Benavides v. State Farm General Insurance

136 Cal. App. 4th 1241, 39 Cal. Rptr. 3d 650, 2006 Cal. Daily Op. Serv. 1593, 2006 Daily Journal DAR 2190, 2006 Cal. App. LEXIS 226
CourtCalifornia Court of Appeal
DecidedFebruary 23, 2006
DocketNo. B179028
StatusPublished
Cited by1 cases

This text of 136 Cal. App. 4th 1241 (Benavides v. State Farm General Insurance) 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
Benavides v. State Farm General Insurance, 136 Cal. App. 4th 1241, 39 Cal. Rptr. 3d 650, 2006 Cal. Daily Op. Serv. 1593, 2006 Daily Journal DAR 2190, 2006 Cal. App. LEXIS 226 (Cal. Ct. App. 2006).

Opinions

Opinion

TURNER, P. J.

I. INTRODUCTION

Before us are appeals from the judgment entered after a jury trial in an action based on the presence of mold in condominium units in Santa Monica instituted by plaintiff, Magda Benavides. Although she prevailed on her negligent investigation claim, plaintiff-appeals from the judgment against her [1245]*1245insurer, defendant State Farm General Insurance Company (State Farm). Plaintiff argues that she is entitled to a new trial on her claims for contract breach and violation of the implied covenant of good faith and fair dealing against State Farm. Plaintiff does not argue she is entitled to a new trial on her negligent investigation claim on which she prevailed during the jury trial. But State Farm appeals from the judgment in favor of plaintiff on her negligent investigation claim. Plaintiff also appeals from a judgment in favor of defendant, Lisa Haley. Ms. Haley’s condominium was upstairs from plaintiff’s unit.

In the published portion of this opinion, we discuss whether plaintiff may recover for negligent handling of her claim despite the fact there is no coverage under the terms of her policy. As will be noted, we conclude plaintiff may not recover for the negligent handling of her claim because there is no coverage under the terms of the policy. Further, none of the circumstances which allow for a contract claim to be pursued as a tort cause of action are present. Hence, we reverse plaintiff’s judgment against State Farm for negligent investigation. We affirm the judgment in all other respects.

II. BACKGROUND

Plaintiff purchased a ground floor condominium unit in Santa Monica in 1994. In 2001, mold was found in the exterior walls of the property, including walls adjacent to plaintiff’s unit. Subsequent testing revealed mold inside plaintiff’s condominium. Plaintiff was advised by a physician to move out of her condominium. Plaintiff submitted a claim for additional living expense to State Farm, which hired a civil engineer to investigate. State Farm later denied plaintiff’s claim on grounds the mold was an excluded loss which was not caused by a covered peril. Plaintiff sued State Farm and Ms. Haley. Plaintiff alleged State Farm had failed to properly investigate her claim, resulting in an erroneous coverage decision. The jury found there was no coverage and no breach of the Insurance contract. However, the jury also found State Farm negligently investigated plaintiff’s claim, causing her $260,000 in damages.

Ms. Haley lived upstairs from plaintiff. The complaint alleged that in May 2000, during remodeling, Ms. Haley’s contractor caused water to leak into plaintiff’s kitchen and living room. At trial, plaintiff presented evidence of other leaks from Ms. Haley’s unit. The jury found Ms. Haley was not negligent with regard to water intrusion into plaintiff’s unit.

