Course of Performance Evidence Can Be Admissible For Contract Interpretation Purposes

As a general matter, course of performance evidence is admissible to interpret insurance policies, explained California’s Appellate Court in Employers Reinsurance Company v. The Superior Court Of Los Angeles County (2008) __Cal.App.4th__ [08 C.D.O.S. 3935] (2nd District).  However, in the case before it, some of the course of performance evidence was not admissible because much of the performance was pursuant to settlement and claims handling agreements (which contained reservation of rights to dispute coverage), and not pursuant to the insurance policies. 

Thorpe Insulation Company was a distributor and installer of asbestos insulation products. Thorpe was sued in thousands of personal injury lawsuits. Thorpe’s insurance policies covered both products/completed operations claims (“products claims”) and non-products claims (“operations claims”). All of its policies’ aggregate limits applied to products claims, but not to operations claims.

In 1978, Thorpe began tendering the asbestos lawsuits to its primary insurers. In 1984, Thorpe and ten of its primary insurers entered into a Claim Handling and Settlement Agreement (the “1984 Agreement”). The stated purpose of the 1984 Agreement was to “clarify among” the parties to the agreement “the apportionment of defense and indemnification of Thorpe[.]” The 1984 Agreement provided, among other things, that it should not be construed “as a policy interpretation, and shall not be used in any Court … to interpret the obligations under general liability or other policies” and was “without prejudice to later assertion by any such parties of claims against each other … pursuant to the several reservations of rights … contained in this Agreement.” 

Thorpe’s primary insurers charged all settlement payments against the policies’ aggregate limits, treating the claims as products claims. As the primary policies exhausted, Thorpe began tendering claims to its first level excess insurers. In 1998, seven of Thorpe’s first level excess insurers entered into an Interim Excess Insurance Claims Handling Agreement (the “1998 Agreement”). The stated purpose and terms of the 1998 Agreement were similar to those of the 1984 Agreement. The 1998 Agreement also considered an excess insurer’s policy to be implicated when the underlying primary policy is “contend[ed to] have been exhausted.” Thorpe was not a party to the 1998 Agreement, but received a copy and advised its first level excess layer insurers that it reserved all rights under their policies.  

Thorpe’s first level (and upper level) excess insurers charged payments under their policies against aggregate limits, again treating all claims as products claims. When Thorpe had nearly exhausted all of its $180 million in aggregate limits, it sued its insurers seeking a declaration that the insurers still owed defense and indemnity in connection with claims that Thorpe now contended were operations claims and not subject to aggregate limits.

The insurers argued that by accepting payment of the policies’ aggregate limits on a layer-by-layer basis over several decades, Thorpe understood that all of the underlying claims were products claims under the terms of the policies. Thorpe filed a motion in limine to exclude evidence of the parties’ post-policy course of performance. The trial court granted the motion on two grounds: (1) course of performance evidence is only relevant if it predates a controversy and the 1984 Agreement indicated the existence of a controversy, and (2) such evidence is relevant only if it sheds light on the intent of the parties at the time of contracting and the individuals who negotiated the subject policies were not the same as those who performed under the policies.

The insurers filed a petition for writ of mandate. The court of appeal issued an order to show cause to consider whether the trial court erred in concluding the policies’ claims handling history was irrelevant to the issue of policy interpretation.  

Preliminarily, the appellate court concluded that course of performance evidence is generally admissible to interpret insurance policies, even standard form insurance policies. The court also concluded the admissibility of course of performance evidence does not require the individual performing under the contract to be the individual who negotiated the contract. 

However, the appellate court held course of performance evidence is only relevant to the issue of contract interpretation when the performance is attributable to the parties’ understanding of the contract. The court determined that in the case before it, the 1984 and 1998 Agreements, not the policies, governed the bulk of the parties’ performance. Among other things, the court found particularly relevant the fact that Thorpe obtained excess coverage proceeds because the insurers to the 1998 Agreement had agreed among themselves to make those payments while reserving rights to subsequently contend the payments were not, in fact, due under their policies. 

The court concluded the trial court did not err in excluding evidence of performance following the 1984 Agreement. But the court left open the possibility that pre-1984 course of performance evidence and course of performance evidence as to excess insurers not parties to the 1998 Agreement could still be admissible.

