http://www.lexisnexis.com/mealeys/news.aspx Headline California Insurance Legal News from LexisNexis® en-us http://www.lexisnexis.com/mealeys/images/lexismealeyslogo.gif 130 29 http://www.lexisnexis.com/mealeys/news.aspx Copyright 2020 http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%201%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN JOSE, Calif. - A California federal judge on Jan. 3 dismissed a former National Football League (NFL) player's complaint seeking additional disability benefits because the complaint fails to state a claim upon which relief can be granted and because the issue of the denial of benefits was litigated in a previous suit filed by the former player (Delvin Williams v. The NFL Player Supplemental Disability Plan et al., No. 19-4236, N.D. Calif., 2020 U.S. Dist. LEXIS 1551). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%202%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - A district court did not err in applying an abuse-of-discretion standard of review in a disability suit because the plan administrator's conduct did not rise to the level of requiring a de novo review of the plan's denial of benefits, the Ninth Circuit U.S. Court of Appeals said Dec. 10 in affirming the lower court's finding that the plan did not abuse its discretion in terminating the disability claimant's benefits (Olga Gorbacheva v. Abbott Laboratories Extended Disability Plan, et al., Nos. 18-15400, 18-16178, 9th Cir., 2019 U.S. App. LEXIS 36542). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%203%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - The Ninth Circuit U.S. Court of Appeals on Jan. 7 vacated and remanded a disability claimant's suit seeking long-term disability benefits after determining that a district court erred in failing to consider letters from the claimant's treating physicians who were not provided with the opportunity to rebut the opinion of one of the insurer's examining physicians (Lea Wagenstein v. Cigna Life Insurance Co., et al., No. 18-55955, 9th Cir., 2020 U.S. App. LEXIS 482). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%204%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' PASADENA, Calif. - The Ninth Circuit U.S Court of Appeals on Dec. 13 rejected a federally authorized au pair program sponsor's argument that California law requires a not-for-profit entity and directors and officers liability insurer to prove that it was prejudiced by the insured's alleged untimely reporting of an underlying lawsuit brought under the Sherman Act, finding that the notice-prejudice rule does not apply to the policy (EurAuPair International, Inc. v. Ironshore Specialty Insurance Company, No. 18-55933, 9th Cir., 2019 U.S. App. LEXIS 36898). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%205%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' SACRAMENTO, Calif. - A California appeals panel on Dec. 31 held that an insurance policy's binding arbitration clause applies to a third party, reversing and ordering a lower court to order arbitration of a coverage dispute arising from an underlying injury that occurred at a convention center parking lot (Philadelphia Indemnity Insurance Company v. SMG Holdings Inc., No. C082841, Calif., App., 3rd Dist., 2019 Cal. App. Unpub. LEXIS 8686). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%206%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' FRESNO, Calif. - Insurers have no duty to defend or indemnify an underlying action over moisture damage to flooring in a student recreation center, a California federal judge ruled Dec. 27, because there is no alleged "property damage" as a contractor is seeking only reimbursement of back-charges to an insured's work (Employers Mutual Casualty Co., et al. v. North American Specialty Flooring, Inc., et al., No. 19-00544, E.D. Calif., 2019 U.S. Dist. LEXIS 221704). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%207%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' PASADENA, Calif. - A Ninth Circuit U.S. Court of Appeals panel on Dec. 4 reversed a federal judge in California's ruling awarding summary judgment to an insurer that refused to defend Pulte Home Corp. in two construction defect lawsuits brought by homeowners, finding that the lawsuits did not provide enough information to show that the occurrence did not happen during the policy period and that the insurer was unable to show that the business risk exclusion was applicable (Pulte Home Corp. v. TIG Insurance Co., No. 18-55792, 9th Cir., 2019 U.S. App. LEXIS 35988). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%208%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - A reinsurer argues in a Jan. 3 reply that the Ninth Circuit U.S. Court of Appeals should reverse an order denying its motion to intervene in a dispute over a $3.2 million judgment and remand to allow the reinsurer to proceed with its claims against another reinsurer, which is the judgment creditor (Odyssey Reinsurance Co. v. Richard Keith Nagby, et al. v. Knight Insurance Company Ltd., Nos. 19-55346, 19-55347, 19-55423, 9th Cir.