• USAA Punished for it Claims Handling

    Punitive Damages Should be Awarded With Caution and Within Narrow Limits

    Read the full article at https://www.linkedin.com/pulse/usaa-punished-claims-handling-barry-zalma-esq-cfe-nbp2c, see the full video at and at and at https://zalma.com/blog plus more than 4950 posts.

    Posted on December 19, 2024 by Barry Zalma

    DISPUTE OVER HURRICANE DAMAGES RESULTS IN MAJOR PUNITIVE DAMAGES FOR BAD FAITH

    Although he Mississippi Supreme Court recognized the need to only award punitive damages with caution and within narrow limits, it did not limit its award in accordance with that maxim. After almost 19 years of litigation the last appeal resolved the various disputes.
    FACTS

    Hurricane Katrina destroyed Paul and Sylvia Minor’s home on August 29, 2005. The Minors had a homeowner’s insurance policy with United Services Automobile Association (USAA). The USAA policy covered damage caused by wind but excluded damage caused by storm surge or flood. The Minors reported their loss with USAA, which resulted in a years-long coverage dispute. USAA ultimately issued payments for damage it concluded was caused by wind but not for damage it concluded was caused by storm surge or flood.

    The Minors maintained that they suffered a total loss caused by wind and demanded that USAA pay the policy limits. The case proceeded to trial in 2013, and the jury awarded the Minors $1,547,293.37 in compensatory damages.

    In United Services Automobile Association v. Estate Of Sylvia F. Minor, Kathryn Minor and Stephen Minor, No. 2023-CA-00049-SCT, Supreme Court of Mississippi, En Banc (December 5, 2024) resolved the bad faith claims.

    The issue was ultimately presented to a jury. The jury awarded the Minors $10,000,000 in punitive damages and $457,858.89 in extra-contractual damages (solely attorneys’ fees). USAA appealed, raising several assignments of error.

    Trial

    To establish its bad faith claim, the Minor Estate introduced various USAA documents, including (1) portions of the USAA underwriting file; (2) the confidential email regarding (a) the engineer’s March 2006 findings and (b) Bergstrom’s conclusion that USAA would be responsible for paying for all the windows and the contents in rooms with windows; and (3) USAA’s letter to the Minors in June 2006 indicating the majority of damage was due to flooding.

    Punitive Damages

    Punitive damages are considered an ‘extraordinary remedy’ and should be awarded ‘with caution and within narrow limits.'” The Supreme Court found that the evidence presented at trial demonstrates a type of conduct for which punitive damages were designed. The Minor Estate provided sufficient proof that USAA acted in bad faith, with complete disregard for the Estate’s rights.

    Whether The $10 Million Punitive Damages Award Should Be Reversed Or, Alternatively, Reduced.

    USAA alternatively argues that the $10 million verdict should be reduced because it claims that the damages award is a 22:1 ratio and therefore unconstitutionally disproportionate to the extra-contractual damages awarded ($457,858.89). USAA relies on State Farm Mutual Auto Insurance Co. v. Campbell, 538 U.S. 408, 425, 123 S.Ct. 1513, 1524, 155 L.Ed.2d 585 (2003), which states that “[s]ingle-digit multipliers are more likely to comport with due process.” USAA argued that a 1:1 ratio should apply to the damages award here.

    The Supreme Court found that punitive damages is less than seven times the amount of compensatory damages, which it concluded clearly falls within the guideline provided in Campbell.

    A punitive damages award not only serves as a deterrent, it also compensates the plaintiff for its public service in bringing the action. The Supreme Court found the trial court’s decision to force the Minor Estate to use nearly half of its award to pay attorneys’ fees does not adequately compensate the Estate for bringing this action against USAA for its bad faith conduct in handling the Minors’ insurance claim from 2005. Therefore, the Supreme Court concluded that the trial court erred by denying the Estate’s post-trial motion for attorneys’ fees.

    CONCLUSION

    In sum, the trial judge did not err as a matter of law by submitting the issue of punitive damages to jury, and the $10 million award of punitive damages is not unconstitutionally disproportionate. The Supreme Court affirmed the jury verdict awarding the Minor Estate $10 million in punitive damages and $457,858.89 in extra-contractual damages as to attorneys’ fees and reverse the judgment of the trial court and render attorneys’ fees on behalf of the Estate in the amount of $4,500,000, plus post-judgment interest at an annual rate of 4 percent from October 3, 2022, the date of judgment, until paid.

