Paradise, Calif., the California insurance commissioner on Nov. 30 requested to be appointed liquidator for Merced Property & Casualty Co. because the insurer projects to be insolvent from those fires losses (Insurance Commissioner of the state of California v. Merced Property & Casualty Co., No. N/a, Calif. Super., Merced Co.).

  • December 4, 2018

    Yahoo, Insurer Brief 9th Circuit On Privacy Issues In TCPA Coverage Appeal

    SAN FRANCISCO — In letter briefs filed Nov. 6 at the direction of the Ninth Circuit U.S. Court of Appeals, Yahoo! Inc. and its commercial general liability (CGL) insurer debate the impact of an August 2017 Ninth Circuit ruling on the present appeal pertaining to insurance coverage for claims brought under the Telephone Consumer Protection Act (TCPA) (Yahoo! Inc. v. National Union Fire Insurance Company of Pittsburgh, PA, No. 17-16452, 9th Cir.).

  • November 30, 2018

    Insured Failed To Comply With Condition Precedent To Coverage, Panel Affirms

    SAN FRANCISCO — An insured failed to comply with the Contractors Special Conditions in its insurance policy before an underlying construction defects lawsuit was filed, the Ninth Circuit U.S. Court of Appeals held Nov. 28, affirming a lower court’s ruling that an insurer has no duty to duty to defend and indemnify (ProBuilders Specialty Insurance Company RRG v. Phoenix Contracting Inc. and FHC LLC, No. 17-35861, 9th Cir., 2018 U.S. App. LEXIS 33384).

  • November 30, 2018

    Federal Judge Issues Protective Order As To Discovery In Flood Coverage Dispute

    SAN FRANCISCO — A California federal magistrate judge on Nov. 27 signed a stipulated protective order regarding disclosure and discovery in an insured’s lawsuit arising from flood damage (Alicia Martin v. CSAA Insurance Exchange, et al., No. 17-04066, N.D. Calif.).

  • November 29, 2018

    Insurance Company’s Owner: Reinsurer Fails To Show Fraudulent Transfer

    SAN DIEGO — In a dispute over a $3.2 million judgment, a principal to an insurance services company argues to a California federal court in a Nov. 21 brief that a reinsurer offers no evidence on its claim of a fraudulent transfer, so seizure of her home or proceeds from the sale of it should be denied (Odyssey Reinsurance Co. v. Richard Keith Nagby, et al., No. 16-3038, S.D. Calif.).

  • November 26, 2018

    Motion To Compel In Insurance Bad Faith Suit Deferred Pending Further Evidence

    FRESNO, Calif. — A federal magistrate judge in California deferred ruling on a third-party claimant’s motion to compel further responses to two discovery requests in an insurance breach of contract and bad faith lawsuit, ruling that although the discovery requests are relevant, not overly broad, vague and ambiguous and not subject to either attorney-client privilege or privacy under California law, an insurer should be allowed to supplement the record with evidence showing that the two interrogatories are burdensome (Jennifer M. Tucker v. AMCO Insurance Co., No. 17-1761, E.D. Calif., 2018 U.S. Dist. LEXIS 197140).

  • November 20, 2018

    HHS Secretary: State Agency Responsible For Workers’ Comp Claims

    SAN FRANCISCO —Secretary of Health and Human Services Alex Azar II argues in a Nov. 16 brief to the Ninth Circuit U.S. Court of Appeals that the California Insurance Guarantee Association (CIGA), as a primary plan, is responsible for making payment to insureds of workers’ compensation plans that become insolvent (California Insurance Guarantee Association v. Alex Azar II, et al., Nos. 17-56526 & 17-56528, 9th Cir.).

  • November 16, 2018

    Motion To Dismiss Denied; Claim Against Insurer’s Parent Company Supported

    SAN FRANCISCO — A California federal judge on Nov. 14 denied a motion to dismiss an insured’s third amended complaint after determining that the insured plausibly alleged that the insurer and its parent company acted in bad faith by engaging in a scheme to hide coverage for a water damage claim from the insured (Tam Vu v. Liberty Mutual Insurance Co., et al., No. 18-3594, N.D. Calif., 2018 U.S. Dist. LEXIS 194471).

  • November 16, 2018

    California Federal Judge Grants Parties’ Request To Dismiss Disability Suit

    SANTA ANA, Calif. — A California federal judge on Nov. 6 dismissed a disability claimant’s suit against a long-term disability (LTD) insurer after the parties notified the court that they reached an agreement to dismiss the suit (Karen Compton v. Life Insurance Company of North America, et al., No. 18-184, C.D. Calif., 2018 U.S. Dist. LEXIS 192680).

  • November 14, 2018

    Insolvent Insurer Told To File Status Report In Breach Of Contract Case

    LOS ANGELES — Having previously stayed a breach of contract case against an insolvent insurer pending resolution of the insurer’s liquidation, a California federal judge on Nov. 2 discharged an order to show cause and ordered the insolvent insurer to file another status report in six months (Yancy Alvarez, et al. v. Access General Insurance Co., No. 18-336, C.D. Calif.).

  • November 12, 2018

    Panel: Some Cross-Claims From Lawyer Accused Of Insurance Fraud Properly Stricken

    LOS ANGELES — A California appeals panel on Nov. 9 upheld a trial court judge’s ruling dismissing cross-claims brought by a lawyer accused of insurance fraud, finding that an insurance company’s subpoenas seeking the attorney’s deposition in three unrelated personal injury actions did not constitute an abuse of process under the state’s anti-SLAPP (strategic lawsuit against public participation) statute or constitute an unfair business practice in violation of California Business and Professions Code Section 17200 (Dennis Gerald Geselowitz v. Allstate Insurance Co., No. B278637, Calif. App., 2nd Dist., 3rd Div., 2018 Cal. App. Unpub. LEXIS 7605).