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Mealey's California Insurance

  • June 18, 2018

    Magistrate Judge Grants Reinsurer’s Motion To Compel Production Of Documents

    SACRAMENTO, Calif. — In two putative class actions over a reinsurance participation agreement (RPA), a California federal magistrate judge on June 14 ordered an insurance agency to produce nonprivileged, responsive information requested by a reinsurer and its affiliates (Shasta Linen Supply Inc. v. Applied Underwriters Inc., et al., Nos. 16-00158 & 16-01211, E.D. Calif., 2018 U.S. Dist. LEXIS 100158).

  • June 13, 2018

    Panel: Trial Court Must Recalculate Restitution For Insurer’s Investigation

    RIVERSIDE, Calif. — An appeals court panel in California on May 31 vacated a trial court judge’s ruling ordering a woman who pleaded guilty to one count of making a false statement in support of an insurance claim to pay $1,042.17 in restitution to an insurance company, finding that the company did not take into account the costs it incurred as a result of its investigation of the defendant’s claim (People of California v. Alyce J. Williams, No. D072783, Calif. App., 4th Dist., 1st Div., 2018 Cal. App. Unpub. LEXIS 3728).

  • June 12, 2018

    Landscaper: Reinsurer’s Service Of Suit Over Arbitration Award Was Defective

    LOS ANGELES — A landscape company says in its June 10 reply brief to a California federal court that service of suit was defective regarding a reinsurer’s petition seeking confirmation of a $82,130.44 arbitration award (Applied Underwriters Captive Risk Assurance Company Inc. v. O’Connell Landscape Maintenance Inc., No. 18-00683, C.D. Calif.).

  • June 11, 2018

    Judge Denies General Practitioner’s Motion To Vacate Fraud Conviction

    SAN JOSE, Calif. — A federal judge in California on June 8 denied a general practitioner’s motion for acquittal on charges of health care fraud, finding that the spreadsheets and explanation of benefit (EOB) documents presented by the government constituted sufficient evidence showing that the doctor submitted fraudulent claims to insurance companies (United States v. Vilasini Ganesh, et al., No. 16cr00211, N.D. Calif., 2018 U.S. Dist. LEXIS 97028).

  • June 8, 2018

    Magistrate Judge Recommends Dismissing State Law Claims, Says They Are Preempted

    SACRAMENTO, Calif. — A California federal judge on June 4 recommended dismissing a disability claimant’s state law claims because the state law claims are preempted under the Employee Retirement Income Security Act (Jerome Clay v. AT&T Umbrella Benefit Plan No. 3, No. 17-749, E.D. Calif., 2018 U.S. Dist. LEXIS 93784).

  • June 6, 2018

    Reinsurer: Motion To Dismiss Suit Over Arbitration Award Is Improper

    LOS ANGELES — In a dispute seeking confirmation of a $82,130.44 arbitration award, a reinsurer argues in a June 4 motion in California federal court that a landscape company’s motion to dismiss is “procedurally and substantively improper” (Applied Underwriters Captive Risk Assurance Company Inc. v. O’Connell Landscape Maintenance Inc., No. 18-00683, C.D. Calif.).

  • June 6, 2018

    Insurer Seeks Panel Rehearing Of Coverage Finding For False Claims Act Suit

    PASADENA, Calif. — An insurer on June 4 filed a petition asking the Ninth Circuit U.S. Court of Appeals to reconsider its May 21 ruling that found a lower federal court erred in holding that an insurer has no duty to defend or indemnify Office Depot Inc. in an underlying qui tam lawsuit (Office Depot Inc. v. AIG Specialty Insurance Company, No. 17-55125, 9th Cir.).

  • June 6, 2018

    Professional Services Exclusion Bars Coverage For Qui Tam Suit, 9th Circuit Affirms

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on June 4 affirmed a lower federal court's finding that coverage for an underlying qui tam action brought against an insured under the False Claims Act (FCA) is barred because the underlying lawsuit alleges that the insured’s professional services caused ineligible students and ineligible universities to submit claims for federal financial aid to the U.S. Department of Education (HotChalk Inc. v. Scottsdale Insurance Co., No. 16-17287, 9th Cir., 2018 U.S. App. LEXIS 14884).

  • June 5, 2018

    California Majority: Claims Against Employer Allege Occurrence Under CGL Policy

    SAN FRANCISCO — In answering a question of “exceptional importance” from the Ninth Circuit U.S. Court of Appeals, a majority of the California Supreme Court on June 4 found that third-party claims against an employer for negligent hiring, retention and supervision of its employee qualify as an "occurrence" under the employer's commercial general liability (CGL) policy (Liberty Surplus Insurance Corporation, et al. v. Ledesma and Meyer Construction Company, Inc., et al., No. S236765, Calif. Sup., 2018 Cal. LEXIS 4063).

  • June 5, 2018

    Insurers Have No Duty To Defend Insured Against Contamination Proceedings

    LOS ANGELES — A California federal judge on May 22 entered judgment in favor of two insurers in an environmental contamination coverage suit after finding that no duty to defend or indemnify an insured exists because an administrative proceeding filed against the insured by the Alabama Department of Environmental Management (ADEM) was not a suit per the terms of the policies at issue (Arrow Electronics Inc. v. Aetna Casualty & Surety Co., et al., No. 17-5247, C.D. Calif., 2018 U.S. Dist. LEXIS 88014).