    ZALMA OPINION

    This case that dragged on through the courts of Mississippi for 19 years and resulted in compensatory damages based upon an interpretation finding coverage for the estate and that the insurer’s conduct was so egregious that the estate was entitled to tort damages plus punitive damages many times more than the compensatory damages. The Supreme Court astonishingly concluded that punitive damages were not limited to punishing the insurer but were payment to the estate for its action on behalf of everyone in the state of Mississippi and that they should not be required to pay their lawyers but that payment should come from the insurer as part of its punishment. The Supreme Court ignored the fact that as a result the estate must pay income taxes on the punishment damages since they are not designed to make the insured whole and punished each member and insured of USAA.

    In my opinion it’s time the courts of the USA do away with the tort of bad faith to avoid excessive judgments and allow contract disputes to be enlarged into a major amount of punishment for an insurer who rejected a claim based on interpretation of contract terms and the facts of a loss, like this case. In that regard see my book, It’s Time to Abolish The Tort of Bad Faith Available as a paperback here. Available as a Kindle book here.

    (c) 2024 Barry Zalma & ClaimSchool, Inc.

    Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.

    Subscribe to my substack at https://barryzalma.substack.com/subscribe

    Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg

    Go to the Insurance Claims Library – https://lnkd.in/gwEYk
    USAA Punished for it Claims Handling Punitive Damages Should be Awarded With Caution and Within Narrow Limits Read the full article at https://www.linkedin.com/pulse/usaa-punished-claims-handling-barry-zalma-esq-cfe-nbp2c, see the full video at and at and at https://zalma.com/blog plus more than 4950 posts. Posted on December 19, 2024 by Barry Zalma DISPUTE OVER HURRICANE DAMAGES RESULTS IN MAJOR PUNITIVE DAMAGES FOR BAD FAITH Although he Mississippi Supreme Court recognized the need to only award punitive damages with caution and within narrow limits, it did not limit its award in accordance with that maxim. After almost 19 years of litigation the last appeal resolved the various disputes. FACTS Hurricane Katrina destroyed Paul and Sylvia Minor’s home on August 29, 2005. The Minors had a homeowner’s insurance policy with United Services Automobile Association (USAA). The USAA policy covered damage caused by wind but excluded damage caused by storm surge or flood. The Minors reported their loss with USAA, which resulted in a years-long coverage dispute. USAA ultimately issued payments for damage it concluded was caused by wind but not for damage it concluded was caused by storm surge or flood. The Minors maintained that they suffered a total loss caused by wind and demanded that USAA pay the policy limits. The case proceeded to trial in 2013, and the jury awarded the Minors $1,547,293.37 in compensatory damages. In United Services Automobile Association v. Estate Of Sylvia F. Minor, Kathryn Minor and Stephen Minor, No. 2023-CA-00049-SCT, Supreme Court of Mississippi, En Banc (December 5, 2024) resolved the bad faith claims. The issue was ultimately presented to a jury. The jury awarded the Minors $10,000,000 in punitive damages and $457,858.89 in extra-contractual damages (solely attorneys’ fees). USAA appealed, raising several assignments of error. Trial To establish its bad faith claim, the Minor Estate introduced various USAA documents, including (1) portions of the USAA underwriting file; (2) the confidential email regarding (a) the engineer’s March 2006 findings and (b) Bergstrom’s conclusion that USAA would be responsible for paying for all the windows and the contents in rooms with windows; and (3) USAA’s letter to the Minors in June 2006 indicating the majority of damage was due to flooding. Punitive Damages Punitive damages are considered an ‘extraordinary remedy’ and should be awarded ‘with caution and within narrow limits.'” The Supreme Court found that the evidence presented at trial demonstrates a type of conduct for which punitive damages were designed. The Minor Estate provided sufficient proof that USAA acted in bad faith, with complete disregard for the Estate’s rights. Whether The $10 Million Punitive Damages Award Should Be Reversed Or, Alternatively, Reduced. USAA alternatively argues that the $10 million verdict should be reduced because it claims that the damages award is a 22:1 ratio and therefore unconstitutionally disproportionate to the extra-contractual damages awarded ($457,858.89). USAA relies on State Farm Mutual Auto Insurance Co. v. Campbell, 538 U.S. 408, 425, 123 S.Ct. 1513, 1524, 155 L.Ed.2d 585 (2003), which states that “[s]ingle-digit multipliers are more likely to comport with due process.” USAA argued that a 1:1 ratio should apply to the damages award here. The Supreme Court found that punitive damages is less than seven times