Mealey's California Insurance
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October 10, 2023
Citing Mudpie, 9th Circuit Affirms Virus Exclusion Bars Coverage For COVID-19 Losses
PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals affirmed a lower federal court’s dismissal of insureds’ lawsuit seeking coverage for their losses arising from the coronavirus pandemic and subsequent governmental orders, finding that, as in Mudpie, Inc. v. Travelers Cas. Ins. Co. of Am., the insureds failed to plausibly assert that “the efficient cause” of their losses was anything other than the spread of the COVID-19 virus throughout California.
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October 10, 2023
Insured Claims Property Insurer Owes Additional Coverage For Water Damage
LOS ANGELES — An insured filed suit in California state court against its property insurer, seeking a declaration that the insurer owes additional coverage to repair a property damaged when water pipes burst in the building and alleging that the insurer breached its contract and acted in bad faith by refusing to release additional fund for repairs.
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October 10, 2023
9th Circuit Panel Won’t Revive $75M ERISA Suit Against Insurers Under Bristol
PASADENA, Calif. — In an unpublished memorandum disposition rejecting the appellant’s reliance on Bristol SL Holdings, Inc. v. Cigna Health & Life Ins. Co., a Ninth Circuit U.S. Court of Appeals panel ruled in part that a debt collector “lacks derivative authority to bring [Employee Retirement Income Security Act] claims as a second assignee.”
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October 06, 2023
IP Exclusion Bars Coverage For Misappropriation Of Likeness Claim, Panel Affirms
LOS ANGELES — A California appeals panel on Oct. 5 affirmed a lower court’s summary judgment ruling in favor of a commercial general liability insurer in its declaratory judgment lawsuit disputing coverage for a lawsuit brought against its insured, finding that the policy’s intellectual property exclusion bars coverage for the underlying misappropriation of likeness claim.
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October 05, 2023
Waiver Provision Bars Insurer’s Equitable Subrogation Claim, California Panel Says
LOS ANGELES — A California appeals panel affirmed a lower court’s summary judgment ruling in favor of Southern California Edison Co. (SCE) in an insurer’s equitable subrogation lawsuit alleging that a wildfire that resulted in $25 million in paid claims was the sole result of SCE’s negligence, finding that the subcontract’s waiver provision barred the insurer’s claims.
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October 04, 2023
Disability Claimant’s Suit Dismissed Following Settlement Reached During Mediation
SAN FRANCISCO — A California federal judge dismissed a disability claimant’s suit seeking a declaration that she is entitled to long-term disability (LTD) benefits after the claimant and the disability insurer agreed to a settlement during a mediation proceeding.
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October 03, 2023
California Panel Reverses Ruling In Insurers’ Favor In Coronavirus Coverage Suit
LOS ANGELES — A California appeals panel on Oct. 2 reversed and remanded a lower court’s order granting a group of insurers’ motion for judgment on the pleadings in a real estate investment firm’s coronavirus coverage dispute, rejecting the insurers’ argument that the pollution exclusion barred coverage.
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October 02, 2023
Panel: Evidence Supports Jury Verdict That Insured Not Owed Additional Benefits
SACRAMENTO, Calif. — A California appeals panel held that “substantial evidence” supports a jury verdict that an insured is not entitled to additional compensation for her loss of personal property, affirming a lower court’s denial of the insured’s four post-verdict motions in a homeowners coverage dispute arising from alleged theft and property damage.
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September 26, 2023
Panel Affirms Demurrer In Entertainment Conglomerate’s Coronavirus Coverage Suit
LOS ANGELES — A California appeals panel affirmed a lower court’s ruling that sustained commercial property insurers’ demurer to an entertainment conglomerate insured’s complaint seeking coverage for its economic losses arising from the coronavirus, finding that, until the U.S. Supreme Court provides guidance in pending cases, it sides with the vast majority of courts that have ruled that direct physical loss or damage to property is a prerequisite for coverage.
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September 25, 2023
Questions Of Fact Exist Regarding When Insureds Knew Of Water Leak Problems
SANTA ANA, Calif. — A California federal judge denied a property insurer’s motion for summary judgment on breach of contract and bad faith claims after determining that questions of fact exist regarding when the insureds became aware of a water leak problem within a hotel they purchased and whether the insurer acted reasonably in handling the insureds’ claim for coverage.
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September 21, 2023
Disability Claimant Met Burden Of Showing She Remains Disabled, Judge Says
OAKLAND, Calif. — A disability claimant met her burden of proving by a preponderance of the evidence that she remains disabled from performing the duties of any occupation, a California federal judge said in granting the claimant’s motion for judgment and in denying the disability insurer’s motion for judgment.
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September 20, 2023
Judgment Entered Against Insured In Fraud Dispute Over $841,881 In Benefits
SAN FRANCISCO — A California federal judge on Sept. 19 entered default judgment against an insured who received more than $800,000 for long-term care benefits under a rider to her life insurance policy, finding that default judgment is appropriate due, in part, to no “excusable neglect” on the part of the insured in her failure to appear.
