Berman v. Health Net

96 Cal. Rptr. 2d 295, 80 Cal. App. 4th 1359, 2000 Daily Journal DAR 5573, 2000 Cal. Daily Op. Serv. 4164, 2000 Cal. App. LEXIS 416
CourtCalifornia Court of Appeal
DecidedMay 26, 2000
DocketB125182
StatusPublished
Cited by33 cases

This text of 96 Cal. Rptr. 2d 295 (Berman v. Health Net) 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
Berman v. Health Net, 96 Cal. Rptr. 2d 295, 80 Cal. App. 4th 1359, 2000 Daily Journal DAR 5573, 2000 Cal. Daily Op. Serv. 4164, 2000 Cal. App. LEXIS 416 (Cal. Ct. App. 2000).

Opinions

Opinion

JOHNSON, J.

Defendants and appellants Health Net and Health Systems International, Inc. (collectively, Health Net), appeal from an order of the trial court denying their petition to compel arbitration of claims by plaintiff and respondent Peter Berman in connection with Health Net’s handling of health care benefits for his late wife, Renee. Health Net argues the discovery it conducted prior to filing its motion to compel arbitration was not enough, in the absence of any other factor, to establish prejudice to the Bermans, and thus was insufficient to support a finding it waived its right to compel arbitration. We disagree and find substantial evidence supports the trial court’s implied finding of prejudice, and its consequent finding of waiver by Health Net. We therefore affirm the judgment based on Davis v. Continental Airlines, Inc. (1997) 59 Cal.App.4th 205 [69 Cal.Rptr.2d 79].

Factual and Procedural Background

Renee Berman, now deceased, was diagnosed with colon cancer in June 1992. She had surgery and chemotherapy in July, receiving medical care under her husband Peter’s insurance, obtained through his employment as a deputy district attorney in Los Angeles County. In the fall of 1992, the Bermans’ health insurance coverage was changed when Los Angeles County changed the companies with which it contracted to provide health care for its [1362]*1362employees. Peter chose a medical plan offered through Health Net, and signed an enrollment form which included his agreement, by enrolling in a medical plan, “to have any dispute decided by arbitration in lieu of a jury or court trial.” (Italics in original.) The plan document contained a clause requiring arbitration of “any dispute or controversy concerning the construction, interpretation, performance or breach of this Evidence of Coverage,” except for claims of medical malpractice.

Renee’s cancer spread, and in 1996 the Bermans filed their first amended complaint against Health Net, Associated Physicians of St. John’s (APSJ), and a number of individual doctors. The first amended complaint alleged many difficulties getting Health Net to approve appropriate treatments, and asserted causes of action against Health Net for breach of the duty of good faith and fair dealing, breach of contract, breach of fiduciary duty, negligent and intentional infliction of emotional distress, and unfair competition under section 17200 of the Business and Professions Code (in the last case, seeking equitable and injunctive relief on behalf of the general public).

Health Net filed a demurrer to the complaint on May 3, 1996. Beginning on May 8, 1996, Health Net served extensive discovery requests on the Bermans, as well as third party subpoenas for Renee’s medical records. On May 9, 1996, and May 13, 1996, respectively, counsel for Health Net and the Bermans signed a stipulation confirming a telephone conversation between counsel, whereby Health Net “shall not be accused of having waived or be deemed to have waived any right to seek an order compelling binding arbitration . . .” by reason of “the filing of any motion or pleading challenging the sufficiency” of the complaint, and providing it would have 30 days after the date on which its answer was due to seek an order compelling arbitration. The Bermans served discovery responses in July 1996, and also served Health Net with their own discovery requests.

After two demurrers and subsequent amendments to the complaint, Health Net answered the third amended complaint on October 22, 1996. On November 12, 1996, Health Net filed a petition to compel arbitration. The petition was ultimately denied on the ground there existed a risk of inconsistent rulings because the Bermans’ claims against the individual physician defendants were not arbitrable. Health Net appealed from the denial. In the fall of 1997, the Bermans settled all claims against the non-Health Net defendants. Because there no longer existed a risk of inconsistent rulings, Health Net’s appeal was rendered moot and was dismissed on January 23, 1998, pursuant to Health Net’s request.

On April 20, 1998, Health Net again petitioned to compel arbitration of the Bermans’ claims, based on the changed circumstance there would no [1363]*1363longer be any risk of conflicting rulings since all other defendants had been dismissed. The Bermans opposed the petition and argued, inter alia, Health Net had waived the right to compel arbitration by engaging in substantial discovery. On May 28, 1998, the court denied Health Net’s petition, citing Davis v. Continental Airlines, Inc., supra, 59 Cal.App.4th 205 (Davis), and agreeing Health Net had waived its right to arbitration by engaging in discovery.1 Health Net filed a motion for reconsideration, offering additional evidence on the waiver issue. The motion was denied on July 15, 1998. Renee Berman died on July 24, 1998. Health Net filed its notice of appeal on August 12, 1998.2

Discussion

I. The Trial Court Properly Found Health Net Waived Its Right to Compel Arbitration, Based on a Finding of Prejudice to the Bermans.

A. The Trial Court’s Finding of Waiver Must Be Affirmed If Supported by Substantial Evidence.

While in general arbitration is a highly favored means of settling disputes (Doers v. Golden Gate Bridge etc. Dist. (1979) 23 Cal.3d 180, 189 (Doers) [151 Cal.Rptr. 837, 588 P.2d 1261]), it is beyond dispute a trial court may deny a petition to compel arbitration if it finds the moving party has waived that right. (Code Civ. Proc., § 1281.2, subd. (a); Davis, supra, 59 Cal.App.4th 205, 211.)

“[T]he question of waiver is one of fact, and an appellate court’s function is to review a trial court’s findings regarding waiver to determine whether these are supported by substantial evidence.” (Engalla v. Permanente Medical Group, Inc. (1997) 15 Cal.4th 951, 983 [64 Cal.Rptr.2d 843, 938 P.2d 903].) “The appellate court may not reverse the trial court’s finding of waiver unless the record as a matter of law compels finding nonwaiver. [Citations.]” (Davis, supra, 59 Cal.App.4th 205, 211.) “There is no single test for waiver of the right to compel arbitration, but waiver may be found where the party seeking arbitration has (1) previously taken steps inconsistent with an intent to invoke arbitration, (2) unreasonably delayed in seeking arbitration, or (3) acted in bad faith or with willful misconduct. [Citations.]” (Id. at pp. 211-212.) Wliile engaging in litigation of the matter may be [1364]*1364inconsistent with an intent to invoke arbitration, “the party who seeks to establish waiver must show that some prejudice has resulted from the other party’s delay in seeking arbitration.” (Id. at p. 212.)

In this case, the trial court reviewed the discovery conducted by the parties and made a finding (albeit implied rather than explicit) the Bermans had been prejudiced by Health Net’s conduct of extensive discovery. This implied finding of prejudice is supported by substantial evidence.3 Accordingly, we affirm the trial court’s finding of waiver. •

B.

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96 Cal. Rptr. 2d 295, 80 Cal. App. 4th 1359, 2000 Daily Journal DAR 5573, 2000 Cal. Daily Op. Serv. 4164, 2000 Cal. App. LEXIS 416, Counsel Stack Legal Research, https://law.counselstack.com/opinion/berman-v-health-net-calctapp-2000.