the amount of compensatory damages, which it concluded clearly falls within the guideline provided in Campbell. A punitive damages award not only serves as a deterrent, it also compensates the plaintiff for its public service in bringing the action. The Supreme Court found the trial court’s decision to force the Minor Estate to use nearly half of its award to pay attorneys’ fees does not adequately compensate the Estate for bringing this action against USAA for its bad faith conduct in handling the Minors’ insurance claim from 2005. Therefore, the Supreme Court concluded that the trial court erred by denying the Estate’s post-trial motion for attorneys’ fees. CONCLUSION In sum, the trial judge did not err as a matter of law by submitting the issue of punitive damages to jury, and the $10 million award of punitive damages is not unconstitutionally disproportionate. The Supreme Court affirmed the jury verdict awarding the Minor Estate $10 million in punitive damages and $457,858.89 in extra-contractual damages as to attorneys’ fees and reverse the judgment of the trial court and render attorneys’ fees on behalf of the Estate in the amount of $4,500,000, plus post-judgment interest at an annual rate of 4 percent from October 3, 2022, the date of judgment, until paid. ZALMA OPINION This case that dragged on through the courts of Mississippi for 19 years and resulted in compensatory damages based upon an interpretation finding coverage for the estate and that the insurer’s conduct was so egregious that the estate was entitled to tort damages plus punitive damages many times more than the compensatory damages. The Supreme Court astonishingly concluded that punitive damages were not limited to punishing the insurer but were payment to the estate for its action on behalf of everyone in the state of Mississippi and that they should not be required to pay their lawyers but that payment should come from the insurer as part of its punishment. The Supreme Court ignored the fact that as a result the estate must pay income taxes on the punishment damages since they are not designed to make the insured whole and punished each member and insured of USAA. In my opinion it’s time the courts of the USA do away with the tort of bad faith to avoid excessive judgments and allow contract disputes to be enlarged into a major amount of punishment for an insurer who rejected a claim based on interpretation of contract terms and the facts of a loss, like this case. In that regard see my book, It’s Time to Abolish The Tort of Bad Faith Available as a paperback here. Available as a Kindle book here. (c) 2024 Barry Zalma & ClaimSchool, Inc. Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg Go to the Insurance Claims Library – https://lnkd.in/gwEYk
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  • https://thewashingtonstandard.com/innocent-homeowners-could-be-subjected-to-warrantless-searches-of-their-homes-based-on-mere-suspicion-that-a-probationer-lives-within/
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    Innocent Homeowners Could Be Subjected to Warrantless Searches of Their Homes Based on Mere Suspicion That a Probationer Lives Within - The Washington Standard
    The open violations of the Fourth Amendment to the US Constitution couldn’t be more obvious than every time one gets on a plane to travel, but we’ve seen the agents of the state attempt to justify their lawless actions. We’ve seen warrantless searches of persons, papers and property gaining momentum ...
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  • Something to think on before letting the family member that's on parole or probation move in with you.
    https://thewashingtonstandard.com/innocent-homeowners-could-be-subjected-to-warrantless-searches-of-their-homes-based-on-mere-suspicion-that-a-probationer-lives-within/
    God Bless America, God Save The Republic.
    Something to think on before letting the family member that's on parole or probation move in with you. https://thewashingtonstandard.com/innocent-homeowners-could-be-subjected-to-warrantless-searches-of-their-homes-based-on-mere-suspicion-that-a-probationer-lives-within/ God Bless America, God Save The Republic.
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    Innocent Homeowners Could Be Subjected to Warrantless Searches of Their Homes Based on Mere Suspicion That a Probationer Lives Within - The Washington Standard
    The open violations of the Fourth Amendment to the US Constitution couldn’t be more obvious than every time one gets on a plane to travel, but we’ve seen the agents of the state attempt to justify their lawless actions. We’ve seen warrantless searches of persons, papers and property gaining momentum ...
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  • Intent to Move is not a Residence

    Residence Premises Requires the Insured to Live in Residence

    Post 4944

    Read the full article at https://www.linkedin.com/pulse/intent-move-residence-barry-zalma-esq-cfe-qmlxc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts.