Excess Insurer Does Not Pay Until Primary Pays Or Held Liable To Pay Full Limits

Full primary insurance limits must be paid (or be held liable to pay) prior to excess coverage attaching where the excess policy requires that the underlying policy “have paid or have been held liable to pay the full amount” of underlying limits. Where the insured settled with its primary insurer for less than policy limits, the excess insurer had no obligation to pay, ruled California’s appellate court in Qualcomm v. Certain Underwriters at Lloyd’s, London, __ Cal.App.4th __ (2008) [2008 WL 763483] (4th District - San Diego). The appellate court found the language of the excess policy clear and unambiguous and required this result, regardless of public policy considerations.

Qualcomm was sued in class actions relating to asserted rights to unvested company stock options. Qualcomm incurred in excess of $25 million defending against and resolving the lawsuits. Qualcomm tendered the claim under its director and officers insurance. Its primary insurer had $20 million in limits for loss, defined as including damages, judgments, settlements and defense costs. The primary insurer disputed coverage. Qualcomm and its primary insurer mediated and settled for $16 million. Qualcomm then sued London, its excess insurer, for declaratory relief and breach of contract for the remaining $9 million.

On demurrer, London moved to dismiss Qualcomm’s complaint for failure to state a cause of action on the basis of the excess policy’s “maintenance of underlying limits” and “exhaustion” clauses. Qualcomm argued in response that: (1) the maintenance of underlying limits clause was ambiguous; (2) the issue had been decided by a 1928 decision out of New York and a 1967 California case (which London was “chargeable” with knowing about) which cases held that when a primary insurer settles for less than policy limits, the excess insurer has to pay the losses that exceed the primary’s limits, and (3) it would be against public policy to rule otherwise because it would discourage settlements and result in a windfall for an excess insurer. The trial court sustained the demurrer.

On appeal, the court found no ambiguity in the exhaustion clause, as the appellate court referred to the “have paid or have been held liable to pay” language in the policy [also often called the attachment clause]. Excess insurance is understood to be secondary insurance, the court explained. Insurance policies should be interpreted according to their language. The court cannot rewrite the policy. The appellate court found the phrase “have paid … the full amount” of underlying limits could mean only actual payment of the $20 million of primary limits. The “have been held liable” language had to mean something different than actual payment or it would be redundant. Even interpreting that language in Qualcomm’s favor, as including a situation where the insurer agrees to pay policy limits as part of a settlement (rather than requiring an adjudication), the language still required full payment of policy limits.

Earlier decisions upon which Qualcomm relied, Home Indem. Co. v. Mission Ins. Co., 251 Cal.App.2d 942 (1967) and Zeig v. Massachusetts Bonding & Ins. Co., 23 F.2d 665 (2d Cir. 1928), were neither precedent nor persuasive. The appellate court disagreed with the Zieg court’s willingness to put public policy considerations before policy language and its strained interpretation of the word “payment.” Both California and out of state authority disagree with the Zeig approach to contract interpretation. Home, the appellate court held,was consistent with the appellate court’s reasoning but the case’s result was based on disparate facts and circumstances.

The appellate court also ruled that public policy considerations, including those favoring settlements, could not supersede plain and unambiguous policy language. The court was “bound” by the policy’s language.

The appellate court did not address the maintenance of underlying limits requirement in the excess policy, which was another basis upon which the trial court had found in London’s favor.

Equitable Defenses Did Not Defeat Class Certification

Blue Shield still faces a possible class action on “post claims underwriting.” California’s Court of Appeal, Second District (Los Angeles), issued a slightly modified opinion after rehearing against Blue Shield. The appellate decisions reverses the Los Angeles County Superior Court’s order denying a motion to certify a class under Proposition 64.  In sum, the appellate court held that equitable defenses cannot be used to defeat a claim under California’s Unfair Competition Law (Bus. & Prof. Code, § 17200 [the “UCL”]) and Blue Shield could not raise as a defense fraud based on statements the insured made in an application for insurance because the application was neither attached to nor endorsed on to the policy when issued. 

