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Mull v. Motion Picture Industry Health Plan
ERISA did not prevent a plan fiduciary from implementing a self-help remedy under the terms of a health care plan since ERISA merely excluded other unauthorized causes of action.
Insurance 9th Jul. 26, 2022
Thompson v. Crestbrook Insurance Company
Issue preclusion applied to subsequent litigation against different insurers where the prior litigation was based on the same underlying facts and concerned an identical issue of policy coverage.
Insurance 1DCA/4 Jul. 18, 2022
Marina Pacific Hotel and Suites, LLC v. Fireman's Fund Insurance Co.
Insurance policy that covered "direct physical loss or damage" to properties may have covered COVID-19 damages since plaintiffs alleged a distinct physical alteration of the property caused by the virus.
Insurance 2DCA/7 Jul. 14, 2022
Williams v. National Western Life Insurance Co.
Insurer was liable for agent's misconduct since an agent submitting a life insurance policy is the insurer's agent under Insurance Code Section 1704.5, even when the agent violates restrictions on his authority.
Insurance 3DCA May 11, 2022
Ghukasian v. Aegis Security Insurance Company
Policyholder's mistake regarding property lines did not make her renovation damage to neighbor's property an accident for the purposes of coverage.
Insurance 2DCA/4 May 6, 2022
Dameron Hospital Association v. AAA Northern California, Nevada & Utah Insurance Exchange
Under the Knox-Keene Health Care Services Plan Act, hospital could not enforce conditions of admission since they were collecting more payment from the client than was negotiated with the insurance company.
Insurance 3DCA Apr. 28, 2022
United Talent Agency v. Vigilant Insurance Co.
COVID-19 losses to United Talent Agency's property did not constitute 'physical loss or damage' under insurance policy because the virus damaged people, not the property itself.
Insurance 2DCA/4 Apr. 26, 2022
Musso & Frank Grill v. Mitsui Sumitomo Insurance USA
A business interruption policy that covers physical loss and damages does not provide coverage for losses incurred by reason of the COVID-19 pandemic.
Insurance 2DCA/1 Apr. 25, 2022
Certain Underwriters at Lloyd's v. Conagra Grocery
Successor corporation was held liable for the willful public nuisance created by its predecessor and was therefore not entitled to indemnity from its insurers.
Insurance 1DCA/2 Apr. 21, 2022
People ex rel. Ellinger v. Magill
A person cannot bring a qui tam action under Section 1871.7 of the Insurance Frauds Prevention Act against an insurance company since the statute only addresses deceptive conduct against the insurer.
Insurance 4DCA/2 Apr. 13, 2022
Williams v. National Western Life Insurance Co.
An insurer was charged with its agent's knowledge that life insurance policies were unsuitable for elderly plaintiff.
Insurance 3DCA Mar. 7, 2022
American National Property and Casualty Co. v. Gardineer
Insured's umbrella policy, by its plain and unambiguous terms, did not provide coverage for entrustment liability arising from entrustee's use of insured's vehicle.
Insurance 9th Feb. 14, 2022
Ernst and Haas Management Co. v. Hiscox, Inc.
The district court erred by relying on the facts of an embezzlement case instead of applying the insurance policy terms to the facts of the case.
Insurance 9th Jan. 27, 2022
Modification: Church Mutual Insurance Co. v. GuideOne Specialty Mutual Insurance
An insurer was not entitled to equitable contribution from another insurer even though both policies covered the risk of fire damage to the same church building.
Insurance 3DCA Jan. 12, 2022
Westmoreland v. Fire Insurance Exchange
A trial court erred in overruling Insurer's demurrer because Insured had already received the full measure of indemnity to which they were entitled.
Insurance 1DCA/3 Dec. 29, 2021
Church Mutual Insurance Co. v. GuideOne Specialty Mutual Insurance
An insurer was not entitled to equitable contribution from another insurer even though both policies covered the risk of fire damage to the same church building.
Insurance 3DCA Dec. 20, 2021
People ex rel. State Farm Mutual Automobile Ins. Co. v. Rubin
An Insurance Fraud Protection Act action that alleges the same fraud as a pending action is not barred if it seeks penalties based on a separate pool of victims.
Insurance 4DCA/3 Dec. 15, 2021
Modification: State Farm General Insurance Company v. Lara
In the prior approval system for insurance rates, the insurance commissioner cannot consider projected investment income from affiliate companies in setting a fair rate.
Insurance 4DCA/1 Nov. 18, 2021
The Inns by the Sea v. California Mutual Ins. Co.
An insured could not recover for loss of business income because it could not reasonably allege that the presence of COVID-19 on its premises caused the suspension of operations.
Insurance 4DCA/1 Nov. 17, 2021
State Farm General Insurance Company v. Lara
In the prior approval system for insurance rates, the insurance commissioner cannot consider projected investment income from affiliate companies in setting a fair rate.
Insurance 4DCA/1 Nov. 2, 2021
State Farm General Insurance Company v. Lara
Intervenor attorneys' fees under Insurance Code Section 1861.10(b) may be obtained as long as the intervenor made a significant, distinct contribution.
Insurance 4DCA/1 Nov. 2, 2021
Janney v. CSAA Insurance Exchange
Because an insured was entitled to the lowest of three calculations, disputed facts related to a higher calculation were immaterial.
Insurance 3DCA Oct. 18, 2021
The Travelers Indemnity Co. v. Navigators Specialty Insurance Co.
A trial court erroneously treated a legal allegation as a factual allegation for the purposes of a demurrer.
Insurance 4DCA/1 Oct. 18, 2021
Modification: Nede Mgmt. Inc. v. Aspen American Insurance Co.
Because plaintiffs failed to allege that an actual conflict of interest existed between them and their insurer-appointed counsel, plaintiffs were not entitled to independent counsel.
Insurance 2DCA/8 Oct. 7, 2021
Mudpie Inc. v. Travelers Casualty Insurance Company of America
Because COVID-19 and government orders did not cause physical damage, an insured could not recover business income losses under its insurance policy.
Insurance 9th Oct. 4, 2021
Nede Mgmt. Inc. v. Aspen American Insurance Co.
Because plaintiffs failed to allege that an actual conflict of interest existed between them and their insurer-appointed counsel, plaintiffs were not entitled to independent counsel.
Insurance 2DCA/8 Sep. 21, 2021
McHugh v. Protective Life Insurance Co.
Insurance Code Sections 10113.71 and 10113.72 apply to all life insurance policies in force when these two sections went into effect, regardless of when the policies were originally issued.
Insurance CASC Aug. 31, 2021
Munden v. Stewart Title Guaranty Co.
District court erred in its interpretation of insurance policy under Idaho law.
Insurance 9th Aug. 16, 2021
Antonopoulos v. Mid-Century Insurance Co.
Triable issue of material fact existed as to insurance company's duty to cover plaintiffs' losses incurred during policy lapse because there was no proof reinstatement was retroactive.
Insurance 1DCA/2 Apr. 29, 2021
Modification: Wexler v. California Fair Plan Association
Daughter of named insureds could not sue for bad faith because she had no contractual relationship with California FAIR Plan Association.
Insurance 2DCA/8 Apr. 28, 2021