    In Paul Villalobos v. Clear Blue Insurance Company, No. 24-20125, United States Court of Appeals, Fifth Circuit (December 10, 2024) the the Fifth Circuit affirmed the district court’s dismissa of Plaintiff-Appellant Paul Villalobos’s breach of contract claim following a coverage dispute between himself and his insurer, Clear Blue Insurance Company, because he admitted he did not live in the insured premises.

    FACTS

    Villalobos is named on a Clear Blue homeowners’ policy, which provides coverage for property located at 7503 Muirwood Lane in Houston, Texas (the “Property”). The policy’s “Property Coverages” section states in pertinent part: “We cover . . . [t]he dwelling on the ‘residence premises’ shown in the Declarations.” The policy defines “residence premises,” also in pertinent part, as “[t]he one-family dwelling where you reside . . . on the inception date of the policy period shown in the Declarations.” The Declarations page lists Villalobos as the insured, his mailing address as the Property, and the inception date as September 21, 2021.

    In mid-November 2021, Villalobos reported to Clear Blue that wind and hail had damaged the Property’s roof earlier that month. Clear Blue denied coverage after Villalobos admitted he lived in Colorado and had never resided at the Property.

    Villalobos sued Clear Blue, alleging breach of contract, breach of the duty of good faith and fair dealing, violations of the Texas Deceptive Trade Practices Act and the Texas Insurance Code, fraud, and ongoing conspiracy to commit illegal acts.

    ANALYSIS

    During his deposition, Villalobos testified that he lived in Colorado for over nine years and did not reside at the Property when the Clear Blue policy went into effect. Clear Blue moved for summary judgment on Villalobos’s claims, arguing there was no insurance coverage for Villalobos’s property damage as a matter of law.

    Applying Louisiana law, the Fifth Circuit has previously determined that an identical residence requirement in a homeowners’ insurance policy required “more than purchasing a home or intending to move into it.” GeoVera Specialty Ins. Co. v. Joachin, 964 F.3d 390, 393 (5th Cir. 2020).

    Applying Joachin the Fifth Circuit agreed with the district court that the Property did not satisfy the policy’s residence requirement and was not a covered “residence premises” because: it is undisputed that Villalobos did not reside on the Property on the inception date of the Clear Blue policy; and
    Villalobos’s only material argument on appeal is that he intended to move onto the Property.

    Joachin held that “intending to move” is not enough. The Fifth Circuit concluded that there is no coverage under the policy. Accordingly, Villalobos’s breach of contract claim failed and the USDC’s judgment was affirmed.

    ZALMA OPINION

    That something as obvious as a home in Texas cannot be the residence premises of a person who lives full time in Colorado. Insurers issue property insurance policies providing coverage similar to a homeowners policy to the owner of a rental property while a homeowners policy limits coverage to the person who actually resides at the property. That this case went to the Fifth Circuit was the waste of Plaintiff’s time and money, the waste of the time of the trial court, and the waste of the time of the Fifth Circuit who rendered a concise and clear opinion. A less kind judge or appellate court would have imposed sanctions on the party plaintiff and his counsel.

    (c) 2024 Barry Zalma & ClaimSchool, Inc.

    Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.

