1 2 3 4 5 6 7 UNITED STATES DISTRICT COURT 8 SOUTHERN DISTRICT OF CALIFORNIA 9 10 OSCAR CHUNG and JAN CHUNG, Case No.: 23-cv-0856-BEN (VET)
11 Plaintiffs,
12 v.
13 QBE INSURANCE CORPORATION, a ORDER Pennsylvania Corporation, 14 Defendant. 15
16 Now before the Court is Plaintiff Oscar Chung’s and Plaintiff Jan Chung’s motion 17 for summary judgment (Dkt. 18) and Defendant QBE Insurance Corporation’s motion for 18 judgment on the pleadings (Dkt. 20). For the reasons discussed below, the Court grants 19 Plaintiffs’ motion for summary judgment on their breach of contract claim (Claim 2) and 20 their request for a declaratory judgment (Claim 3). The Plaintiffs’ motion for summary 21 judgment as to their claim for breach of the implied covenant of good faith and fair 22 dealing (Claim 1) is denied. Defendant’s motion for judgment on the pleadings on the 23 breach of contract claim (Claim 2) is denied. Defendant is granted summary judgment on 24 Claim 1 pursuant to the genuine disputes doctrine and the associated request for punitive 25 damages is dismissed. The only issue that remains is the amount of damages which 26 Plaintiffs incurred due to Defendant’s breach of contract. 27
28 1 I. BACKGROUND 2 This is a case about a homeowner’s insurance policy. The Plaintiffs own a home. 3 They bought a homeowner’s insurance policy from defendant QBE Insurance, policy 4 number PHP2663552. The plaintiffs have a disabled adult child with special needs, 5 Jonathan. To help with care for their son, the Plaintiffs hired a homecare assistant by the 6 name of Maria Estela Medina. In California, workers like Medina who work within a 7 residence may be considered employees of the homeowners who hire them. 8 Homeowners like the Plaintiffs, in turn, may be considered employers of residential 9 workers like Median. Homeowner-employers are required to carry insurance coverage 10 for worker’s compensation claims. 11 If an employee gets hurt while working, she may file a worker’s compensation 12 claim. That is what happened here. On February 17, 2022, Medina claimed to suffer an 13 on-the-job injury while caring for Jonathan. Consequently, on March 17, 2022, Medina 14 filed an Application for Adjudication of Claim before the Workers’ Compensation 15 Appeals Board, Case No. ADJ15923278 (the “Underlying Action”), against Plaintiffs for 16 this alleged injury. Aware that their homeowner’s insurance policy issued by QBE 17 Insurance said it covered worker’s compensation claims for residential employees, 18 Plaintiffs timely notified QBE Insurance and tendered the defense of Medina’s claim. 19 QBE Insurance, in turn, accepted the claim and undertook a defense of the Plaintiffs, as 20 expected. 21 Things changed when Medina filed another claim with the Worker’s 22 Compensation Appeals Board. She filed for compensation enhancement based on 23 California Labor Code §132a. On July 25, 2022, Medina filed a Petition for Enhanced 24 Benefits Pursuant to Labor Code § 132a before the Workers’ Compensation Appeals 25 Board, also under the Case No. ADJ15923278 (“132a Petition”). As before, Plaintiffs 26 timely notified QBE Insurance and tendered the defense of Medina’s second claim. This 27 time, however, QBE Insurance did an about-face and refused to defend saying it was not 28 covered by its policy of insurance. 1 Plaintiffs now bring three claims for relief. Plaintiffs allege a beach of the 2 insurance contract and a breach of the implied covenant of good faith and fair dealing. 3 Plaintiffs also seek a declaratory judgment clarifying that both of Medina’s worker’s 4 compensation claims are covered by their homeowner’s insurance policy. 5 II. APPLICABLE LAW 6 Plaintiffs move for summary judgment on each of their claims under FRCP Rule 7 56. QBE Insurance moves for judgment on the pleadings on the breach of contract claim 8 under FRCP Rule 12(c).1 The standards for considering these motions are well-known 9 and are not questioned by the parties here. In applying these procedural standards, 10 because plaintiffs’ claims are based on state law, it is a federal court’s task to apply state 11 law as determined by the state’s highest court. Angel v. Bullington, 330 U.S. 183, 191 12 (1947) (“The essence of diversity jurisdiction is that a federal court enforces State law 13 and State policy.”). Where the state’s highest court has not decided a question, it is a 14 federal court’s task to predict what the state’s highest court will decide. Vazquez v. Jan- 15 Pro Franchising Int'l, Inc., 939 F.3d 1045, 1048–49 (9th Cir. 2019) (“If a state’s highest 16 court has not spoken on an issue, ‘then we must predict how the state’s highest court 17 would decide’ the issue.”). The prediction may be based on decisions made by the state’s 18 own courts of appeal or other persuasive authorities. 19 Under California law, the interpretation of contract language is a question of law. 20 Great Minds v. Office Depot, Inc., 945 F.3d 1106, 1110 (9th Cir. 2019). The California 21 Supreme Court has not addressed the particular interpretative question here, but it has set 22 out general principles to be used for interpreting contracts of insurance.2 Where the 23
