
COVERAGE
QUARTERLY
California insurance
law decisions from the
third quarter of 2014
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TOPICS
ADDRESSED IN THIS ISSUE:
Advertising
Injury, Auto
Liability, Bad
Faith, Ciga, Claims Made, Construction
Defects,
Contribution / Subrogation, Computer Fraud
Exclusion, Fidelity
/ Forgery Coverage, First Party Coverage,
"Habitability"
Exclusion, Independent
Counsel, Insurance Brokers, Miscellaneous Exclusions,
Occurrence, "Ongoing
Operations" Exclusion, "Pollution" Exclusion, Privilege, Reimbursement of
Attorneys' Fees, Rescission, Self-Insured Retention, "Your Work"
Exclusion
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ADVERTISING INJURY
Millennium Labs, Inc. v. Darwin Select Ins. Co., 2014 U.S. Dist. LEXIS 89742 (S.D. Cal. July
1, 2014)
In a coverage action, the court denied reconsideration of
its order granting summary judgment to the plaintiff insured.
The complaint in the underlying action alleged Millennium engaged in
a concerted plan to attack its competitor through marketing efforts
that included statements disparaging Millennium's competitor.
These allegations of disparagement fell within the scope of coverage
by the insurer for advertising injury.
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AUTO LIABILITY
Discover Property and Casualty Ins. Co. v.
Blair, 2014 U.S. Dist. LEXIS
128029 (C.D. Cal. August 26, 2014)
In a coverage action, the court found there was
no duty to defend claims for injuries arising out of an accident
involving a passenger van with a load capacity in excess of 1,500
pounds under a policy that did not list the van on the Declarations
page and barred coverage for injuries resulting from the use of a
vehicle with a load capacity in excess of 1,500 pounds. The
court found the phrase "load capacity" was not ambiguous,
and readily understood by reference to common dictionary definitions.
Mercury Casualty Co. v. Chu, 229 Cal.App.4th 1432 (September 24, 2014)
In an action for declaratory relief, the court held that
California's statutory scheme governing auto liability insurance does
not permit an auto liability policy to bar coverage for
"residents" defined as individuals who reside with the
named insured and applied to include individuals who are not related
to the named insured.
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CIGA
Snyder v. California Ins. Guaranty Ass'n, 229 Cal.App.4th 1196 (Sept. 17, 2014)
In an action seeking coverage from CIGA for asbestos-related
bodily injury claims, the court held that claims against CIGA do not
accrue until the insured has exhausted all claims for coverage
against other insurers and determined what recovery the insured will
obtain in any related insolvency proceedings.
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CLAIMS MADE
Alterra Excess & Surplus Ins. Co. v. Gotama
Building Engineers, Inc.,
2014 U.S. Dist. LEXIS 110416 (C.D. Cal. July 24, 2014)
In an action for declaratory relief, the court
granted plaintiff's motion for summary judgment, holding that
coverage for a claim based on a demand letter delivered during the
2012 policy period but not disclosed in the application for insurance
in the 2013 policy, was barred under an exclusion for any claim
arising from any act, error or omission which might reasonably be
expected to give rise to a claim but which the insured did not
disclose in its application. Coverage was also barred under the
2012 policy because the insured did not report that claim during the
2012 policy period.
Blum Collins, LLP v. NCG Professional Risks
Ltd., 2014 U.S. Dist. LEXIS
109915 (C.D. Cal. July 31, 2014)
In a coverage action, the court found a tolling agreement
with a former client regarding their dissatisfaction with the
insured's services constituted circumstances that "may result in
a claim," and the failure to disclose that agreement was a
material omission in the application for insurance that entitled the
insurer to deny coverage under an exclusion that barred coverage for
acts, errors or omissions prior to the date of insurance if the
insured could have reasonably foreseen that such acts, errors or
omissions might be expected to be the basis of a claim.
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CONSTRUCTION DEFECTS
American Zurich Ins. Co. v. Ironshore Specialty
Ins. Co., 2014 U.S. Dist.
