Decedent John Roe had entered into an accidental-death-and- dismemberment insurance contract with Defendant Doe Insurance Company. The policy was obtained by the insured through a third party and provi...ded for $250,000 death benefit. Because Mr. Roe did not have sufficient funds in the account from which the premiums were to be deducted, payment of the premium was not received until one day following Roe's death. Doe Insurance Company denied the claim made by Roe's surviving spouse.
Plaintiff's Contentions: The Defendants had waived their right to assert or were stopped from asserting that John Roe's late payment precluded recovery under the policy.
Defendant's Contentions: The premium payment was not received until after Mr. Roe's death and that the policy was not in force or effect at that time. Accordingly, Defendants asserted that they had no obligation to compensate Plaintiff under the terms and conditions of the policy.
Damages: Policy benefits of $250,000; interest; Brandt fees; and emotional distress.
Insurance
Kuhar v. Doe Insurance Company
N/A
OUTCOME: $2,400,000 settlement
A twenty-two year old, killed 6-year old Amanda Kuhar while driving a heavily modified Mustang GT owned by his friend. He was driving the Mustang GT as part of his effort to make the vehicle meet Calif...ornia's smog emission standards.
At the time of the accident, the Mustang GT was insured under a primary policy of automobile insurance issued by Insurance Company A, and an excess policy of insurance issued by sister company, Insurance Company B. Each policy had "bodily injury" limits of $1,000,000. Defendant insurers flatly refused to defend or indemnify the driver against the wrongful death and emotional distress claims of Amanda's parents, and rejected the Kuhars' reasonable offers to the faulty assumption that the young driver drove the Mustang GT while he was "working in a business of servicing or repairing automobiles" and therefore excluded from coverage under the policies. The refusal to defend the driver ultimately exposed him to an "excess" judgment in the amount of $6,750,000. On August 12, 1999, defendant insurers filed a Complaint for Declaratory Relief; Demand for Jury Trial naming Mark Kuhar and Lorna Kuhar as Real Parties in Interest. The Kuhars counterclaimed, pleading a direct cause of action as a judgment creditor, and also causes of action for insurance bad faith.
Plaintiffs' Contentions: The driver was a Mustang hobbyist who was not working in the business of servicing and repairing automobiles, but rather helping out a friend on the day of the accident. Defendants wrongfully refused to defend the underlying wrongful death action, exposing the driver to an excess verdict.
Defendants denied the claim before they knew the exclusion applied, and failed to conduct a proper investigation of the claim at any point in time. Defendants ignored a large number of allegations and facts which created a potential of coverage under the subject insurance policy.
Defendants' Contentions: The driver worked out of an automobile shop, that performed mechanical work for pay on numerous occasions before the accident, including mechanical work for pay for the owner of the Mustang GT. At the time of the accident, the driver was performing mechanical work, under a sort of warranty arrangement with the owner of the Mustang GT. Accordingly, the driver was working in the business of servicing and repairing automobiles and the subject exclusion applied.
Damages: Wrongful death of Amanda Kuhar.
Insurance
Jiminez v. Roe Insurance Company
N/A
OUTCOME: $1,150,000
On November 26, 1989, defendant #1 issued an automobile insurance policy to plaintiff. The insurance policy provided liability coverage for bodily injury and property damage. On Feb. 17, 1990, plaintif...f was involved in a motor vehicle collision and, one year later, was sued.
On or about June 11, 1991, defendant #1 retained defendant #2 to "defend" plaintiff against the personal injury allegations. At that time, defendant #1 informed defendant #2 that the accident was "suspicious". Defendant #1 knew its suspicions created a conflict of interest between it and plaintiff, but did nothing to apprise her of her right to Cumis counsel.
Shortly after its assignment, defendant #2 began to communicate with defendant #1's attorneys about the possibility of the plaintiff's fraud. Defendant #2 never informed plaintiff of its activities or of the suspicions of her insurance company. Defendant #2 provided defendant #1's attorneys with photographs, pleadings and discovery. Eventually, defendant #2 learned that defendant #1 was going to sue its client, the plaintiff, but did not tell her.
