Avedian v. Progressive Casualty Co. CA2/7

CourtCalifornia Court of Appeal
DecidedMarch 2, 2015
DocketB244193
StatusUnpublished

This text of Avedian v. Progressive Casualty Co. CA2/7 (Avedian v. Progressive Casualty Co. CA2/7) 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
Avedian v. Progressive Casualty Co. CA2/7, (Cal. Ct. App. 2015).

Opinion

Filed 3/2/15 Avedian v. Progressive Casualty Co. CA2/7 NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

SECOND APPELLATE DISTRICT

DIVISION SEVEN

RAFI AVEDIAN, B244193

Plaintiff and Appellant, (Los Angeles County Super. Ct. No. BC455138) v.

PROGRESSIVE CASUALTY INSURANCE CO., et al.,

Defendants and Respondents.

JILLIAN MCGUINNESS, et al. B245747

Plaintiffs and Appellants, (Los Angeles County Super. Ct. No. BC455138) v.

APPEALS from judgments of the Superior Court of Los Angeles County, Holly E. Kendig, Judge. Reversed and remanded. Mancini & Associates, Marcus A. Mancini and Christopher M. Barnes; Benedon & Serlin, Gerald M. Serlin and Douglas G. Benedon for Plaintiffs and Appellants. Littler Mendelson (Los Angeles) and Brandie N. Charles; Littler Mendelson (Sacramento) and Michelle L. Christian for Defendants and Respondents Progressive Casualty Insurance Co., Jim Grant and Peter Hawkins. ___________________________________

INTRODUCTION Three insurance company claims representatives were terminated for falsification of their timecards. They each filed a complaint against their former employer. Two appellants, Rafi Avedian and Dawn Diaz, alleged wrongful termination in violation of public policy, among other claims, asserting they had been terminated for complaining about their employer’s business practices that allegedly violated the Insurance Code. The third appellant, Jillian McGuinness, alleged the employer had failed to accommodate her disability and failed to engage in the interactive process, among other claims. The insurance company filed motions for summary judgment, and the trial court granted each of these motions. This appeal followed. As we shall explain, triable issues of fact exist as to the appellants’ respective claims. We conclude the trial court erred in granting summary judgment for Progressive, and accordingly reverse. FACTUAL AND PROCEDURAL SUMMARY 1. Appellants’ Employment with Progressive. Rafi Avedian, Dawn Diaz, Jillian McGuinness and Kristin Giarletto worked together as claims specialists in the Sherman Oaks office of Progressive Casualty Insurance Company (Progressive).1 Claims specialists negotiate on Progressive’s behalf

1 Avedian, Diaz, McGuinness and Giarletto filed separate complaints against Progressive, but their actions were consolidated in the trial court. Each filed a notice of appeal. Kristin Giarletto subsequently dismissed her appeal and is no longer a party (although she is discussed as relevant). In an order dated September 24, 2013, we denied 2 and settle claims with Progressive’s funds. Beginning in May 2009, the branch manager of the Sherman Oaks office was Peter Hawkins.2 Marcia Meyers and Laura Doran were supervisors in the office. In its Code of Business Conduct and Ethics (Code), Progressive states: “We operate in a highly regulated industry” and “are subject to many laws and regulations designed to protect the communities and people we serve.” “These include state insurance laws and federal state and local laws of general application. [¶] You are responsible for complying with all applicable laws and regulations in your work for Progressive.”3 Claims specialists were required to review the Code each year, and Avedian and Diaz did so.

joint motions to consolidate the appeals but ordered the court may consider appeals B244193 (relating to Avedian) and B245747 (relating to Diaz and McGuinness) concurrently for purposes of oral argument and decision.

2 Before Hawkins, Charlie Neville was the branch manager of the Sherman Oaks office, but when Progressive terminated Neville’s employment, Hawkins took his place.

3 In fact, under the heading “Voicing Concerns and Reporting Possible Violations,” Progressive’s Code further states: “It is your responsibility under this Code to speak up whenever you know of or suspect a possible Code violation. As you consider this responsibility, keep in mind: [¶] Speaking up is not optional. It is your duty to speak up anytime you become aware of a concern, even if you aren’t sure whether the Code has been violated. [¶] Speaking up is not risky. As explained in detail below, you can speak up anonymously and are protected from retaliation whenever you speak up in good faith. [¶] Speaking up is not harmful to Progressive. Reporting concerns helps keep our Company strong by allowing us to address issues promptly and remedy problems quickly.” (Original emphasis.)

