Alta California Regional Center v. Fremont Indemnity Co.

25 Cal. App. 4th 455, 30 Cal. Rptr. 841, 94 Cal. Daily Op. Serv. 3979, 30 Cal. Rptr. 2d 841, 94 Daily Journal DAR 7396, 1994 Cal. App. LEXIS 541
CourtCalifornia Court of Appeal
DecidedMay 31, 1994
DocketC014660
StatusPublished
Cited by21 cases

This text of 25 Cal. App. 4th 455 (Alta California Regional Center v. Fremont Indemnity Co.) 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
Alta California Regional Center v. Fremont Indemnity Co., 25 Cal. App. 4th 455, 30 Cal. Rptr. 841, 94 Cal. Daily Op. Serv. 3979, 30 Cal. Rptr. 2d 841, 94 Daily Journal DAR 7396, 1994 Cal. App. LEXIS 541 (Cal. Ct. App. 1994).

Opinion

Opinion

SCOTLAND, J.

Plaintiff Alta California Regional Center (Alta) is a defendant in consolidated actions pending in Placer County Superior Court. In that litigation, a disabled person, Elizabeth A., and her parents, Gerald and Mary A., seek recovery for personal injuries arising from a sexual assault on Elizabeth which allegedly resulted from Alta’s negligent placement, supervision, entrustment, care and control of Elizabeth in a residential care facility.

At the time of the alleged assault, Alta was insured by a professional liability insurance policy issued by defendant Fremont Indemnity Company (Fremont) and a commercial general liability insurance policy issued by the Great American Insurance Company (Great American). Great American agreed to defend Alta in the underlying litigation. However, Fremont declined to do so and tendered the defense to Great American on the ground the litigation “is not a malpractice lawsuit arising from any injuries resulting from the rendered [sic] or failure to render medical services by health care practitioners with Alta . . . .”

Alta filed the instant action for breach of contract and declaratory relief, alleging Fremont was obligated to defend and indemnify Alta in the underlying litigation but failed and refused to do so. Thereafter, Alta learned *459 Fremont no longer was asserting that its policy did not cover the claims alleged in the underlying litigation. Instead, Fremont’s sole contention was that, under the “other insurance” clause of its policy, Fremont was an excess insurer and, therefore, was not obligated to defend or indemnify Alta until the coverage provided by the Great American policy was exhausted.

On cross-motions for summary judgment, the trial court granted summary judgment for Alta. The court ruled that Fremont “waived” application of the “other insurance” clause by failing to assert it when Fremont refused Alta’s tender of defense of the underlying litigation. The court then concluded that, having waived the “other insurance” clause, Fremont is a “primary insurer” which has the “present duty” to provide Alta with a defense and indemnification. Accordingly, the trial court entered judgment in Alta’s favor, obligating Fremont “to pay all attorney fees and defense costs incurred on behalf of [Alta] in the underlying consolidated action[].” Fremont also was ordered to reimburse Alta for the costs of the instant lawsuit.

In the published portion of this opinion, we conclude the trial court erred in applying the doctrine of waiver to Fremont’s belatedly stated ground for limiting its exposure once Alta’s claim of coverage was found to be valid. As we shall explain, there is a distinction between an insurer’s assertion of lack of coverage and its subsequent claim that, if coverage exists, the coverage is limited under the terms of the policy. If a ground for asserting lack of coverage under an insurance policy could have been discovered by the insurer through reasonable investigation, that ground is waived if the insurer fails to state it at the time a request for coverage is tendered by the insured; consequently, the insurer may not belatedly raise that ground if the reason upon which the insurer initially denied coverage is found to have no merit or if the insurer did not deny coverage at the outset. Application of the waiver rule to disputes over whether coverage exists is designed as an incentive to compel an insurance company to fulfill its duty to thoroughly investigate a claim before denying coverage. However, there is no similar public policy which justifies expanding the waiver rule to a situation where, at the time it denies the insured’s request for coverage, the insurer fails to raise policy provisions which limit the scope of coverage to which the insured is entitled under the policy if coverage exists. When it denies a claim outright on the ground of lack of coverage, the insurer has no occasion to assert limitations on coverage. Nothing is gained by compelling the insurer to state the obvious, i.e., if there is coverage, the policy provisions which limit the scope of coverage apply. Therefore, in our view, it is unreasonable to require that—in order to avoid the doctrine of waiver—an insurer which denies a request for coverage also must assert at the outset an inconsistent *460 theory that coverage (which the insurer believes does not exist) is limited in scope under the terms of the policy. Because summary judgment in this matter was based solely on the trial court’s erroneous application of the waiver rule, the ensuing judgment must be reversed.

