Ross v. Pioneer Life Insurance

545 F. Supp. 2d 1061, 2008 U.S. Dist. LEXIS 33123, 2008 WL 1756355
CourtDistrict Court, C.D. California
DecidedApril 15, 2008
DocketCV 06-07081-VBK
StatusPublished
Cited by5 cases

This text of 545 F. Supp. 2d 1061 (Ross v. Pioneer Life Insurance) is published on Counsel Stack Legal Research, covering District Court, C.D. California primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ross v. Pioneer Life Insurance, 545 F. Supp. 2d 1061, 2008 U.S. Dist. LEXIS 33123, 2008 WL 1756355 (C.D. Cal. 2008).

Opinion

ORDER GRANTING PLAINTIFF’S MOTION FOR LEAVE TO AMEND COMPLAINT TO ADD REQUEST FOR DAMAGES UNDER CALIFORNIA CIVIL CODE § 3345 AND ALLOWING PLAINTIFF TO FILE FIRST AMENDED COMPLAINT

VICTOR B. KENTON, United States Magistrate Judge.

The Court heard argument on this motion on April 15, 2008. Counsel appearing for Plaintiff were Corinne Chandler and Robert F. Keehn; counsel appearing for Defendants were Marc J. Wodin and Ela-na Bitton.

PROCEEDINGS

On March 10, 2008, Ruth Ross (“Plaintiff’) filed “Plaintiffs Notice of Motion and Motion for Leave to Amend Complaint to Add Request for Damages Under Section 3345 of the California Civil Code;” “Memorandum of Points and Authorities in Support of Plaintiffs Motion for Leave to Amend Complaint to Amend Complaint to Add Prayer for Damages Pursuant to California Civil Code Section 3345;” “[Proposed] First Amended Complaint for Damages (1) Breach of Contract; (2) Breach of the Covenant of Good Faith and Fair Dealing; Demand for Jury Trial;” and “[Proposed] Order Granting Plaintiffs Motion for Leave to File First Amended Complaint; [Proposed] Order.”

On March 18, 2008, Defendants Pioneer Life Insurance Company (“Pioneer”) and Washington National Insurance Company (‘Washington”) (hereinafter referred to as “Defendants”), filed documents entitled “Defendants’ Memorandum in Opposition to Plaintiffs Motion for Leave to File a First Amended Complaint; Defendants’ Request That Plaintiffs Motion Be Continued until after the Hearing on.Defendants’ Motion for Summary Judgment/ Adjudication” and “Defendants’ Objections to Plaintiffs Motion for Leave to File a First Amended Complaint.”

On April 8, 2008, Plaintiff filed “Plaintiffs Reply Brief in Support of Motion to Amend Complaint” and “Declaration of Corinne Chandler in Support of Reply Brief Filed in Connection with Plaintiffs Motion to Amend.”

BACKGROUND

On November 3, 2006, Plaintiff filed a Complaint for breach of contract and for breach of the covenant of good faith and fair dealing (“bad faith”) based on the denial of her claim for benefits under an insurance policy issued by Defendants. In September of 2001, Plaintiff, who was 80 years old, suffered a broken ankle and pursuant to the terms of the insurance policy made a claim to Defendants for long-term care benefits under the policy which she received. In June 2003 Plaintiff suffered another fall and crushed her right ankle and was required to undergo sur *1063 gery to repair it. Plaintiff received additional benefits after this injury. (See Complaint at 3.)

On August 7, 2006, Plaintiff was notified by Defendants that she was no longer eligible for benefits under the terms of her Long Term Care Policy as it had paid the maximum benefits allowed per occurrence. On August 14, 2006, Plaintiff appealed this determination informing Defendants that it had made an error in its decision to terminate her benefits. Plaintiff alleged that her 2001 and 2003 injuries were two separate injuries and therefore should not have been classified as a reoccurrence. (See Complaint at 3.).

In Plaintiffs bad faith cause of action, she alleged that Defendants’ conduct relating to the handling of her claim was so egregious as to entitle her to punitive damages. (See Complaint at 5.)

Based on recent depositions taken in January of 2008 of certain claim representatives (Kim Sharpe — Manager of the Customer Call Center and Terri Smith — claim representative who made the decision to terminate Plaintiffs benefits), Plaintiff now seeks to amend her Complaint in order to allege that the bad faith acts committed by Defendants with respect to Plaintiffs claim were committed by Defendants with an institutional reckless disregard of her rights. Plaintiff seeks to add a claim for damages under California Civil Code § 3345, which permits the trier of fact to treble punitive damages for “unfair or deceptive practices against senior citizens or disabled persons.”

California Civil Code § 3345 provides as follows:

“(A) This section shall apply only in actions brought by, on behalf of, or for the benefit of senior citizens or disabled persons, as those terms are defined in subdivisions (f) and (g) of Section 1761, to redress unfair or deceptive acts or practices or unfair methods of competition.
(B) Whenever a trier of fact is authorized by statute to impose either a fine, or a civil penalty or other penalty, or any other remedy for the purpose or effect of which is to punish or deter, when the amount of the fine, penalty, or other remedy is subject to the trier of fact’s discretion, the trier of fact shall consider all of the following factors, in addition to other appropriate factors, in determining the amount of fine, civil penalty or other penalty, or other remedy to impose. Whenever the trier of fact makes an affirmative finding in regard to one or more of the following factors, it may impose a fine, civil penalty or other penalty, or other remedy in an amount up to three times greater than authorized by the statute, or, where the statute does not authorize a specific amount, up to three times greater than the amount the trier of fact would impose in the absence of that affirmative finding:
(1) Where the defendant knew or should have known that his or her conduct was directed to one or more senior citizens or disabled persons.
(2) Whether the defendant’s conduct caused one or more senior citizens or disabled persons to suffer: loss or encumbrance of a primary residence, principal employment, or source of income; substantial loss of property set aside for retirement, or for personal or family care and maintenance; or substantial loss of payments received under a pension or a retirement plan or a government benefits program, or assets essential to the health or welfare of the senior citizen or disabled person.
*1064 (3) Whether one or more one or more senior citizens or disabled persons are substantially more vulnerable than other members of the public to the defendant’s conduct because of age, poor health or infirmity, impaired understanding, restricted mobility, or disability, and actually suffered substantial physical, emotional, or economic damage resulting from the defendant’s conduct.”

Plaintiff is both a senior citizen and/or a disabled individual. Plaintiff alleges that Defendants have committed one or more unfair or deceptive trade practices by their institutional conduct, which Plaintiff alleges is designed to terminate insurance benefits, without giving adequate notice of the reasons for the termination. California’s civil statutory scheme permits a trier of fact to impose a penalty for such conduct, by virtue of California Civil Code § 3294, which permits a trier of fact to impose punitive damages for the purpose of deterrence. As a result of Defendants’ actions, Plaintiff alleges she has been deprived of funds set aside for her personal or family care and maintenance and/or assets essential to her health and wealth.

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Cite This Page — Counsel Stack

Bluebook (online)
545 F. Supp. 2d 1061, 2008 U.S. Dist. LEXIS 33123, 2008 WL 1756355, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ross-v-pioneer-life-insurance-cacd-2008.