Bansal v. Nationwide Mutual Insurance Company

CourtDistrict Court, N.D. California
DecidedAugust 10, 2025
Docket3:23-cv-05527
StatusUnknown

This text of Bansal v. Nationwide Mutual Insurance Company (Bansal v. Nationwide Mutual Insurance Company) is published on Counsel Stack Legal Research, covering District Court, N.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Bansal v. Nationwide Mutual Insurance Company, (N.D. Cal. 2025).

Opinion

1 2 3 4 5 6 7 8 UNITED STATES DISTRICT COURT 9 NORTHERN DISTRICT OF CALIFORNIA 10 San Francisco Division 11 RAKESH BANSAL, et al., Case No. 23-cv-05527-LB

12 Plaintiffs, ORDER GRANTING SUMMARY 13 v. JUDGMENT

14 NATIONWIDE MUTUAL INSURANCE Re: ECF No. 53 COMPANY, 15 Defendant. 16 17 INTRODUCTION 18 In this insurance-coverage action, the parties dispute whether defendant Nationwide Mutual 19 Insurance Company paid full insurance benefits to the plaintiffs, Rakesh and Hema Bansal, after a 20 water accident damaged their home. Nationwide ultimately paid the cost of repairs after a 21 contractually required appraisal. It did not pay other costs: moving costs, living expenses for food 22 and housing, and fair rental value. It moved for summary judgment on the grounds that it paid 23 covered losses, which did not include the other expenses, there is no bad-faith claim because it 24 paid and never unreasonably withheld benefits, and punitive damages thus are not warranted. 25 Summary judgment is granted on all grounds. 26 27 1 STATEMENT 2 The next sections summarize (1) the policy, (2) the loss and investigation, and (3) relevant 3 procedural history. 4 5 1. The Policy 6 The policy for the plaintiff’s house has the following loss provisions. 7 A. Coverage A — Dwelling 1. We cover: 8 a. The dwelling on the “residence premises” shown in the Declarations, 9 including structures attached to the dwelling; and 10 b. Materials and supplies located on or next to the “residence premises” used to construct, alter or repair the dwelling or other structures on the “residence 11 premises.” 12 . . . . 13 D. Coverage D — Loss of Use . . . . 14 1. Additional Living Expense 15 If a loss covered under Section I makes that part of the “residence premises” where 16 you reside not fit to live in, we cover any necessary increase in living expenses incurred by you so that your household can maintain its normal standard of living. 17 Payment will be for the shortest time required to repair or replace the damage or, if 18 you permanently relocate, the shortest time required for your household to settle elsewhere. Payment will not exceed the actual loss sustained or 24 months from the 19 date of loss, whichever occurs first. 20 2. Fair Rental Value If a loss covered under Section I makes that part of the “residence premises” rented 21 to others or held for rental by you not fit to live in, we cover the fair rental value of 22 such premises less any expenses that do not continue while it is not fit to live in. Payment will be for the shortest time required to repair or replace such premises. 23 Payment will not exceed the actual loss sustained or 24 months from the date of loss, 24 whichever occurs first. . . . . 25 C. Duties After Loss 26 In case of a loss to covered property, we have no duty to provide coverage under this 27 policy if you or an “insured” seeking coverage fails to comply with the following . . . . 1 5. Cooperate with us in the investigation of a claim; 2 . . . . 3 8. Send to us, within 60 days after our request, your signed, sworn proof of loss which sets forth, to the best of your knowledge and belief: 4 . . . . 5 g. Receipts for additional living expenses incurred and records that support the fair 6 rental value loss; 7 . . . . F. Appraisal 8 If you and we fail to agree on the amount of loss, either may demand an appraisal of 9 the loss. . . . The appraisers will separately set the amount of loss. . . . A decision agreed to by any two will set the amount of loss. 10 . . . . 11 The appraisers and umpires are only authorized to determine the “actual cash value,” replacement cost, or cost to repair the property that is the subject of the claim.1 12 . . . . 13 “Actual Cash Value” means the amount it would cost the “insured” to repair or 14 replace covered property in its condition at the time of the loss, such expense being computed as of the time of the loss and quantified as follows. The measure of this 15 “actual cash value” recovery, in whole or partial settlement of the claim, for either a total or partial loss to the structure or its contents, shall be the amount it would cost 16 the “insured” to repair, rebuild, or replace the thing lost or damaged less a fair and 17 reasonable deduction for physical depreciation based on its condition at the time of the loss or the policy limit, whichever is less. A deduction for physical depreciation 18 shall apply only to components of a structure that are normally subject to repair and replacement during useful life of that structure.2 19 20 2. The Loss and Investigation 21 On July 19, 2021, Mr. Bansal reported water damage in his home from a July 17 leak in a 22 refrigerator line. Nationwide’s adjuster Robert Mulcahey, based in Iowa and not a California- 23 24 25

