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Mealey's California Insurance

  • November 14, 2025

    Judge: Software Engineer With Long COVID Was Due LTD Benefits

    LOS ANGELES — After weighing the opinions of treating and reviewing physicians, a California federal judge concluded that a software engineer “was unable to perform the specific duties required by his job with reasonable continuity due to diagnosed symptoms of cognitive impairment, brain fog, and fatigue likely resulting from long-haul COVID-19” and therefore entitled to long-term disability (LTD) benefits.

  • November 14, 2025

    Parties File 9th Circuit Briefs In LTD Denial Appeal Involving Long COVID

    SAN FRANCISCO — Issues including assessing differing medical opinions and whether new reasons for denial of long-term disability (LTD) benefits were improperly raised during a bench trial are disputed in Ninth Circuit U.S. Court of Appeals briefs in the case of a former underwriter who says he was disabled by cognitive impairments and other symptoms he attributes to long COVID.

  • November 13, 2025

    Insurer Urges 9th Circuit To Vacate Amended Judgment In Damages Coverage Row

    SAN FRANCISCO — In its opening appellant brief, a general contractor’s insurer argues that the Ninth Circuit U.S. Court of Appeals should vacate a lower court’s amended judgment in favor of a subcontractor’s commercial general liability insurer, stating that the subcontractor’s insurer had a duty to defend the subcontractor in the insurer’s equitable contribution and equitable indemnification suit arising from construction defect-related damages to a hotel that the general contractor and subcontractor were constructing.

  • November 12, 2025

    Stay Denied In Class Suit Over Insurer’s ‘Discriminatory Advertising’ On Facebook

    SAN DIEGO — A California federal judge denied an insurer’s motion for a stay in a putative class action accusing the insurer of “discriminatory advertising” on Facebook, finding that the insurer failed to show how a ruling in a parallel state court case would have a “preclusive effect” on the instant case.

  • November 12, 2025

    Railway Company, Insurer Dismiss Case Over Coverage Of Underlying Flood Claim

    OAKLAND, Calif. — A railway company and an insurer filed a stipulation to dismiss the insurer’s claim for declaratory relief that it did not have a duty to indemnify the railway company in an underlying complaint against it for negligence after the construction of the railway caused property to flood.

  • November 10, 2025

    Putative Damages Dismissed Against Subcontractor’s Insurer; Other Claims Proceed

    SANTA ANA, Calif. — A federal judge in California found a construction company did not sufficiently plead punitive damages in its third amended complaint (TAC) against its subcontractor’s insurer for damages the company alleges were caused by using the subcontractor’s drawings for the project, but allowed the construction company’s other claims against the insurer to proceed.

  • November 10, 2025

    Partial Disability Claimant Wins Just Over $100,000 After Summary Judgment Ruling

    OAKLAND, Calif. — A long-term disability (LTD) claimant described by a California federal judge as having a “constellation of psychological and physical issues” was awarded retroactive partial disability benefits and interest totaling $100,849.01 pursuant to a stipulation the parties entered after she prevailed at summary judgment.

  • November 06, 2025

    Insurer Owes No Defense To Subcontractor In Faulty Power Pole Installation Suit

    LOS ANGELES — A federal judge in California held that an insurer does not owe a duty to defend or indemnify a subcontractor in an underlying suit brought by a contractor to recover costs and expenses incurred in the inspection and remediation of nonconforming installations of power pole anchors and guy wires by the subcontractor on power poles, finding that the subcontractor’s defective work doesn’t constitute property damage under the terms of the policy.

  • November 04, 2025

    Majority Affirms Ruling In Favor Of Travel Insurers In Unjust Enrichment, UCL Suit

    PASADENA, Calif. — A majority of the Ninth Circuit U.S. Court of Appeals affirmed a lower federal court’s grant of summary judgment in favor of travel insurers in a plaintiff’s unjust enrichment and unfair competition lawsuit, holding that the insured is not entitled to recover any portion of the premium for a travel insurance policy he purchased for a cruise that was later canceled due to the coronavirus pandemic because there was no unearned premium.

  • October 28, 2025

    Motion To Vacate Granted In Employee Fraud Suit With Jury Award Of Over $2.4M

    SANTA ANA, Calif. — After the parties filed a joint stipulation to vacate upon reaching a confidential settlement, a California federal judge on Oct. 27 issued an order vacating a prior final judgment after a jury awarded an insurer more than $2.4 million in damages for fraud committed by an insured employer and his California limited liability company regarding misrepresenting the employer’s nonagenarian father as an employee insured under the company’s group health plan.

  • October 23, 2025

    Judge Affirms Dismissal Of Hospital Operator’s Suit Against Insurer For ER Fees

    LOS ANGELES — A California appellate panel affirmed the dismissal of several hospitals’ lawsuit against an insurer for violation of California’s unfair competition law (UCL) in relation to its alleged failure to pay reasonable reimbursement to the hospitals, which are out-of-network, for emergency room services provided to its insureds, finding that the claims were premised on a hypothetical duty that does not exist in the state Insurance Code.

  • October 23, 2025

    Construction Company Sues Insurer For Denying Coverage Based On Wrong Exclusion

    LOS ANGELES — A construction company sued its insurer and insurance broker in California state court, arguing that the insurer breached its contract by not defending it in an underlying complaint against the company alleging construction defects in the building of five houses; the company argues that the insurer wrongly denied coverage based on a condominium construction exception.