LEXIS 100787 (E.D. Cal. July 23, 2014)
In a contribution action, the court denied plaintiff's
motion for summary judgment of defendant's duty to defend reasoning
defendant's policy excluded coverage for property damage from work
performed prior to the policy period. Plaintiff argued
defendant could not foreclose the "sudden and accidental"
exception to the exclusion, but the court found "the only
rational interpretation of the allegations is that the claim was
predicated on faulty construction. Common sense dictates that
where a plaintiff has alleged that they were given a product in a
defective condition that they are not alleging the opposite, i.e.,
that damage was sudden and accidental."
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CONTRIBUTION / SUBROGATION
Continental Casualty Co. v. Surplus Lines Ins.
Co., 2014 U.S. Dist LEXIS
131289 (E.D. Cal. September 17, 2014)
In an action for contribution and subrogation,
the court found plaintiff was entitled to subrogation for portions of
the settlement paid on behalf of the insured for which it provided
excess insurance coverage. Defendant argued its insured was
entitled to indemnity from plaintiff's insured, but the court
declined to resolve that issue in this action. The court found
defendant was obligated to pay that portion of the settlement
attributable to the negligence of its insured.
Valley Forge Ins. Co. v. Zurich American Ins.
Co., 2014 U.S. Dist. LEXIS
142075 (N.D. Cal. September 30, 2014)
In a contribution action seeking reimbursement
of defense costs and settlement payments, the court found there was
no contribution or indemnity due to plaintiff. Plaintiff insured
the subcontractor; defendant insured the general contractor; the
subcontractor agreed to indemnify the general contractor, but not for
damages arising from the sole negligence or willful misconduct of the
general contractor. The court found the injuries caused by the
collapse of the roof arose out of the performance of the
subcontractor's work to demolish the roof. The court also found
the subcontractor was negligent, in part, which entitled the general
contractor to indemnity and precluded contribution from the general
contractor's insurer.
AIG Specialty Ins. Co. v. Phoenician, LLC, 2014 U.S. Dist. LEXIS 135019 (E.D. Cal.
September 24, 2014)
In a subrogation action, the plaintiff excess insurer
complained the defendant primary insurer misinformed plaintiff that
their insured was a defunct corporation when the insured was in
operation, and also failed to properly respond to a notice of defect
thereby limiting its defenses. The insured and primary insurer
subsequently settled some of those claims purporting to allocate them
so as to trigger coverage under plaintiff's excess policy. The
court found plaintiff had no claim for equitable subrogation because
the insured had no discernable cause of action against its primary
insurer for failing to settle those claims earlier, and the primary
insurer had no duty to the excess insurer to provide more accurate
information regarding the insured. Defendant's motion to
dismiss was granted with leave to amend.
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COMPUTER FRAUD EXCLUSION
Pest Master Servs. v. Travelers Casualty &
Surety Co., 2014 U.S. Dist.
LEXIS 108416 (C.D. Cal. July 17, 2014)
In a coverage action, the court granted the insurer's motion
for summary judgment reasoning that losses the insured sustained
because of its payroll company's failure to properly pay payroll
taxes were not "computer fraud." Although the payroll
company used a computer to fraudulently transfer money, coverage did
not extend to an authorized person submitting fraudulent data into a
computer system; "fraudulently causing a transfer" as
specified in the policy is different than "causing a fraudulent
transfer," which was done in this case.
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OCCURRENCE
David v. Allstate Ins. Co., 2014 U.S. Dist. LEXIS 119473 (C.D. Cal.
August 25, 2014)
In a coverage action, the court found there was no duty to
defend a claim alleging damages caused by a physical assault,
although the insured insisted he acted in self defense; whether the
insured acted in self defense or otherwise, his conduct was not an
accident, and so not an "occurrence" under the policy.
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"ONGOING OPERATIONS"
EXCLUSION
St. Paul Fire & Marine Ins. Co. v. Ace
American Ins., 2014 U.S.
Dist. LEXIS 113295 (E.D. Cal. August 14, 2014)
In a contribution action, the court found defendant's
commitment to various Additional Insureds for liability arising out
of the additional insureds' "ongoing operations" provided
coverage for alleged construction defects and associated property
damage. The court acknowledged the coverage did not extend to
property damage arising out of completed operations but found the
alleged claims potentially alleged property damage that arose from
the subcontractors' ongoing operations and occurred during those
operations. The manifestation of that property damage did not
conclusively resolve that potential.
