Mealey's California Insurance : Mealey's : Legal News & Analysis

Mealey's California Insurance

May 16, 2024
California Says Insurers, Valuation Companies Conspire To ‘Lowball’ Vehicle Claims

OAKLAND, Calif. — A California district attorney on behalf of the state filed an amended complaint in state court against a group of insurance and valuation companies for allegedly violating California’s unfair competition law (UCL) and other laws for engaging in a criminal and civil conspiracy to “systematically and pervasively underpay claims” for totaled cars.
May 15, 2024
Judge Overrules Abbott’s Objections To Discovery Order In FCA Suit Over Kickbacks

SAN DIEGO — A California federal judge on May 14 overruled Abbott Laboratories’ objections and affirmed a magistrate judge’s discovery order that denied Abbott’s motion to compel production of certain documents in a suit alleging violations of the False Claims Act (FCA) and state false claims laws regarding Abbott’s alleged kickback scheme to induce hospitals and physicians to use an Abbott cardiac medical device, finding that Abbott is not entitled to discover certain documents, which are considered privileged work product.
May 15, 2024
Additional Insured Failed To Show Specific Jurisdiction Exists Over Insurer

SAN FRANCISCO — A California federal judge on May 14 granted, with leave to amend, an insurer’s motion to dismiss an additional insured’s bad faith complaint arising out of the insurer’s appointment of counsel to represent the additional insured and the insured in an arbitration proceeding in Texas because the additional insured failed to show that specific jurisdiction exists in California over the insurer.
May 14, 2024
Life Insurance Benefit Not Available Based On Failure To Prove Total Disability

PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals on May 13 affirmed a district court’s finding that a life insurance waiver-of-premium benefit was properly terminated because the claimant failed to show that he was totally disabled from working in any occupation as required by the life insurance plan to retain the waiver-of-premium benefit.
May 14, 2024
9th Circuit Partly Affirms, Partly Vacates Ruling In Coverage Suit Over Lost Rent

PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals affirmed a lower federal court’s ruling that unpaid rent, late fees and government fines did not trigger “property damage” coverage under a commercial general liability insurance policy but vacated the lower court’s application of the policy’s leased property exclusion and remanded for consideration of the appellant’s new evidence.
May 09, 2024
Magistrate Denies Motion For Indicative Relief In FCA Suit Alleging Overcharging

SAN FRANCISCO — A California federal magistrate judge denied a relator’s motion for an indicative ruling that pursuant to the Ninth Circuit U.S. Court of Appeals’ decision in United States ex rel. Silbersher v. Valeant Pharms. Int’l, Inc., a similar False Claims Act (FCA) suit brought by the same relator, the magistrate judge should grant the relator “relief” from the judgment on appeal to the Ninth Circuit after dismissing his claims that pharmaceutical companies overcharged the federal government and states under Medicare and Medicaid.
May 08, 2024
Spinal Conditions Continued To Render Claimant Disabled, Calif. Federal Judge Says

LOS ANGELES — Following remand from the Ninth Circuit U.S. Court of Appeals, a California federal judge found that additional long-term disability (LTD) benefits are owed to a disability claimant because the medical evidence shows that the claimant’s degenerative spinal conditions continued to render him disabled following the claimant’s recovery from a cardiac procedure.
May 03, 2024
Federal Judge Finds No Jurisdiction In Construction Insurance Dispute, Remands

SAN FRANCISCO — A federal judge in California remanded to state court a construction insurance dispute brought by a contractor alleging that its insurer acted in bad faith when it refused to pay for most of an arbitration award related to a faulty roof, finding that the insurer failed to join necessary parties when removing the case to federal court.
May 03, 2024
Disability Claimant Seeks Rehearing Of Preexisting Condition Exclusion Ruling

PASADENA, Calif. — A disability claimant filed a petition for panel rehearing and rehearing en banc in the Ninth Circuit U.S. Court of Appeals, contending that rehearing is warranted because the Ninth Circuit panel’s decision that a long-term disability (LTD) policy’s preexisting condition exclusion bars coverage creates an intracircuit conflict with a prior ruling of the Ninth Circuit.
May 03, 2024
Disability Insurer Awarded More Than $11,000 In Costs In Bad Faith Benefits Suit

FRESNO, Calif. — A California federal magistrate judge awarded a disability insurer more than $11,000 in costs that the insurer incurred in successfully defending a breach of contract and bad faith suit lodged against it by an oral surgeon who stopped working to reduce the risk of contracting COVID-19 and suffering complications from the virus based on his comorbid conditions of asthma and hypertension.
May 02, 2024
Disability Insurer, Claimant Settle Dispute Over Policy’s Monthly Benefit Rider

SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals entered an order staying a disability claimant’s appeal and directing the parties to file a joint status report following the disability insurer’s filing of a notice of a settlement between the parties.
May 01, 2024
9th Circuit Denies Homeowner’s Rehearing Bid In Fire Loss Coverage Dispute

SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on April 30 denied a homeowner’s request for rehearing and rehearing en banc of its decision affirming a district court’s grants of summary judgment for insurers in two coverage disputes consolidated on appeal regarding whether the homeowner misrepresented in the insurance application that she used her property for commercial purposes or that she had prior losses.
May 01, 2024
9th Circuit Denies Insureds’ Request To Remand Pollution Coverage Suit

SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on April 30 denied a motion filed by insureds for a limited remand to allow a district court to rule on a post-judgment motion in an environmental contamination coverage suit, noting in its order that a review of the record shows that the district court denied the parties’ post-judgment motions without prejudice and that the parties did not file a renewed motion.
April 30, 2024
Insurer, Insured Reach Settlement In Water Damage Coverage Suit

SAN FRANCISCO — An insurer filed a notice of settlement in California federal court after reaching a settlement with its insured in a suit seeking coverage for water damages to the insured’s business.
April 19, 2024
Question Of Fact Exists On Cause Of Injuries Suffered By Airline Employees

SAN FRANCISCO — A California federal judge denied motions for summary judgment filed by a primary insurer and an excess insurer on the issue of the number of occurrences because a question of fact exists on what caused the injuries of underlying American Airlines’ employees who claim they suffered health ailments after wearing uniforms manufactured by the insured.
April 17, 2024
LTD Claim Excluded By Policy’s Preexisting Condition Exclusion, 9th Circuit Says

PASADENA, Calif. — A district court did not err in entering judgment in favor of a disability insurer because the long-term disability (LTD) policy’s preexisting condition exclusion barred coverage as the disability claimant received medical treatment for symptoms related to the claimed disability within three months prior to the effective date of coverage of the policy, the Ninth Circuit U.S. Court of Appeals said.
April 17, 2024
Federal Judge Clarifies Claims Deadline For Preliminarily Approved Class Settlement

SAN FRANCISCO — A federal judge in California issued an order clarifying the claims deadline for the submission of claims for purposes of a $23,997,500 settlement and notice plan that received preliminary approval in a putative class action alleging claims for unfair business practices, false advertising, fraud, deceit, misrepresentation and breach of the duty of good faith against travel insurers.
April 16, 2024
AG Sides With Insured In UCL Time Limit Case Before California High Court

SAN FRANCISCO — California Attorney General Rob Bonta filed an amicus curiae brief with the state’s Supreme Court supporting an insured in her challenge to the dismissal as time-barred of her lawsuit claiming that her insurer failed to properly investigate a claim, writing that the court should have applied the four-year statute of limitations based on her claim for injunctive relief under California’s unfair competition law (UCL).
April 16, 2024
Rehab Plan Approved Over Workers’ Comp Insurer’s Objections In California Court

REDWOOD CITY, Calif. — Rejecting numerous objections from California Insurance Co. (CIC), a California state judge approved a rehabilitation plan that she said the state insurance commissioner described as being “designed to . . . complete CIC's exit from the state on terms that protect the Company, policyholders, and the public.”
April 11, 2024
Insurer Accused Of Using AI Software To Deny Claims ‘En Masse’ In Class Suit

OAKLAND, Calif. — An insured filed a putative class action in California state court accusing his insurer of violating California’s insurance regulations and its unfair competition law (UCL) by using artificial intelligence (AI) software to deny claims for coverage.
April 10, 2024
Pharma Companies Seek High Court Review Of Ruling Reversing FCA Suit Dismissal

WASHINGTON, D.C. — Pharmaceutical companies accused of violating the False Claims Act (FCA) by artificially inflating drug prices filed a petition for writ of certiorari in the U.S. Supreme Court, seeking review of the Ninth Circuit U.S. Court of Appeals’ reversal of a district court’s dismissal of a qui tam suit against them, arguing, in part, that the panel “created a circuit split by holding that a relator can avoid the public disclosure bar by ‘stitching together’ public disclosures.”
April 10, 2024
No Evidence Supports Bad Faith Claim Against Auto Insurer, Federal Judge Says

LOS ANGELES — An insured failed to present any evidence supporting its allegation that its auto insurer acted in bad faith by failing to properly settle underlying bodily injury claims arising out of an auto accident for which the insured conceded liability, a California federal judge said in granting the auto insurer’s motion for summary judgment.
April 09, 2024
Insureds Say Remand In Pollution Dispute Is Necessary, Appeal Is Premature

SAN FRANCISCO — Insureds involved in an environmental contamination coverage suit urge the Ninth Circuit U.S. Court of Appeals to remand its suit to the district court, contending that the insurer’s notice of appeal was premature because the district court did not rule on the insureds’ motion to alter or amend the judgment entered in favor of the insureds on the applicability of the pollution exclusion.
April 08, 2024
Driver Appeals Grant Of Summary Judgment On UCL Claim For ‘Unfair’ COVID Premiums

SAN FRANCISCO — A driver on April 5 appealed to the Ninth Circuit U.S. Court of Appeals a California federal judge’s grant of summary judgment in favor of GEICO after finding that it did not violate California’s unfair competition law (UCL) by unfairly profiting from a premium giveback program initiated during the COVID-19 pandemic.
April 05, 2024
Bad Faith Claim Against Auto Insurer To Proceed, California Federal Judge Says

FRESNO, Calif. — An insured’s claim for bad faith against an auto insurer can proceed because the disparity between an arbitrator’s determination of the insured’s damages and the available policy limit supports the insured’s bad faith claim, a California federal judge said in denying the insurer’s motion for judgment on the pleadings.