The Code provides a “confidential, toll-free Alertline” (accessible by telephone or online) “if you’d like confidential assistance on ethics and compliance issues, to anonymously report suspected violations of this Code, or if you believe that ethics and compliance issues raised through other channels have not been resolved.” Initially, however, the Code indicates: “You might start with your manager or your Human Resources (HR) representative, but you should feel free to consult any of Progressive’s managers or business leaders.” 3 A. Insurance Code Section 790.03. The purpose of Insurance Code section 790 et seq. is to “regulate trade practices in the business of insurance . . . by defining, or providing for the determination of, all such practices in this State which constitute unfair methods of competition or unfair or deceptive acts or practices and by prohibiting the trade practices so defined or determined.” (Ins. Code, § 790 [all statutory references are to the Insurance Code unless otherwise indicated].) “No person shall engage in this State in any . . . unfair method of competition or an unfair or deceptive act or practice in the business of insurance.” (§ 790.02.) Section 790.03 lists conduct expressly “define[d] as unfair methods of competition and unfair and deceptive acts or practices in the business of insurance.” As relevant here, subdivision (h) of section 790.03 “enumerates sixteen claims settlement practices that, when either knowingly committed on a single occasion, or performed with such frequency as to indicate a general practice, are considered unfair claims settlement practices and are, thus, prohibited” by the Insurance Code. (Cal. Code Regs., tit. 10 (Regs.), § 2695.1, subdivision (a); § 790.03, subd. (h).) The unfair practices listed in subdivision (h) of section 790.03 include: “(2) Failing to acknowledge and act reasonably promptly upon communications with respect to claims arising under insurance policies[;] [¶] (3) Failing to adopt and implement reasonable standards for the prompt investigation and processing of claims arising under insurance policies[;] [¶] (4) Failing to affirm or deny coverage of claims within a reasonable time after proof of loss requirements have been completed and submitted by the insured[;] [¶] (5) Not attempting in good faith to effectuate prompt, fair, and equitable settlements of claims in which liability has become reasonably clear[;] . . . [and] (13) Failing to provide promptly a reasonable explanation of the basis relied on in the insurance policy, in relation to the facts or applicable law, for the denial of a claim or for the offer of a compromise settlement . . . .” As stated in the preamble of the “Fair Claims Settlement Practices Regulations” (Regs., § 2695.1, subd. (a)), “The Insurance Commissioner has promulgated . . . regulations in order the accomplish the following objectives: [¶] (1) To delineate certain

4 minimum standards for the settlement of claims . . . [and] (2) to promote the good faith, prompt, efficient and equitable settlement of claims on a cost effective basis . . .

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

Related

McDonnell Douglas Corp. v. Green
411 U.S. 792 (Supreme Court, 1973)
Petermann v. International Brotherhood of Teamsters, Local 396
344 P.2d 25 (California Court of Appeal, 1959)
Green v. Ralee Engineering Co.
960 P.2d 1046 (California Supreme Court, 1998)
Gantt v. Sentry Insurance
824 P.2d 680 (California Supreme Court, 1992)
Turner v. Anheuser-Busch, Inc.
876 P.2d 1022 (California Supreme Court, 1994)
Fisher v. San Pedro Peninsula Hospital
214 Cal. App. 3d 590 (California Court of Appeal, 1989)
Hentzel v. Singer Co.
138 Cal. App. 3d 290 (California Court of Appeal, 1982)
Collier v. Superior Court
228 Cal. App. 3d 1117 (California Court of Appeal, 1991)
Scotch v. Art Institute of California-Orange County, Inc.
173 Cal. App. 4th 986 (California Court of Appeal, 2009)
Scott v. Phoenix Schools, Inc.
175 Cal. App. 4th 702 (California Court of Appeal, 2009)
Nadaf-Rahrov v. the Neiman Marcus Group, Inc.
166 Cal. App. 4th 952 (California Court of Appeal, 2008)
Wilson v. County of Orange
169 Cal. App. 4th 1185 (California Court of Appeal, 2009)
Claudio v. Regents of University of Cal.
35 Cal. Rptr. 3d 837 (California Court of Appeal, 2005)
Laulifou Aaitui v. Grande Properties
29 Cal. App. 4th 1369 (California Court of Appeal, 1994)
People v. Smith
179 Cal. App. 4th 986 (California Court of Appeal, 2009)
Holmes v. General Dynamics Corp.
17 Cal. App. 4th 1418 (California Court of Appeal, 1993)
Loggins v. Kaiser Permanente International
60 Cal. Rptr. 3d 45 (California Court of Appeal, 2007)
Jensen v. Wells Fargo Bank
102 Cal. Rptr. 2d 55 (California Court of Appeal, 2000)
People v. Fields
61 Cal. App. 4th 1063 (California Court of Appeal, 1998)
Raine v. City of Burbank
37 Cal. Rptr. 3d 899 (California Court of Appeal, 2006)

Cite This Page — Counsel Stack

Bluebook (online)
Avedian v. Progressive Casualty Co. CA2/7, Counsel Stack Legal Research, https://law.counselstack.com/opinion/avedian-v-progressive-casualty-co-ca27-calctapp-2015.