a recent ruling out of Nevada involving a case in which a plaintiff alleged bad faith, a judge opined a bad faith allegation did not survive Rule 12(b)(6) scrutiny. Rule 12(b)(6) pertains to a pre-trial motion for “failure to state a claim upon which relief can be granted.” In Sahinov v. Geico Advantage Ins. Co., the court deemed it “difficult for the court to sufficiently analyze whether one party was acting in bad faith” based on the details provided.
Using clear language and specifically defining terms can be of paramount importance when writing an insurance policy. In a recent case in Massachusetts, the court found in favor of the insurer based on their clear and concise insurance policy, which left no question as to whether they were liable for coverage in a complicated situation.
On November 4, 2021, the Second District Court of Appeal, Division 2, ruled against establishing tort liability for insurers who paid less than what the hospital believed to be the “reasonable and customary value.” This partially published opinion is based on the underlying suit between plaintiffs Long Beach Memorial Medical Center and Orange Coast Memorial Medical Center (collectively “the hospitals”) and defendant Kaiser Foundation Health Plan, Inc. (“Kaiser”) stemming from alleged underpayment by Kaiser for emergency medical services rendered at the hospitals.
In the wake of the COVID-19 pandemic, restauranteurs are facing a litany of issues. With changing governmental restrictions, restaurants have had to adapt more than most businesses. Some restauranteurs have taken to the courts to try and recoup losses. In a recent Colorado case, the court examined loss coverage stemming from the pandemic.
In State Farm General Insurance Company v. Oetiker, Inc. (2020) 58 Cal.App.5th 940 the Second District Court of Appeal addressed a Right to Repair Act (the “Act”) case concerning a product manufacturer trying to dodge a subrogation action based on the Right to Repair Act, California Civil Code Title 7, Section 895, et seq.i The Court of Appeal determined that the Right to Repair Act governing residential construction defect litigation does not preclude a homeowner, or its insurer, from bringing causes of action which fall outside of the Act.ii
The Ninth Circuit Court of Appeals affirmed summary judgment in favor of Philadelphia Indemnity Insurance Company (“Philadelphia”) regarding its denial of coverage to Oak Park Unified School District (“Oak Park”) based on a “design defect” exclusion in its policy, holding the denial was not in bad faith even though the Ninth Circuit had previously found the defect exclusion was ambiguous
In our April Newsletter, Tyson & Mendes reported a California federal court dismissed a lawsuit filed by the wife of a construction worker. Plaintiff claimed her husband contracted COVID-19 at work and brought the virus home infecting her as well. Following the dismissal, the district court judge gave plaintiff an opportunity to amend her complaint. At a hearing on May 7, 2021, the court upheld the dismissal without further leave to amend. As of this date, it is unknown whether plaintiff will appeal.