Plaintiff Augusto Ticconi alleged he applied for a policy of short term health and accidental death insurance from Blue Shield of California Life and Health Insurance Company and truthfully answered all health questions on the policy application. Blue Shield issued the policy to Ticconi effective January 1, 2004 with a one year duration. Ticconi’s application was not attached to or endorsed onto the Policy when issued. Thereafter, Ticconi required “significant health care services” totaling over $100,000. After Ticconi submitted his bills for payment, Blue Shield rescinded the Policy on the basis that Ticconi has made material misrepresentations in his application for insurance.

In his class action lawsuit against Blue Shield, Ticconi alleged Blue Shield had a practice of issuing policies without attaching or endorsing a copy his application in violation of Insurance Code §§ 10113 and 10381.5, and rescinding policies in violation of those statutes, which conduct constituted an unfair and unlawful business practice in violation of the UCL.

Ticconi moved for certification of a class defined as all California residents issued health insurance since May 2001 by Blue Shield and who thereafter had the policy rescinded by Blue Shield based upon alleged misrepresentations contained in the policy application.  Blue Shield opposed the motion on the basis, among others, that there was a lack of community-of-interest required for class certification. The trial court denied Ticconi’s motion for class certification on the basis that Blue Shield’s defenses of fraud and unclean hands to Ticconi’s and other insureds’ claims raised individual factual issues  and would require separate trials on the merits of each individual’s case based on its unique facts.

In reversing the trial court’s decision, the court of appeal noted that the unlawful conduct alleged by Ticconi was “postclaims underwriting.” The court found such practice to be “categorically prohibited” by Insurance Code § 10384. The court also stated that the consequence for failing to comply with Insurance Code §  10113 and 10381.5 is that the insured is not bound by statements made in the application and the insurer claim misrepresentation or omission based on the unattached and unendorsed application. The court further held that conduct in contravention of Insurance Code §§ 10113, 10381.5 and 10384, constitutes a predicate unlawful practice sufficient for a UCL cause of action. 

The court of appeal found Ticconi’s defined class raised factual and legal issues relevant to Blue Shield’s liability and universal to class members, thus common issues of law and fact would predominate.  The court found that equitable defenses of unclean hands were not available in a UCL action based on violation of a statute, because allowing such a defense would “sanction the defendant for engaging in an act declared by statute to be void or against public policy.” Fraud was not available to Blue Shield as a defense to the UCL cause of action because Blue Shield failed to attach or endorse the insureds’ application to the policy.  Thus, it was error for the trial court to weigh the legal and factual issues associated with such defenses in denying Ticconi’s motion for class certification.

The case was remanded to the district court with instructions. The appellate court noted there were other issues to consider as to whether the class should be certified, including whether Ticconi’s claims were typical and whether he could adequately represent the class, especially since Ticconi’s policy had been reinstated and medical bills paid.  

The California Supreme Court denied review (3/26/08).

California Court of Appeal Again Upholds Absolute Pollution Exclusion

After the California Supreme Court's 2003 opinion in MacKinnon, rejecting the application of an absolute pollution exclusion to injuries to building occupants by pesticide sprayings and declaring that such exclusions are limited to "injuries commonly thought of as "pollution" (ie. environmental pollution),  one might well have assumed that it would be a rare day indeed before a California court gave effect to such exclusions in bodily injury cases.  In surprising turn of events, however, the Court of Appeal has since done that in several recent cases.

The latest ruling to give an expansive interpretation to MacKinnon's construct of "environmental pollution" is the Second District's opinion this week in American Casualty Co. of Reading, PA v. Miller.  At issue were personal injuries suffered by a workman who, in the course of performing maintenance work in a sewer line, was exposed to methylene chloride that had been flushed into the sewer by Stripper Herk, a furniture stripping business (why don't the insureds in my cases ever have cool names like that).  Stripper Herk ultimately enter into a plea agreement with the U.S. Attorney in which it confessed to have discharged chemicals in violation of its permit. 

In the ensuing coverage litigation, the Los Angelese Superior Court ruled for CNA in 2006, holding that the worker's suit for injuries caused by exposure to the methylene chloride were clearly subject to the APE in a 2002 American Casualty policy as arising out of a discharge of pollutants on or from the insured's premises.  This finding was affirmed by the Second District of the Court of Appeal on January 29.