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"POLLUTION"
EXCLUSION
EFK Investments, LLC v. Peerless Ins. Co., 2014 U.S. Dist. LEXIS 137864 (N.D. Cal.
September 26, 2014)
In a coverage action, the court denied defendant's motion to
dismiss based on application of the pollution exclusion. The
underlying complaint alleged damage caused by dust and debris from
sandblasting operations, some of which was contaminated with
lead. The court found there was insufficient information to
find the pollution exclusion barred coverage. The court also
found the lead exclusion did not preclude coverage for all damage
arising from an occurrence, without information regarding what
portion was caused in whole or in part by lead contamination and
absent evidence of efforts made to limit that contamination.
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PRIVILEGE
McAdam v State Nat'l Ins. Co., 2014 U.S. Dist LEXIS 99694 (S.D. Cal. July
21, 2014)
In a discovery dispute, the court found
communications between an independent claims adjuster assigned to
investigate the insured's claim and a third-party claims service were
not privileged, because the independent claims adjuster was
principally concerned with gathering facts and defendants failed to
establish the claims adjuster needed any confidential information to
fulfill its obligations.
Feduniak v. Old Republic Nat'l Title Ins. Co., 2014 U.S. Dist. LEXIS 109639 (N.D. Cal.
August 7, 2014)
In a coverage action, the plaintiff insured sought
communications between their counsel in the underlying action and
their insurance company that paid for the work of their
counsel. Old Republic argued the underlying action was really a
subrogation suit, but the court reasoned the insured also had an
interest in that action and under the "joint client"
exception to the attorney-client privilege, the insured was entitled
to communications between its counsel and its insurance company.
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"YOUR WORK"
EXCLUSION
Arroyo v. Uniguard Ins. Co., 2014 U.S. Dist. LEXIS 131191 (N.D. Cal.
September 17, 2014)
In an action seeking coverage for a default judgment after
the tender was denied, the court found coverage for claims the
insured chose inappropriate root stocks and improperly planted a
vineyard was barred under a general liability policy by Exclusion
j(5), barring coverage for property damage to that "particular
part of real property, including but not limited to vines or other
growing crops" on which the insured was performing
operations. The court rejected plaintiff's efforts to separate
the insureds work into different parts, separating planting the
vineyard from maintaining the vineyard.
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BAD FAITH
Jones v. Travelers Casualty Ins. Co., 2014 U.S. Dist. LEXIS 98187 (N.D. Cal. July
18, 2014)
In an action alleging defendant's underwriting
violated the federal Fair Housing Act and California's Fair
Employment and Housing Act, the court permitted plaintiff to seek
documents revealing the identity of other landlords subject to the
same underwriting practices from underwriting files reflecting
treatment of similarly situated landlords.
Peerless Ins. Co. v. Clear Gear, LLC, 2014 U.S. Dist. LEXIS 100679 (N.D. Cal. July
23, 2014)
In a coverage action, the court dismissed
counterclaims for fraud on the grounds there were no allegations that
could support that the insurance company did not intend to fulfill
its representations of coverage at the time the contract was made.
Reitz v. Progressive Direct Ins. Co., 2014 U.S. Dist. LEXIS 119974 (E.D. Cal.
August 27, 2014)
In a coverage action seeking coverage for
damages to an automobile because of theft and fire, the court granted
with leave to amend a motion to dismiss the claims for bad faith on
the grounds that those claims were subject to a two-year statute of
limitations and the complaint alleged the claim was denied on May 28,
2010 and the complaint was filed on May 15, 2014.
McDaniel v. GEICO General Ins. Co., 2014 U.S. Dist. LEXIS 134906 (E.D. Cal.
September 24, 2014)
In a bad faith action after a judgment and assignment of
rights in the underlying action, the court held the insurer was
liable for breach of its duty to accept reasonable settlement offers
when the insurer did not timely accept a policy limits demand.
Although the insurer argued its failure to meet the settlement demand
deadline was excusable neglect, the court found subjective bad faith
was not required, only the failure to accept a reasonable settlement
offer. The insurer's subsequent rejected offer of its policy
limits was insufficient to avoid potential liability for bad
faith. Although the assets of the insured were approximately
$12,500, and the judgment was in excess of $3 million, the assets
were nonetheless sufficient to establish the insurer's obligation to
protect the assets of its insured.