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%209%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN DIEGO - A California federal judge on Dec. 27 awarded $218,246 to a reinsurer for the contemptuous conduct of an insolvent insurance agency's principal regarding a preliminary injunction and a temporary restraining order in a dispute over the alleged fraudulent transfer of the agency's assets to avoid payment of a $3.2 million judgment (Odyssey Reinsurance Co. v. Richard Keith Nagby, et al., No. 16-3038, S.D. Calif., 2019 U.S. Dist. LEXIS 221812). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2010%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - In a dispute over payment for workers' compensation insurance, a California appeals panel on Jan. 7 dismissed an appeal regarding a trial court's statement of decision (SOD) that neither side proved damages elements in breach of contract claims because the SOD is not a judgment or an appealable order (Warwick California Corp., et al. v. Applied Underwriters, Inc., et al., No. A155523, Calif. App., 1st Dist., Div. 4, 2020 Cal. App. LEXIS 13). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2011%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' RIVERSIDE, Calif. - An insurer and a reinsurer tell a California federal judge in Jan. 16 joint status report that they have selected individual arbitrators and are choosing an umpire for arbitration of a breach of contract case over $8.6 million in equipment breakdown claims (Nationwide Agribusiness Insurance Co. v. The Hartford Steam Boiler Inspection and Insurance Co., No. 19-00531, C.D. Calif.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2012%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN JOSE, Calif. - A California appeals panel on Jan. 16 affirmed a lower court's ruling that a commercial liability insurer has no duty to defend or indemnify its insured against underlying claims that it fraudulently procured a patent from the U.S. Patent and Trademark Office (PTO) and used that particular patent to attempt to monopolize the active dopant metrology market, rejecting the argument that it was objectively reasonable for the insured to expect that the policy's "malicious prosecution" coverage extended to this claim (Travelers Property Casualty Company of America v. KLA Tencor Corp., No. H044890, Calif. App., 6th Dist.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2013%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' OAKLAND, Calif. - An operator of vineyards and winemaking operations in California on Jan. 3 sued London insurers for breach of contract and bad faith in a California federal court, alleging that they wrongfully refused to pay for smoke exposure damage to its finished wines caused by the October 2017 wildfires in Sonoma and Napa County, Calif., and seeking $12 million for its loss (Vintage Wine Estates, Inc. v. Royal & Sun Alliance Insurance PLC, et al., No. 20-00101, N.D. Calif.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2014%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - An insured recently filed a brief in the Ninth Circuit U.S. Court of Appeals contending that a district court erred when it held that an insurer did not owe coverage for underlying litigation pertaining to violations of several provisions of the California Labor Code (U.S. Telepacific Corp. v. U.S. Specialty Insurance Company, No. 19-55828, 9th Cir.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2015%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' SANTA ANA, Calif. - An insurer's lawsuit accusing a number of substance abuse treatment centers of common-law fraud, violation of California' unfair competition law (UCL) and other claims can proceed in state court, a federal judge in California ruled Nov. 13, holding that the plaintiff company's claims are not preempted by the Employee Retirement and Income Security Act (Health Net Life Insurance Co. v. Morningside Recovery LLC, et al., No. 19-cv-1342, C.D. Calif., 2019 U.S. Dist. LEXIS 197937). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2016%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' LOS ANGELES - A California appeals court panel on Dec. 23 affirmed a ruling denying a lawyer and law firm's motion to strike allegations brought against them by Allstate Insurance Co. over an alleged insurance fraud scheme, finding that demand letters sent by the defendants to the insurer are not protected activity under California law (People of the state of California, ex rel. Allstate Insurance Co. v. Kelly L. Casado, et al., No. B288742, Calif. App., 2nd Dist., 7th Div., 2019 Cal. App. Unpub. LEXIS 8572). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2017%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - A California federal judge on Dec. 18 determined that a primary insurer breached its duty of good faith and fair dealing by refusing to settle an underlying action filed against its insured within its policy limits (Houston Casualty Co. v. National Union Fire Insurance Company of Pittsburgh, Pa., et al., No, 18-6147, N.D. Calif., 2019 U.S. Dist. LEXIS 217615). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-7%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2018%20(2020)&view=full&ORIGINATION_CODE=00144 target='_blank' RIVERSIDE, Calif. - A federal judge in California on Dec. 20 denied a motion for judgment on the pleadings brought by two estates seeking cost recovery under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) for remediation costs associated with the cleanup of perchloroethylene (PCE) contamination caused by dry cleaning operations, finding that insurers can represent two defendant estates and a suspended corporation (Estate of Betty Goldberg, et al. v. Goss-Jewett Co., et al., No. 14-1872, C.D. Calif.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%201%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' PORTLAND, Ore. - The Ninth Circuit U.S. Court of Appeals on Dec. 3 held that a former regional field dive officer for the U.S. Fish and Wildlife Service's sexual contact with a fellow employee was not an occurrence under a homeowners insurance policy, affirming a lower court in part (American Reliable Insurance Company v. Lawrence Lockard, et al., Nos. 18-35758 and 18-35786, 9th Cir., 2019 U.S. App. LEXIS 35869). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%202%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' PASADENA, Calif. - The Ninth Circuit U.S. Court of Appeals on Nov. 19 remanded a long-term disability (LTD) benefits claim to the plan administrator after determining that the plan administrator abused its discretion in denying benefits based on the one-week waiting period required by the plan (Michael Alves v. Hewlett-Packard Comprehensive Welfare Benefits Plan, et al., No. 18-55819, 9th Cir., 2019 U.S. App. LEXIS 34362). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%203%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - A California federal judge on Nov. 27 granted a disability claimant's motion for judgment on the administrative record after determining that the claimant met his burden of proving that he remained disabled from performing the duties of his sedentary occupation as a project manager (Steven S. Garretson v. Metropolitan Life Insurance Co., No. 17-7052, N.D. Calif., 2019 U.S. Dist. LEXIS 206700). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%204%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SACRAMENTO, Calif. - A disability claimant failed to prove that a disability insurer breached its contract or acted in bad faith in denying any-occupation disability benefits, a California federal judge said Nov. 21 in granting summary judgment in favor of the insurer (Loretta Bruce v. Hartford Life & Accident Insurance Co., No. 17-2201, E.D. Calif., 2019 U.S. Dist. LEXIS 202511). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%205%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SACRAMENTO, Calif. - A California federal judge on Nov. 8 dismissed a long-term disability plan from a disability claimant's suit seeking long-term disability benefits based on a stipulation submitted to the court by the parties (Lydia Kahler v. Hartford Life & Accident Insurance Co., et al., No. 19-1913, E.D. Calif., 2019 U.S. Dist. LEXIS 195381). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%206%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' OAKLAND, Calif. - A California federal judge on Nov. 25 denied a disability claimant's request to conduct discovery after determining that the claimant failed to prove that additional evidence is necessary to conduct an adequate de novo review (Natalya Vigdorchik v. Liberty Life Assurance Company of Boston, et al., No. 19-3891, N.D. Calif., 2019 U.S. Dist. LEXIS 204512). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%207%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - A California federal magistrate judge on Nov. 15 remanded a disability claimant's suit after determining that diversity of jurisdiction does not exist because a negligence claim asserted against the insurance agency that sold the disability policies to the claimant may not be time-barred under California law (Mark Bennett, D.D.S. v. Ohio National Life Assurance Corp., et al., No. 19-5774, N.D. Calif., 2019 U.S. Dist. LEXIS 198719). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%208%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SACRAMENTO, Calif. - A California federal judge on Dec. 3 denied motions to intervene by a number of insurers in a dispute over liability for groundwater contamination under the Comprehensive Environmental Response, Compensation, and Liability Act after determining that the insurers failed to show good cause for intervening in the suit (California Department of Toxic Substances Control, et al. v. Jim Dobbas Inc., et al., No. 14-0595, E.D. Calif., 2019 U.S. Dist. LEXIS 209377). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%209%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - An additional insured contractor alleges in a Nov. 7 complaint filed in a California federal court that a builders risk insurer breached its policy, acted in bad faith and violated California Business and Professions Code Section 17200 et seq., regarding its claim handling of water and mold-related damage in a construction project (Build Group, Inc. v. Liberty Surplus Insurance Corp., No. 19-07359, N.D. Calif.