Lee v. Amguard Insurance Company

District Court, N.D. California·Decided July 27, 2021·No. 5:20-cv-00210·Unknown

Opinion

JUNG LEE, et al., Case No. 20-cv-00210-EJD Plaintiffs, v. ORDER GRANTING IN PART PLAINTIFFS’ MOTION FOR LEAVE AMGUARD INSURANCE COMPANY, et al., TO FILE AND SERVE FIRST AMENDED COMPLAINT; DENYING Defendants. MOTION FOR REMAND OF PROCEEDINGS TO STATE COURT Re: Dkt. No. 26

Plaintiffs Fuji Sushi, a California Corporation, and business owners Jung Lee and Young Lee (“Plaintiffs”) bring this suit against Defendant Amguard Insurance Company (“Amguard”) seeking payment of insurance benefits under a fire insurance policy issued by Amguard. Presently before the Court is Plaintiffs’ Motion for Leave to File and Serve First Amended Complaint and for Remand of These Proceedings to State Court (“Mot.”). Dkt. No. 26. Having considered the parties’ briefing, the relevant law, and the record in this case, the Court GRANTS in part and DENIES in part Plaintiffs’ Motion. A. The Original Complaint 1. Fuji Sushi Restaurant Plaintiffs own a sushi restaurant and business called “Fuji Sushi.” Verified Compl. for Breach of Insurance Contract; Insurance Bad Faith (“Compl.”), Dkt. No. 1-1 ¶ 7. The restaurant is located on the ground floor of a building in downtown San Jose (the “Premises”) that Plaintiffs Case No.: 20-cv-00210-EJD first leased from Timothy and Sandra Gill (the “Landlord”) in 2007. Compl. ¶ 7. In 2012, Plaintiffs and the Landlord entered a new lease agreement (the “Lease”) for the continuation of the business which provides, in part, that if the Premises are totally or partially damaged by a fire through no fault of the Plaintiffs, then the Landlord shall have the right to restore the premises by repairing or rebuilding. Id. ¶¶ 7-8. 2. The Insurance Policy On or about February 27, 2018, Plaintiffs purchased a Business Owners Insurance Policy issued by Defendant Amguard (the “Insurance Policy”) for the period of April 3, 2018 to April 3, 2019. Id. ¶¶ 10-11. The Insurance Policy provides coverage for, among other things, Business Income Loss in the amount of “actual loss of Business Income you sustain due to the necessary suspension of your ‘operations’ during the ‘period of restoration.’” Compl. Ex. B (“Business Income Loss Coverage”) at 20. The loss of Business Income must be sustained “during the period of restoration and … within 12 consecutive months after the date of direct physical loss or damage. Id. at 21. The Policy also provides coverage for Extra Expenses incurred “(a) to avoid or minimize the suspension of business and to continue ‘operations’ [or] (b) to minimize the suspension of business if you cannot continue operations.” Compl. Ex. C (“Extra Expense Coverage”) at 24. These expenses must also occur “during the period of restoration” and “within 12 months of the direct physical loss or damage.” Id. The Insurance Policy defines the “period of restoration” as the period of time that “ends on the earlier of (a) the date when the property at the described premises should be repaired, rebuilt or replaced with reasonable speed and similar quality or (b) the date when the new business is resumed.” Compl. Ex. D (“Definitions”) at 26. 3. The Fire and Plaintiffs’ Losses On February 5, 2019, a fire started at the building through no fault of Plaintiffs (the “Fire”), which damaged all portions of the Premises and made it unsuitable for conducting restaurant operations. Id. ¶¶ 12-14. As a result, Plaintiffs were forced to stop conducting business on the day of the fire and have been unable to resume operations since because the Premises have Case No.: 20-cv-00210-EJD not been repaired. Compl. ¶ 14. Plaintiffs allege that the fire has caused them to suffer Business Income Losses, which have accrued at a rate of $37,002.20 per month and have continued unabated since February 5, 2019. Id. ¶ 16. Plaintiffs believe their business income losses over the course of the year will total at least $444,030. Id. ¶ 17. Amguard made one payment of $148,010 to cover Plaintiffs’ Business Income Losses from February 5, 2019 to June 4, 2019. Id. ¶ 21. Since then, Amguard has not made any further payments for Business Income Loss or for Extra Expenses, because they contend that the period of restoration has ended. Id. ¶ 22. 