26 1 Policy, Ex. A to Lathrum Decl. – ECF No. 53-3 at 20 (Bates NMIC_000014), 23 (Bates 27 NMIC_000017), 36–39 (Bates NMIC_000030–33) (cleaned up). Citations refer to the Electronic Case File (ECF); pinpoint citations are to the ECF-generated page numbers at the top of documents. 1 licensed contractor, hired Alacrity, a third-party vendor, to inspect the damage.3 Alacrity charged 2 $300.06. Alacrity vets its adjusters for experience, certifications, and licenses but does not provide 3 training. It did not know its adjuster’s training or qualifications.4 On July 28, 2021, Nationwide 4 sent its initial repairs estimate ($11,845.44 for replacement costs and $11,068.13 for actual cash 5 value), paid Mr. Bansal $8,568.13 (the amount after the policy deductible and depreciation), and 6 explained how to request additional payment for other necessary repair work.5 7 In August, the plaintiffs retained a public adjuster, Jahn Miller, in exchange for ten percent of 8 any Nationwide payment. Mr. Miller and Mr. Mulcahey communicated about the scope of work 9 and covered living expenses, including Mr. Mulcahey’s ability to pay hotel expenses directly or 10 via reimbursement. Mr. Miller’s contractor, Tom Koester, inspected the property and took 11 measurements but did not perform destructive testing. He identified additional damage and 12 suggested that Nationwide should reinspect the property. Mr. Mulcahey scheduled a reinspection 13 with Alacrity for October 26, 2021, so that Mr. Bansal could be present. On September 20, 2021, 14 Mr. Koester sent Mr. Miller a preliminary replacement estimate of $140,905.69 that included 15 replacement of the wood floor because of its age and thinness, though he did not measure the 16 thickness or know how often it had been refinished.6 Mr. Miller sent the estimate to Nationwide 17 on October 21, 2021, before the October 26 inspection.7 18 19

20 3 Lathrum Decl. – ECF No. 53-2 at 3 (¶¶ 7–8); Claim Notes, Ex. B to id. – ECF No. 53-3 at 84–85 (Bates NMIC_003687–88); Mulcahey Dep., Ex. B to Roldan Decl. – ECF No. 56-1 at 35–37 (pp. 21 6:19–25, 12:12–13:20). 22 4 Moran Dep., Ex. C to Roldan Decl. – ECF No. 56-1 at 54–57 (pp. 20:1–22:20, 37:1–38:22). 5 Lathrum Decl. – ECF No. 53-2 at 3 (¶¶ 11–12); Nationwide Estimate, Ex. C to id. – ECF No. 53-3 at 23 110 (Bates NMIC_000834); Email, Ex. E to id. – ECF No. 53-3 at 156 (Bates NMIC_000382). 24 6 Koester Dep., Ex. D to Roldan Decl. – ECF No. 56-1 at 60–62 (pp. 65:18–66:11) & Estimate, Ex. 5 to id. – ECF No. 56-1 at 94 (p. 28); Koester Dep., Ex. C to Chipman Decl. – ECF No. 53-1 at 133 (p. 25 50:18–20), 134 (p. 57:11–17), 138 (p. 61:18–22), 139 (p. 63:2–21), 140–41 (pp. 64:18–65:9); Email, Ex. 4 to Chipman Decl. – ECF No. 53-1 at 153; Claim Notes, Ex. B to Lathrum Decl. – ECF No. 53-3 at 87 26 (Bates NMIC_003286); Letter, Ex. F to Lathrum Decl. – ECF No. 53-3 at 159–61 (Bates NMIC_000764–66); Emails, Ex. G to Lathrum Decl. – ECF No. 53-3 at 163–64 (Bates NMIC_001187– 27 88); Email, Ex. I to Lathrum Decl. – ECF No. 53-3 at 169 (Bates NMIC_001148); Email, Ex. J to Lathrum Decl. – ECF No. 53-3 at 171 (Bates NMIC_000367).

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

Related

Marbury v. Brooks
20 U.S. 556 (Supreme Court, 1822)
Anderson v. Liberty Lobby, Inc.
477 U.S. 242 (Supreme Court, 1986)
Devereaux v. Abbey
263 F.3d 1070 (Ninth Circuit, 2001)
Oasis West Realty v. Goldman
250 P.3d 1115 (California Supreme Court, 2011)
Waller v. Truck Insurance Exchange, Inc.
900 P.2d 619 (California Supreme Court, 1995)
Foster-Gardner, Inc. v. National Union Fire Insurance
959 P.2d 265 (California Supreme Court, 1998)
Klubnikin v. California Fair Plan Assn.
84 Cal. App. 3d 393 (California Court of Appeal, 1978)
Belz v. Clarendon America Insurance
69 Cal. Rptr. 3d 864 (California Court of Appeal, 2007)
CHATEAU CHAMBERAY HOA v. Associated Internat. Ins. Co.
108 Cal. Rptr. 2d 776 (California Court of Appeal, 2001)
Tomaselli v. Transamerica Insurance
25 Cal. App. 4th 1269 (California Court of Appeal, 1994)
MacKinnon v. Truck Insurance Exchange
73 P.3d 1205 (California Supreme Court, 2003)
Wilson v. 21st Century Insurance
171 P.3d 1082 (California Supreme Court, 2007)

Cite This Page — Counsel Stack

Bluebook (online)
Bansal v. Nationwide Mutual Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/bansal-v-nationwide-mutual-insurance-company-cand-2025.