The court ruled that “an ordinary insured would reasonably expect that the release of methylene chloride into a public sewer is environmental pollution.”   In keeping with other recent opinions such as Ortega Rock Quarry and Garamendi v. Golden Eagle, the court held that the insured's discharge of methylene chloride into the sewer was a widespread dissemination of a pollutant into the environment.  The court rejected the insured's argument that such exclusions do not apply to "one-time, negligent" discharges or should be limited to "catastrophic events such as large scale industrial pollution   The court also held that the fact that the sewer in question was sealed merely limited the scope of injury and did not alter the fact that there had been a release into the environment.. Finally, the Second District held that the operator of a furniture stripping business should have been well aware of the need to handle such chemicals carefully.

Although not discussed in the opinion, the Second District's analysis is in keeping with the First District's opinion late last year in Cold  Creek Compost, Inc. v. State Farm Fire & Casualty Co., A114623 (Cal. App. November 20, 2007), in whichh the Court of Appeal ruled that neighbors’ nuisance claims due to exposure to offensive odors, dust and noise from the insured’s composting operations are subject to an absolute pollution exclusion. The First District declared that “the widespread dissemination of offensive and injurious odors from a commercial compost facility is ‘environmental pollution’ under MacKinnon and thus excluded from coverage...”

It will be interesting to see if the California Supreme Court takes an appeal from one of these cases.  Meanwhile, it appears that the rumors of the demise of the absolute pollution exclusion  in California were exaggerated after all.

Cautionary Tale on Responding To E-Discovery Requests

On January 7, 2008, a Magistrate Judge in California issued a sanctions order imposing over $8.5 million in monetary sanctions on a company for discovery abuses in a case that company lost at trial, in what should be a cautionary tale for companies and their lawyers as they respond to discovery requests. (Qualcomm, Inc. v. Broadcom, Inc., U.S. Dist. Ct., So. Dist. Of Calif., Case No. 05civ958-B (BLM).)  Magistrate Judge Barbara Major sanctioned six of Qualcomm's outside counsel -- junior associates through partners. Although she did not impose monetary sanctions on counsel, she referred the sanctioned attorneys to the State Bar and ordered them and Qualcomm’s in-house attorneys to determine how the discovery breaches occurred and to develop a protocol to prevent similar failures in future cases.

Qualcomm v. Broadcom was a patent infringement case tried in the U.S. District Court in 2007. Broadcom filed a counterclaim alleging Qualcomm's patents were not enforceable due to waiver.  The waiver defense was predicated on Qualcomm's participation in a Joint Video Team ("JVT") in 2002 and early 2003 when the JVT was setting standards for the technology at issue. Qualcomm's participation in setting the standards would have required it to disclose certain patents and prohibited Qualcomm from suing for infringement of those patents.

Broadcom sent discovery seeking information about Qualcomm's participation in the JVT.  Qualcomm's written responses did not raise any issues.  However, witnesses produced for deposition as most knowledgeable about Qualcomm's participation in the JVT were not adequately prepared by Qualcomm for their depositions and Qualcomm did not search their computers for relevant emails or documents in preparation for the depositions (or to respond to the written discovery requests).  Consequently, the witnesses testified falsely about Qualcomm's involvement in the JVT. One denied any involvement and the other asserted Qualcomm participated only in late 2003 and after.

At Trial, Qualcomm aggressively advocated the position it did not participate in the JVT during a critical period.  While preparing one of Qualcomm's witnesses for Trial, a junior associate found 21 emails on the witness' computer that had not previously been produced.  Some of the emails were sent to JVT email groups and dated back to 2002.  Qualcomm's Trial team discounted the impact these emails, concluding the emails were not responsive to Broadcom's discovery requests, and decided not to produce them.  Counsel did not investigate further to determine if other emails had not been produced.

In seeking to avoid admission of certain evidence, Qualcomm's attorneys affirmatively argued there were no emails sent to the JVT email groups. Trial counsel did not elicit from witnesses information that might have revealed the emails. However, during Broadcom’s cross-examination, the witness disclosed the existence of the emails.  Thereafter, Qualcomm produced the emails during a lunch break after the witness testified.

