Judge: Curtis A. Kin, Case: 21STCV20524, Date: 2023-03-16 Tentative Ruling
Case Number: 21STCV20524 Hearing Date: March 16, 2023 Dept: 72
MOTION FOR SUMMARY JUDGMENT OR, ALTERNATIVELY, SUMMARY
ADJUDICATION
MOTION TO CONTINUE TRIAL
Date: 3/16/23 (9:30 AM)
Case: Michelle Cadwell v. Wawanesa
General Insurance Company (21STCV20524)
TENTATIVE RULING:
Defendant Wawanesa General Insurance Company’s Motion for
Summary Judgment or, Alternatively, Summary Adjudication is GRANTED.
Plaintiff Michelle Cadwell’s Motion to Continue Trial is DENIED.
I.
DEFENDANT WAWANESA GENERAL INSURANCE COMPANY’S
MOTION FOR SUMMARY JUDGMENT OR, ALTERNATIVELY, SUMMARY ADJUDICATION
With respect to the first cause of action for breach of
contract, defendant Wawanesa General Insurance Company argues that this cause
of action fails because defendant paid the $100,000 limit under the policy.
(UMF 1, 30, 31.) No breach of contract in an insurance case lies when the
policy limit has been paid. (See Everett v. State Farm General Ins. Co. (2008)
162 Cal.App.4th 649, 660 [“Everett's policy expressly provides that State Farm
will pay the reasonable cost to replace the damaged property up to the stated
policy limits. Because State Farm did just that, Everett's assertion that State
Farm failed to pay to replace her home does not support a claim for breach of
contract.”]; Ives v. Allstate Insurance Company (C.D. Cal. 2021) 520
F.Supp.3d 1248, 1255, citing Everett, 162 Cal.App.4th at 660
[“There can be no breach of contract where an insurer pays all benefits due”].)
Plaintiff Michelle Cadwell does not dispute that the policy limit was paid.
Accordingly, the breach of contract cause of action fails as a matter of law.
Because the policy limit was paid, plaintiff cannot rely on
out-of-pocket medical expenses to proceed with the breach of contract cause of
action. (Satvati v. Allstate Northbrook Indemnity Company (C.D. Cal.
2022) 2022 WL 6184730, at *4 [“Direct damages cannot exceed the value of the
breaching party's promised performance”].) Plaintiff also asserts that
defendant violated Insurance Code § 790.03(h) by failing to promptly investigate
and process her claim. As a private litigant, plaintiff may not assert a cause
of action based on Insurance Code § 790.03. (Moradi-Shalal v. Fireman's Fund
Ins. Companies (1988) 46 Cal.3d 287, 304.)
To the extent plaintiff contends the delay from February
2018 (when plaintiff made a claim) to August 2020 (when defendant issued
payment for the policy limit) constitutes a breach, plaintiff points to no
provision in the policy indicating that payment had to be made by a certain
time. (Compl. ¶ 16; see Satvati v. Allstate Northbrook Indemnity Company (C.D.
Cal. 2022) 2022 WL 6184730, at *3 [“For delay in payment to constitute breach
of contract, Defendant's conduct, or lack of conduct, would need to breach a
provision within the Policy. In the Complaint, Plaintiffs fail to identify a
Policy provision that Defendant breached…. Thus, Defendant's delay does not
constitute a breach of contract”].)
Accordingly, plaintiff fails to demonstrate a triable issue
of fact with respect to the first cause of action.
With respect to the second cause of action for breach of the
duty of good faith and fair dealing, “[A]n insurer denying or delaying the payment of policy benefits due to
the existence of a genuine dispute with its insured as to the existence of
coverage liability or the amount of the insured's coverage claim is not liable
in bad faith even though it might be liable for breach of contract.” (Chateau Chamberay
Homeowners Ass'n v. Associated Intern. Ins. Co. (2001) 90 Cal.App.4th 335, 347.) “In a first party case…the withholding of benefits due
under the policy is not unreasonable if there was a genuine dispute between the
insurer and the insured as to coverage or the amount of payment due.” (Rappaport-Scott
v. Interinsurance Exchange of the Automobile Club (2007) 146 Cal.App.4th
831, 837.)