24 1 Defendant also requests judicial notice be taken of five documents. RJN. Dkt 20-2. 25 The motion is granted as to Exhibit A which is a certified copy of the insurance policy. The motion is denied as to the other documents including Exhibit D (an amicus brief) and 26 Exhibits B and C (the pleadings in this case). 27 2Jurisdiction in this case is based upon diversity, and neither party disputes that the interpretation of the Policy is governed by California law. See, e.g., Manzarek v. St. Paul 28 1 2 insurance law in diversity case). Crane v. State Farm Fire & Cas. Co., 5 Cal. 3d 112, 3 115–16 (1971) lists some of the interpretative rules: “In analyzing the extent of the exclusion, our boundaries 4 are the rules to be applied in the interpretation of insurance 5 policies. Any ambiguity or uncertainty in an insurance policy is to be resolved against the insurer. If semantically permissible, 6 the contract will be given such construction as will fairly 7 achieve its manifest object of securing indemnity to the insured for the losses to which the insurance relates. Any reasonable 8 doubt as to uncertain language will be resolved against the 9 insurer whether that doubt relates to the peril insured against or other relevant matters. The policy should be read as a layman 10 would read it and not as it might be analyzed by an attorney or 11 an insurance expert. An exclusionary clause must be conspicuous, plain and clear and must be construed strictly 12 against the insurer and liberally in favor of the insured. 13 (Citations omitted.) AIU Ins. Co. v. Superior Ct., 51 Cal. 3d 807, 821–22 (1990), provides other rules: 14 Under statutory rules of contract interpretation, the 15 mutual intention of the parties at the time the contract is formed governs interpretation. Such intent is to be inferred, if possible, 16 solely from the written provisions of the contract. The “clear 17 and explicit” meaning of these provisions, interpreted in their “ordinary and popular sense,” unless “used by the parties in a 18 technical sense or a special meaning is given to them by usage” 19 controls judicial interpretation. Thus, if the meaning a layperson would ascribe to contract language is not ambiguous, 20 we apply that meaning.
Free access — add to your briefcase to read the full text and ask questions with AI
1 2 3 4 5 6 7 UNITED STATES DISTRICT COURT 8 SOUTHERN DISTRICT OF CALIFORNIA 9 10 OSCAR CHUNG and JAN CHUNG, Case No.: 23-cv-0856-BEN (VET)
11 Plaintiffs,
12 v.
13 QBE INSURANCE CORPORATION, a ORDER Pennsylvania Corporation, 14 Defendant. 15
16 Now before the Court is Plaintiff Oscar Chung’s and Plaintiff Jan Chung’s motion 17 for summary judgment (Dkt. 18) and Defendant QBE Insurance Corporation’s motion for 18 judgment on the pleadings (Dkt. 20). For the reasons discussed below, the Court grants 19 Plaintiffs’ motion for summary judgment on their breach of contract claim (Claim 2) and 20 their request for a declaratory judgment (Claim 3). The Plaintiffs’ motion for summary 21 judgment as to their claim for breach of the implied covenant of good faith and fair 22 dealing (Claim 1) is denied. Defendant’s motion for judgment on the pleadings on the 23 breach of contract claim (Claim 2) is denied. Defendant is granted summary judgment on 24 Claim 1 pursuant to the genuine disputes doctrine and the associated request for punitive 25 damages is dismissed. The only issue that remains is the amount of damages which 26 Plaintiffs incurred due to Defendant’s breach of contract. 27
28 1 I. BACKGROUND 2 This is a case about a homeowner’s insurance policy. The Plaintiffs own a home. 3 They bought a homeowner’s insurance policy from defendant QBE Insurance, policy 4 number PHP2663552. The plaintiffs have a disabled adult child with special needs, 5 Jonathan. To help with care for their son, the Plaintiffs hired a homecare assistant by the 6 name of Maria Estela Medina. In California, workers like Medina who work within a 7 residence may be considered employees of the homeowners who hire them. 8 Homeowners like the Plaintiffs, in turn, may be considered employers of residential 9 workers like Median. Homeowner-employers are required to carry insurance coverage 10 for worker’s compensation claims. 