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FIDELITY / FORGERY COVERAGE
Fidelity National Financial, Inc. v. Nat'l
Union Fire Ins. Co., 2014
U.S. Dist. LEXIS 140030 (S.D. Cal. September 30, 2014)
In a coverage action, the court granted summary judgment for
the insured finding coverage for a Ponzi scheme perpetrated by a
third party using the insured's escrow services. The court
found coverage under the forgery bond because the insured suffered
direct losses for which it was legally liable. The court also
found the insured's suspicion of wrongdoing was not sufficient to
constitute an awareness of knowledge of facts and circumstances of a
covered loss.
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FIRST PARTY COVERAGE
Martz v. Leading Ins. Co., Ltd., 2014 U.S. Dist LEXIS 104235 (N.D. Cal. July
29, 2014)
In a coverage action, the court found there was
coverage for water damage because the insured could reasonably expect
coverage for "specified causes of loss," which included
water damage defined as the accidental discharge or leakage of water,
notwithstanding exclusions barring coverage for negligent work,
corrosion, continuous leakage and mold, reasoning the policy
affirmatively provided coverage for "specified" losses,
which could reasonably apply regardless of other exclusions.
Fay Avenue Properties, LLC v. Travelers
Property Casualty Company of America, 2014 U.S. Dist LEXIS 134393 (S.D. Cal.
September 23, 2014)
In a coverage action, the court denied
defendant's motion for summary judgment, finding there were genuine
issues of material fact whether it was reasonable for plaintiff to
refuse to attend the fifth EUO under the circumstances. The
court also denied defendant's motion for summary judgment of the
breach of contract claims based on misrepresentations by the insured,
finding genuine issues were created by plaintiff's explanation that
prior conflicting and false statements were made because the insured
was mistaken or confused.
Nationwide Mutual Ins. Co. v. Ryan, 2014 U.S. Dist. LEXIS 135829 (N.D. Cal.
September 25, 2014)
Material misrepresentations in vandalism claim
submitted by insured regarding the scope of purported damages and
items requiring repair supported voiding policy and declining to pay
further benefits, notwithstanding a separate arbitration award for
payment of further losses.
Najah
v Scottsdale Ins. Co., 2014 Cal.App. LEXIS 878 (2nd App. Dist.
September 30, 2014)
In an unreported decision, the California court of appeals
affirmed a judgment against an insured seeking coverage for property
damage to real property acquired through foreclosure proceedings,
reasoning the "full credit bid rule" prevents a lender from
seeking insurance coverage for damages to property damaged before the
foreclosure sale.
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"HABITABILITY"
EXCLUSION
Burlington Ins. Co. v. Affordable Housing
Alternatives, Inc., 2014 U.S.
Dist. LEXIS 102199 (C.D. Cal. July 11, 2014)
In an action for reimbursement of defense costs, the court
affirmed the application of an habitability exclusion to claims for a
breach of habitability and ordered a reimbursement of defense costs
paid by plaintiff in the underlying action.
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INDEPENDENT COUNSEL
In re Subpoena to Produce Documents of Clapp,
Moroney, Bellagamba, Vucinich, Beeman & Scheley, 2014 U.S. Dist. LEXIS 105751 (N.D. Cal. July
31, 2014)
In a motion filed to quash a subpoena served in
another action, the court required production of a redacted conflict
check which reflects any entities related to clients and former
clients whose representations may create a conflict of interest.
Fidelity & Guaranty Ins. Co. v. Centex
Homes, 2014 U.S. Dist. LEXIS
113845 (E.D. Cal. August 15, 2014)
In an action for declaratory relief, the court
found the plaintiff's request for a judicial declaration of their
right to appoint counsel to defend the insured was not ripe, as the
insured had agreed to allow plaintiff to appoint co-counsel to
participate in the defense of the insured.
St. Paul Mercury Ins. Co. v. Shappell
Industries, 2014 U.S. Dist. LEXIS
132934 (N.D. Cal. September 19, 2014)
In an action for declaratory relief, the court granted
plaintiff's motion to dismiss a counterclaim for breach of contract
based on plaintiff's refusal to participate in the Joint Defense
Agreement of the insured and assign its own separate counsel, finding
there was no prohibition to appointing counsel, absent a conflict of
interest. Defendant was given leave to amend to allege such a
conflict of interest.