    Subscribe to my substack at https://barryzalma.substack.com/subscribe

    Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg

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    Intent to Move is not a Residence Residence Premises Requires the Insured to Live in Residence Post 4944 Read the full article at https://www.linkedin.com/pulse/intent-move-residence-barry-zalma-esq-cfe-qmlxc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts. In Paul Villalobos v. Clear Blue Insurance Company, No. 24-20125, United States Court of Appeals, Fifth Circuit (December 10, 2024) the the Fifth Circuit affirmed the district court’s dismissa of Plaintiff-Appellant Paul Villalobos’s breach of contract claim following a coverage dispute between himself and his insurer, Clear Blue Insurance Company, because he admitted he did not live in the insured premises. FACTS Villalobos is named on a Clear Blue homeowners’ policy, which provides coverage for property located at 7503 Muirwood Lane in Houston, Texas (the “Property”). The policy’s “Property Coverages” section states in pertinent part: “We cover . . . [t]he dwelling on the ‘residence premises’ shown in the Declarations.” The policy defines “residence premises,” also in pertinent part, as “[t]he one-family dwelling where you reside . . . on the inception date of the policy period shown in the Declarations.” The Declarations page lists Villalobos as the insured, his mailing address as the Property, and the inception date as September 21, 2021. In mid-November 2021, Villalobos reported to Clear Blue that wind and hail had damaged the Property’s roof earlier that month. Clear Blue denied coverage after Villalobos admitted he lived in Colorado and had never resided at the Property. Villalobos sued Clear Blue, alleging breach of contract, breach of the duty of good faith and fair dealing, violations of the Texas Deceptive Trade Practices Act and the Texas Insurance Code, fraud, and ongoing conspiracy to commit illegal acts. ANALYSIS During his deposition, Villalobos testified that he lived in Colorado for over nine years and did not reside at the Property when the Clear Blue policy went into effect. Clear Blue moved for summary judgment on Villalobos’s claims, arguing there was no insurance coverage for Villalobos’s property damage as a matter of law. Applying Louisiana law, the Fifth Circuit has previously determined that an identical residence requirement in a homeowners’ insurance policy required “more than purchasing a home or intending to move into it.” GeoVera Specialty Ins. Co. v. Joachin, 964 F.3d 390, 393 (5th Cir. 2020). Applying Joachin the Fifth Circuit agreed with the district court that the Property did not satisfy the policy’s residence requirement and was not a covered “residence premises” because: it is undisputed that Villalobos did not reside on the Property on the inception date of the Clear Blue policy; and Villalobos’s only material argument on appeal is that he intended to move onto the Property. Joachin held that “intending to move” is not enough. The Fifth Circuit concluded that there is no coverage under the policy. Accordingly, Villalobos’s breach of contract claim failed and the USDC’s judgment was affirmed. ZALMA OPINION That something as obvious as a home in Texas cannot be the residence premises of a person who lives full time in Colorado. Insurers issue property insurance policies providing coverage similar to a homeowners policy to the owner of a rental property while a homeowners policy limits coverage to the person who actually resides at the property. That this case went to the Fifth Circuit was the waste of Plaintiff’s time and money, the waste of the time of the trial court, and the waste of the time of the Fifth Circuit who rendered a concise and clear opinion. A less kind judge or appellate court would have imposed sanctions on the party plaintiff and his counsel. (c) 2024 Barry Zalma & ClaimSchool, Inc. Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg Go to the Insurance Claims Library – https://lnkd.in/gwEYk
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  • https://open.substack.com/pub/thewickedscientist/p/i-didnt-know-cheetahs-meow-ive-always?utm_campaign=post&utm_medium=web
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  • EUO is a Material Condition Precedent

    Claim Properly Denied for Refusal to Testify at EUO

    Post 4936

    Read the full article at https://www.linkedin.com/pulse/euo-material-condition-precedent-barry-zalma-esq-cfe-exccc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts.

    See the full video at and at

    Erin Hughes appealed from the grant of summary judgment in favor of defendant and respondent Farmers Insurance Exchange (Farmers) on her causes of action for breach of contract and bad faith arising after Farmers’ denial of Hughes’s property insurance claim because she refused to testify at a second examination under oath (EUO).

    In Erin Hughes v. Farmers Insurance Exchange, B331168, California Court of Appeals (November 8, 2024) the condition precedent was enforced.

    FACTUAL BACKGROUND

    Hughes is the owner of real property in Malibu (the property). In December 2020, Hughes obtained an insurance policy to cover the property for fire loss through the California FAIR Plan Association (FAIR Plan). Also in December 2020, Hughes obtained a homeowner’s insurance policy from Farmers to cover perils other than fire, including losses due to theft (the policy).

    One month later, in January 2021, the property sustained significant fire damage. Hughes contacted Farmers, which advised her that fire loss was not covered by her Farmers policy, and she would have to pursue any such claim through her FAIR Plan policy. Unhappy, on January 21, 2021, Hughes tendered a theft claim under the Farmers policy, asserting in excess of $2 million worth of personal property was stolen from the property.

    Farmers ultimately denied the claim on January 5, 2022, on the ground that Hughes failed to cooperate with Farmers’ investigation, including by failing to participate in a second examination under oath as required by the policy.
    Hughes’s Complaint Against Farmers

    One week after the denial of her claim, Hughes sued Farmers and alleged Farmers demanded “duplicative, onerous and/or unnecessary” documentation of stolen items. Further, she alleged Farmers subjected her to “two confrontational, accusatory and grueling examinations under oath.” Hughes alleged her second examination under oath had been “suspended due to [her] medical condition,” but Farmers disregarded her condition and demanded a third examination.