11 If an employee gets hurt while working, she may file a worker’s compensation 12 claim. That is what happened here. On February 17, 2022, Medina claimed to suffer an 13 on-the-job injury while caring for Jonathan. Consequently, on March 17, 2022, Medina 14 filed an Application for Adjudication of Claim before the Workers’ Compensation 15 Appeals Board, Case No. ADJ15923278 (the “Underlying Action”), against Plaintiffs for 16 this alleged injury. Aware that their homeowner’s insurance policy issued by QBE 17 Insurance said it covered worker’s compensation claims for residential employees, 18 Plaintiffs timely notified QBE Insurance and tendered the defense of Medina’s claim. 19 QBE Insurance, in turn, accepted the claim and undertook a defense of the Plaintiffs, as 20 expected. 21 Things changed when Medina filed another claim with the Worker’s 22 Compensation Appeals Board. She filed for compensation enhancement based on 23 California Labor Code §132a. On July 25, 2022, Medina filed a Petition for Enhanced 24 Benefits Pursuant to Labor Code § 132a before the Workers’ Compensation Appeals 25 Board, also under the Case No. ADJ15923278 (“132a Petition”). As before, Plaintiffs 26 timely notified QBE Insurance and tendered the defense of Medina’s second claim. This 27 time, however, QBE Insurance did an about-face and refused to defend saying it was not 28 covered by its policy of insurance. 1 Plaintiffs now bring three claims for relief. Plaintiffs allege a beach of the 2 insurance contract and a breach of the implied covenant of good faith and fair dealing. 3 Plaintiffs also seek a declaratory judgment clarifying that both of Medina’s worker’s 4 compensation claims are covered by their homeowner’s insurance policy. 5 II. APPLICABLE LAW 6 Plaintiffs move for summary judgment on each of their claims under FRCP Rule 7 56. QBE Insurance moves for judgment on the pleadings on the breach of contract claim 8 under FRCP Rule 12(c).1 The standards for considering these motions are well-known 9 and are not questioned by the parties here. In applying these procedural standards, 10 because plaintiffs’ claims are based on state law, it is a federal court’s task to apply state 11 law as determined by the state’s highest court. Angel v. Bullington, 330 U.S. 183, 191 12 (1947) (“The essence of diversity jurisdiction is that a federal court enforces State law 13 and State policy.”). Where the state’s highest court has not decided a question, it is a 14 federal court’s task to predict what the state’s highest court will decide. Vazquez v. Jan- 15 Pro Franchising Int'l, Inc., 939 F.3d 1045, 1048–49 (9th Cir. 2019) (“If a state’s highest 16 court has not spoken on an issue, ‘then we must predict how the state’s highest court 17 would decide’ the issue.”). The prediction may be based on decisions made by the state’s 18 own courts of appeal or other persuasive authorities. 19 Under California law, the interpretation of contract language is a question of law. 20 Great Minds v. Office Depot, Inc., 945 F.3d 1106, 1110 (9th Cir. 2019). The California 21 Supreme Court has not addressed the particular interpretative question here, but it has set 22 out general principles to be used for interpreting contracts of insurance.2 Where the 23
24 1 Defendant also requests judicial notice be taken of five documents. RJN. Dkt 20-2. 25 The motion is granted as to Exhibit A which is a certified copy of the insurance policy. The motion is denied as to the other documents including Exhibit D (an amicus brief) and 26 Exhibits B and C (the pleadings in this case). 27 2Jurisdiction in this case is based upon diversity, and neither party disputes that the interpretation of the Policy is governed by California law. See, e.g., Manzarek v. St. Paul 28 1 2 insurance law in diversity case). Crane v. State Farm Fire & Cas. Co., 5 Cal. 3d 112, 3 115–16 (1971) lists some of the interpretative rules: “In analyzing the extent of the exclusion, our boundaries 4 are the rules to be applied in the interpretation of insurance 5 policies. Any ambiguity or uncertainty in an insurance policy is to be resolved against the insurer. If semantically permissible, 6 the contract will be given such construction as will fairly 7 achieve its manifest object of securing indemnity to the insured for the losses to which the insurance relates. Any reasonable 8 doubt as to uncertain language will be resolved against the 9 insurer whether that doubt relates to the peril insured against or other relevant matters. The policy should be read as a layman 10 would read it and not as it might be analyzed by an attorney or 11 an insurance expert. An exclusionary clause must be conspicuous, plain and clear and must be construed strictly 12 against the insurer and liberally in favor of the insured. 