Here, plaintiff was claiming pain in her neck and back, left
shin, shoulders, and right knee, both arms, and clavicle. (UMF 3, 8.) Defendant
presents evidence that plaintiff had a history of neck and back pain before the
subject accident. (UMF 12, 21.) The police report from the accident also
indicated that plaintiff’s vehicle had “minor damage to the rear bumper,” that
plaintiff complained of back pain but refused medical treatment, and that
plaintiff drove her vehicle away from the scene of the accident. (UMF 6.) For
the foregoing reasons, defendant reasonably questioned whether plaintiff’s
asserted need future medical treatment arose from the subject accident. (UMF
15, 20.)
The genuine dispute doctrine also
may be applied when an insurer denies a claim based on expert opinion. (Fraley v. Allstate Ins. Co. (2000) 81
Cal.App.4th 1282, 1292.) Defendant presents evidence that Orthopedic and
Spine Surgery expert Charles Rosen, M.D. examined plaintiff and reviewed
plaintiff’s medical records. (UMF 26.) Dr. Rosen concluded that any neck and
low back pain suffered by plaintiff would be appropriately treated with one to
two weeks of rest or inflammatory management. (UMF 27.) Dr. Rosen also
concluded that any extra treatment was not objectively related to the subject
accident. (UMF 27.) Plaintiff’s assertion that Dr. Rosen’s opinion was cursory
or biased is unavailing. (See PAMF 1.) “A triable issue of fact can only be
created by a conflict of evidence, not speculation or
conjecture.” (Pipitone v. Williams (2016) 244 Cal.App.4th 1437,
1453.) Plaintiff cannot rely on her own disagreement with the
report to create a triable issue of material fact. (PAMF 32, 50.)
Further, it is undisputed that, beginning April 2018,
defendant asked plaintiff for a recorded statement. (UMF 10, 18, 19, 23.)
Defendant was entitled to withhold payment until after it deposed plaintiff on
July 16, 2020. (UMF 29.) Defendant issued payment in August 2020, which was
shortly after the deposition. (UMF 31.) Plaintiff was contractually obligated
to cooperate in the investigation, including by submitting to an examination
under oath. (UMF 1.) “The right to require the insured to submit to an
examination under oath concerning all proper subjects of inquiry is reasonable
as a matter of law…. There can be no ‘unreasonable delay’ until the insurer
receives adequate information to process the claim and reach an agreement with
the insureds.” (Globe Indemnity Co. v. Superior Court (1992) 6
Cal.App.4th 725, 731.) Until plaintiff submitted to a deposition, defendant had
a genuine dispute regarding the amount of payment due.
For the foregoing reasons, plaintiff fails to demonstrate a
triable issue of fact with respect to the second cause of action.
Because plaintiff does not demonstrate a triable issue
regarding any cause of action in the operative Complaint, plaintiff cannot
prevail on her claim for punitive damages.
Plaintiff requests a continuance to pursue discovery into
defendant’s policies and procedures related to the evaluation of uninsured
motorist claims. However, plaintiff does not explain how such policies and
procedures would effectively dispute the facts discussed above with respect to
whether defendant had a genuine dispute regarding the amount owed to plaintiff.
Accordingly, plaintiff
fails to show that “facts essential to justify opposition may exist but cannot,
for reasons stated, be presented,” such that a continuance of the motion is
warranted. (See CCP § 437c(h).)
The motion for summary judgment is GRANTED. The Final Status
Conference set for 4/7/23 and the jury trial set for 4/17/23 are VACATED. The
Court enters the judgment proposed by defendant.
II.
PLAINTIFF MICHELLE CADWELL’S MOTION TO CONTINUE
TRIAL
Based on the ruling on the motion for summary judgment,
plaintiff’s motion to continue trial is DENIED as MOOT.