Tomaselli v. Transamerica Insurance

25 Cal. App. 4th 1269, 94 Cal. Daily Op. Serv. 4443, 31 Cal. Rptr. 2d 433, 94 Daily Journal DAR 8129, 1994 Cal. App. LEXIS 604
CourtCalifornia Court of Appeal
DecidedJune 13, 1994
DocketDocket Nos. D015481, D015808
StatusPublished
Cited by165 cases

This text of 25 Cal. App. 4th 1269 (Tomaselli v. Transamerica Insurance) 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
Tomaselli v. Transamerica Insurance, 25 Cal. App. 4th 1269, 94 Cal. Daily Op. Serv. 4443, 31 Cal. Rptr. 2d 433, 94 Daily Journal DAR 8129, 1994 Cal. App. LEXIS 604 (Cal. Ct. App. 1994).

Opinion

Opinion

FROEHLICH, J.

Dominick and Denise Tomaselli (Tomasellis) sued Transamerica Insurance Company (appellant), alleging appellant’s refusal to pay a claim on their homeowners policy was both a breach of contract and in bad faith. The jury awarded contract damages of $260,000, emotional distress damages totaling $500,000, and punitive damages of $11,250,000. Appellant’s claims fall into five basic categories: (1) that there is no substantial evidence to support the liability determinations; (2) that a series of evidentiary and instructional errors prejudiced the verdicts; (3) that the compensatory damages are excessive; (4) that the punitive damages award is unsupported by proper evidence and is excessive; and (5) that the attorney fee award is improper.

*1274 I

Factual and Procedural Background

A. The Parties and the Policies

Tomasellis purchased a three-year-old house in 1977. Between 1977 and 1982 they had homeowners insurance from Premier Insurance Company, an affiliate of appellant, and from 1982 through 1987 they purchased homeowners insurance from appellant.

The policies originally contained three relevant limitations on coverage: (1) an exclusion for earth movement; (2) a “prompt notice” requirement; and (3) a requirement that suit on any claim be filed within one year of the loss.

In 1984 appellant added a fourth relevant limitation—endorsement No. 14461 (hereafter the 14461 endorsement), which reduced coverage. Under the 14461 endorsement, losses caused by faulty or defective construction or compaction were excluded from coverage even if another covered cause had contributed to the loss. The 14461 endorsement was first listed by appellant as part of Tomasellis’ policy beginning in July 1984.

B. The Claim

In May 1987, Tomasellis discovered a large crack in the house slab and submitted a claim for damages. Appellant promptly sent out an adjuster, Mr. Watanabe, who spent an hour at the property on May 19. He questioned Mrs. Tomaselli, went around the home looking for signs of damage, and took photographs. Mrs. Tomaselli pointed out various cracks, but made no mention of a bathroom crack at this meeting. Watanabe observed other signs of distress (primarily exterior stucco cracks, as well as a crack in the garage floor) which indicated there might be other problems.

On May 20, Watanabe prepared and sent an “Advance Large Loss Notice” to his superiors, Mr. Friend and Mr. Kirk. On May 27, he prepared a “claim brief” which summarized Tomasellis’ claim. In his claim brief Watanabe indicated there were no “apparent” policy violations. At trial, Watanabe testified he had made no final determination of whether the policy provisions had been followed, which is why his brief reflected there were no “apparent” policy violations. Watanabe’s brief noted Mrs. Tomaselli stated she did not know about the cracking in the house slab, did not understand the significance of the cracking in the garage slab, and the prior owner had not disclosed any soils problems to Tomasellis. The brief reported (1) a soils *1275 engineer would undertake an investigation and (2) an “examination under oath” (hereafter EUO) might be conducted if warranted.

Also on May 27, Watanabe sent Tomasellis a “reservation of rights” letter. The letter specifically quoted the 14461 endorsement, the proof of loss clause and the “prompt notice” clause. Watanabe’s letter made no reference to the “one-year-suit” clause, which requires that any suit be filed within one year of the loss. Watanabe testified he did not cite that clause in his May 27 letter because, at that point, he had no reason to believe Tomasellis had been on notice of the problems for an extended period of time.

C. The Investigation Begins

The soils firm began its investigation in early June. By June 9, Watanabe began questioning whether Tomasellis had become aware of the damage at an earlier time, and hence Watanabe asked the engineer if he could determine when the damage first became manifest.

Also on June 9, Watanabe referred the matter to the Law Offices of Barry Zalma for analysis and advice as to coverage, and sent the firm the relevant documents. Watanabe indicated he was interested in “when” Tomasellis became aware of the damage and the issues surrounding the “concurrent cause” problems. 2 Watanabe’s letter noted that Tomasellis admitted seeing the crack in the garage slab “within the last year” but Tomasellis had “dismissed the crack since it was not inside the dwelling.” Watanabe’s letter concluded by suggesting Tomasellis were “excellent candidate[s] for an EUO.” Kirk, Watanabe’s superior, testified an EUO was the only means of determining what the insureds knew and when they acquired the knowledge, the insureds being the only sources of information about progressive damage. Tomasellis’ expert, on the other hand, testified the use of an EUO was improper and evidenced bad faith because: (1) use of an EUO is rare (absent some suggestion of fraud or lack of cooperation), and he had never heard of it being used in “concurrent cause” cases; (2) there was no reason to administer the EUO in this case; and (3) use of an EUO was a way appellant could “telegraph” to the coverage attorneys its intention to deny the claim.

D. Tomasellis’ Prior Knowledge Surfaces

The initial soils report, dated June 16, indicated that the problem was fill settlement which appeared to have been a long-term process occurring over *1276 several years; that it was an ongoing process since “patched areas inside the house [were] beginning to crack again”; and that Tomasellis “stated that the stress features [had] gradually worsened and some [had] appeared more recently than others.” Watanabe believed that the statement about damage worsening over time conflicted with Mrs. Tomaselli’s earlier report that Tomasellis were unaware of any prior damage to the home, and noted this apparent discrepancy to the attorney.

The attorney from the Zalma law office assigned to handle the matter was Cynthia Hamilton. Hamilton told Watanabe on June 19 that she had insufficient information to evaluate and advise on the issue of when the cracking occurred and when the insured knew or should have known of damage, and that further information from the soils engineer and the insureds would help answer these questions. Her subsequent request for authorization to conduct an EUO was granted. Hamilton thereafter wrote to Tomasellis, indicating they should direct all further communications to her, and required them to produce 10 categories of documents for her inspection as part of the process of investigation. She also told them that an EUO was required. With respect to possible defenses, she indicated that in addition to the reservation of rights letter, the policy required “prompt notice” and “suit within one year” after inception of the loss, and that there was some question about when the loss occurred.

Before the EUO took place, Mrs. Tomaselli discussed the procedure with Watanabe.

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25 Cal. App. 4th 1269, 94 Cal. Daily Op. Serv. 4443, 31 Cal. Rptr. 2d 433, 94 Daily Journal DAR 8129, 1994 Cal. App. LEXIS 604, Counsel Stack Legal Research, https://law.counselstack.com/opinion/tomaselli-v-transamerica-insurance-calctapp-1994.