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September 18, 2023
Insured Sufficiently Alleged Insurer Was A Party To Commercial Property Policy
FRESNO, Calif. — A California federal judge denied a motion to dismiss filed by two insurers after determining that an insured’s breach of contract, bad faith and unfair business practices claims can proceed against one of the insurers because the insured nursing home sufficiently alleged that the insurer was a party to a commercial property insurance policy.
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September 15, 2023
California High Court Won’t Review UCL Mental Health Coverage Ruling
SACRAMENTO, Calif. — The California Supreme Court denied a petition for review after a lower court published its opinion finding that two insureds adequately alleged standing under the California unfair competition law (UCL) and that the way the insurer handles mental health care results in shortages of that care.
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September 13, 2023
Judge Dismisses Elder Abuse Suit Against LTC Insurer, Cites Inadequate Pleading
SAN FRANCISCO — A California federal judge dismissed a breach of contract and elder abuse suit filed against a couple’s long-term care (LTC) insurer for its failure to cover the wife’s claim for benefits, finding that though the amended complaint contains “a bundle of allegations that might constitute plausible causes of action with some additional facts,” the amended complaint does not currently suffice to “allow this case to proceed.”
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September 13, 2023
No Coverage Owed For Restaurants’ Coronavirus Losses, 9th Circuit Affirms
SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals affirmed a lower federal court’s dismissal of a restaurant owner insured’s breach of contract and declaratory judgment lawsuit seeking coverage for its losses stemming from the coronavirus pandemic, finding that the policy’s virus exclusion bars coverage.
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September 12, 2023
Judicial Estoppel Bid Doesn’t Stop Transfer Of Reinsurer’s Breach Suit
SAN FRANCISCO — Concluding that judicial estoppel doesn’t apply and a reinsurer failed to meet its “burden of showing why the court should not transfer the case to the agreed-upon forum,” a California federal judge granted the defendants’ motion to transfer the case involving allegations of a fraudulent scheme to inflate provisional commissions and breach of various agreements.
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September 11, 2023
Amber Heard Seeks Dismissal Of Insurer’s Complaint In Defamation Coverage Suit
LOS ANGELES — Amber Heard moved to dismiss an insurer’s second amended complaint seeking a declaratory judgment that it has no duty to defend or indemnify her for a defamation judgment awarded to Johnny Depp.
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September 08, 2023
Federal Judge Dismisses TCPA Coverage Suit After Yahoo, Insurer Reach Settlement
SAN JOSE, Calif. — One day after Yahoo! Inc. and its commercial general liability insurer filed a notice of settlement, a federal judge in California dismissed with prejudice Yahoo’s lawsuit seeking coverage for underlying class actions alleging that it violated the Telephone Consumer Protection Act (TCPA).
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September 08, 2023
Federal Judge Dismisses Bobcat Wildfire Coverage Suit After Parties Reach Settlement
LOS ANGELES — A federal judge in California dismissed without prejudice a coverage dispute over underlying lawsuits arising from the Bobcat Wildfire one day after the parties announced that they reached a settlement.
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August 31, 2023
In 2-1 Decision, 9th Circuit Reverses On Threshold Question In Preemption Row
SAN FRANCISCO — In a 2-1 ruling concerning a threshold issue, a Ninth Circuit U.S. Court of Appeals panel reversed and remanded a summary judgment order against a trade organization that argued that a city and county of San Francisco ordinance concerning health insurance benefits for airline employees is preempted by federal law including the Employee Retirement Income Security Act.
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August 30, 2023
Defamation Claimed In 2nd Cross-Complaint Filed In Breach Suit
LOS ANGELES — In the second cross-complaint filed in a lawsuit in California state court involving allegations that a claim should have been covered by reinsurance of a shared risk incentive pool, a managed services organization (MSO) and its CEO allege defamation.
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August 29, 2023
Joint Statement Filed In Coverage Row Over Jet Leased To Russian Operator
SAN FRANCISCO — Plaintiffs in an international aviation insurance coverage dispute involving Russia’s invasion of Ukraine plan to initially focus depositions “on persons identified by the ‘War Risk’ insurers,” according to a filing in California state court.
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August 29, 2023
Appeal Of Dispute Over Arbitrator’s Firm’s Work For Reinsurer Is Dismissed
SANTA ANA, Calif. — A California appellate case over confirmation of an arbitration panel’s ruling against a university was dismissed after the parties filed a joint notice of settlement and a stipulation for dismissal, the case docket shows.
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August 22, 2023
Parties In Reinsurance Row Dispute Bifurcating Declaratory Judgment Claim
LOS ANGELES — Parties in a dispute over reinsurance billings have filed responses in a California court disagreeing on whether a declaratory judgment claim should be bifurcated, with the plaintiff saying it does not object to bifurcation and the defendants opposing bifurcation but saying it would be appropriate for the court to decide some factual issues before a jury trial.