Cummings v. Fire Insurance Exchange

202 Cal. App. 3d 1407, 249 Cal. Rptr. 568, 1988 Cal. App. LEXIS 656
CourtCalifornia Court of Appeal
DecidedJuly 22, 1988
DocketB027690
StatusPublished
Cited by43 cases

This text of 202 Cal. App. 3d 1407 (Cummings v. Fire Insurance Exchange) 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
Cummings v. Fire Insurance Exchange, 202 Cal. App. 3d 1407, 249 Cal. Rptr. 568, 1988 Cal. App. LEXIS 656 (Cal. Ct. App. 1988).

Opinion

*1412 Opinion

CROSKEY, J.

Plaintiff Mary L. Cummings, (plaintiff), appeals from a summary judgment granted to defendant Fire Insurance Exchange (defendant), 1 on her complaint seeking damages from defendant for its failure to pay a property damage claim and its allegedly malicious instigation of an unsuccessful criminal prosecution of plaintiff. Because the record demonstrates (1) that plaintiff knowingly and wilfully filed a false claim on a casualty policy issued by the defendant and (2) that defendant had a reasonable basis for believing that plaintiff had violated the law in so doing, we affirm the judgment.

Factual Background

In her complaint, plaintiff alleged claims for breach of contract, false imprisonment, malicious prosecution, tortious breach of contract (which also included an allegation of a violation of Insurance Code section 790.03, subdivision (h)(5)) and intentional infliction of emotional distress. Each of these alleged causes of action arises from a claim which plaintiff made against a casualty insurance policy issued to plaintiff by defendant. Her claim was for damages sustained when her home and its contents were vandalized. The policy contains a provision (hereinafter sometimes referred to as the fraud and concealment provision) which states: “We do not cover an insured who has concealed or misrepresented any material fact or circumstance relating to this insurance, before or after the loss.” 2

The vandalism occurred May 1, 1983, and plaintiff reported it to defendant the next day. Within a month, plaintiff’s premises had been almost completely repaired. Defendant expended $18,146 for repairs and $800 for living expenses for plaintiff.

On May 17, 1983, defendant received a call from one of plaintiff’s neighbors, a Mr. Wiley. He stated that another neighbor, Mr. Rodriguez, had told him that on the day the vandalism occurred, plaintiff’s son was in the premises and there was screaming, commotion and things being broken. In order to determine the facts, defendant retained an investigator. On May 24, 1983, the investigator interviewed plaintiff and recorded her statement concerning the events of May 1. In her statement, plaintiff gave a false *1413 version of those events. 3 The next day, the investigator interviewed Mr. Wiley who gave him Mr. Rodriguez’s account of the incident. Mr. Wiley also indicated that plaintiff’s son was living with plaintiff.

Thereafter, on August 25, 1983, defendant examined plaintiff under oath. During that examination, she initially repeated the false version of what occurred; however, when she was confronted with the information which defendant’s investigation had uncovered, she changed her story and finally gave a true accounting of the vandalism to her home.

Based on plaintiff’s admitted misrepresentations, 4 defendant denied further payments on her claim and reported the matter to the criminal authorities. Plaintiff was arrested for violation of Insurance Code section 556, which makes it a crime to knowingly present a false claim for payment of a loss. 5 She was bound over for trial at her preliminary hearing but the charges were later dismissed when the superior court granted her Penal Code section 995 motion (although it is not clear from the record before us upon what ground(s) the motion was granted).

Contentions on Appeal

Plaintiff contends on appeal that issues of fact existed with respect to the materiality of the alleged misrepresentation and defendant’s reliance thereon and that the trial court erred in determining that, as a matter of law, plaintiff could assert no claims for malicious prosecution, false imprisonment or emotional distress. She argues that summary judgment was therefore improper.

*1414 Discussion

“Summary judgment is properly granted only when the evidence in support of the moving party establishes that there is no triable issue of fact and that the moving party is entitled to a judgment as a matter of law. [Citations.]” (Isaacs v. Huntington Memorial Hospital (1985) 38 Cal.3d 112, 134 [211 Cal.Rptr. 356, 695 P.2d 653].) Thus, issue finding and not issue resolution characterizes a hearing on a motion for summary judgment. All doubts about granting such a motion must be resolved against the moving party, who bears the burden of producing evidence which establishes the invalidity of the claims of the adverse party. (Mann v. Cracchiolo (1985) 38 Cal.3d 18, 35-36 [210 Cal.Rptr. 762, 694 P.2d 1134], and cases cited therein.) Our review of the record convinces us that the defendant has met its burden on all of plaintiff’s causes of action.

1. Breach of Contract (Including the “Tortious Breach” Claim)

Plaintiff’s first and fourth causes of action, for breach of contract and tortious breach of contract, 6 allege a wrongful refusal by defendant to pay plaintiff’s entire claim. Defendant’s answer asserts as an affirmative defense that the insurance policy was voided, in accordance with its fraud and concealment provision, because plaintiff made material concealments and misrepresentations in the processing of her claim. The motion for summary judgment focused on this affirmative defense. 7 In neither her *1415 opposition to that motion nor in her briefs on appeal does plaintiff deny that she misrepresented to defendant the facts surrounding the vandalism of her property.

On appeal plaintiff asserts that the trial court erred in granting summary judgment on the breach of contract causes of action because certain factual issues are still unresolved. She contends that whether she lied as to any material facts, whether she intended to defraud defendant and whether defendant relied on her misrepresentations are all issues which a trial court cannot properly resolve in a motion for summary judgment, because they are for a jury’s consideration. However, these arguments ignore the body of law which has developed during the past 100 years with respect to the “fraud and concealment” provisions found in most property insurance policies.

Our review of that law begins with a United States Supreme Court case, Claflin v. Commonwealth Insurance Co. (1884) 110 U.S. 81 [28 L.Ed. 76, 3 S.Ct. 507]. Claflin

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Bluebook (online)
202 Cal. App. 3d 1407, 249 Cal. Rptr. 568, 1988 Cal. App. LEXIS 656, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cummings-v-fire-insurance-exchange-calctapp-1988.