13 (Citations omitted.) AIU Ins. Co. v. Superior Ct., 51 Cal. 3d 807, 821–22 (1990), provides other rules: 14 Under statutory rules of contract interpretation, the 15 mutual intention of the parties at the time the contract is formed governs interpretation. Such intent is to be inferred, if possible, 16 solely from the written provisions of the contract. The “clear 17 and explicit” meaning of these provisions, interpreted in their “ordinary and popular sense,” unless “used by the parties in a 18 technical sense or a special meaning is given to them by usage” 19 controls judicial interpretation. Thus, if the meaning a layperson would ascribe to contract language is not ambiguous, 20 we apply that meaning. 21 If there is ambiguity, however, it is resolved by interpreting the ambiguous provisions in the sense the promisor 22 (i.e., the insurer) believed the promisee understood them at the 23 time of formation. If application of this rule does not eliminate the ambiguity, ambiguous language is construed against the 24 party who caused the uncertainty to exist. In the insurance 25 context, we generally resolve ambiguities in favor of coverage. Similarly, we generally interpret the coverage clauses of 26 insurance policies broadly, protecting the objectively 27 reasonable expectations of the insured. These rules stem from the fact that the insurer typically drafts policy language, leaving 28 1 insurance customer is not a sophisticated business customer, interpretations favor the 2 insured. “The policy should be read as a layman would read it and not as it might be 3 analyzed by an attorney or an insurance expert.” Crane v. State Farm Fire & Cas. Co., 5 4 Cal. 3d 112, 115–16 (1971). “[I]f the meaning a layperson would ascribe to contract 5 language is not ambiguous, we apply that meaning.” AIU Ins. Co. v. Superior Ct., 51 6 Cal. 3d 807, 821–22 (1990). 7 III. DISCUSSION 8 The QBE Insurance policy specifically covers worker’s compensation claims. In a 9 two-page endorsement the policy provides: 10 11 WORKER’S COMPENSATION AND EMPLOYERS’ 12 LIABILITY INSURANCE ENDORSEMENT – CALIFORNIA 13 Residence Employees 14 With respect to residence employees of the insured, and in consideration of an 15 additional premium, the Company agrees: 16 Insuring Agreements 17 Coverage I 18 to pay promptly when due all compensation and other benefits required of the insured by the workers' compensation law, and 19
20 Coverage II ….. 21 Conditions 22 ….. 2. Additional Provisions Applicable to Coverage I 23 The following provisions are applicable to Coverage I afforded under this 24 endorsement:
25 bargain for modifications. Because the insurer writes the 26 policy, it is held “responsible” for ambiguous policy language, 27 which is therefore construed in favor of coverage. (Citations omitted.) 28 1 (a) The Company shall be directly and primarily liable to any residence employee of the insured entitled to the benefits of the Workers' 2 Compensation Law under this policy. 3 4 Exhibit 1, Dkt 18-7, at 63-64 (the policy of insurance) (emphasis in original) (italics 5 added). 6 Reading this policy as a layman would read it, the policy is straightforward and on 7 point. The policy covers worker’s compensation claims made by residence employees. 8 Under a plain reading this policy covers both of the worker’s compensation claims filed 9 by Medina. Under this reading, QBE Insurance clearly breached the insurance contract 10 by refusing to defend or pay for Medina’s second worker’s compensation claim (i.e., the 11 §132a claim) against the Plaintiffs. 12 QBE Insurance disagrees. QBE Insurance spends 84 combined pages of briefing 13 and 400 pages of exhibits to analyze the policy as an attorney would or an insurance 14 expert would to arrive at a different conclusion, i.e., that Medina’s §132a worker’s 15 compensation claim is somehow not covered. To summarize the arguments, QBE 16 Insurance says §132a claims are not ordinary worker’s compensation claims. Instead, it 17 asserts that §132a worker’s compensation claims are intentional discrimination claims 18 and presumes3 from the beginning that the Chungs (its insureds) did in fact intentionally 19 discriminate. QBE then maintains that its insurance policy does not insure against acts of 20 intentional discrimination and further that state law does not allow insurance against 21 intentional discrimination. Based on these arguments, QBE Insurance claims that its 22 worker’s compensation policy coverage does not cover worker’s compensation claims 23 brought under §132a even though there is nothing in the policy that mentions -- much 24 less specifically excludes -- §132a claims. The arguments are not persuasive. 25 26 27 3 Note the tone of QBE Insurance’s briefing: “That the Chungs try to pass off to their homeowners insurer liability for their allegedly reprehensible behavior is astounding.” 