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Mealey's California Insurance

  • July 03, 2025

    Judge: Reinsurer Failed To Meet Burden Of Proof In Motion For Partial Judgment

    FORT WORTH, Texas — A Texas federal judge denied a reinsurer’s motion for partial judgment on the pleadings for claims brought by National Transportation Associates Inc. (NTA) concerning a dispute over whether contractual mandates issued by California and other states render a commission payment structure unenforceable; the case is part of broader consolidated litigation among reinsurers and NTA that centers on the reinsurers’ claims of inflated provisional commissions and breach of various agreements.

  • July 03, 2025

    California Federal Judge Sanctions Lawyer For AI-Faked Cites In Disability Case

    SANTA ANA, Calif. — A California federal judge imposed sanctions including a $500 payment on a plaintiff’s attorney who told the court that he “failed to scrutinize and oversee the preparation of” memoranda “filed with erroneous case citations that were invented by AI”; the breach of contract suit over termination of total disability benefits is headed toward a jury trial after the judge last month granted summary judgment for the insurer on a bad faith claim.

  • July 01, 2025

    California Appellate Court Lets Rehab Plan For Workers’ Comp Insurer Stand

    SAN FRANCISCO — In an unpublished opinion, the First District California Court of Appeal upheld a nonconsensual rehabilitation plan for a workers’ compensation insurance carrier; the plan was approved as part of conservation proceedings brought by California’s insurance regulator and includes options to resolve dozens of reinsurance participation agreement (RPA) lawsuits.

  • June 30, 2025

    California Insureds Allege Insurers Underinsured Homes Destroyed In Wildfires

    LOS ANGELES — In two separate complaints filed in Los Angeles County Superior Court, insureds whose homes were destroyed in the January wildfires allege that their homeowners insurers underinsured their homes, leaving the homeowners unable to rebuild their destroyed homes.

  • June 27, 2025

    California Judge Denies Insured’s Motion For Summary Adjudication As To UCL Claim

    LOS ANGELES — A California judge granted an insured’s motion for summary adjudication as to his declaratory relief claim in a lawsuit alleging that the California Fair Plan Association (CFP) issued property insurance policies with fire coverage that is unlawfully restrictive as to smoke damage claims but denied the insured’s motion as to his unfair competition law (UCL) claim, finding that he failed to satisfy his burden to establish standing to bring the UCL claim.

  • June 27, 2025

    Breach Of Contract, Bad Faith Claims To Proceed Against Life Insurer, Judge Says

    FRESNO, Calif. — A life insurer’s filing of a third-party interpleader complaint does not absolve it of liability for a beneficiary’s breach of contract and bad faith claims based on the life insurer’s delay in handling the beneficiary’s claim after the insured’s death, a California federal judge said in partially denying the life insurer’s motion for summary judgment.

  • June 26, 2025

    California Federal Judge Gives Disability Insurers Win In Breach, Bad Faith Row

    LOS ANGELES — Granting summary judgment for insurers in an individual disability insurance (IDI) dispute, a California federal judge ruled in part that insurers were prejudiced by late notice of the claim.

  • June 26, 2025

    Insurer Was Not Contractually Bound To Provide COVID-19 Premium Relief, Judge Says

    SAN DIEGO — A California federal judge on June 25 granted an auto insurer’s motion for summary judgment on a claim alleging that the insurer breached the implied covenant of good faith and fair dealing by not sufficiently refunding policyholders a percentage of premium payments made during the COVID-19 pandemic because the insurer was not contractually bound to refund any premiums under its auto policies.

  • June 25, 2025

    In ‘Close Call’ Case, Judge Rules For LTD Claimant In Any-Occupation Dispute

    SACRAMENTO, Calif. — In a decision he described as “a very close call,” a California federal judge ruled on de novo review that a claimant was disabled from any occupation under the terms of a long-term disability (LTD) plan; among other things, the judge resolved opposed requests for judicial notice and explained his findings that the opinions of several doctors should be given little to no weight but the claimant’s “reports of pain are entitled to some weight.”

  • June 25, 2025

    Judge: Housing Developer Didn’t Prove Insurer Waived Consent To Claims Procedures

    SAN FRANCISCO — A federal judge in California denied a housing developer’s motion for partial summary judgment in its case against its excess insurer for breach of contract after homeowners reported construction defects, finding that the developer didn’t provide sufficient evidence that the insurer waived its right to consent to mediation proceedings the developer conducted with the homeowners.

  • June 24, 2025

    Judge: D&O Coverage Restored By Dilution Claims Exception To Policy Exclusion

    SAN DIEGO — A federal judge in California on June 23 held that a business and management indemnity insurer has a duty to defend and indemnify its insured against an underlying unfair dilution lawsuit because the “dilution claims exception” to the “insured vs. insured” exclusion restores directors and officers liability coverage, granting the insured’s motion for summary judgment and denying the insurer’s motion for judgment on the pleadings.

  • June 19, 2025

    Insureds’ Breach Of Contract, Bad Faith Suit Remanded To California State Court

    FRESNO, Calif. — A breach of contract and bad faith suit filed against a homeowners insurer must be remanded to state court because the insurer failed to meet its burden of proving by a preponderance of the evidence that the amount in controversy exceeds the federal jurisdictional minimum, a California federal judge said, noting that the insurer specifically failed to provide a reasonable estimate of the amount of attorney fees that could potentially be awarded to the insureds.

  • June 18, 2025

    Auto Insurer Did Not Act In Bad Faith, Judge Says In Granting Summary Judgment

    FRESNO, Calif. — A bad faith suit filed against an auto insurer cannot proceed because there is no evidence from which a jury could conclude that the insurer acted in bad faith in failing to settle an assignee’s claim for injuries, a California federal judge said in granting the auto insurer’s motion for summary judgment.