    Farmers’ Motion for Summary Judgment

    Farmers moved for summary judgment contending it properly denied Hughes’s theft claim based on her failure to cooperate with Farmers’ investigation of her claim as well as her material misrepresentations in obtaining the Farmers policy.

    In May 2021, as part of Farmers’ theft claim investigation, Hughes participated in an examination under oath. During the examination, Hughes’s counsel informed the Farmers attorney he had just sent more than 40 additional receipts that the attorney would be receiving shortly. Recognizing they would not have time to go through the new items that day and the examination would need to continue on a future date, the Farmers attorney proposed “continu[ing] to work with one another to identify what’s missing.” In response, Hughes and her counsel agreed, with Hughes stating she would be happy to get “every single thing that you need and I’ll send it to my attorney right away.”

    In October 2021, a second session of the examination under oath was held regarding documentation Hughes had produced during and after the first session. Hughes appeared remotely with counsel and before any questions were asked of her, she objected to a further examination.

    Hughes accused the Farmers attorney of interrogating her “like a fucking criminal” and stated, “if you want to take my deposition . . . you are going to take a second deposition in court, and that’s going to be a formal deposition.” Hughes’s remote connection then cut out, and her counsel indicated she would not proceed with the examination.

    Farmers informed Hughes that it was denying coverage based on her failure to cooperate with Farmers’ investigation and particularly her refusal to proceed with the second examination under oath.
    Trial Court’s Grant of Summary Judgment and Denial of Hughes’s Continuance Request and Motion for New Trial

    The trial court granted summary judgment in favor of Farmers. Noting an insurer has “an absolute right” to require the insured to submit to an examination under oath “as long as the insurer exercises the right reasonably,” the court determined Hughes had not shown Farmers acted unreasonably. The court concluded summary judgment was appropriate “based solely on failure to cooperate.”

    DISCUSSION

    The trial court properly concluded there was no genuine dispute that Hughes’s failure to participate in an examination under oath constituted a material breach of the policy; accordingly, Farmers was excused from having to pay on Hughes’s claim. 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.

    An insured’s compliance with a policy requirement to submit to an examination under oath is a prerequisite to the right to receive benefits under the policy.
    Because Hughes refused to cooperate with Farmers’ investigation by participating in and completing her examination under oath, she cannot establish her own performance under the policy.
    Breach of Implied Covenant Claim

    The implied covenant of good faith and fair dealing is based on general contract law and the long-standing rule that neither party will do anything which will injure the right of the other to receive the benefits of the agreement. Hughes’s claim for bad faith fails as a matter of law.

    ZALMA OPINION

    Wildfires tend to destroy everything. That is why insurers are unwilling to write fire insurance in Malibu and other areas prone to wildfires and obtain fire insurance from the Fair Plan, an organization designed to cover uninsurable risks. Because of the destruction done by a wildfire or a dwelling fire a $2 million dollar theft loss after a fire is questionable and a good reason to take a thorough EUO. Farmers tried to do so and Hughes refused without reason after admitting she left open much investigation elements at the agreed conclusion of the first session and an agreement to a second only to refuse.

    (c) 2024 Barry Zalma & ClaimSchool, Inc.

    Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos.

