Judge: Malcolm Mackey, Case: 21STCV38226, Date: 2023-04-03 Tentative Ruling


Case Number: 21STCV38226    Hearing Date: April 3, 2023    Dept: 55

SULAHIAN v. NATIONAL GENERAL INSURANCE CO.,                   21STCV38226

Hearing Date:  4/3/23,  Dept. 55.

#6:   MOTION FOR SUMMARY JUDGMENT AND/OR SUMMARY ADJUDICATION.

 

Notice:  Okay

Opposition

 

MP: Defendant INTEGON NATIONAL INSURANCE COMPANY.

RP:  Plaintiffs.

 

 

Summary

 

On 10/18/21, plaintiffs VASKEN SULAHIAN and JOSE MORALES filed a Complaint alleging:  SULAHIAN was a named owner of an automobile insurance policy, and plaintiffs were involved in an automobile accident.  Defendant, as insurer, asserted boilerplate exclusionary language related to workers compensation benefits, only as to Plaintiff MORALES, yet policy proceeds were not timely paid to SULAHIAN, nor was there  any explanation as to why policy limits were not tendered to him.  Defendants have not provided any analysis, investigation, or legal and/or factual analysis as to the preliminary determination of the required employee/employer relationship required under the California Labor Code.

 

The causes of action are:

 

1. BREACH OF CONTRACT

2. BREACH OF THE COVENANT OF GOOD FAITH AND FAIR DEALING

3. BAD FAITH DENIAL OF INSURANCE CLAIM

4. DECLARATORY RELIEF.

 

 

MP Positions

 

Moving party requests an order granting summary judgment or adjudication, against co-Plaintiff VASKEN SULAHIAN, on grounds including the following:

 

1. The first cause of action for breach of contract is without merit because

Integon National Insurance Company paid Vasken Sulahian $75,000 for his

underinsured motorist claim, which was the maximum amount to which he was

entitled under the insurance policy;

 

2. The second cause of action for breach of the covenant of good faith and

fair dealing is without merit because, in not issuing payment of Vasken Sulahian’s

underinsured motorist claim under the subject insurance policy until March 4,

2022, Integon National Insurance Company acted with proper cause as there was

at all times prior a genuine dispute as to whether the claim was subject to an offset

for workers’ compensation benefits paid or payable to Mr. Sulahian as a result of

the subject auto accident;

 

3. The third cause of action for bad faith denial of insurance claim is without

merit because, in not issuing payment of Vasken Sulahian’s underinsured motorist

claim under the subject insurance policy until March 4, 2022, Integon National

Insurance Company acted with proper cause as there was at all times prior a genuine dispute as to whether the claim was subject to an offset for workers’

compensation benefits paid or payable to Mr. Sulahian as a result of the subject

auto accident;

 

4. The fourth cause of action for declaratory relief is without merit because

Integon National Insurance Company paid Vasken Sulahian $75,000 for his

underinsured motorist claim, which was the maximum amount to which he was

entitled under the insurance policy; and

 

5. The claim for punitive damages is without merit because there is no clear

and convincing evidence that Integon National Insurance Company acted with

malice, oppression, or fraud in the handling of Vasken Sulahian’s underinsured

motorist claim.

 

(Notice of Motion, pp. 2 – 3.)

 

 

 

RP Positions

 

Opposing parties advocate denying, for reasons including the following:

 

·         Defendant never contacted or updated Plaintiff on the status of his claim for over 5 months. This is not only a violation of the applicable regulations, but also illustrates that Defendant was not reasonably diligent in handling Plaintiff’s claim.

·         Defendant knew from the beginning of the underinsured motorist claim that Plaintiff was the named insured under his policy, that he did not open a workers’ compensation claim, that he did not receive any benefits from workers’ compensation, and he did not have any claims pending with the workers ‘compensation appeals board (“WCAB”). (PDMF Nos. 20, 21, 22-23, 25, Donabedian Decl., Ex. G-J; Defendant UMF Nos. 1, 3, & 17).

