Aim Insurance Co. v. Culcasi

229 Cal. App. 3d 209, 280 Cal. Rptr. 766, 91 Daily Journal DAR 4203, 91 Cal. Daily Op. Serv. 2603, 1991 Cal. App. LEXIS 342
CourtCalifornia Court of Appeal
DecidedApril 10, 1991
DocketH006828
StatusPublished
Cited by57 cases

This text of 229 Cal. App. 3d 209 (Aim Insurance Co. v. Culcasi) 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
Aim Insurance Co. v. Culcasi, 229 Cal. App. 3d 209, 280 Cal. Rptr. 766, 91 Daily Journal DAR 4203, 91 Cal. Daily Op. Serv. 2603, 1991 Cal. App. LEXIS 342 (Cal. Ct. App. 1991).

Opinion

Opinion

CAPACCIOLI, Acting P. J.

Statement of the Case

Defendant James Culcasi (Culcasi), doing business as Rosine’s, a restaurant, appeals from a judgment entered after the trial court granted plaintiff Aim Insurance Company’s (Aim) motion for summary judgment. He claims the court erred in granting the motion. We affirm the judgment.

*213 Scope of Review

The trial court may properly grant a motion for summary judgment only if there are no triable issues of fact and, as a matter of law, the moving party is entitled to judgment. (Blankenheim v. E. F. Hutton & Co. (1990) 217 Cal.App.3d 1463, 1470 [266 Cal.Rptr. 593].)

The Undisputed Facts

In October 1986, Culcasi hired Noemi Grijalva as a waitress at Rosine’s. At that time, Culcasi made health insurance available to his employees. Around July 24, 1986, Grijalva submitted an application for insurance coverage to Culcasi, who accepted it and undertook to forward it to the insurer. According to Culcasi, the application “was entrusted by her to [me] for the purpose of transmitting the same to the group health insurance company and plan administrator.” 1

In January 1989, Grijalva sued Culcasi and others, for negligent breach of fiduciary duty, breach of contract, and infliction of emotional distress. In her complaint, she alleged that eligibility for insurance was part of the compensation Culcasi paid his employees, and this potential eligibility induced Grijalva to apply for and accept the job at Rosine’s.

She alleged that on July 24, 1987, she filled out an application and gave it to Culcasi. He, in turn, represented that she would be properly enrolled in the health insurance program and undertook the obligation “to insure that her application and documents were promptly and properly forwarded to the health plan and that her premium payment would result in the expected coverage.”

Grijalva alleged that she met all the requirements for enrollment in the plan, premiums were deducted from her paycheck, she believed she was so enrolled in the plan, and, as a result, she did not attempt to purchase other health insurance. However, according to Grijalva, Culcasi negligently failed “to properly complete her enrollment in the plan despite his assurances that she was so enrolled.” Thereafter, he requested and obtained another application, which he told her to backdate to July 24, 1987.

On September 6, 1987, Grijalva was injured in an automobile accident. In late September 1987, the insurer received her second application and *214 enrolled her in the health plan as of October 1, 1987. However, this enrollment date precluded recovery for the injuries she suffered in early September. Thus, she alleged that Culcasi’s conduct deprived her of insurance coverage and as a result she had to pay her own medical expenses and suffered great emotional distress.

Culcasi tendered his defense action to Aim, which had issued a liability insurance policy (the Policy) to him. Under it, Aim agreed to “pay on behalf of [Culcasi] all sums which [he] shall become legally obligated to pay as damages because of bodily injury or property damage to which this insurance applies” and to “defend any suit against [Culcasi] seeking damages on account of such bodily injury or property damage, even if any of the allegations of the suit are groundless, false or fraudulent[.]”

Aim assumed the defense under a reservations of rights. On April 4, 1989, it filed the instant action, seeking a declaration that it had no potential duty to indemnify Culcasi in the event Grijalva prevailed and no duty to provide his defense. Culcasi answered and filed a cross-complaint seeking a declaration that Aim had a duty to defend and, if necessary, indemnify him.

Thereafter, Aim filed a motion for summary judgment. After a hearing, the trial court granted the motion and entered judgment in favor of Aim. In a minute order, the court explained that any duties Culcasi might have had regarding the handling of Grijalva’s medical plan application could only be based on their employment contract, and, therefore, Culcasi would be liable for damages only if he breached this contract. However, the court found that the Policy covered only tort, not contractual, liability. Consequently, Aim had no duty to defend against Grijalva’s contract action.

Discussion

The Trial Court's Rationale

The Policy provided indemnification for amounts Culcasi “shall become legally obligated to pay as damages.” Courts have construed this language to limit coverage to tort liability only. (Fragomeno v. Insurance Co. of the West (1989) 207 Cal.App.3d 822, 828 [255 Cal.Rptr. 111]; Insurance Co. of the West v. Haralambos Beverage Co. (1987) 195 Cal.App.3d 1308, 1317 [241 Cal.Rptr. 427]; Fireman's Fund Ins. Co. v. City of Turlock (1985) 170 Cal.App.3d 988, 997-998 [216 Cal.Rptr. 796]; International Surplus Lines Ins. Co. v. Devonshire Coverage Corp. (1979) 93 Cal.App.3d 601, 610-611 [155 Cal.Rptr. 870].) Thus, we agree with the trial court’s conclusion that Aim had no duty to defend Culcasi against an action for breach of contract.

*215 However, we disagree with the trial court’s conclusion that Grijalva’s complaint sounds only in contract. The complaint clearly purports to state a cause of action for negligence, i.e., the breach of a duty of care.

Generally, “[a] person who has not created a peril is ordinarily not liable in tort merely for failure to take affirmative action to assist or protect another, no matter how great the danger in which the other is placed, or how easily he could be rescued, unless there is some relationship between them which gives rise to a duty to act.” (6 Witkin, Summary of Cal. Law (9th ed. 1988) Torts, § 858, p. 220, and cases cited there, italics in original.) However, there is an exception to this rule based on a voluntary or gratuitous undertaking. {Id., § 868, p. 234, and cases cited there; Bloomberg v. Interinsurance Exchange (1984) 162 Cal.App.3d 571, 575 [207 Cal.Rptr. 853]; Schwartz v. Helms Bakery Limited (1967) 67 Cal.2d 232, 238 [60 Cal.Rptr. 510, 430 P.2d 68].)

Particularly instructive here is Valdez v. Taylor Automobile Co. (1954) 129 Cal.App.2d 810 [278 P.2d 91]. There, the defendant, a car dealer, advertised that the purchase price of a car would include the cost of a premium on a liability insurance policy for the new owner. {Id. at p.

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Bluebook (online)
229 Cal. App. 3d 209, 280 Cal. Rptr. 766, 91 Daily Journal DAR 4203, 91 Cal. Daily Op. Serv. 2603, 1991 Cal. App. LEXIS 342, Counsel Stack Legal Research, https://law.counselstack.com/opinion/aim-insurance-co-v-culcasi-calctapp-1991.