Aetna Life Insurance v. Superior Court

182 Cal. App. 3d 431, 227 Cal. Rptr. 460, 1986 Cal. App. LEXIS 1715
CourtCalifornia Court of Appeal
DecidedJune 13, 1986
DocketD004510
StatusPublished
Cited by32 cases

This text of 182 Cal. App. 3d 431 (Aetna Life Insurance v. Superior Court) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Aetna Life Insurance v. Superior Court, 182 Cal. App. 3d 431, 227 Cal. Rptr. 460, 1986 Cal. App. LEXIS 1715 (Cal. Ct. App. 1986).

Opinion

Opinion

BUTLER, J.

Aetna Life Insurance Company (Aetna) seeks mandate review as authorized by Code of Civil Procedure 1 section 437c of a referee’s decision granting partial summary adjudication in favor of the insured, Mary Ellen Hammer, on questions of coverage under a group health insurance policy. The superior court adopted the referee’s findings of fact and conclusions of law without a hearing and ordered the findings and conclusions deemed established as a matter of law. We have concluded the reference was not authorized by statute and therefore the writ must issue ordering the partial summary adjudication be vacated.

I

Mrs. Hammer, both individually and as the executrix of the estate of her husband John E. Hammer, is the plaintiff in an action against Aetna for tortious breach of insurance contract. While Hammer and her husband were insured under Aetna’s group health policy made available to employees of the County of San Diego, Mr. Hammer received treatment at a facility in the Bahamas known as the Immunology Researching Centre for his disease of spindle cell malignant melanoma. The treatment was known as “immunoaugmentative therapy” (IAT). Mr. Hammer has since died. Aetna refused to pay the expenses of the IAT treatment, taking the position the policy covered only “NECESSARY” medical treatment, defined as treatment which is broadly accepted by the medical profession as essential to treat the disease. All parties are here agreed the IAT treatment is not broadly accepted anywhere, and indeed the facility has since been closed, apparently because AIDS virus was detected in the treatment serum.

The superior court made an order assigning all law and motion summary judgment proceedings in the matter to a referee, Louis A. Tepper, Esq., for hearing and determination. The order purported to be by authority of section *434 639, subdivision (d). Further, the order specified the referee was a “special” referee. 2

After the court made the above reference order, Mrs. Hammer moved for partial summary adjudication of coverage issues, and Aetna cross-moved for summary judgment in its favor or alternatively for partial summary adjudication. Tepper heard these motions and concluded the policy was ambiguous and did not validly exclude coverage for the IAT treatment. He prepared a written report memorializing his findings of fact and conclusions of law. Counsel for Aetna submitted a letter to the court requesting that it treat Tepper’s findings as merely advisory and that it reject the findings; counsel also appeared before a judge requesting a hearing on the referee’s report. The court denied a hearing and made an order accepting the referee’s report. The court order recites that the summary judgment motions were *435 heard before the referee and he submitted his report, recommending findings of fact and conclusions of law, which the court order recites. The court orders these findings and conclusions of law are without substantial controversy and “shall be deemed established.” Aetna’s petition for mandate challenges this order.

II

Aetna’s petition for review here argues the insurance policy is not ambiguous and plainly excludes coverage for treatment admittedly not broadly authorized in the medical community. Because we perceived a jurisdictional problem, we asked the parties specially to brief the issue of the validity of the reference, We have concluded the referee had no authority to decide these motions and his decision must be annulled.

The reference purported to be by authority of section 639, subdivision (d), which authorizes a reference without the parties’ consent “[wjhen it is necessary for the information of the court in a special proceeding.” Clearly, as both parties admit, this statute does not apply to law and motion proceedings in an ordinary civil action, as we have here. (See § 22; cf. § 23; see generally, 3 Witkin, Cal. Procedure (3d ed. 1985) Actions, § 13.)

Section 638 of the Code of Civil Procedure broadly authorizes consensual references “[t]o try any or all of the issues in an action or proceeding, ...” However, the statute calls for “the agreement of the parties filed with the clerk, or judge, or entered in the minutes . . .” or alternatively requires there be a written contract or lease with specific authorization for a reference of disputes under the agreement. Here, although the parties apparently did not object to the reference, they did not agree to it in writing and therefore did not meet the statutory conditions.

The superior court has no power to assign matters to a referee for decision without explicit statutory authorization. (In re Marriage of Galis (1983) 149 Cal.App.3d 147, 150 [196 Cal.Rptr. 659]; Bird v. Superior Court (1980) 112 Cal.App.3d 595, 599 [169 Cal.Rptr. 530]; see generally, 6 Witkin, Cal. Procedure (3d ed. 1985) Proceedings Without Trial, § 48.)

Particularly, the court has no power to make an unconsented-to general reference, which conclusively decides all or part of a matter, because not only is such a general reference not authorized except by explicit agreement of the parties (§ 638, supra), but also, the California Constitution prevents delegation of judicial power except for the performance of “subordinate judicial duties.” (Cal. Const., art. VI, § 22; see In re Perrone C. (1979) 26 Cal.3d 49 [160 Cal.Rptr. 704, 603 P.2d 1300]; In re Edgar M. *436 (1975) 14 Cal.3d 727 [122 Cal.Rptr. 574, 537 P.2d 406].) Deciding a major legal issue in a case, which probably will determine liability, is not a subordinate judicial duty. The Supreme Court said in In re Edgar M. a referee can make a binding determination only in a consensual general reference. (In re Edgar M., supra, at p. 734; see §§ 638, 644; Estate of Hart (1938) 11 Cal.2d 89, 91 [77 P.2d 1082].)

The statutes carefully preserve the distinction of special and general reference to comply with the constitutional mandate; a general reference has binding effect, but must be consensual, whereas a special reference may be ordered without consent but is merely advisory, not binding on the superior court. (See §§ 644, 645; Estate of Bassi (1965) 234 Cal.App.2d 529, 536-537 [44 Cal.Rptr. 541]; 6 Witkin, Cal. Procedure (3d ed. 1985) Proceedings Without Trial, §§ 50, 51.)

Here, the reference order purported to be a special reference, under section 639, subdivision (d); it even referred to the referee as “special.” (See fn. 2, supra.) Yet, the superior court treated the referee’s findings and conclusions of law as binding and determinative of the issue. No rehearing procedure was provided and there is no evidence the superior court judge who made the final order ever considered the matter himself, independently of the referee’s decision.

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Cite This Page — Counsel Stack

Bluebook (online)
182 Cal. App. 3d 431, 227 Cal. Rptr. 460, 1986 Cal. App. LEXIS 1715, Counsel Stack Legal Research, https://law.counselstack.com/opinion/aetna-life-insurance-v-superior-court-calctapp-1986.