28 1 QBE Insurance remonstrates that a §132a claim is not an ordinary worker’s 2 compensation claim so it is not covered by its insurance policy. “A Labor Code Section 3 132a Petition seeking penalties for unlawful termination is not in the same universe as a 4 claim for workers compensation benefits for industrial injuries,” says QBE Insurance. 5 QBE’s Reply ISO Mot. for Judgment, Dkt 25 at 1. Of course, both types of claims are 6 worker’s compensation claims arising out of an employer/employee relationship and 7 presented to the California Worker’s Compensation Appeals Board for resolution, which 8 QBE Insurance acknowledges. QBE’s Mem ISO Judgment, Dkt 20 at 16 (“Despite the 9 fact that both types of claims are heard before the WCAB, they are, in fact, separate types 10 of actions.”). It is true that the two types of claims may be procedurally distinct. “[I]n 11 workers’ compensation practice, a petition for discrimination benefits under section 132a 12 is procedurally separate and distinct from an application for ordinary benefits.” 13 Morehouse v. Workers’ Comp. Appeals Bd., 154 Cal. App. 3d 323, 331 (1984); Sullivan 14 v. Workers’ Comp. Appeals Bd., 71 Cal. Comp. Cases 1065, 1066, fn. 3 (2006) (same). 15 Nevertheless, they are both brought before the Worker’s Compensation Appeals Board 16 and are based on California’s worker’s compensation laws. 17 What is a §132a claim for enhanced benefits? California Labor Code §132a states, 18 It is the declared policy of this state that there should not be discrimination against workers who are injured in the course and scope of their employment. 19 (1)Any employer who discharges, or threatens to discharge, or in any 20 manner discriminates against any employee because he or she has filed or made known his or her intention to file a claim for compensation with his or her 21 employer or an application for adjudication, or because the employee has received 22 a rating, award, or settlement, is guilty of a misdemeanor and the employee’s compensation shall be increased by one-half, but in no event more than ten 23 thousand dollars ($10,000), together with costs and expenses not in excess of two 24 hundred fifty dollars ($250). Any such employee shall also be entitled to reinstatement and reimbursement for lost wages and work benefits caused by the 25 acts of the employer.… 26 Cal. Lab. Code §132a(1). A successful §132a claim increases the employee’s worker’s 27 compensation award by one-half (up to an amount of $10,000) and may include back pay. 28 1 A §132a award falls comfortably within the QBE Insurance policy language which 2 covers: “compensation and other benefits required of the insured by the workers' 3 compensation law.” QBE Insurance says that the §132a petition does not fall within its 4 coverage because it is penal in nature and does not assess compensation or benefits. 5 QBE’s Mem ISO Judgment, Dkt 20 at 19. It may be penal in nature but the language of 6 §132 uses the terms “employee’s compensation” (“employee’s compensation shall be 7 increased by one-half”) and “work benefits” (“reimbursement for lost wages and work 8 benefits”). (Emphasis added.) Consequently, whether penal or not, a §132a claim seeks 9 worker’s compensation and benefits and is covered by the broad language of the 10 insurance policy. 11 QBE Insurance discounts the similarities and highlights the difference. QBE 12 Insurance argues that the difference between the two types of claims is evident because 13 part of the law is codified in Division 1 of the California Labor Code while another part 14 is found in §3207 of Division 4 of the Labor Code. And QBE Insurance argues that 15 “compensation” under one section is different from “back pay” under another section, 16 and both are different from “benefits” under a third section. Whatever the differences 17 may be between ordinary claims and §132a claims, the language of the QBE Insurance 18 policy coverage is broad and encompasses all types of awards under the worker’s 19 compensation law. The policy does not limit its language to insuring against only 20 ordinary or commonplace claims. Consequently, there is no reason why an insured 21 policyholder (like the Chungs) would understand that some kinds of worker’s 22 compensation claims are not covered. AIU Ins. Co., 51 Cal. 3d at 821–22 (“[W]e 23 generally interpret the coverage clauses of insurance policies broadly, protecting the 24 objectively reasonable expectations of the insured.”). 25 QBE Insurance next concedes that there is no specific exclusion in its policy of 26 insurance for worker’s compensation §132a claims, but it does not matter because 27 “[t]here are literally hundreds of problems…and it would be a limitless task for 28 1 the insurer to specifically enumerate each of them as being excluded from coverage.” 