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Insurance Law

[09/08] Scottsdale Ins. Co. v. Univ. Crop Protection Alliance, LLC
In a declaratory judgment action seeking a ruling that a pollution exclusion in defendant's insurance policy relieved plaintiff of any obligation to defend or indemnify defendant, summary judgment for plaintiff is affirmed where: 1) in the insurance policy coverage context, a declaratory judgment action is ripe irrespective of whether the underlying litigation is ongoing or resolved; and 2) the underlying complaint made clear the relofted particulates at issue were toxic, and therefore, would qualify as "pollutants" under the policy.

[09/08] Murphy v. Deloitte & Touche Grp. Ins. Plan
In an action concerning defendant's denial of disability benefits under an ERISA plan, summary judgment for defendant is vacated where: 1) the court's case law prohibited courts from considering materials outside the administrative record where the extra-record materials sought to be introduced related to a claimant's eligibility for benefits; and 2) neither a claimant nor an administrator should be allowed to use discovery to engage in unnecessarily broad discovery that slows the efficient resolution of an ERISA claim.

[09/03] Conseco Life Ins. Co. v. Williams
In an interpleader action to determine the rights to life insurance proceeds, district court's grant of decedent's sister's motion for summary judgment is affirmed where: 1) the district court properly admitted the affidavits as, under Primerica Life Ins. Co. v. Watson, 207 S.W. 3d 442 (Ark. 2005), a deceased insured's oral statements to several people concerning that insured's future intentions to change the beneficiary in an insurance contract in favor of another are admissible to resolve disputes as to who is the proper beneficiary; and 2) the decedent's sister rebutted the presumption of undue influence with the affidavits in support of her motion for summary judgment.

[09/02] Travelers Prop. Cas. Ins. Co. of Am. v. Nat'l. Union Ins. Co.
In an action by one insurer against another seeking $10 million in subrogation proceeds, summary judgment for defendants is affirmed in part where plaintiff waived certain rights by refusing repeated invitations to participate in subrogation discussions. However, the judgment is reversed in part where, as the excess insurer, plaintiff was entitled to a priority interest in the subrogation proceeds representing insured losses.

[09/02] Atlantic Nat'l Trust LLC v. Mt. Hawley Ins. Co.
In an action seeking insurance proceeds arising from a fire, defendants' appeal from the grant of plaintiff's motion to remand is dismissed where the court lacked appellate jurisdiction to review a federal district court order remanding a case to state court based on a ground colorably characterized as a "defect" for purposes of 28 U.S.C. section 1447(c).

[09/01] Sprinkles v. Associated Indem. Corp.
In plaintiffs' bad faith action against Fireman's Fund Insurance Company, arising from an underlying suit against defendant and his employer for causing the death of plaintiffs' father in an automobile accident, trial court's judgment sustaining the insurer's demurrer is affirmed as, under the complaint and matters judicially noticed, the defendant-employee was an insured, rendering the automobile exclusion in the GCL policy applicable, and Fireman's Fund had no duty to defend the employer.

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Health Law

[09/08] Murphy v. Deloitte & Touche Grp. Ins. Plan
In an action concerning defendant's denial of disability benefits under an ERISA plan, summary judgment for defendant is vacated where: 1) the court's case law prohibited courts from considering materials outside the administrative record where the extra-record materials sought to be introduced related to a claimant's eligibility for benefits; and 2) neither a claimant nor an administrator should be allowed to use discovery to engage in unnecessarily broad discovery that slows the efficient resolution of an ERISA claim.

[09/08] Brown v. Auto. Components Holdings, LLC
In plaintiff's suit against her former employer for interference with her rights under the Family and Medical Leave Act (FMLA), district court's entry of summary judgment in favor of the defendant is affirmed as defendant's termination of plaintiff's employment based on her noncompliance with its internal leave procedures did not violate the FMLA because the undisputed facts establish that plaintiff was absent without leave after failing to give proper FMLA notice for an extension of a previously requested leave period.

[09/07] Armstrong v. Schwarzenegger
In a class action against California officials with responsibility over the corrections system and parole proceedings, seeking accommodations to plaintiffs' disabilities under the Americans with Disabilities Act, the Rehabilitation Act, and the Constitution, the district court's order granting plaintiffs' motion to require defendants to track and accommodate the needs of class members housed in county jails and to ensure a workable grievance procedure for such class members is affirmed in part where: 1) defendants were responsible for providing reasonable accommodations to the disabled prisoners and parolees they housed in county jails; and 2) the district court made the findings required by the Prison Litigation Reform Act (PLRA) regarding the necessity for relief and the narrowness and lack of intrusiveness of the relief order. However, the order is vacated in part where injunctions, whether controlled by the PLRA or otherwise, required evidence of rights violations commensurate with the scope of the relief being ordered.