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2010%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN DIEGO - In a case of first impression in California, a state appeals panel on Oct. 30 found, for the purpose of excess insurance, that a trial court has jurisdiction to characterize an employee's injury under an insolvent insurer's excess policy differently than what was reflected in a stipulation by the Workers' Compensation Appeals Board (WCAB) (California Insurance Guarantee Association v. San Diego County Schools Risk Management Joint Powers Authority, et al., No. D074360, Calif. App., 4th Dist., Div. 1, 2019 Cal. App. LEXIS 1070). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2011%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' REDWOOD CITY, Calif. - A California judge on Nov. 4 appointed the state's insurance commissioner as conservator of California Insurance Co. (CIC) and enjoined all litigation involving the insurer (Insurance Commissioner of the State of California v. California Insurance Co., No. 19CIV06531, Calif. Super., San Mateo Co.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2012%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' LOS ANGELES - An unmarried couple recently filed a brief in California appellate court contending that a lower court erred when it ruled that an insurer did not breach its contract to the insureds by refusing to cover one member of the couple when they were both sued for malicious prosecution related to an underlying lawsuit (Gilbert Purcell, et al. v. Farmers Insurance Exchange, et al., No. B292698, Calif. App., 2nd Dist., Div. 1). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2013%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN JOSE, Calif. - A California federal judge on Nov. 25 denied a commercial general liability insurer's renewed motion for judgment as a matter of law on Yahoo! Inc.'s bad faith and bad faith damages claims, finding that the insurer has failed to present any new evidence or new argument since the original motion was denied in May (Yahoo! Inc. v. National Union Fire Insurance Company of Pittsburgh, PA, No. 17-00489, N.D. Calif., 2019 U.S. Dist. LEXIS 204411). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-6%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2014%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' LOS ANGELES - A law firm representing 23 public entities on Nov. 13 issued a press release announcing that a $360 million settlement in principle has been reached with Southern California Edison for taxpayer losses arising from the 2017 Thomas and Koenigstein Fires and 2018's Montecito Debris Flows and Woolsey Fire. http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%201%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - The First District California Court of Appeal on Oct. 21 affirmed a trial court's denial of an insurer's motion to strike a complaint after determining that the insureds' bad faith claim is not barred by California's law banning a strategic lawsuit against public participation (anti-SLAPP) because the bad faith claim is not based on protected litigation activity (Miller Marital Deduction Trust, et al. v. Zurich American Insurance Co., No. A155398, Calif. App., 1st Dist., Div. 3, 2019 Cal. App. LEXIS 1036). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%202%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - An errors and omissions liability insurer's failure to settle a consumer class action lawsuit against its insured for violating provisions of the Telephone Consumer Protection Action (TCPA) amounts to a bad faith breach of contract, an assignee argues in a Nov. 5 complaint filed in California federal court (Ignacio Perez v. Indian Harbor Insurance Co., et al., No. 19-7288, N.D. Calif.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%203%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' PASADENA. Calif. - A district court properly dismissed a spouse's claims for breach of contract, bad faith, breach of fiduciary duty and fraud because an aviation exclusion included in an accidental death and dismemberment policy clearly barred coverage for her claim following her husband's death as a result of a plane crash, the Ninth Circuit U.S. Court of Appeals said Oct. 22 (Rivka Ofir Ph.D. v. Transamerica Premier Life Insurance Co., No. 18-55393, 9th Cir., 2019 U.S. App. LEXIS 31466). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%204%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' LOS ANGELES - A California federal judge on Nov. 4 dismissed a breach of contract claim and a bad faith claim against a life insurer because the plaintiffs' allegations, which arise out of the life insurer's increase in policy premiums, do not support a claim for breach of contract or for bad faith (Brighton Trustees, et al. v. Transamerica Life Insurance Co., No. 19-4210, C.D. Calif., 2019 U.S. Dist. LEXIS 193359). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%205%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - Because California Insurance Guarantee Association (CIGA) is not a primary plan under the Medicare Act's secondary payer provisions, the Ninth Circuit U.S. Court of Appeals ruled Oct. 10 that CIGA has no obligation to reimburse the Centers for Medicare and Medicaid Services (CMS) for conditional payments made on behalf of insureds under workers' compensation plans that become insolvent (California Insurance Guarantee Association v. Alex Azar II, et al., Nos. 17-56526 & 17-56528, 9th Cir., 2019 U.S. App. LEXIS 30339). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%206%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' RICHMOND, Va. - Because surplus proceeds belong to Circuit City's bankruptcy estate and all claims under excess insurance policies were settled, the California Self-Insurers' Security Fund may not continue to demand payments from the excess insurer for Circuit City's California workers' compensation claims under the terms of a settlement agreement, a federal judge in Virginia ruled Sept. 27, affirming a bankruptcy court's judgment (California Self-Insurers' Security Fund, et. al. v. Alfred Siegel, No. 18-619, E.D. Va., 2019 U.S. Dist. LEXIS 167399). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%207%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - A trial attorney's failure to raise the youth factors argument in two U.S. Supreme Court rulings and one California Supreme Court case following a man's conviction on two counts of insurance fraud did not constitute ineffective assistance of counsel, a California appeals panel ruled Nov. 13, finding that the contents of the presentence report prepared by the prosecution showed the defendant's history of failing to comply with probation and post-sentence requirements (People v. Lamont James, Nos. A155627, A157772, Calif. App., 1st Dist., 2nd Div., 2019 Cal. App. Unpub. LEXIS 7507). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%208%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - A federal judge in California on Oct. 18 allowed a relator in a False Claims Act (FCA) suit brought against his former employer to amend his allegations that the company's CEO violated the California Insurance Fraud Prevention Act (IFPA) when the company submitted claims to Medicare and other private insurers for medically unnecessary cardiovascular tests, finding that the man can include inferences that the insurers would not have paid for the tests had they known that they were not necessary (United States, ex rel. Bryan Barnette v. CardioDX Inc., et al., No. 15-cv-01339-WHO, N.D. Calif., 2019 U.S. Dist. LEXIS 181015). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%209%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SANTA ANA, Calif. - A California appeals court panel on Nov. 8 found that while a trial court judge's decision to admit evidence regarding a 2009 incident in which a police officer injured his right hand while on duty was erroneous, it does not warrant vacating the officer's conviction for insurance fraud because the error was not prejudicial (People v. Ryan Patrick Natividad, No. G055248, Calif. App., 4th Dist., 3rd Div., 2019 Cal. App. Unpub. LEXIS 7451). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2010%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN JOSE, Calif. - A disability claimant failed to prove that he was disabled from his own occupation as a result of sickness or injury according to the plan's terms, a California federal judge said Nov. 6 after applying a de novo standard of review based on a remand order issued by the Ninth Circuit U.S. Court of Appeals (Robert Gordon v. Metropolitan Insurance Co., No. 10-5399, N.D. Calif., 2019 U.S. Dist. LEXIS 193142). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2011%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN DIEGO - A district court did not err in entering judgment in favor of a disability insurer because the disability claimant failed to prove that she was unable to perform the duties of her own occupation while she was still employed by her former employer and because the district court properly considered all of the claimant's evidence, the Ninth Circuit U.S. Court of Appeals said Oct. 18 (Kelly Demko v. Unum Life Insurance Company of America, No. 18-55428, 9th Cir., 2019 U.S. App. LEXIS 31102). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2012%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' FRESNO, Calif. - A disability insurer acted in bad faith and breached its contract in terminating a claimant's long-term disability (LTD) benefits because the insurer's termination was not reasonable and not based on reliable medical evidence, the claimant alleges in an Oct. 15 complaint filed in California federal court (Jennifer Sims v. Life Insurance Company of North America, No. 19-1460, E.D. Calif.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2013%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SACRAMENTO, Calif. - A California federal magistrate judge on Nov. 1 recommended that judgment be entered in favor of a disability claim because the denial of a claim for an extension of short-term disability (STD) benefits was not an abuse of discretion and is supported by the medical evidence (Jerome Clay v. AT&T Umbrella Benefit Plan No. 3, No. 17-749, E.D. Calif., 2019 U.S. Dist. LEXIS 190308). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2014%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - An appellant recently asked a California appeals court to reverse a lower court's ruling that stayed his declaratory judgment lawsuit disputing the validity of a professional liability insurer's subrogation claim against his family trust, arguing that the stay "has no legal basis" (John Berman v. Minnesota Lawyers Mutual Insurance Company, No. A155394, Calif. App., 1st Dist., Div. 3). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2015%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' RIVERSIDE, Calif. - Finding that water damage occurred outside a plumbing company's insurance policy period, a California federal judge on Oct. 17 ruled that the insurer has no duty to defend or indemnify the plumbing company and is entitled to judgment on the pleadings on bad faith, breach of contract and indemnification/contribution claims (Graham Plumbing & Drain Cleaning, Inc. v. Colony Insurance Co., No. 19-1130, C.D. Calif., 2019 U.S. Dist. LEXIS 180984). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2016%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - An additional insured general contractor recently asked the Ninth Circuit U.S. Court of Appeals to reverse a lower federal court's finding that commercial general liability insurance policies' business risk exclusions preclude coverage for construction defects alleged by homeowners (Pulte Home Corporation v. TIG Insurance Company, No. 18-55792, 9th Cir.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2017%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN JOSE, Calif. - A California court erred in sustaining demurrers without leave to amend in a construction defects insurance lawsuit because the discovery that an insurer's obligations to a subcontractor arose from fraudulent activity should not result in the general contractor's insurers avoiding their obligations to their insured "in their entirety," punishing the subcontractor's insurer for fulfilling its obligations to it insurer, the subcontractor's insurer argues in a Sept. 4 appellant brief filed in a California appellate court (The Travelers Indemnity Company of Connecticut v. Navigators Specialty Insurance Co., et al., No. H046784, Calif. App., 6th Dist.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2018%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' FRESNO, Calif. - A per-claim deductible provision applies on a per-claimant/per-home basis regarding 200 individual homeowners in five separate underlying construction defects cases, a federal judge in California ruled Oct. 3, finding that the insureds failed to pay the deductibles and, thus, the insurance policy is void (ProBuilders Specialty Insurance Company, RRG v. JKB Homes Norcal, Inc., et al., No. 15-01381, E.D. Calif., 2019 U.S. Dist. LEXIS 172322). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2019%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SANTA ANA, Calif. - Trucking companies sued the administrators of their self-insured employee benefit plans on Oct. 18 in a California federal court, alleging that the administrators negligently failed to obtain reinsurance coverage for the plans (A&I Transport, Inc., et al. v. KG Administrative Services, Inc., et al., No. 19-1992, C.D. Calif.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2020%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' RIVERSIDE, Calif. - A federal judge in California on Oct. 18 compelled arbitration of a breach of contract case over $8.6 million in equipment breakdown claims because all of an insurer's claims arise out of a reinsurance agreement's interpretation (Nationwide Agribusiness Insurance Co. v. The Hartford Steam Boiler Inspection and Insurance Co., No. 19-00531, C.D. Calif.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2021%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - An insured recently asked a California appeals court to reverse a lower court's ruling in favor of excess insurers in its lawsuit seeking coverage for settlements paid to underlying claimants who sued the insured for asbestos-related bodily injury, arguing that the lower court misinterpreted the insurance policies' "other insurance" clauses in concluding that horizontal exhaustion applies notwithstanding the attachment points in the excess insurance policies "that envision vertical exhaustion" (SantaFe Braun, Inc. v. Insurance Company of North America, No. A151428, Calif. App., 1st Dist.). http://www.lexis.com/research/xlink?canceldest=form&keyenum=25271&keytnum=0&searchtype=get&search=19-5%20Mealey%27s%20Litig.%20Rep.%20Cal.%20Ins.%2022%20(2019)&view=full&ORIGINATION_CODE=00144 target='_blank' SAN FRANCISCO - A panel of the Ninth Circuit U.S. Court of Appeals is scheduled to hear oral arguments on Oct. 25 in an insurance dispute in which an insured contends that a lower court wrongly dismissed his lawsuit because his auto insurer is liable for breach of contract for its failure to respond to his claim (Edward Stolz v. Safeco Insurance Co. of America, No. 17-17214, 9th Cir.).