  • June 4, 2018

    District Court Correctly Dismissed Disability Claimant’s Suit, Panel Says

    SAN FRANCISCO — A district court did not abuse its discretion in dismissing a disability claimant’s amended complaint because the prelitigation costs and attorney fees sought by the claimant are not available as equitable relief under the Employee Retirement Income Security Act, the Ninth Circuit U.S. Court of Appeals said May 31 (Larry A. Benson v. Life Insurance Company of North America, No. 17-55253, 9th Cir., 2018 U.S. App. LEXIS 14367).

  • June 4, 2018

    Issues Of Fact Exist As To Whether Disability Insurer Properly Denied Claim

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on May 31 reversed a district court’s ruling in favor of a disability insurer after determining that genuine issues of fact exists regarding whether the insurer improperly denied the claim before the amount of time to submit additional materials had expired (Narciso Cuaresma Jr. v. Farmers Group Disability Income Plan, et al., No. 16-16946, 9th Cir., 2018 U.S. App. LEXIS 14368).

  • June 1, 2018

    No Coverage Owed For Suit Over Subdivision, California Panel Affirms

    SAN DIEGO — A California appeals panel on May 29 affirmed a lower court’s ruling that an insurer has no duty to defend or indemnify its general contractor insured against an underlying lawsuit arising from the unsuccessful development of a 16-home residential subdivision (THV Investments, LLC v. Certain Underwriters at Lloyds of London, et al., No. D073601, Calif. App., 4th Dist., Div. 1, 2018 Cal. App. Unpub. LEXIS 3671).

  • May 30, 2018

    Reinsurer Asks Court To Confirm $82,130.44 Arbitration Award

    LOS ANGELES — Based upon a landscape company’s failure to seek an order vacating, modifying or correcting a $82,130.44 arbitration award, a reinsurer argues in a May 23 motion that a California federal court should confirm the award issued in its favor regarding a bad faith claim made against a reinsurance participation agreement (RPA) (Applied Underwriters Captive Risk Assurance Company Inc. v. O’Connell Landscape Maintenance Inc., No. 18-00683, C.D. Calif.).

  • May 30, 2018

    High Court’s Review Of 9th Circuit’s Offset Ruling Not Warranted, Plan Says

    WASHINGTON, D.C. — The U.S. Supreme Court should deny a disability claimant’s petition for writ of certiorari in a dispute over the offsetting of a claimant’s long-term disability (LTD) benefits to account for Social Security disability income (SSDI) benefits received on behalf of the claimant’s dependents because the plan administrators applied the language of the LTD plan as written, the defendants maintain in a May 25 response brief (Susan Rene Jones v. Merck Sharpe & Dohme Corp., et al., No. 17-1478, U.S. Sup.).

  • May 23, 2018

    Coverage Claims Arising From Alleged Theft Are Time-Barred, 9th Circuit Affirms

    PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals on May 21 affirmed a lower federal court’s finding that insureds’ bad faith, breach of contract and negligence claims arising from an alleged theft loss are time-barred (Dean Seymour, et al. v. State Farm General Insurance Company, No. 17-5529, 9th Cir., 2018 U.S. App. LEXIS 13166).

  • May 23, 2018

    Panel Reverses No Coverage Ruling For False Claims Act Suit Against Office Depot

    PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals on May 21 found that a lower federal court erred in holding that an insurer has no duty to defend or indemnify Office Depot Inc. in an underlying qui tam lawsuit, reversing and remanding (Office Depot Inc. v. AIG Specialty Insurance Company, No. 17-55125, 9th Cir., 2018 U.S. App. LEXIS 13136).

  • May 22, 2018

    Class Suit Fails To Allege Covered Disparagement Claim, California Panel Affirms

    SAN FRANCISCO — A California appeals court on May 21 affirmed a lower court’s ruling that an underlying consumer class action alleging that a shampoo manufacturer insured falsely advertised its hair products as "organic" does not trigger a covered disparagement claim under its insurance policy (Hartford Casualty Insurance Co. v. Vogue International, LLC, et al., No. A150921, Calif. App., 1st Dist., Div. 5, 2018 Cal. App. Unpub. LEXIS 3467).

  • May 22, 2018

    Homeowner Alleges Illegal Kickback Scheme Involving Reinsurance Payments

    LOS ANGELES — A homeowner filed a class action complaint on May 17 against a mortgage loan company and financial services company for engaging in an illegal kickback scheme involving reinsurance payments arising out of force-placed hazard insurance policies (Kathleen Angel Eisenberg v. Ocwen Loan Servicing LLC, et al., No. 18-04157, C.D. Calif.).

  • May 17, 2018

    Federal Magistrate Judge Says Surety Is Entitled To Reimbursement For Paid Claims

    SAN FRANCISCO — A California federal magistrate judge on May 15 determined than a surety is entitled to reimbursement of more than $4 million for claims it paid on behalf of a construction company that contracted with the government on a number of construction projects (Travelers Casualty and Surety Company of America v. K.O.O. Construction Inc., et al., No. 16-518, N.D. Calif., 2018 U.S. Dist. LEXIS 81914).