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

Mealey's California Insurance

April 30, 2025
Residents Sue State-Mandated Insurer ‘Of Last Resort’ Over Los Angeles Wildfires

LOS ANGELES — California residents sued the California Fair Plan Association (CFPA) and its largest members in a state court seeking damages for the defendants’ alleged bad faith breach of their property insurance policies following the Los Angeles wildfires in January.
April 29, 2025
Water Damage Loss Dispute Dismissed After Insureds, Insurer Settle

LOS ANGELES — A federal judge in California on April 28 dismissed with prejudice an insured couple’s suit against their homeowners insurer related to their water damage loss in accordance with a stipulation of voluntary dismissal the parties filed after reaching a settlement.
April 29, 2025
Magistrate: Relator Must Provide All Alleged False Claims In FCA Kickback Suit

SAN DIEGO — A California federal magistrate judge granted Abbott Laboratories’ motion to compel discovery into all the alleged false claims it purportedly submitted to the government in a suit alleging Abbott violated the False Claims Act (FCA) and state false claim laws regarding Abbott’s purported kickback scheme to induce hospitals and physicians to use an Abbott cardiac medical device, finding that Abbott is “entitled to know the specific false claims” against it.
April 28, 2025
Panel Says No Additional Coverage Owed For Underlying Carbon Monoxide Suit

SAN FRANCISCO — An insured landlord is not entitled to additional coverage for the settlement of a tenant’s underlying bodily injury suit arising out of carbon monoxide poisoning because the apartment insurance policy’s liability limit applies only to the year in which the occurrence took place, the Ninth Circuit U.S. Court of Appeals said April 25 in affirming a district court’s finding that the stacking of annual policy limits is prohibited by the policy.
April 25, 2025
Oral Argument Set In Challenge To Rehab Plan For Workers’ Comp Insurer

SAN FRANCISCO — Oral argument is scheduled in the First District California Court of Appealin a workers’ compensation insurance carrier’s challenge to a nonconsensual rehabilitation plan that was approved as part of conservation proceedings brought by California’s insurance regulator and includes resolution of dozens of reinsurance participation agreement (RPA) lawsuits.
April 25, 2025
Watchdog Group Seeks To Invalidate Insurance Bulletins Allowing Policy Surcharges

LOS ANGELES — A consumer research and advocacy organization alleges in a California state court lawsuit that California Insurance Commissioner Ricardo Lara exceeded his statutory authority by issuing two unlawful insurance bulletins that authorize member insurers of the California FAIR Plan to recoup assessments from policyholders and seeks a writ of mandate and injunction commanding Lara not to enforce the bulletins.
April 23, 2025
Jury Trial Should Not Be Limited To Defense Costs, Insurer Tells 9th Circuit

SAN FRANCISCO — An insurer filed a petition for panel rehearing in the Ninth Circuit U.S. Court of Appeals, contending that the panel should modify its recent opinion and remand for a jury trial on all of the damages claimed by an insured in an environmental contamination coverage suit rather than remand only for a jury trial to determine the reasonableness of the defense costs incurred by the insured from the date of the insured’s tender of the underlying complaint through the date of the district court’s order.
April 22, 2025
Homeowners Accuse Insurers Of ‘Nefarious Conspiracy’ In Suit Arising From Wildfires

LOS ANGELES — California homeowners affected by the Los Angeles wildfires sued insurers in a California court for violations of the state’s Cartwright Act and unfair competition law (UCL), alleging that the insurers participated in a “nefarious conspiracy to eliminate competition between them, and to intentionally and systematically force Plaintiffs to obtain fire insurance from the state’s insurer of last resort.”
April 21, 2025
Insureds, Insurer File Joint Notice Of Settlement In Water Damage Dispute

LOS ANGELES — Insureds and their insurer notified a California federal court that they have reached a settlement in principle of their dispute over the insureds’ water damage loss.
April 17, 2025
9th Circuit Denies Petition For Panel Rehearing In FCA Medicare Fraud Row

SAN JOSE, Calif. — In a one-page order without providing explanation, the Ninth Circuit U.S. Court of Appeals denied a petition for panel rehearing of its ruling affirming a lower court’s dismissal of a qui tam relator’s suit accusing pharmaceutical companies of violating the False Claims Act (FCA) by overcharging the federal government and states under Medicare and Medicaid.
April 17, 2025
$195,000 Class Deal Gets Final OK In Suit Over Allegedly Fraudulent Policies

SANTA ANA, Calif. — Noting the absence of objections and that “the average class member payment will be $467.77, and the highest payment will be $5,204.40,” a California federal judge granted final approval to a $195,000 class settlement that resolves a suit over allegedly counterfeited insurance policies sold through a captive reinsurance arrangement.
April 16, 2025
Insurers Have No Duty To Defend Based On Silica Exclusions, Judge Says

LOS ANGELES — Insurers of an importer and distributor of quartz stone products have no duty to defend their insured in underlying bodily injury suits stemming from exposure to silica dust from the insured’s quartz products because the policies’ silica exclusion clearly bars coverage for the underlying suits.
April 15, 2025
Bad Faith Suit: CFPA Systematically Failed To Investigate, Pay Wildfire Claims