  • October 21, 2025

    Insurer: No Connection Between Subcontractor’s Work, Company’s Liability

    SANTA ANA, Calif. — A subcontractor’s insurer says that a federal court in California should grant its motion to dismiss a construction company’s third amended complaint (TAC) against it alleging that it wrongly denied the coverage for claims brought against the company by a builder for damages the company alleges were caused by using the subcontractor’s drawings for the project, arguing the company provides no connection between the subcontractor’s work and the company’s liability.

  • October 21, 2025

    Insurers Voluntarily Dismiss Silica Coverage Suit After Home Depot Withdraws Tender

    LOS ANGELES — Two insurers filed a notice of voluntary dismissal in California federal court after Home Depot U.S.A. Inc. withdrew its request for coverage for underlying bodily injury lawsuits seeking damages as a result of silica exposure from countertops manufactured by an insured and sold and marketed by Home Depot.

  • October 17, 2025

    Bad Faith, Financial Elder Abuse Claims Again Dismissed Without Prejudice

    FRESNO, Calif. — A California federal judge granted a long-term care insurer’s motion to dismiss bad faith and financial elder abuse claims without prejudice after determining that the insured failed to specifically show how the insurer breached its contract when it denied the insured’s claim for benefits under the policy.

  • October 17, 2025

    Partly Revived COVID Risk Disability Case Is Dismissed Per Joint Stipulation

    FRESNO, Calif. — A disability case in which the Ninth Circuit U.S. Court of Appeals revived a breach of contract claim has been dismissed with prejudice by a California federal magistrate judge pursuant to a joint stipulation; an oral surgeon filed the suit after unsuccessfully seeking 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.

  • October 15, 2025

    California ‘Insurer Of Last Resort’ Sued For Alleged Wrongful Denial Of Claim

    LOS ANGELES — A homeowner whose property is covered by the California FAIR Plan sued the insurance pool in state court, alleging that the state’s “insurer of last resort” unlawfully denied coverage for fire, smoke and contamination damage in violation of California insurance law after his home was damaged in the Eaton Fire.

  • October 15, 2025

    High Court Won’t Hear Life Insurance Beneficiary’s Certifying Questions Appeal

    WASHINGTON, D.C. — The U.S. Supreme Court on Oct. 14 denied a petition for a writ of certiorari filed by a life insurance policy beneficiary who brought a putative class complaint against the insurer and presented to the high court two questions regarding certifying state law issues to state high courts.

  • October 13, 2025

    Newsom Signs FAIR Plan Legislation For State ‘Insurer Of Last Resort’

    SACRAMENTO, Calif. — California Gov. Gavin Newsom signed California Assembly Bill 234, California FAIR Plan Association Governing Committee, a bill sponsored by Democratic Assembly Member Lisa Calderon, who stated that the bill “increases transparency of the FAIR Plan by requiring the Speaker of the Assembly and the Chairperson of the Senate Committee on Rules (or a designee) to serve as members” of the committee and “ensures the public has a seat at the table.”

  • October 10, 2025

    Judge Finds No Coverage After Insurer, Construction Worker Rescind Policy

    LOS ANGELES — A federal judge in California granted an insurer’s motion for summary judgment on its complaint seeking a declaration that an insurance policy it issued to a construction worker had been rescinded and, therefore, that it did not need to provide indemnity for any sums for which the construction worker could be found liable to a property owner whose property was damaged allegedly due to the construction worker’s faulty work; the judge found that the worker and insurance company had mutually rescinded the policy.

  • October 09, 2025

    California Panel Affirms Ruling In Insurer’s Favor In Suit Arising From Assault

    SAN DIEGO — A California appeals panel affirmed a lower court’s judgment in favor of a homeowners insurer in its declaratory relief lawsuit disputing coverage for an underlying judgment against its insured, concluding that the insured’s conduct was not the result of an “accident” and, therefore, the underlying damages did not arise from a covered “occurrence” under the policy.

  • October 08, 2025

    Disability Case Involving Brain Injury Is Remanded For Vocational Analysis

    SAN FRANCISCO — On de novo review of a case challenging termination of long-term disability (LTD) benefits under an any-occupation standard, a California federal magistrate judge found that “the medical evidence does not establish that Plaintiff is unable to enter the workforce” but that vocational evidence is needed to determine whether the claimant is disabled under the plan terms.

  • October 07, 2025

    Professional Negligence Suit Against Broker Is Untimely, California Panel Affirms

    LOS ANGELES — A California appeals panel on Oct. 6 determined that a lower court properly determined that a professional negligence lawsuit against an insurance broker is time-barred because the action was filed more than two years after the professional negligence cause of action accrued and the plaintiff has failed to plead any facts supporting his argument that the lower court should have applied equitable tolling principles.

  • October 02, 2025

    California Insurance Commissioner Issues Bulletin On Fire-Related Cancellation

    SACRAMENTO, Calif. — California Insurance Commissioner Ricardo Lara issued a bulletin requiring insurance companies not to cancel or refuse to renew residential property insurance for properties located in a specified ZIP code within or adjacent to a fire perimeter for one year after the state of emergency that was issued by Gov. Gavin Newsom on Sept. 19 related to the TCU Lightning Complex Fires near Chinese Camp, Calif.

  • October 01, 2025

    Judge: Misappropriation Of Funds Exclusion Bars Professional Liability Coverage

    FRESNO, Calif. — A federal judge in California granted a professional liability insurer’s motion for summary judgment in an insured’s breach of contract and bad faith lawsuit seeking coverage for underlying claims alleging that the insured conducted a negligent background check on a client’s potential employee, ruling that the policy exclusion for “misappropriation of funds” unambiguously bars coverage.