  • June 18, 2025

    Stay Granted, Trial Vacated In Captive Insurance Dispute After Settlement Offer

    LOS ANGELES — A California federal judge stayed litigation and vacated a forthcoming trial date to allow time for the United States to respond to and prepare acceptance of a written offer submitted by the executive of a purported captive insurance company that the United States says would resolve all claims and counterclaims brought forth in the litigation. 

  • June 16, 2025

    Insurer Says Pollution Exclusion Bars Coverage For Silica Dust Exposure Suits

    LOS ANGELES — No coverage is owed for underlying bodily injury suits filed against an insured stemming from silica dust exposure from the insured’s products because the suits are barred by the pollution exclusion contained in primary and excess policies issued to the insured, an insurer maintains in its motion for summary judgment filed in California federal court.

  • June 13, 2025

    Calif. Panel Affirms $200K Judgment Against Life Policy Beneficiary In Fraud Row

    LOS ANGELES — A California appellate court on June 12 affirmed a lower court judgment awarding a decedent’s son $35,000 for elder abuse and the decedent’s estate $165,000 for unjust enrichment against the woman the son sued alleging fraud in her making herself a beneficiary under the decedent’s $200,000 life insurance policy, finding no need for the jury to consider whether the beneficiary change was related to fraud because the damages finding in a jury question addressed the fraud presumption.

  • June 13, 2025

    Claimant With Long COVID To Challenge LTD Benefit Denial In 9th Circuit

    SAN DIEGO — A claimant who unsuccessfully sought long-term disability (LTD) benefits due to symptoms he attributed to long COVID and cardiac issues is taking his case to the Ninth Circuit U.S. Court of Appeals after a California federal judge upheld denial of his claim on de novo review.

  • June 11, 2025

    Judge Adopts Recommendation To Dismiss Insureds’ Breach Of Contract, Bad Faith Suit

    FRESNO, Calif. — A California federal judge granted a homeowners insurer’s motion to dismiss breach of contract and bad faith claims alleged by insureds, agreeing with a magistrate judge’s finding that the claims fail because no coverage is afforded for an underlying suit filed against the insureds stemming from the insureds’ sale of their home.

  • June 10, 2025

    9th Circuit Sets Argument In Oral Surgeon’s Bid To Revive Disability Benefits Case

    SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals has scheduled oral argument for July 7 in an appeal seeking revival of an oral surgeon’s breach of contract and bad faith suit filed after he unsuccessfully sought disability benefits on the grounds that his comorbid conditions and inability to access recommended personal protective equipment (PPE) made it necessary to close his practice early in the COVID-19 pandemic.

  • June 06, 2025

    Claimant Who Sought LTD Benefits After Termination Wins Reversal

    RIVERSIDE, Calif. — In minute findings of fact and conclusions of law reversing denial of long-term disability (LTD) benefits for a claimant who has a genetic musculoskeletal disorder, received a kidney transplant and asserted that he “pushed himself to work far beyond his ability to effectively do so,” a California federal judge ruled in part that “[a] plaintiff could be disabled under the Plan without experiencing a loss of earnings and while still working continuously.”

  • June 06, 2025

    Insurer Says Lower Court Properly Found Policies Include Aggregate Limit

    SAN FRANCISCO — A district court did not err in finding that an umbrella liability insurer’s policies include an aggregate limit and cap the insured’s recovery for environmental contamination remediation costs, the insurer tells the Ninth Circuit U.S. Court of Appeals in its appellee brief.

  • June 05, 2025

    Insurer Appeals Judgment For CGL Insurer In Suit Arising From Hotel Damages

    SANTA ANA, Calif. — An insurer that issued an owner controlled consolidated insurance policy to a general contractor hired to construct a Hard Rock Hotel notified a federal court in California on June 4 that it is appealing to the Ninth Circuit U.S. Court of Appeals the lower court’s rulings in favor of a subcontractor’s commercial general liability insurer in the CGL insurer’s equitable contribution and equitable indemnification suit arising from construction defect-related damages to the hotel.

  • June 04, 2025

    Judge Denies CEO Dismissal Bid In FCA Suit Against Lab Alleging Illegal Kickbacks

    SHERMAN, Texas — A Texas federal judge denied a dismissal motion filed by the CEO of a former laboratory accused, along with other individuals and entities, of violating the federal False Claims Act (FCA) and Anti-Kickback Statute (AKS) through payment of illegal kickbacks to doctors and medical practices and fraud against government insurers by billing them for medically unnecessary tests, finding that “dismissal is not warranted.”

  • June 03, 2025

    9th Circuit Fixes Ruling Mostly Affirming Claimant’s Victory In ERISA Row

    PASADENA, Calif. — Correcting what the appellant called “an apparent typographical error” in the original May 16 unpublished memorandum disposition, the Ninth Circuit U.S. Court of Appeals on June 2 issued an order and amended ruling mostly affirming judgment against a multiemployer health plan in a coverage denial case; the change did not affect the key holding that the appellee hadn’t been given sufficient notice that meeting the plan’s “definition of ‘medical necessity’ required attempting lower levels of care . . . before residential treatment.”

  • June 03, 2025

    Car Wash’s Breach Of Contract Suit Against Insurer Is Untimely, 9th Circuit Affirms

    PASADENA, Calif. — The Ninth Circuit U.S. Court of Appeals affirmed a lower court’s grant of summary judgment in favor of a businessowners insurer in a car wash operator insured’s breach of contract and bad faith lawsuit seeking coverage for two theft claims, agreeing with the lower court that the lawsuit was untimely as a matter of law.