Mealey's California Insurance

  • November 17, 2020

    U.S. High Court Refuses To Review Whether LRRA Preempts Anti-Arbitration Statute

    WASHINGTON, D.C. — The U.S. Supreme Court on Nov. 16 denied a petition for writ of certiorari seeking review of the Ninth Circuit U.S. Court of Appeals’ finding that Washington’s anti-arbitration statute is preempted by the Liability Risk Retention Act (LRRA) as it applies to risk retention groups chartered in another state, leaving undisturbed a lower court’s order compelling arbitration in a coverage dispute arising from an underlying malpractice claim (Michael Scott Anglesey, M.D., et al. v. Allied Professionals Insurance Co., No. 20-166, U.S. Sup.).

  • November 16, 2020

    Judge Says Underlying Claim Alleges Property Damage Caused By An Occurrence

    SAN DIEGO — A California federal judge on Nov. 12 denied a commercial property insurer’s motion to dismiss breach of contract and bad faith claims asserted by an insured after determining that an underlying dispute arising out of incomplete renovations to a leased property alleges property damage caused by an occurrence (La Roca Christian Communities International Inc. v. Church Mutual Insurance Co., No. 20-1324, S.D. Calif., 2020 U.S. Dist. LEXIS 211654).

  • November 16, 2020

    Panel: Exclusion Bars Coverage For Whistleblower Complaint Against Office Depot

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on Nov. 13 affirmed a lower federal court’s ruling in favor of an insurer in Office Depot Inc.’s lawsuit seeking coverage for an underlying whistleblower complaint alleging that the company improperly charged California government entities for office supplies, finding that the policy’s “contract exclusion” bars coverage (Office Depot Inc. v. AIG Specialty Insurance Company, No. 19-55819, 9th Cir.).

  • November 16, 2020

    Judge Says Long-Term Care Policy Void, Awards Insurer Damages For Misrepresentations

    LOS ANGELES — A federal judge in California on Nov. 13 entered a declaratory judgment in favor of an insurer that contended that a couple’s long-term care (LTC) policy should be voided after it learned that they were submitting falsified bills and awarded the company $919,290.49 in compensatory and punitive damages based on a jury’s August 2018 verdict in the company’s favor.

  • November 16, 2020

    Bad Faith Claim Against Disability Insurer Barred By 2-Year Statute Of Limitations

    LOS ANGELES — A California federal judge on Sept. 16 granted a disability insurer’s motion to dismiss a bad faith claim after determining that the claim is barred by the applicable two-year statute of limitations (Beth L. Vitug v. AXA Equitable Life Insurance Co., et al., No. 20-5492, C.D. Calif., 2020 U.S. Dist. LEXIS 208783).

  • November 13, 2020

    California Insurance Company Files Anti-SLAPP Motion In Light Of Rehabilitation Plan

    REDWOOD CITY, Calif. — In response to the California insurance commissioner’s recent rehabilitation plan against it, California Insurance Co. (CIC) filed an anti-SLAPP motion on Oct. 29 in a California state court, alleging that political motivations were behind its conservatorship and seeking to protect its First Amendment rights (Insurance Commissioner of the State of California v. California Insurance Company, No. 19CIV06531, Calif. Super., San Mateo Co.).

  • November 12, 2020

    Disability Benefits Ruling Modified To Correct End Date Of Benefits Owed

    LOS ANGELES — A California federal judge on Nov. 9 granted a stipulation to modify a ruling entered in favor of a disability claimant because the ruling failed to account for the disability plan’s 60-day waiting period in the calculation of the end date on which long-term disability (LTD) benefits must be paid (Joel Groch v. Dearborn National Life Insurance Co., No. 18-6614, C.D. Calif., 2020 U.S. Dist. LEXIS 209570).

  • November 11, 2020

    Federal Judge Dismisses California Hotel Owners’ Coronavirus Coverage Suit

    LOS ANGELES — A federal judge in California on Oct. 27 granted insurers’ motion to dismiss their hotel owner insureds’ lawsuit seeking business income and civil authority coverage for their losses caused by the novel coronavirus and subsequent governmental closure orders, noting that amendment of the complaint would be futile (West Coast Hotel Management, LLC, et al. v. Berkshire Hathaway Guard Insurance Companies, et al., No. 20-05663, C.D. Calif., 2020 U.S. Dist. LEXIS 201161).

  • November 10, 2020

    Threat Of Contamination From Coronavirus Does Not Constitute Physical Loss

    SAN FRANCISCO — A California federal judge on Nov. 9 dismissed an insured business’s suit seeking coverage for business losses caused by the COVID-19 pandemic because the insured failed to prove that the imminent threat of contamination by the novel coronavirus qualifies as a covered physical loss under its policy (Water Sports Kauai Inc. v. Fireman’s Fund Insurance Co., No. 20-3750, N.D. Calif., 2020 U.S. Dist. LEXIS 209547).

  • November 10, 2020

    Disability Claimant Failed To Prove Disability Under Terms Of Plan, Judge Says

    SAN DIEGO — A disability claimant failed to prove by a preponderance of the evidence that he was disabled under the terms of his disability plan, a California federal judge said Nov. 6 in granting the disability insurer’s motion for judgment and in denying the claimant’s motion for judgment (Brian Joseph Driscoll v. MetLife Insurance, et al., No. 15-1162, S.D. Calif., 2020 U.S. Dist. LEXIS 208846).