·         Defendant failed to reasonably pay Plaintiff’s claim, because it was preoccupied with the workers’ compensation issues only related to Plaintiff’s passenger, Mr. Morales.

·         The “genuine dispute” defense was not pled in the Answer, and the main support is Defendant’s unreasonable reading of its own policy, and post-lawsuit alleged conduct. 

·         Defendant allegedly sent a letter on November 2, 2021, requesting a sworn statement by Plaintiff.  But this letter was allegedly sent 15 days after the lawsuit was filed.

·         Facts indicate that Defendant’s alleged November 2, 2021 letter was never really mailed to counsel.

 

 

 

Tentative Ruling

 

The motion and alternative motion are denied entirely.

The Court sustains the following evidentiary objections:  Plaintiff’s objections filed 3/2023, p. 1, ¶ 2.  Evidentiary objections are otherwise overruled.  CCP   § 437c(Q).

The Court determines that there are triable issues of material fact as to each issue noticed for summary adjudication, including whether (1) there was any genuine dispute after sufficient insurer investigation that would justify delayed payment of insurance benefits, and (2) plaintiffs can recover prejudgment interest for the period of delayed payment of policy limits  (e.g., sep. stmnts., fact numbers 21 – 23, 26 - 26, and proof referenced thereat).

“‘[A]n insurer is not entitled to judgment as a matter of law where, viewing the facts in the light most favorable to the plaintiff, a jury could conclude that the insurer acted unreasonably.’”  Wilson v. 21st Century Ins. Co.  (2007) 42 Cal.4th 713, 724.

The genuine dispute rule does not apply unless insurers thoroughly and fairly investigated, processed and evaluated insured claims, and maintained positions in good faith, and on reasonable grounds, under all of the circumstances.  Brehm v. 21st Century Ins. Co, (2008) 166 Cal.App.4th 1225, 1238-39.  “The genuine dispute rule does not relieve an insurer from its obligation to thoroughly and fairly investigate, process and evaluate the insured's claim. A genuine dispute exists only where the insurer's position is maintained in good faith and on reasonable grounds.”  Wilson, supra, 42 Cal.4th at 724. 

Where insurers deny or delay benefits, without any reasonable basis, and in doing so were acting with malice, oppression or fraud, they may be exposed to punitive damages.  Jordan v. Allstate Ins. Co.  (2007) 148 Cal.App.4th 1062, 1073, 1080.  Insurers may be liable for punitive damages based upon a showing of malice, without the need to prove insurer motive or evil intent.  George F. Hillenbrand, Inc. v. Ins. Co. of No. Amer. (2002) 104 Cal.App.4th 784, 816.

Finally, an opinion summarizes law applicable to interest on liquidated damages, as follows:

 

The applicable statute provides that “[e]very person who is entitled to recover damages certain, or capable of being made certain by calculation, and the right to recover which is vested in him upon a particular day, is entitled also to recover interest thereon from that day.” (§ 3287, subd. (a).)

 

Damages are deemed certain when, though the parties dispute liability, they essentially do not dispute the computation of damages, if any. ( Wisper Corp. v. California Commerce Bank (1996) 49 Cal.App.4th 948, 958, 57 Cal.Rptr.2d 141.) “The statute does not authorize prejudgment interest where the amount of damage, as opposed to the determination of liability, ‘depends upon a judicial determination based upon conflicting evidence and is not ascertainable from truthful data supplied by the claimant to his debtor.’ [Citations.]” (Fireman's Fund Ins. Co. v. Allstate Ins. Co. (1991) 234 Cal.App.3d 1154, 1173, 286 Cal.Rptr. 146.)

 

Employers Mut. Cas. Co. v. Philadelphia Indem. Ins. Co. (2008) 169 Cal.App.4th 340, 354-55.