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INSURANCE BROKERS
Daly v. Garrett, 2014 Bankr. LEXIS 3087 (E.D. Cal. Bankr. July
11, 2014)
Negligence claim against insurance broker was subject to
two-year period of limitations, which also applied to claims for
breach of fiduciary duties.
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MISCELLANEOUS EXCLUSIONS
Huwyler v. Amco Ins. Co., 2014 U.S. Dist. LEXIS 131291 (N.D. Cal.
September 16, 2014)
In a coverage action, the court found there was
no coverage under a business owner's policy issued to a general
automotive repair business for claims alleging a negligent
pre-purchase inspection of an automobile, because coverage was barred
by an exclusion for claims arising out of any test, evaluation,
consultation or advice given by the insured. The insured's
"garage operations" were limited to "servicing,
repairing, parking or storing" vehicles, which did not include
as necessary or incidental to those operations pre-purchase
inspections and reports.
Darwin National Assurance Co. v. Rosenthal, 2014 U.S. Dist. LEXIS 135207 (C.D. Cal.
September 24, 2014)
In an action for declaratory relief, the court
found coverage for claims alleging bad investment advice and other
negligent services was barred by an Investment Advice Exclusion
barring coverage for claims "based on, arising out of, directly
or indirectly resulting from, in consequence of, or in any way
involving, in whole or in part" investment advice, reasoning
that because the claims include damages for negligent investment
advice, coverage for the entire complaint was excluded.
Employers Ins. Co. v. Lexington Ins. Co., 2014 U.S. Dist. LEXIS 115747 (C.D. Cal.
August 19, 2014)
In a contribution action for the costs of
defending and settling a bodily injury claim suffered in a
construction site accident when a concrete pump boom fell down and
struck several workers, the court found coverage under a general
liability policy was barred by a subsidence exclusion, because the
accident was caused by poorly compacted soil that failed to support
the concrete dump truck. The court also found there was no duty
to defend because the "other insurance" clause specified
coverage was excess under the narrow circumstance of coverage
provided under an auto liability policy.
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REIMBURSEMENT OF ATTORNEYS'
FEES
Travelers Indemnity Co. v. Centex Homes, 2014 U.S. Dist. LEXIS 105009 (E.D. Cal. July
30, 2014)
In an action for declaratory relief, the court
granted a motion to dismiss plaintiff's third cause of action for
equitable reimbursement of defense costs on the ground that such
relief is only available to insurance companies that "agreed to
immediately defend" their insured and reserved their right to
seek reimbursement, but the insurer admittedly only planned to accept
its insured's tender six months after the underlying complaint was
filed and still, a month after filing its Second Amended Complaint,
had not yet agreed to accept the tender and defend its insured
necessarily establishes it failed to "immediately" defend
its insured.
Hanes v. Armed Forces Ins. Exchange, 2014 U.S. Dist. LEXIS 106036 (N.D. Cal. July
31, 2014)
In a coverage action in which defendant sought reimbursement
of defense costs, the court granted summary judgment finding the
discovery responses clarified that the underlying action was for
"declaratory and injunctive relief and does not contain a claim
for personal injury," and also affirmed the claim did not allege
any bodily injury. The court reasoned defendant's duty to
defend was extinguished upon receipt of those discovery responses.
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RESCISSION
Century Surety Co. v. Cal-Regent Ins. Servs.
Corp., 2014 U.S. Dist. LEXIS
101362 (S.D. Cal. July 16, 2014)
In rescission action the court denied defendants motion to
stay the litigation pending resolution of the underlying liability
arbitration reasoning the issues to be litigated in the coverage
action were separate and distinct from those to be litigated in the
liability arbitration.
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SELF-INSURED RETENTION
Evanston Ins. Co. v. North American Capacity
Ins. Co., 2014 U.S. Dist.
LEXIS 92682 (E.D. Cal. July 8, 2014)
In a contribution action, the court held that coverage under
defendant insurer's policy was not triggered until the $10,000
retained limit was paid for every "claim," which applied
separately to every home included in the underlying construction
defect action. The policy specified that the SIR applied
"to each and every claim made against you, regardless of how
many claims arise from a single occurrence or are combined in a
single suit."
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