  • November 10, 2020

    Trucking Companies Seek Costs For Compelling Plan Administrators To Discovery

    SANTA ANA, Calif. — Trucking companies ask a California federal court in a Nov. 9 motion to order third-party administrators for a self-insured employee benefit plan to reimburse $5,541.25 in expenses incurred by the companies in filing a motion to compel the administrators to discovery in their dispute alleging a negligent failure to obtain reinsurance coverage for the plans (A&I Transport, Inc., et al. v. KG Administrative Services, Inc., et al., No. 19-1992, C.D. Calif.).

  • November 09, 2020

    Public Disclosure Bar Dooms Relator’s Suit Over Alleged Fraudulent Billing Scheme

    SAN JOSE, Calif. — A federal judge in California on Nov. 6 dismissed without prejudice a woman’s second False Claims Act (FCA) lawsuit accusing two medical foundations and a group of doctors of fraudulently billing Medicare and Medicaid for breast cancer surgeries by upcoding services and unbundling procedures, finding that her request for information from the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA) triggered the application of the public disclosure bar.

  • November 04, 2020

    Pollution Exclusion Does Not Bar Coverage For Honking Of Car Horns

    SAN DIEGO — A pollution exclusion does not bar coverage for the honking of car horns by residents of a community driving through a neighboring community because the exclusion does not clearly and explicitly state that noise pollution includes the honking of car horns, a California federal judge said Nov. 3 in granting the insured’s motion for summary judgment (The Crosby Estate at Rancho Santa Fe Master Association v. Ironshore Specialty Insurance Co., No. 19-2369, S.D. Calif., 2020 U.S. Dist. LEXIS 205411).

  • November 04, 2020

    Auto Insurer Named In Bad Faith Suit Over Failure To Make Coverage Decision

    SANTA MONICA, Calif. — An automobile insurer has breached the terms of two insurance policies held by its insurers and acted in bad faith by failing to timely render a decision on coverage for a covered vehicle that sustained damage in a collision, insureds allege in a complaint filed Sept. 7 in California state court (Amir Abramov, et al. v. Government Employees Insurance Co., et al, No. 20SMCV01249, Calif. Super., Los Angeles Co., 2020 Ca. Sup. Ct. Pleadings LEXIS 7180).

  • November 03, 2020

    Additional Disability Benefits Owed Under Disability Plan, Federal Judge Says                            

    LOS ANGELES — A disability insurer’s termination of a long-term disability (LTD) benefits claim is not supported by the medical evidence, a California federal judge said Oct. 29 in determining that the insurer must pay the claimant additional benefits under the disability plan (Joel Groch v. Dearborn National Life Insurance Co., No. 18-6614, C.D. Calif., 2020 U.S. Dist. LEXIS 204171).

  • November 03, 2020

    Insurers:  Reimbursement Should Be Made For BP’s Faulty Pipe Suit Settlement

    LOS ANGELES — A commercial general liability insurer and an umbrella insurer filed suit  Nov. 2 in a California federal court seeking reimbursement from a pipe manufacturer for their settlement of BP America Production Co.’s defective pipe products lawsuit (American Home Assurance Company, et al. v. Ameron International Corporation, No. 20-10049, C.D. Calif.).

  • November 02, 2020

    Insurer’s Termination Of Benefits Supported By Evidence, Judge Determines

    SANTA ANA, Calif. — A disability insurer did not wrongfully terminate a disability claimant’s benefits after 17 years because the medical evidence, the claimant’s Facebook posts and the insurer’s investigative reports support the insurer’s conclusion that the claimant was no longer disabled from performing the duties of her own occupation, a California federal judge said Oct. 28 (Michele Reed McCoy v. Aetna Life Insurance Co., et al., No. 19-575, C.D. Calif., 2020 U.S. Dist. LEXIS 202032).

  • November 02, 2020

    Retailer Appeals Dismissal Of Coronavirus Coverage Suit To 9th Circuit

    SAN FRANCISCO — A retailer insured on Sept. 23 filed a notice indicating that it is appealing to the Ninth Circuit U.S. Court of Appeals a federal judge’s dismissal of its class complaint seeking coverage under a comprehensive business insurance policy for its claimed losses following the state’s “Stay at Home” order in response to the novel coronavirus pandemic (Mudpie, Inc. v. Travelers Casualty Insurance Company of America, No. 20-03213, N.D. Calif.).

  • November 02, 2020

    Cal Alumnus Dismisses Suit Arising From Canceled Cruise Due To Coronavirus

    SAN FRANCISCO — A University of California alumnus on Sept. 30 filed a notice to voluntarily dismiss without prejudice his breach of contract and bad faith class complaint arising from a deluxe travel company’s failure to provide a refund for a cruise canceled because of the novel coronavirus pandemic (Guy Saperstein v. Thomas P. Gohagan & Company, No. 20-03143, N.D. Calif.).

  • November 02, 2020

    Federal Judge Dismisses Counterclaims Against Insurer In Coronavirus Coverage Suit

    LOS ANGELES — A federal judge in California on Oct. 19 granted an insurer’s motion to dismiss declaratory relief, breach of contract, bad faith and California unfair competition law (UCL) counterclaims brought by its insured, finding that the policy’s virus exclusion explicitly precludes civil authority coverage and the business income and extra expenses coverage does not apply because there was no physical damage to the insured’s property (Travelers Casualty Insurance Company of America v. Geragos & Geragos, Nos. 20-3619, C.D. Calif., 2020 U.S. Dist. LEXIS 196932).

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