Eventually, defendant #1 did sue plaintiff, but failed to serve her with the complaint. As a result, plaintiff did not respond to the complaint. Although defendant #1 knew that it never served plaintiff, it nevertheless filed a request for entry of default and judgment in the amount of $38,000.
Plaintiffs' Contentions:
Plaintiff contended that defendant #1 failed and refused to provide plaintiff with Cumis counsel despite its knowledge of a profound conflict of interest. This undisclosed conflict allowed defendant #1 to void coverage under the policy. Plaintiff further contended that defendant #1 had engaged in the identical wrongful conduct with defendant #2 on previous occasions in order to achieve the same ill-advised objective. Finally, plaintiff contended that defendant #2 breached its fiduciary duty and engaged in legal malpractice by failing to disclose plaintiff's right to independent counsel and its participation in the plan to defraud her.
Defendants' Contentions:
Defendant #1 contended that plaintiff actively participated in a staged accident in an effort to defraud it. This contention was based on plaintiff's extensive accident history, her involvement in other accidents defendant #1 deemed fraudulent, the unusual factual circumstances of the accident in question, the unsavory individuals involved in the subject accident, and plaintiff's failure to cooperate with defendant #1's investigation.
Damages:
Legal Malpractice, Malicious Prosecution, Breach of Implied Covenant of
Good Faith and Fair Dealing.
Insurance
Jiminez v. Roe Insurance Company
N/A
OUTCOME: $1,150,000
On November 26, 1989, defendant #1 issued an automobile insurance policy to plaintiff. The insurance policy provided liability coverage for bodily injury and property damage. On Feb. 17, 1990, plaintif...f was involved in a motor vehicle collision and, one year later, was sued.
On or about June 11, 1991, defendant #1 retained defendant #2 to "defend" plaintiff against the personal injury allegations. At that time, defendant #1 informed defendant #2 that the accident was "suspicious". Defendant #1 knew its suspicions created a conflict of interest between it and plaintiff, but did nothing to apprise her of her right to Cumis counsel.
Shortly after its assignment, defendant #2 began to communicate with defendant #1's attorneys about the possibility of the plaintiff's fraud. Defendant #2 never informed plaintiff of its activities or of the suspicions of her insurance company. Defendant #2 provided defendant #1's attorneys with photographs, pleadings and discovery. Eventually, defendant #2 learned that defendant #1 was going to sue its client, the plaintiff, but did not tell her.
Eventually, defendant #1 did sue plaintiff, but failed to serve her with the complaint. As a result, plaintiff did not respond to the complaint. Although defendant #1 knew that it never served plaintiff, it nevertheless filed a request for entry of default and judgment in the amount of $38,000.
Plaintiffs' Contentions:
Plaintiff contended that defendant #1 failed and refused to provide plaintiff with Cumis counsel despite its knowledge of a profound conflict of interest. This undisclosed conflict allowed defendant #1 to void coverage under the policy. Plaintiff further contended that defendant #1 had engaged in the identical wrongful conduct with defendant #2 on previous occasions in order to achieve the same ill-advised objective. Finally, plaintiff contended that defendant #2 breached its fiduciary duty and engaged in legal malpractice by failing to disclose plaintiff's right to independent counsel and its participation in the plan to defraud her.
Defendants' Contentions:
Defendant #1 contended that plaintiff actively participated in a staged accident in an effort to defraud it. This contention was based on plaintiff's extensive accident history, her involvement in other accidents defendant #1 deemed fraudulent, the unusual factual circumstances of the accident in question, the unsavory individuals involved in the subject accident, and plaintiff's failure to cooperate with defendant #1's investigation.
Damages:
Legal Malpractice, Malicious Prosecution, Breach of Implied Covenant of
Good Faith and Fair Dealing.