Facts and Procedural Background

In the underlying litigation, Elizabeth and her parents allege the following: Gerald and Mary A. contracted with Alta for the care, protection, development and education of Elizabeth. Due to her autistic-like disability, Elizabeth was placed by Alta in the Rodgers Care Home under the care of Jan and Kirk Rodgers. Elizabeth’s placement in that environment and the care and supervision she subsequently received were negligent. As a result, Elizabeth was sexually assaulted by Kirk Rodgers and suffered substantial mental and physical injuries. Elizabeth’s parents relied on Alta’s recommendation that Elizabeth be placed in the Rodgers Care Home, and suffered emotional distress when she was sexually assaulted by Kirk Rodgers.

At the time of the underlying acts, Alta was insured by a claims-made- and-reported professional liability insurance policy issued by Fremont, which provides coverage for claims reported against the insured “for injury arising out of the rendering or failure to render . . . professional services,” including professional services rendered by social workers employed by Alta. Alta also was insured by a commercial general liability insurance policy issued by Great American, which provides coverage for “sums that the insured becomes legally obligated to pay as damages because of ‘bodily injury’ ” caused “by an ‘occurrence.’ ”

Following service of Elizabeth’s summons and complaint, Alta requested that both insurers defend it in the underlying litigation. On February 13, 1990, Gregory Matzen, counsel for Fremont, wrote to attorney Paul Kwong, whose law firm was retained by Great American to defend Alta. Matzen stated: “It would appear, based upon my conversations with [Alta’s director of administrative services]; yourself; and [Elizabeth’s counsel]; that this is not a malpractice lawsuit arising from any injuries resulting from the rendered [sic] or failure to render medical services by health care practitioners with Alta .... Accordingly, Fremont... is tendering the defense of Alta ... to Great American, the general liability insurer of Alta . . . . H] Please acknowledge the tender by Fremont ... as to the defense of Alta . . . in the above-entitled matter by the end of this month.”

On June 3, 1991, Matzen again wrote to Alta’s counsel regarding the obligation to defend Alta in the underlying litigation. Matzen stated in *461 pertinent part: “A copy of [Fremont’s] policy was provided to Mr. Kwong in correspondence of February 13, 1990. It was in the course of that correspondence to Mr. Kwong that I requested a copy of the Great American policy ... as well as the tendering of the defense in this case to Great American on behalf of [Fremont], . . .

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Kyle Zoellner v. Eric Losey
N.D. California, 2022
Flintkote Co. v. Aviva PLC
177 F. Supp. 3d 1165 (N.D. California, 2016)
George Clinton v. Universal Music Group, Inc.
376 F. App'x 780 (Ninth Circuit, 2010)
The FLINTKOTE v. General Acc. Assur. Co. of Canada
480 F. Supp. 2d 1167 (N.D. California, 2007)
Westoil Terminals v. Industrial Indem.
1 Cal. Rptr. 3d 516 (California Court of Appeal, 2003)
Westoil Terminals Co. v. Industrial Indemnity Co.
110 Cal. App. 4th 139 (California Court of Appeal, 2003)
Insua v. Scottsdale Ins. Co.
129 Cal. Rptr. 2d 138 (California Court of Appeal, 2002)
Insua v. Scottsdale Insurance
104 Cal. App. 4th 737 (California Court of Appeal, 2002)
Melton v. Industrial Indemnity Co.
103 Cal. Rptr. 2d 222 (California Court of Appeal, 2001)
Mitchell, Silberberg & Knupp v. Yosemite Ins. Co.
58 Cal. App. 4th 389 (California Court of Appeal, 1997)
Farmers Insurance Exchange v. Knopp
50 Cal. App. 4th 1415 (California Court of Appeal, 1996)
Waller v. Truck Insurance Exchange, Inc.
900 P.2d 619 (California Supreme Court, 1995)
Lunardi v. Great-West Life Assurance Co.
37 Cal. App. 4th 807 (California Court of Appeal, 1995)
Russell v. Dopp
36 Cal. App. 4th 765 (California Court of Appeal, 1995)
Legarra v. Federated Mutual Insurance
35 Cal. App. 4th 1472 (California Court of Appeal, 1995)

Cite This Page — Counsel Stack

Bluebook (online)
25 Cal. App. 4th 455, 30 Cal. Rptr. 841, 94 Cal. Daily Op. Serv. 3979, 30 Cal. Rptr. 2d 841, 94 Daily Journal DAR 7396, 1994 Cal. App. LEXIS 541, Counsel Stack Legal Research, https://law.counselstack.com/opinion/alta-california-regional-center-v-fremont-indemnity-co-calctapp-1994.