During post-Trial proceedings, the Judge found Qualcomm and its counsel had acted inequitably by concealing its patents from the JVT and later concealing its involvement in the JVT from Broadcom, the Court, jury and opposing counsel during litigation. Finding the case was “exceptional” within the meaning of the patent laws, the Trial Judge granted Broadcom's motion for attorneys' fees and court costs, awarding Broadcom $8.5 million in fees and costs, plus interest.

Qualcomm's attorneys continued to argue post-Trial that the 21 emails were not responsive to Broadcom’s discovery requests. However, eventually, Qualcomm agreed to search the current and archived emails of five Trial witnesses, and thereafter admitted there were thousands of responsive documents that had not been produced. Qualcomm conceded some of the documents contained facts inconsistent with Qualcomm's position at Trial and in the post-Trial proceedings.   Qualcomm later expanded its search to the email accounts of 21 employees and found a total of 46,000 emails (over 300,000 pages) that had been requested by Broadcom but not produced.

Broadcom brought a motion for discovery sanctions against Qualcomm and its attorneys that was referred to Magistrate Judge Major. Judge Major concluded there was "clear and convincing" evidence Qualcomm "intentionally" engaged in conduct designed to prevent Broadcom from learning about Qualcomm’s participation in the JVT. Judge Major imposed over $8.5 million in attorneys fees and costs as sanctions on Qualcomm, subject to a credit for amounts paid on the attorneys fee award issued by the trial court. Judge Major sanctioned six attorneys.  In sanctioning a junior attorney, the Judge suggested that a junior attorney with concerns about a client’s search for responsive documents should take his or her concerns to a more senior attorney who, in turn, would ultimately be obligated to withdraw if the client refused to conduct an adequate search for responsive documents. The Judge also noted that junior attorneys need to be properly supervised and trained for the tasks to which they are assigned.

Judge Major ordered the sanctioned attorneys and several Qualcomm in-house attorneys to participate in a comprehensive Case Review and Enforcement of Discovery Obligations program. This process is to identify, with a "detailed analysis," what went wrong, craft alternatives that will prevent problems in the future, and prepare a protocol for other situations, including where the client does not have corporate counsel or has only a single in-house attorney, or where multiple law firms are involved, and other scenarios.

Asbestos BI Claims All Separate Occurrences

Bad news for a primary insurance company and good news for the excess insurers comes from the trial court’s decision finding multiple occurrences on remand in the Kaiser Cement case (Truck Ins. Exchg. v. Kaiser Cement, et al., Los Angeles Superior Court, Case No. BC249550 [Order 1/24/08]).  The number of occurrence issue is of major importance to insurers and their insureds in asbestos, construction, sexual abuse, and other multiple-claimant coverage disputes.  

The California Court of Appeal (Second Appellate District [Los Angeles]) in 2007 ruled that Truck Insurance Exchange was wrong in asserting that its payment of claims had exhausted its policies’ occurrence limits because, the court held, the occurrence under Truck’s policies was the injurious exposure to asbestos, not the manufacture and distribution of products containing asbestos. London Market Insurers v. Superior Court (Truck Ins. Exchg.) (2007) 146 Cal.App.4th 648 (review denied). Truck’s position had been that all asbestos-related claims in any given year arose from a single occurrence because all the claims had the same underlying cause, i.e., “the design, manufacture and distribution by Kaiser and its subsidiaries of asbestos-bearing products.” The appellate court also concluded that, given its ruling, it could not make a decision on the number of occurrences based on the record before it and remanded the case to the trial court for further proceedings.

On remand, the trial court held that, based on the policies’ language and in light of the stipulated facts, Truck failed to prove the claims could be aggregated and, thus, each claim of asbestos bodily injury was a separate and distinct occurrence under Truck's 19 policies.

Truck’s policies had two different occurrence definitions and aggregating clauses. From 1964 to 1974 the policies had a “one lot” clause which provided that “all damages arising out of one prepared or acquired lot of goods or products” arose out of one occurrence. Truck argued that under this provision, claims from exposure to products produced at the same manufacturing facility should be deemed one occurrence. Based on the appellate court’s decision, the trial court held the focus had to be on the exposure rather than the manufacturing process. Truck had stipulated that the number of product lines was not known and that individual claims could not be connected with particular product lines. Therefore, Truck failed to meet its burden to demonstrate that the “one lot” clause aggregated particular claims.