2 QBE’s Mem ISO Judgment, Dkt 20 at 18 (quoting Glavinich v. Commonwealth Land 3 Title Ins. Co., 163 Cal. App. 3d 263, 270 (1984)). Glavinich is not particularly helpful 4 here because it involved a completely different type of insurance: title insurance. 5 Glavinich makes this clear when the entire sentence is presented, “[t]here are literally 6 hundreds of problems that may affect real property, its condition or value and it would be 7 a limitless task for the insurer to specifically enumerate each of them as being excluded 8 from coverage.” Id. (emphasis added). It goes on to make the more general point that 9 one first looks to the coverage defined by the insuring clause. 10 QBE Insurance suggests that it is too difficult to write specific exclusions into a 11 policy. But if there is anything more commonplace in insurance policies than exclusions, 12 it is hard to imagine what it would be. After all, QBE was able to write an exclusion 13 under the same worker’s compensation and employers’ liability endorsement for Labor 14 Code §§4553/4557 conduct (conduct that the law explicitly prohibits insuring against), 15 while failing to include any language in the policy limiting, in any way, coverage for 16 §132a claims (which the law does not prohibit insuring against). So, that argument is not 17 particularly persuasive. 18 QBE Insurance next argues that even though there is no explicit exclusion in its 19 policy for §132a worker’s compensation claims, California law imposes an implied 20 exclusionary clause in every insurance policy for willful wrongs of an insured, based on 21 Insurance Code §533. QBE’s Mem ISO Judgment, Dkt 20 at 16 (citing Certain 22 Underwriters at Lloyd’s London v. ConAgra Grocery Prods. Co., 77 Cal. App. 5th 729, 23 739 (2022)). That could be a good argument but the caselaw does not support it. 24 California Insurance Code §533 states, “An insurer is not liable for a loss caused 25 by the willful act of the insured; but he is not exonerated by the negligence of the insured, 26 or of the insured's agents or others.” Cal. Ins. Code §533. This is a legal argument that 27 an insurance lawyer might love, but a homeowner layman cannot be expected to 28 understand. Plaintiffs argue that reading a §533 exclusion into the policy would render 1 part of the Worker’s Compensation Endorsement illusory. Plaintiffs also argue that 2 California courts have concluded that §533 does not apply to worker’s compensation 3 claims. For example, Azevedo v. Able, 264 Cal.App.2d 451, 458 (1968), explained, 4 “[t]here is, then, a surface conflict between the compensation law’s demand for secured 5 compensation and the statutory policy against insurance for willful torts. The conflict 6 disappears in the light of additional statutes.” Azevedo continues, “Section 533 of the 7 Insurance Code and section 1668 of the Civil Code do not apply to workmen's 8 compensation insurance coverage and do not prohibit insurance against the employer's 9 ordinary liability for disability compensation and medical expense, even when 10 occasioned by his willful wrong.” Id. (emphasis added). The Azevedo court is not alone. 11 “All three statutes [§4553, §11661, §533] express the same public policy and would refer 12 to the same conduct except that section 533 does not apply to workers' compensation 13 insurance.” Shell Oil Co. v. Winterthur Swiss Ins. Co., 12 Cal. App. 4th 715, 741 (1993), 14 reh'g denied and opinion modified (Feb. 22, 1993) (emphasis added). QBE Insurance 15 argues that the Azevedo decision is “inconsequential and distinguishable.” QBE’s Mem 16 ISO Mot. Judgment, Dkt 20 at n.12; QSE’s Oppo. to Plaintiffs’ MSJ, Dkt. 21, at 14 17 (same). It does not, however, address the more recent Shell Oil Co. case. Even QBE 18 Insurance’s own agent agreed that precedent allows for insurance for a §132a claim. An 19 email to Plaintiffs’ attorney explaining QBE’s decision to not defend the §132a claim 20 said, “[t]here is generally a public-policy concern about insuring for willful, wrongful 21 acts. Despite this, precedent allows insurance for 132a claims. . . . It depends, however, 22 on the language of the insurance contract.” Plaintiffs’ Mot. for Summary Judgment, 23 Exhibit 6, Dkt. 18-12 (email from Kimberly Poese to Joseph Dicks, Esq. dated Aug. 29, 24 2022). 25 If §533 means what QBE Insurances contends, one would expect to find a court 26 decision interpreting insurance policy language as excluding workmen’s compensation 27 coverage for §132a claims, in view of its decision to deny coverage and decline to defend 28 its insureds. But QBE Insurance has not identified such a case. Instead, the only case 1 that is on point supports the Plaintiffs’ position: Melton v. Industrial Indemnity Co., 103 2 Cal.Rptr.2d 222 (2001). QBE Insurance argues against considering that case because the 3 opinion was depublished. 