[09/03] Campbell v. Davol, Inc.
In plaintiff's product liability suit against defendants claiming that a hernia patch that was surgically placed in her abdomen following breast reconstructive surgery was defective, district court's grant of summary judgment in favor of the defendants is affirmed where: 1) district court did not err in granting summary judgment in favor of the defendants with respect to the issue of successor liability; 2) district court did not err in granting summary judgment on the post-sale failure to warn claim as there was no contractual relationship to provide services to customers who purchased the hernia patch from the manufacturer; and 3) there is no err in finding plaintiff's claims against defendant were barred by Texas law.

[09/02] Conservatorship of the Person & Estate of Carol K.
Trial court's judgment ordering a 62-year-old woman to be placed in a locked skilled nursing facility as the least restrictive placement, after the jury found the woman gravely disabled beyond a reasonable doubt, is affirmed where: 1) the issue is not moot because "collateral consequences remain even after the conservatorship has been terminated"; and 2) substantial evidence supports a finding that the woman is gravely disabled and cannot obtain food, clothing, or shelter.

[08/31] Florida Dep't of State v. Mangat
Judgment of the circuit court, finding that the ballot summary for Amendment 9, for creating a new section related to health care services in article I of the Florida Constitution, does not meet the requirements of section 101.161 and therefore may not be included on the November 2010 ballot is affirmed as, the ballot language put forth by the party proposing the constitutional amendment contains misleading and ambiguous language and the only recourse is to strike the proposed amendment from the ballot.

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Elder Law

[08/30] HCM Healthcare, Inc. v. California Ins. Guarantee Ass'n
In a residential nursing facility's suit against California Insurance Guarantee Association (CIGA) for breach of contract and for violating the Insurance Code for refusing to provide plaintiffs with defense counsel and indemnification for underlying lawsuits for elder abuse, judgment in favor of defendant is affirmed where: 1) as a creature of statute, and not of contract, in some instances CIGA may not be responsible for an insured loss to the same extent as the insolvent insurer might be under the terms of its insurance contract; and 2) Pennsylvania's liquidation order imposed a June 30, 2005 deadline for filing against an insurer and because plaintiff did not meet the deadline, CIGA may not honor their claims.

[08/09] Clark v. Superior Court
In senior citizens' suit against an insurance company, claiming deceptive business practices relating to the purchase and sale of annuity contracts, and claiming that statutory law entitled them to a trebling of the award, court of appeal's grant of plaintiffs' petition for a writ of mandate directing the trial court to enter a new order denying defendant's motion for judgment on the pleadings is reversed as, because Civil Code section 3345 authorizes the trebling of a remedy only when it is in the nature of a penalty, and because restitution under the unfair competition law is not a penalty, an award of restitution under the unfair competition law is not subject to section 2234's trebling provision.

[07/12] Das v. Bank of Am. N.A.
In a daughter's suit for elder abuse against Bank of America, claiming that the bank failed to report financial abuse involving her father and engaged in other misconduct, including predatory lending, trial court's dismissal of the complaint is affirmed where: 1) as section 15610.30(b)'s 2008 amendments to the statutory scheme were substantive, rather than procedural, and the Legislature did not state that the amendments were retroactive in effect, they are inapplicable to plaintiff's claims; 2) plaintiff's allegations regarding defendant's failure to comply with the statutory reporting duty state no claim against defendant; 3) the demurrers to plaintiff's remaining claims were properly sustained; and 4) there is no basis for finding the trial court abused its discretion when it sustained the demurrer without leave to amend.

[05/06] FAL-Meridian, Inc. v. US Dep't of Health & Human Serv.
A nursing home's petition to set aside a final decision by the Department of Health and Human Services, that imposed a civil penalty of $7,100 for having violated a regulation under the Medicare and Medicaid provisions of the Social Security Act, is denied as the nursing home failed to tender evidence that would show that it had done everything possible to minimize the risk of an accident to the deceased resident.

[02/05] Villano v. Waterman Convalescent Hosp., Inc.
In plaintiff's action against a convalescent hospital claiming she was admitted without her consent, judgment of the trial court is affirmed where, although a stipulated judgment is appealable, plaintiff cannot show that allegedly erroneous rulings were prejudicial.

[12/22] Massey v. Mercy Med. Center Redding
In plaintiff's negligence action against a nurse and the hospital that employed the nurse alleging that he sustained injury after falling from a walker because the nurse placed the plaintiff on the walker and left him unattended, judgment of the trial court is reversed in part where: 1) the question of nurse's alleged negligence for the fall poses a question of common knowledge, and therefore does not require expert opinion testimony; and 2) trial court's judgment that denied plaintiff's attempt to amend his complaint to add causes of action for battery, fraud and elder abuse is affirmed.

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