4. Procedural History Plaintiffs filed a Verified Complaint for Breach of Insurance Contract; Insurance Bad Faith on December 11, 2019 in Santa Clara County Superior Court, alleging two causes of action: first, that Amguard breached its contract with Plaintiffs by discontinuing payment of Business Income Losses and Extra Expenses (id. ¶ 28); and second, that Amguard breached its duty of good faith and fair dealing by contending that the period of restoration had ended and by refusing to provide any data, analysis, or reports that Amguard relied upon to support this contention. Id. ¶ 37. In their Complaint, Plaintiffs requested damages of at least $292,020 ($444,030 total anticipated Business Income Losses less $148,010) in addition to exemplary and punitive damages. Id. at 8. On January 10, 2020, Amguard properly removed the case to this Court based on diversity jurisdiction. See generally Def. Amguard Insurance Company’s Notice of Removal to Federal Court (“Notice of Removal”), Dkt. No. 1-3. The parties have conducted discovery in the form of document requests, requests for admissions and interrogatories. Mot. at 2. Plaintiffs filed this Motion for leave to file their first amended complaint on March 12, 2021. See generally Mot. B. The Proposed Amended Complaint Plaintiffs now seek leave to amend and to supplement their Complaint (1) to add new allegations and claims against Amguard based on (a) events that occurred before the filing of the Complaint but were learned during discovery and (b) events that occurred after the filing of the Complaint and (2) to add claims for breach of contract and professional negligence against a new Case No.: 20-cv-00210-EJD defendant, Altamont Insurance Brokers, Inc. (“Altamont”). Mem. of P. & A. in Supp. of Mot. (“Mem. of P. & A.”), Dkt. No. 26-1 at 3. Plaintiffs also allege that the Fire has caused them to incur various losses, including: property damage exceeding $150,000, loss of business income amounting to $444,030 in the 12 months after the Fire and that have continued since, and various related losses and expenses totaling $24,000 to date. Am. and Suppl. Compl. for Breach of Contract; Negligence; Insurance Bad Faith (“Am. Compl.”), Dkt. No. 26-4, ¶¶ 22a-c. 1. New Allegations Against Defendant Amguard In the Factual Background section of the proposed Amended Complaint, Plaintiffs have explained additional details regarding Amguard’s alleged failure to pay benefits due under the Policy. Notably, Plaintiffs allege that Amguard failed to conduct a full investigation into the cause of the Fire. Id. ¶ 14. Further, Plaintiffs allege that Amguard and the Landlord’s insurance carrier (“Hartford”) disagreed over their respective obligations to pay damages resulting from the Fire, which caused or contributed to delays in the restoration of the Premises and building. Id. ¶ 19. As of March 10, 2021, Plaintiffs still have not resumed restaurant operations because the Premises have not been restored. Id. ¶ 20. Plaintiffs’ Additional Allegations in Support of Their Breach of Insurance Policy Claim Against Amguard In the original Complaint, Plaintiffs alleged that Amguard breached the insurance policy contract by refusing to pay benefits under the Insurance Policy (including Business Income Losses), and by asserting that the period of restoration had ended. Compl. ¶¶ 28-30. In the proposed Amended Complaint, Plaintiffs add several new allegations to support this claim. Plaintiffs allege that Amguard further breached the Insurance Policy by: violating California Insurance Code Section 2071 by failing to notify Plaintiffs that they could obtain, upon request, copies of claim related documents (Am. Compl. ¶ 31a); violating California Code of Regulations, Title 10, Section 2695 by failing to disclose to Plaintiffs all benefits,

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