4 A California appellate court addressed §132a insurance coverage in Melton. In 5 Melton, an insurance policy with worker’s compensation coverage used precisely the 6 same policy language as is used in the QBE Insurance policy: “to pay promptly when due 7 all compensation and other benefits required of the insured by the workers' compensation 8 law.” Id. at 236. In Melton, as in the QBE Insurance policy, there were no exclusions for 9 §132a claims. Id. Faced with many of the same arguments QBE Insurance makes today, 10 the Melton court was unpersuaded and by applying the state law rules of policy 11 interpretation it concluded that §132a claims were covered by the policy language. For 12 example, Melton explained, “[a]lthough section 132a does not provide the exclusive 13 remedy for discrimination based on a work-related disability, the specific remedies it 14 affords can only be recovered in a proceeding before the WCAB [Worker’s 15 Compensation Appeals Board]. It follows that section 132a is part of the general 16 ‘workers' compensation law’ and anything it provides in the nature of ‘compensation’ or 17 ‘other benefits’ therefore falls within the ambit of coverage A.” Id. at 239 (citations 18 omitted). Disposing with another argument, Melton said, “[the insurer] also contends a 19 132a award is really a penalty rather than a form of compensation. However, section 20 132a itself provides for increased ‘compensation.’ And a 132a award serves a remedial as 21 well as a deterrent purpose.” Id. at 240 (citations omitted). Finally, Melton dispensed 22 with the argument that §533 precludes insurance coverage altogether, explaining inter 23 alia, “[i]t is because some intentional workplace injuries are compensable under the 24 workers' compensation system, and because an employer is required to ‘secure the 25 payment of compensation’ by purchasing insurance against its liability for those injuries 26 (§ 3700), that sections 533 of the Insurance Code and 1668 of the Civil Code do not 27 apply to workers' compensation policies.” Id. at 246. 28 1 Of course, Melton was not a published decision of the California Supreme Court 2 and is not binding precedent on state trial courts. Nevertheless, federal courts sitting in 3 diversity are not prohibited from citing, nor considering, a depublished state appellate 4 decision for its persuasive reasoning. Melton’s reasoning is persuasive on the question of 5 whether QBE Insurance’s policy language covers a §132 worker’s compensation claim 6 like that of residential worker Medina, and based on Melton’s reasoning and the 7 discussion above, this Court concludes QBE Insurance breached its insurance contract 8 when it denied coverage and a defense of the Plaintiffs. 9 Because Plaintiffs are entitled to summary judgment on the breach of contract 10 claim, granting Defendant’s motion for judgment on the pleadings would be inconsistent. 11 Therefore, Defendant’s motion for judgment on the pleadings is denied. However, 12 Plaintiffs’ motion for summary judgment on the remaining claim for breach of the duty of 13 good faith and fair dealing is a different story. 14 In order to establish a breach of the implied covenant of good faith and fair dealing 15 by an insurer under California law, a plaintiff must show: (1) benefits due under the 16 policy were withheld; and (2) the reason for withholding benefits was unreasonable or 17 without proper cause. Aram Logistics v. United States Liab. Ins. Co., No. 3:23cv1869-H- 18 DEB, 2024 WL 390076, at *10 (S.D. Cal. Jan. 31, 2024) (citations omitted). In first-
19 party insurance cases, as is the case here, the test of liability is whether the refusal to pay 20 policy benefits was unreasonable. Austero v. Nat'l Cas. Co., 84 Cal. App. 3d 1, 31 21 (1978), overruled on other grounds by Egan v. Mutual of Omaha Ins. Co., 24 Cal. 3d 809 22 (1979). “While the reasonableness of an insurer’s claims-handling conduct is ordinarily a 23 question of fact, it becomes a question of law where the evidence is undisputed and only 24 one reasonable inference can be drawn from the evidence.” Chateau Chamberay 25 Homeowners Ass'n v. Associated Int'l Ins. Co., 90 Cal. App. 4th 335, 346, as modified on 26 denial of reh'g (July 30, 2001). “The mistaken or erroneous withholding of policy 27 benefits, if reasonable or if based on a legitimate dispute as to the insurer’s liability under 28 1 California law, does not expose the insurer to bad faith liability.” Id. (citation omitted). 