American National Insurance v. Low

101 Cal. Rptr. 2d 288, 84 Cal. App. 4th 914, 2000 Daily Journal DAR 11961, 2000 Cal. Daily Op. Serv. 9023, 2000 Cal. App. LEXIS 859
CourtCalifornia Court of Appeal
DecidedNovember 8, 2000
DocketB137765
StatusPublished
Cited by10 cases

This text of 101 Cal. Rptr. 2d 288 (American National Insurance v. Low) 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
American National Insurance v. Low, 101 Cal. Rptr. 2d 288, 84 Cal. App. 4th 914, 2000 Daily Journal DAR 11961, 2000 Cal. Daily Op. Serv. 9023, 2000 Cal. App. LEXIS 859 (Cal. Ct. App. 2000).

Opinion

Opinion

CURRY, J.

This case involves the proper interpretation of the statutory provisions which prioritize claims among creditors of insolvent insurance companies, and govern the obligations of the California Insurance Guarantee Association (CIGA) to policyholders of insolvent member insurers. Under the Insurance Code, CIGA is obligated to pay an insolvent member insurer’s “covered claims,” which are defined, on the one hand, to include all obligations of the insurer arising from an insurance policy and, on the other, to exclude all'obligations to insurers. (Ins. Code, § 1063.1, subd. (c).) 1 Section 1033, which contains the priority scheme for payment of claims by an insolvent insúrer’s estate, similarly excludes from priority obligations owed to insurers. The issue raised in this appeal is whether appellant American National Insurance Company, which is itself in the business of providing insurance to the public, can obtain priority for its claims as a policyholder after the insurer to which it looked for liability coverage became insolvent. Appellant maintains that as an insured seeking payment under the terms of a policy, its claims are entitled to policyholder priority. Respondent Insurance Commissioner and amicus curiae CIGA ask us to uphold a ruling by the trial court that relegated appellant to general creditor status. After review of the relevant statutes and their history, we conclude that the Legislature intended all policyholders’ claims to fall within the category of “covered claims” even where the policyholders also happen to be in the business of providing insurance, and reverse.

Factual and Procedural Background

Appellant filed an order to show cause why its claim against Mission Insurance Company (Mission), a liquidated insurer, should not have been allowed by the liquidator, respondent Insurance Commissioner. The following facts pertinent to appellant’s claim were laid out in appellant’s moving papers and are not disputed.

Appellant obtained an automobile liability insurance policy in the amount of $250,000 from Great American Insurance Company (Great American), which was issued effective January 1, 1980. Effective May 15 of that same year, Great American issued appellant a catastrophic liability insurance *918 policy in the amount of $5 million. Mission issued an excess umbrella insurance policy in the amount of $10 million to appellant also effective May 15, 1980. Under the policy, Mission had the duty to indemnify appellant after the underlying insurer, Great American, had paid or been held liable to pay the full amount of its liability.

On May 15, 1980, Scott Duff, one of appellant’s agents, struck Anthony Markese, a three-year-old boy, in an automobile/pedestrian accident, resulting in the boy becoming a quadriplegic. An action was brought on behalf of the child in Illinois, which resulted in a 1986 judgment against Duff and appellant in the amount of $6,591,344.

Great American tendered its policy limits (a total of $5.25 million under the automobile policy and the catastrophic liability policy) to Mission as the excess liability carrier. Mission had been declared insolvent and placed in conservatorship in California in 1985, 2 and was unable to accept the tender. Appellant thereafter settled with Markese at a cost of approximately $1 million over the amount received from the Great American policies. In addition, appellant filed a lawsuit against Great American in Texas alleging a failure to settle within policy limits, and received a settlement of $423,741 in June 1987.

In September 1987, appellant filed a proof of claim with the ancillary receiver for Mission in Texas. In October 1988, its claim was rejected as a covered claim as that term is defined under the provision of articles 21.28 and 21.28-C of the Texas Insurance Code, 3 but approved as a class 2 claim as defined by article 21.28, section 8 of the Texas Insurance Code 4 in the amount of $585,608.54. No funds were available to pay the claim. Thereafter, appellant filed a petition against the State of Texas in the Texas courts alleging that rejection of its claim as a covered claim was improper. The Texas Property and Casualty Insurance Guarantee Association (Texas Guarantee Association), the nonprofit unincorporated legal entity created pursuant to the Texas Insurance Code to pay covered claims, filed a plea in *919 intervention. In May 1996, judgment was entered in favor of appellant against the Texas Guarantee Association in the amount of $100,000.

In the meantime, appellant was notified by respondent of the proposed liquidation of Mission and filed a proof of claim in the amount of $1 million with respondent, the Mission liquidator and trustee of the Mission Insurance Company trust, in May 1987. In August 1998, it received notice by letter that respondent had rejected its claim. In respondent’s letter, under “reason(s) for rejection,” a box entitled “Claim paid in full by Guaranty Association” was checked. Beside it the word “settled” was handwritten in. Appellant filed its order to show cause contending its claim had not been satisfied by either the Texas Guarantee Association or by settlement. Respondent stated in its opposition that the rejection would be modified to a partial approval in the amount of $458,608.54, 5 but that appellant’s claim would be assigned general creditor status rather than policyholder priority.

The trial court denied the order to show cause, giving the following rationale in its order: “When, as here, an insurance company purchases a simple liability insurance policy exactly the same as thousands of other policyholders, a logically sound argument can be made that they should not be differentiated in any manner. The legislature has, however, unequivocally differentiated the claims of an insurance company from those of all other policyholders, (Insurance Code sections 1033 & 1063.1) and relegated those claims to the lower priority (6). Although it can be argued that this constitutes a distinction without a difference, the classification is not irrational or arbitrary under the reasoning supporting the more explicit though substantially identical provision of the Model Act. It can also be argued that when an insurance company lays off its own direct risk by the purchase of a policy, as between two insurance companies, this is substantively a policy of reinsurance. Finally, policyholder status for [appellant] in these circumstances would set a dangerous precedent; an unwarranted camel’s nose in the insolvency tent.” An appeal was taken from this order.

Discussion

I

The statutory provisions which we are called on to interpret are the versions of sections 1033 and 1063.1 in effect when appellant submitted its proof of claim. Section 1033 is contained in article 14 (div. 1, pt. 2, ch. 1) of *920 the code, which governs insolvency and delinquency of insurance companies. Section 1063.1 appears in article 14.2 of the same chapter, which created CIGA and dictates its powers and duties.

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Bluebook (online)
101 Cal. Rptr. 2d 288, 84 Cal. App. 4th 914, 2000 Daily Journal DAR 11961, 2000 Cal. Daily Op. Serv. 9023, 2000 Cal. App. LEXIS 859, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-national-insurance-v-low-calctapp-2000.