From 1974 to 1983, the Truck policies had a “premises deemer” clause which provided that exposure to substantially the same general conditions “at or emanating from each premises location” was one occurrence. Truck argued all claims were one occurrence as they arose from exposure to products produced at the same Kaiser manufacturing facility or, alternatively, because them were due to the same corporate decision (or multiple corporate decisions from the same location) to place asbestos in products.  The trial court was not persuaded. Relying on Judge Ira Brown’s decisions from the coordinated asbestos proceedings in 1990, the court held that the premises location in a deemer clause could not refer to the plant from which the products were shipped or distributed since that is not where the exposure to asbestos occurred. Furthermore, Truck stipulated that it could not connect the claimant’s injuries to a particular plant. As to the corporate decision argument, the appellate court already decided that was not the correct focus, since it was not the exposure to asbestos. Besides, there was no evidence of one decision to incorporate asbestos into all Kaiser products.

Truck had stipulated that if the court found Truck’s aggregation arguments unpersuasive, then each asbestos bodily injury claimant must be treated as a separate occurrence. Thus, that is what the trial court concluded.

No Coverage For Mold

Although winter storms may bring another round of mold claims, California appellate courts again have upheld the right of insurers to exclude coverage for damage caused by mold. De Bruyn v. Superior Court (Fire Ins. Exchg.) (2007) 07 C.D.O.S. 5019. The efficient proximate doctrine, which in California (unlike many states) constrains insurers in how they communicate what they want to cover and not cover, did not prevent the insurer in this case from excluding mold, even where the insurer agreed to cover water damage from sudden and accidental discharge of water from plumbing and household appliances.

In De Bruyn, the California appellate court (Second Appellate District [Los Angeles]) ruled that a water damage exclusion that excepted out coverage for sudden and accidental release of water, did not cover the resulting mold. That is because the exclusion “plainly and precisely” indicated that: “We never, under any circumstances, cover rust, mold, fungus, or wet or dry rot, even if resulting from exceptions . . .” In addition, the policy had a specific exclusion for rust, mold, fungus, or wet or dry rot.

The court held that Fire Insurance Exchange’s exclusion of coverage for mold did not violate Insurance Code § 530 or the efficient proximate cause doctrine in California. The efficient cause doctrine provides that if there is both a covered and non-covered cause of the loss for which the insured seeks coverage, there is coverage for the claim. Calif. Ins. Code § 530; Garvey v. State Farm Fire & Cas. Co. (1989) 48 Cal.3d 395, 403. In California, insurers are not permitted to “contract around” this rule. See, e.g., Howell v. State Farm Fire & Cas. Co. (1990) 218 Cal.App.3d 1446. In other states, courts recognize that an insurer can, if it does so clearly and explicitly, contract that despite the fact that one cause of the loss may be covered, if the other cause is not covered, there is no coverage. See, e.g., Arizona: Millar v. State Farm Fire & Cas. Co., 804 P.2d 822 (Ariz. Ct. App. 1991), review denied, 811 P.2d 1081 (Ariz. 1991); Utah: Alf v. State Farmer Fire & Cas. Co., 850 P.2d 1272 (Utah 1993).) See, also, the De Bruyn court’s footnote 3.

In De Bruyn, the California appellate court again confirms that an insurance company is permitted to provide coverage for some but not all manifestations of a loss, as long as the company does so in manner that communicates the information and does not violate public policy. Accord, Julian v. Hartford Und. Ins. Co. (2005) 35 Cal.4th 747 (insurer can exclude coverage for certain perils, i.e., weather conditions and landslides, even if the policy provides that it will cover the results of other weather conditions; the policy clearly communicated that the insurer intended to exclude coverage for rain that induced a landslide).

In De Bruyn, the California appellate court (Second Appellate District [Los Angeles]) ruled that a water damage exclusion that excepted out coverage for sudden and accidental release of water, did not cover the resulting mold. That is because the exclusion “plainly and precisely” indicated that: “We never, under any circumstances, cover rust, mold, fungus, or wet or dry rot, even if resulting from exceptions . . .” In addition, the policy had a specific exclusion for rust, mold, fungus, or wet or dry rot.