2 “Without more, such a denial of benefits is merely a breach of contract.” Id. 3 It is settled law in California that an insurer denying policy benefits due to the 4 existence of a genuine dispute as to the existence of coverage liability is not liable in bad 5 faith, even though it might be liable for breach of contract. Id. (citing Fraley v. Allstate 6 Ins. Co., 81 Cal.App.4th 1282, 1292 (2000)). In view of the absence of authority from 7 the California Supreme Court and the dearth of precedential opinions from the California 8 courts of appeal, there is little evidence of bad faith. Plaintiff’s motion for summary 9 judgment on its claim that QBE Insurance breached the implied duty of good faith and 10 fair dealing is denied.4 Cf. Feldman v. Allstate Ins. Co., 322 F.3d 660, 669 (9th Cir. 2003) 11 (“Because the key to a bad faith claim is whether denial of a claim was reasonable, a bad 12 faith claim should be dismissed on summary judgment if the defendant demonstrates that 13 there was ‘a genuine dispute as to coverage.’”). Moreover, according to what the Ninth 14 Circuit refers to as ‘the genuine dispute doctrine,” a bad faith claim can be dismissed on 15 summary judgment as a matter of California law. Guebara v. Allstate Ins. Co., 237 F.3d 16 987, 992 (9th Cir. 2001) (“Under California law, a bad faith claim can be dismissed on 17 summary judgment if the defendant can show that there was a genuine dispute as to 18 coverage.”) (citations omitted); see also Case v. State Farm Mut. Auto. Ins. Co., 30 Cal. 19 App. 5th 397, 414 (2018) (no triable issues on bad faith claim due to genuine dispute over 20 worker’s compensation payment). 21 Here, the bad faith claim arises from a genuine dispute as to policy coverage for 22 the §132a claim. Because a genuine disputed existed, summary judgment is granted to 23 QBE Insurance on the bad faith claim. Because summary judgment is granted as to the 24 bad faith claim based on the genuine dispute doctrine, there is no basis for plaintiffs’ 25 punitive damages request. Therefore, summary judgment is also granted in favor of QBE 26
27 4 QBE Insurance did not move for summary judgment specifically on the Plaintiff’s claim 28 1 Insurance on Plaintiffs’ request for punitive damages. Leung v. Unum Life Ins. Co. of 2 Am., No. 22cv0767 W (JLB), 2023 WL 7351581, at *15 (S.D. Cal. Nov. 6, 2023) (“The 3 genuine-dispute doctrine is an affirmative defense to a bad-faith claim. Under the 4 doctrine, ‘an insurer denying or delaying the payment of policy benefits due to the 5 existence of a genuine dispute with its insured as to the existence of coverage liability or 6 the amount of the insured's coverage claim is not liable in bad faith even though it might 7 be liable for breach of contract.’”) (granting summary judgment to insurer on bad faith 8 claim and punitive damages based on the genuine dispute doctrine) (quoting Wilson v. 9 21st Century Ins. Co., 42 Cal.4th 713, 723 (2007)); Case, 30 Cal. App. 5th at 417 (“In 10 view of our conclusion regarding summary adjudication on the bad faith claim, summary 11 adjudication was also proper with respect to Case's request for punitive damages.”); Jean 12 Jacques Darmon, Inc. v. State Farm Gen. Ins. Co., No. LACV2105235JAKASX, 2023 13 WL 9019042, at *8 (C.D. Cal. Nov. 14, 2023) (same). 14 IV. CONCLUSION 15 Therefore, 16 (1) Plaintiffs’ motion for summary judgment under FRCP 56 is granted as to Claim 17 2 (the breach of contract claim); QBE Insurance’s motion for judgment on the 18 pleadings as to Claim 2 (the breach of contract claim) is denied. 19 (2) Plaintiffs are entitled to a judicial declaration (Claim 3) that the QBE Insurance 20 homeowner’s policy of insurance covers a residential employee’s workman’s 21 compensation claims including claims brought pursuant to California Labor 22 Code §132a; QBE Insurance’s motion for judgment on the pleadings as to 23 Claim 3 is denied. 24 (3) Plaintiffs’ motion for summary judgment on Claim 1 (breach of the implied 25 covenant of good faith and fair dealing is denied. 26 (4) QBE Insurance is entitled to summary judgment as to Claim 1 (breach of the 27 implied covenant of good faith and fair dealing) and Plaintiffs’ request for 28 punitive damages. 1 The parties are reminded of the following direction from the Magistrate Judge: 2 “Within two (2) business days of Judge Benitez’s ruling on any dispositive motions 3 regarding the coverage issues related to California Labor Code §132a and an underlying 4 132a Petition, the Parties shall file a Joint Status Report updating the Court as to whether 5 a second Case Management Conference is warranted and if so, providing counsel’s 6 availability for a second Case Management Conference.” See Order dated Sept. 28, 7 2023. 8 IT IS SO ORDERED.
9 Dated: June 21, 2024 __________________________________ 10 HON. ROGER T. BENITEZ United States District Judge 11
12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28