LOS ANGELES — Plaintiffs sued California Fair Plan Association (CFPA) and its “largest” members for breach of contract and bad faith in a California court, seeking compensation for their losses incurred by the January Los Angeles wildfires and to hold CFPA “accountable for its decade-long, systematic failure to properly investigate and pay wildfire claims.”
April 15, 2025
Effective Vindication Rule Is Focus Of ERISA Imprudence Appeal In 9th Circuit

SAN FRANCISCO — In separate briefs, a former 401(k) participant and amicus curiae organization Public Justice urge the Ninth Circuit U.S. Court of Appeals to affirm that a nonseverable arbitration provision is void because it contains a class, collective and representative action waiver that they say prevents effective vindication of plan participants’ substantive right under the Employee Retirement Income Security Act.
April 15, 2025
Skechers Seeks Coverage For Injury Claims Caused By Shoes’ Lack Of Slip-Resistance

LOS ANGELES — Skechers USA Inc. sued its commercial liability insurer in a California court for breach of contract, breach of the implied covenant of good faith and fair dealing and unfair competition, alleging that the insurer has a duty to defend it against an underlying action contending that class members were harmed by actual physical accidents caused by the insured’s shoes’ lack of slip-resistance or by the fact that the shoes were unusable.
April 09, 2025
Bad Faith Claim In Water Damage Coverage Suit To Proceed, Judge Says

LOS ANGELES — An insured’s bad faith claim alleged against a homeowners insurer in a dispute over coverage for water damage in the insured’s home can proceed because dismissal of the bad faith claim would be premature, a California federal judge said in partially denying the insurer’s motion.
April 08, 2025
Panel: Insurer Entitled To Jury Trial On Defense Costs Issue In Contamination Suit

SAN FRANCISCO — The Ninth Circuit U.S. Court of Appeals on April 7 affirmed a district court’s ruling that an insurer has a duty to defend an insured in an underlying environmental contamination lawsuit, however, the panel said the insurer is entitled to a jury trial to determine the reasonableness of the defense costs incurred by the insured from the date of the insured’s tender of the underlying complaint through the date of the district court’s order.
April 08, 2025
Insurers: ‘Had SCE Acted Responsibly, The Eaton Fire Could Have Been Prevented’

LOS ANGELES — Insurers have filed a subrogation lawsuit alleging negligence and inverse condemnation against Southern California Edison Co. (SCE) in a California court, alleging that the Eaton fire could have been prevented had the defendant acted responsibly.
April 07, 2025
Silica, Pollution Exclusions Bar Coverage For Dust Exposure Suits, Insurer Says

LOS ANGELES — No coverage is owed for underlying bodily injury suits stemming from exposure to silica dust released from an insured’s countertops and stone products because the suits are barred by silica exclusions and total pollution exclusions included in the insured’s commercial general liability insurance policies, an insurer says in a complaint filed in California federal court.
April 04, 2025
California Panel Reverses Judgment For Insurer In HOA’s Suit Over Water Damage

LOS ANGELES — Finding that there are issues of material fact regarding whether the water damage and faulty workmanship exclusions in a condominium homeowners association’s all risks policy preclude coverage for rain damage that occurred during a reroofing project, a California appellate panel reversed a lower court’s grant of summary judgment to the insurer on the association’s breach of contract and bad faith claims.
April 02, 2025
Judge Allows Insureds’ ERISA, UCL Claims Against Cigna In AI Claims Denial Case

SACRAMENTO, Calif. — A California federal judge granted in part and denied in part Cigna Corp. and its affiliate’s motion to dismiss insureds’ claims that they violated the Employee Retirement Income Security Act (ERISA) and California’s unfair competition law (UCL) by allegedly denying coverage using an artificial intelligence algorithm.
March 31, 2025
Insured’s Failure To Cooperate Dooms Contract Breach, Bad Faith Claims, Judge Says

SAN DIEGO — An insured’s breach of contract and bad faith claims against a property insurer cannot proceed because the insurer did not breach the contract or act in bad faith based on the insured’s failure to cooperate with the insurer’s requests during the investigation of the insured’s fire damage claim, a California federal judge said in granting the insurer’s motion for summary judgment.
March 27, 2025
Judge Partly Grants, Partly Denies Insureds’ Motion To Strike In Water Damage Suit

LOS ANGELES — A federal judge in California on March 26 granted in part and denied in part insureds’ motion to strike portions of their insurer’s trial declarations in a dispute over the insureds’ water damage loss.
March 25, 2025
Magistrate Judge Approves Joint Case Management Statement In PFAS Coverage Dispute

SAN FRANCISCO — After finding that a pollution exclusion bars coverage for some, but not all, underlying lawsuits filed against an insured and alleging injuries related to exposure to per- and polyfluoroalkyl substances (PFAS) allegedly contained in aqueous film-forming foams (AFFF) that were manufactured and sold by the insured, a California federal magistrate judge approved a joint case management statement submitted by the parties regarding how to adjudicate the hundreds of lawsuits filed against the insured.
March 24, 2025
Suit Alleged Wrongful Acts By Insured, No Coverage Owed, 9th Circuit Affirms

LAS VEGAS — The Ninth Circuit U.S. Court of Appeals concluded that there is no genuine dispute that an underlying lawsuit alleged willful acts by an insured and, therefore, the exclusionary clause in California Insurance Code Section 533 was triggered, affirming a lower federal court’s judgment in favor of the insurer in an coverage dispute arising from underlying claims that the insured illegally stole a competitor’s clients and agents.