[1246]*1246III. DISCUSSION

A. The Policy and the Jury Findings

The State Farm insurance policy issued to plaintiff excluded mold unless a covered peril was the predominant cause of the mold. Plaintiff’s additional living expense claim fell within “Coverage C—Loss of Use.” That provision stated in part: “Additional Living Expense. When a Loss Insured causes the residence premises to become uninhabitable, we will cover the necessary increase in cost you incur to maintain your standard of living for up to 24 months.” “Losses Insured” included “Coverage A—Building Property.” Coverage A provided: “We cover: [][] 1. alterations, appliances, fixtures and improvements which are part of the building contained within your unit; Q] 2. items of real property which pertain exclusively to your unit; or [][] 3. property which is your insurance responsibility under the governing rules of the condominium. . . .” (Italics omitted.) In “Section I—Losses Insured,” the policy stated: “We insure for accidental direct physical loss to the property described in Coverage A [building property] . . . , except as provided in SECTION I—LOSSES NOT INSURED.” “Section I—Losses Not Insured” stated in relevant part: “1. We do not insure under any coverage for any loss consisting of the items in paragraphs 2., 3., 4. or 5. below. This exclusion does not apply if the loss is caused by a peril which is not otherwise excluded. HQ 2. We do not insure for any loss to the property described in Coverage A [building property] . . . which is caused by one or more of the items below, regardless of whether the loss occurs suddenly or gradually, involves isolated or widespread damage, arises from natural or external forces, or occurs as a result of any combination of these: [f] . . . [][] f. continuous or repeated seepage or leakage of water . . . from a: [][]... [][] (2) household appliance; or [][] (3) plumbing system, including from, within or around any shower stall, shower bath, tub installation, or other plumbing fixture, including their walls, ceilings or floors; [f] which occurs over a period of time . . . ; [f] g. wear, tear, marring, scratching, deterioration, inherent vice, latent defect or mechanical breakdown; [][] h. corrosion, electrolysis or rust; [f] i. Mold, fungus or wet or dry rot; [][] j. contamination; [][]... [][] 4. We do not insure under any coverage for any loss which is caused by one or more of the items below, regardless of whether the event occurs suddenly or gradually, involves isolated or widespread damage, arises from natural or external forces, or occurs as a result of any combination of these: [][]... [][] c. Water Damage, meaning: [][] (1) . . . surface water .... [][]... [][] 5. We do not insure for loss described in paragraphs 2., 3. and 4. immediately above regardless of whether one or more of the following: (a) directly or indirectly cause, contribute to or aggravate the loss; or (b) occur before, at the same time, or after the loss or any other cause of the loss: [][]... [][] b. defect, weakness, inadequacy, fault or unsoundness in: [][]... [1247]*1247Pf] (2) design, specifications, workmanship, construction, grading, compaction; HO (3) materials used in construction or repair; or [f] (4) maintenance; HO of any property (including land, structures, or improvements or any kind) whether on or off the residence premises; or [f] c. weather conditions. HQ However, we do insure for any resulting loss from items a., b. and c. unless the resulting loss is itself a Loss Not Insured by this Section.”

With respect to building property coverage, the insurance policy at issue was a first party “all-risk” policy. (Garvey v. State Farm Fire & Casualty Co. (1989) 48 Cal.3d 395, 399 [257 Cal.Rptr. 292, 770 P.2d 704]; Croskey et al., Cal. Practice Guide: Insurance Litigation (The Rutter Group 2005) ¶ 6:250.1, p. 6B-24 (rev. # 1, 2005).) (The parties do not discuss and we do not consider the policy provisions relating to personal property loss.) An all-risk policy covers risks of physical loss except those excluded under the terms of the insuring contract. Under an all-risk policy, the limits of coverage are defined by the exclusions. (Garvey v. State Farm Fire & Casualty Co., supra, 48 Cal.3d at p. 406; Nissel v. Certain Underwriters at Lloyds of London (1998) 62 Cal.App.4th 1103, 1114 [73 Cal.Rptr.2d 174].) If an excluded risk is the “efficient proximate” or predominant cause of the loss, there is no coverage. (Julian v. Harford Underwriters Ins. Co. (2005) 35 Cal.4th 747, 761 [27 Cal.Rptr.3d 648, 110 P.3d 903];

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Related

Benavides v. State Farm General Ins. Co.
39 Cal. Rptr. 3d 650 (California Court of Appeal, 2006)

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Bluebook (online)
136 Cal. App. 4th 1241, 39 Cal. Rptr. 3d 650, 2006 Cal. Daily Op. Serv. 1593, 2006 Daily Journal DAR 2190, 2006 Cal. App. LEXIS 226, Counsel Stack Legal Research, https://law.counselstack.com/opinion/benavides-v-state-farm-general-insurance-calctapp-2006.