Sych v. Insurance Co. of North America

173 Cal. App. 3d 321, 220 Cal. Rptr. 692
California Court of Appeal·Decided October 15, 1985·No. B003996·Published·Cited by 9 cases

Opinion

173 Cal.App.3d 321 (1985)
220 Cal. Rptr. 692

ALISON RAE SYCH, a Minor, etc., Plaintiff and Appellant,
v.
INSURANCE COMPANY OF NORTH AMERICA et al., Defendants and Respondents.

Docket No. B003996.

Court of Appeals of California, Second District, Division Six.

October 15, 1985.

*323 COUNSEL

Lewis Graham for Plaintiff and Appellant.

Wise & Nelson, Wise, Wiezorek, Timmons & Wise, Anthony F. Wiezorek, Richard P. Dieffenbach, Greines, Martin, Stein & Richland, Kent L. Richland and Alan G. Martin for Defendants and Respondents.

OPINION

STONE, P.J.

May a plaintiff who, at trial, fails to prove an insured defendant's liability subsequently sue the defendant's insurers for unfair practices in not attempting, in good faith, to settle the case once liability to plaintiff is "reasonably clear"? It may not. We affirm the judgment of dismissal.

Minor, Alison Rae Sych, by and through Marianne Sych, mother and guardian ad litem, appeals the trial court's sustaining demurrers of Insurance Company of North America (INA) and Pacific Indemnity (Pacific), *324 without leave to amend, on grounds that plaintiff could not state a cause of action for unfair practices, restraint of trade, declaratory relief and violations of Insurance Code section 790.03.[1]

FACTS

Material complaint allegations are: from December 18, 1969, to and including June 2, 1970, Constantine S. Innes, M.D., ministered to Marianne Sych who was pregnant with appellant. June 2, 1970, Marianne Sych gave birth to appellant two months prematurely; appellant had cerebral palsy and hyaline membrane disease.

Appellant filed suit against Doctor Innes claiming professional negligence by inducing labor prematurely. After discovery proceedings, appellant demanded policy limits from INA and Pacific, response due by June 1, 1977. Included therewith were numerous newspaper articles advising of verdicts that juries had rendered in cases judged by her to be similar to that of Sych v. Innes, "all being in excess of 3.3 million." Appellant indicated to INA and Pacific that "(i)t seems quite clear that the total claim of Alison Sych far exceeds the alleged limits of the carriers' liability and failure to settle at this time might subject Alison Sych to unwarranted emotional distresses. It would appear that good faith under the circumstances would require the insurance carriers ... to accept the foregoing offer to settle."[2] Pacific, primary carrier, had policy limits of $300,000; INA, excess liability carrier, had policy limits of $1 million. Appellant received no correspondence nor offer of settlement until April 19, 1979, close to the trial setting and mandatory settlement conference date. April 13, 1979, Pacific informed appellant its policy limits were available for settlement, and, at the settlement conference, INA offered the following structured settlement:

$150,000 cash for fees & expenses                       $ 150,000
$ 10,000 per year to age 18                             $  90,000
$ 25,000 lump sum at age 18                             $  25,000
$ 15,000 per year from age 18 for remainder of life     $ 915,000

Appellant told Pacific it would accept the $300,000 as "credit" against eventual judgment in exchange for releasing Pacific from excess liability for "bad faith." Pacific refused to pay without complete settlement, contending it to be contrary to its client's interest and bad faith to the excess *325 carrier. Appellant refused INA's offer. INA made a second offer July 11, 1979:

$ 10,000 to age 18                                    $    90,000
$ 25,000 cash at age 18                               $    25,000
$ 15,000 compounded at 3% annually from age 18        $ 3,459,000
$225,000 attorney fees expenses                       $   225,000
$ 50,000 to guardian ad litem                         $    50,000

Appellant refused any structured settlement and told INA its proffers were not "good faith" offers. January 4, 1980, the case came to trial. The insurers offered $600,000 cash, which appellant rejected as untimely. The jury returned an unanimous verdict for the defense. Appellant appealed from that judgment which was affirmed, and remittitur issued February 7, 1983.

Appellant then filed this action, alleging that Doctor Innes' malpractice carriers were in bad faith in failing to settle the underlying action based upon facts discussed infra. Appellant repleaded the alleged negligence of Doctor Innes, damages and violations of Insurance Code section 790.03, subdivisions (b), (c), and (h), i.e., respondents: (1) made untrue, deceptive and misleading statements with respect to the business of insurance; (2) entered into an agreement to commit, and did commit, an act of boycott, coercion and intimidation resulting in unreasonable restraint of trade; (3) failed to adopt and implement reasonable standards for prompt investigation and processing of claims; (4) failed to attempt, in good faith, to effectuate prompt, fair, and equitable settlements of claims in which liability had become reasonably clear, and "compelled Plaintiff ... to institute litigation and litigate to recover amounts due Plaintiff under said insurance policies by offering substantially less than the amounts ultimately recovered in said action ... when Plaintiff made claim for amounts reasonably similar to the amount ultimately recovered ... in said litigation;" (5) attempted to settle for amounts less than a reasonable man would believe he was entitled to "by reference to written and printed advertising material accompanying and made part of the claim and application;" (6) failed to settle where liability had become apparent; and (7) failed to provide promptly a reasonable explanation of facts and applicable law for denial of the claim. Appellant also included a request for declaratory relief.

Respondents demurred to the complaint on grounds it failed to state a cause of action under Insurance Code section 790.03, based on the jury's verdict in the underlying action exonerating Doctor Innes, and, additionally, that appellant's claim for declaratory relief sought only retrospective rather than prospective relief.

The court permitted amendment by interlineation that "liability to Dr. Innes [sic] to plaintiff had become reasonably clear," held appellant had *326 failed to state a cause of action, sustained the demurrers without leave to amend, and pursuant thereto, entered judgment in favor of respondents.

DISCUSSION

(1) A demurrer admits all material and issuable facts properly pleaded, (Daar v. Yellow Cab Co. (1967) 67 Cal.2d 695, 713 [63 Cal. Rptr. 724, 433 P.2d 732]) but it does not admit contentions, deductions or conclusions of fact or law alleged therein. (Ibid.) (2) Similarly, the reviewing court accepts factual allegations as true. (State Farm Fire & Casualty Co. v. Cooperative of American Physicians, Inc. (1984) 163 Cal. App.3d 199 [209 Cal. Rptr. 251]; Carr v. Warden (1984) 159 Cal. App.3d 1166 [206 Cal. Rptr. 162].) (3a) Although appellant's shotgun pleadings encompass different subdivisions of section 790.03, the apparent gravamen lies in subdivision (h)(5) which defines unfair methods of competition and unfair and deceptive acts or practices in the business of insurance as "(n)ot attempting in good faith to effectu

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Sych v. Insurance Co. of North America, 173 Cal. App. 3d 321, 220 Cal. Rptr. 692 (Cal. Ct. App. 1985).

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