The court held that Fire Insurance Exchange’s exclusion of coverage for mold did not violate Insurance Code § 530 or the efficient proximate cause doctrine in California. The efficient cause doctrine provides that if there is both a covered and non-covered cause of the loss for which the insured seeks coverage, there is coverage for the claim. Calif. Ins. Code § 530; Garvey v. State Farm Fire & Cas. Co. (1989) 48 Cal.3d 395, 403. In California, insurers are not permitted to “contract around” this rule. See, e.g., Howell v. State Farm Fire & Cas. Co. (1990) 218 Cal.App.3d 1446. In other states, courts recognize that an insurer can, if it does so clearly and explicitly, contract that despite the fact that one cause of the loss may be covered, if the other cause is not covered, there is no coverage. See, e.g., Arizona: Millar v. State Farm Fire & Cas. Co., 804 P.2d 822 (Ariz. Ct. App. 1991), review denied, 811 P.2d 1081 (Ariz. 1991); Utah: Alf v. State Farmer Fire & Cas. Co., 850 P.2d 1272 (Utah 1993).) See, also, the De Bruyn court’s footnote 3.

In De Bruyn, the California appellate court again confirms that an insurance company is permitted to provide coverage for some but not all manifestations of a loss, as long as the company does so in manner that communicates the information and does not violate public policy. Accord, Julian v. Hartford Und. Ins. Co. (2005) 35 Cal.4th 747 (insurer can exclude coverage for certain perils, i.e., weather conditions and landslides, even if the policy provides that it will cover the results of other weather conditions; the policy clearly communicated that the insurer intended to exclude coverage for rain that induced a landslide).

California Court Affirms Insurer's Right To Rescission And Explains Burden Of Proof On Reimbursement Claim

A California appellate court provided further guidance to insurers on satisfactory grounds for rescission of an insurance policy and the burden on the insurer to obtain reimbursement of defense costs and settlement amounts paid on an insureds’ behalf. The court’s decision provides further delineation of the difficult burden imposed on insurers in obtaining reimbursement from an insured (even when the insured is able to pay).

In LA Sound USA, Inc. v. St. Paul Fire & Marine Ins. Co., __ Cal.App.4th __ [2007 Cal.App. LEXIS 1853], the California Court of Appeal for the Fourth Appellate District (which includes Orange County) ruled that: (1) the failure to advise the insurance company that the insureds were involved in a joint venture was a material misrepresentation supporting rescission of the policy ab initio; and (2) the insurance company was entitled to reimbursement of all amounts paid to defend and settle the claim against its insureds; but (3) the insurer had the burden of showing by a preponderance of the evidence how much each of three insureds should reimburse and had failed to do this, so the case was remanded for this determination.

The insureds were LA Sound, an audio equipment company, and its two officers and directors. At the time of renewing their insurance policy with St. Paul, the insureds (through their broker) answered an application indicating they were not involved in any joint ventures or in a labor interchange with any other business or subsidiary. In fact, the insureds had been involved for six months in a joint venture with Hollywood Sound to produce, market and sell audio and speaker products. The joint venture was a new corporation by the name of LSY Trading Development, Inc.

The joint venture stalled and Hollywood Sound sued the insureds and LSY for unfair competition (trademark infringement).

St. Paul agreed to defend LA Sound and its officers/directors, but only in their capacity as such, under a full reservation of rights. St. Paul specifically disclaimed any obligation to defend LSY and its (same) officers and directors. St. Paul agreed to pay the portion of the defense costs being incurred by LA Sound. St. Paul reserved the right to get the money back.  Thereafter, St. Paul settled the claim against LA Sound and its officers/directors, and the case proceeded against LSY and its (same) officers/directors until resolved.

Following conclusion of that lawsuit, LA Sound sued St. Paul for breach of contract and bad faith and St. Paul counterclaimed for rescission and reimbursement of amounts paid on LA Sound’s behalf. Trial resulted in a decision for St. Paul in all respects. The appellate court on review agreed there were grounds for rescission of the policy. Misrepresentations had been made to St. Paul about whether there was a joint venture or labor agreement. The omitted information was material to St. Paul’s assessment of the risk, underwriting, and determination of the premium to charge.

The appellate court also found St. Paul was entitled under Buss v. Sup. Ct. [16 Cal.4th 35 (1997)] to be reimbursed for defense costs and the settlement paid on LA Sound’s behalf. However, the appellate court found St. Paul had not met its burden of showing by a preponderance of the evidence an allocation as between LA Sound and its two officers/directors. It was not fair, according to the court, to allocate all amounts to the insureds jointly and severally as there was no showing each faced the same liability and received the same benefit from the payments. As the court explained:

"[I]n the absence of proof, we decline to assume that every dollar St. Paul spent on the underlying action benefited all three insureds. Whether this is true depends on a detailed analysis of how the defense costs were spent – did any discovery or motion practice benefit one insured alone, or did all litigation costs benefit all insureds equally? It also depends on a detailed analysis of how the indemnity costs were spent – did the insureds face the same amount of liability , and was the liability settled on identical terms?" *15.

Under Buss the burden was on the insurer to prove the right to reimbursement and allocation, which the court found appropriate since the insurers were in the "best position to monitor the underlying litigation, track expenses, and allocate policy benefits among insureds.” Id.

Thus, the case was remanded for further determination on the proper allocation of restitution based upon the “respective benefits received by each” of the insureds under the rescinded policy.

California Court's Confusing Conflicts Conclusion

As one grows older and sometimes wiser, it becomes apparent that the most important legal subjects are the ones that we largely ignored during law school. Such is clearly the case with Conflicts of Law.   Apart from allocation, few fields of insurance law have generated so many different analyses: lex loci contractus, “LeFlar factors,” “most significant contacts,” “governmental interest,” “grouping of contacts” and (the author’s personal favorite): renvoi (what can you say about a state like Maryland whose university mascot is a turtle?).

Now comes California to further muddy the waters. Until recently, it had seemed relatively settled that California followed a “governmental interest” approach wherein the law of conflicting jurisdictions would be evaluated in accordance with which state had the more substantive interest in the outcome of the dispute. However, a recent opinion of the California Court of Appeal has suggested an entirely different approach.

In Frontier Oil Corp. v. RLI Ins. Co., B189158, 2007 Cal. App. LEXIS 1298 (2d Dist. August 6, 2007) an oil company and its subsidiary were sued by students and residents near the Beverly Hills High School (an area whose riches apparently include not only Tori Spelling but also significant oil and gas deposits) for respiratory problems and other injuries from exposure to airborne contaminants discharged in the course of the defendants’ oil and gas production operations in the area.. The Superior Court granted summary judgment to RLI holding that, under Texas law, the claims were subject to an absolute pollution exclusion in its policies. 

 

However, the Second District of the California Court of Appeal has since declared that the Superior Court erred in failing to apply the law of California, which takes a broader view of the duty to defend than Texas. Writing for the court, Justice Croskey declared that Civil Code Section 1646, which requires that a contract be interpreted according to the law and usage of the place where the contract is to be performed, compelled the application of California law, as California was the state where RLI would be obligated to perform its defense obligations under the policies and that the contracting parties knew this at the time that the policy was issued as the RLI policy includes several endorsements reflecting the existence of a covered risk located in California. The court then went on to hold that RLI’s duty to defend was triggered under California law.

This focus on the place of performance is not unheard of. For instance, New Jersey courts have applied different choice of law rules in pollution cases depending on the nature of the underlying issue and have adopted the current domicile of the insured as applying to issues involving the obligation to give timely notice since the insured was located in that jurisdiction at the time that the notice obligation arose. See . Unisys Corp. v. INA, 154 N.J. 217, 712 A.2d 649 (1998). On the other hand, the California court’s approach seems more of a fig leaf for adopting a place of the tort approach since construing the “place of performance” as the jurisdiction where the insurer is required to provide a defense necessarily means that the jurisdiction where the underlying litigation is pending will be the state whose law controls. As far as the author knows, this approach is unprecedented (although hardly the first time that California courts have leaped into the abyss).

The opinion is also worthy of note in that it was written by Justice Croskey, whose views on insurance are often viewed as being close to gospel in California. Of late, however, Croskey has authored several opinions that are far from mainstream.