    Subscribe to my substack at https://barryzalma.substack.com/subscribe

    Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg
    EUO is a Material Condition Precedent Claim Properly Denied for Refusal to Testify at EUO Post 4936 Read the full article at https://www.linkedin.com/pulse/euo-material-condition-precedent-barry-zalma-esq-cfe-exccc, see the full video at and at and at https://zalma.com/blog plus more than 4900 posts. See the full video at and at Erin Hughes appealed from the grant of summary judgment in favor of defendant and respondent Farmers Insurance Exchange (Farmers) on her causes of action for breach of contract and bad faith arising after Farmers’ denial of Hughes’s property insurance claim because she refused to testify at a second examination under oath (EUO). In Erin Hughes v. Farmers Insurance Exchange, B331168, California Court of Appeals (November 8, 2024) the condition precedent was enforced. FACTUAL BACKGROUND Hughes is the owner of real property in Malibu (the property). In December 2020, Hughes obtained an insurance policy to cover the property for fire loss through the California FAIR Plan Association (FAIR Plan). Also in December 2020, Hughes obtained a homeowner’s insurance policy from Farmers to cover perils other than fire, including losses due to theft (the policy). One month later, in January 2021, the property sustained significant fire damage. Hughes contacted Farmers, which advised her that fire loss was not covered by her Farmers policy, and she would have to pursue any such claim through her FAIR Plan policy. Unhappy, on January 21, 2021, Hughes tendered a theft claim under the Farmers policy, asserting in excess of $2 million worth of personal property was stolen from the property. Farmers ultimately denied the claim on January 5, 2022, on the ground that Hughes failed to cooperate with Farmers’ investigation, including by failing to participate in a second examination under oath as required by the policy. Hughes’s Complaint Against Farmers One week after the denial of her claim, Hughes sued Farmers and alleged Farmers demanded “duplicative, onerous and/or unnecessary” documentation of stolen items. Further, she alleged Farmers subjected her to “two confrontational, accusatory and grueling examinations under oath.” Hughes alleged her second examination under oath had been “suspended due to [her] medical condition,” but Farmers disregarded her condition and demanded a third examination. Farmers’ Motion for Summary Judgment Farmers moved for summary judgment contending it properly denied Hughes’s theft claim based on her failure to cooperate with Farmers’ investigation of her claim as well as her material misrepresentations in obtaining the Farmers policy. In May 2021, as part of Farmers’ theft claim investigation, Hughes participated in an examination under oath. During the examination, Hughes’s counsel informed the Farmers attorney he had just sent more than 40 additional receipts that the attorney would be receiving shortly. Recognizing they would not have time to go through the new items that day and the examination would need to continue on a future date, the Farmers attorney proposed “continu[ing] to work with one another to identify what’s missing.” In response, Hughes and her counsel agreed, with Hughes stating she would be happy to get “every single thing that you need and I’ll send it to my attorney right away.” In October 2021, a second session of the examination under oath was held regarding documentation Hughes had produced during and after the first session. Hughes appeared remotely with counsel and before any questions were asked of her, she objected to a further examination. Hughes accused the Farmers attorney of interrogating her “like a fucking criminal” and stated, “if you want to take my deposition . . . you are going to take a second deposition in court, and that’s going to be a formal deposition.” Hughes’s remote connection then cut out, and her counsel indicated she would not proceed with the examination. Farmers informed Hughes that it was denying coverage based on her failure to cooperate with Farmers’ investigation and particularly her refusal to proceed with the second examination under oath. Trial Court’s Grant of Summary Judgment and Denial of Hughes’s Continuance Request and Motion for New Trial The trial court granted summary judgment in favor of Farmers. Noting an insurer has “an absolute right” to require the insured to submit to an examination under oath “as long as the insurer exercises the right reasonably,” the court determined Hughes had not shown Farmers acted unreasonably. The court concluded summary judgment was appropriate “based solely on failure to cooperate.” DISCUSSION The trial court properly concluded there was no genuine dispute that Hughes’s failure to participate in an examination under oath constituted a material breach of the policy; accordingly, Farmers was excused from having to pay on Hughes’s claim. 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. An insured’s compliance with a policy requirement to submit to an examination under oath is a prerequisite to the right to receive benefits under the policy. Because Hughes refused to cooperate with Farmers’ investigation by participating in and completing her examination under oath, she cannot establish her own performance under the policy. Breach of Implied Covenant Claim The implied covenant of good faith and fair dealing is based on general contract law and the long-standing rule that neither party will do anything which will injure the right of the other to receive the benefits of the agreement. Hughes’s claim for bad faith fails as a matter of law. ZALMA OPINION Wildfires tend to destroy everything. That is why insurers are unwilling to write fire insurance in Malibu and other areas prone to wildfires and obtain fire insurance from the Fair Plan, an organization designed to cover uninsurable risks. Because of the destruction done by a wildfire or a dwelling fire a $2 million dollar theft loss after a fire is questionable and a good reason to take a thorough EUO. Farmers tried to do so and Hughes refused without reason after admitting she left open much investigation elements at the agreed conclusion of the first session and an agreement to a second only to refuse. (c) 2024 Barry Zalma & ClaimSchool, Inc. Please tell your friends and colleagues about this blog and the videos and let them subscribe to the blog and the videos. Subscribe to my substack at https://barryzalma.substack.com/subscribe Go to X @bzalma; Go to Newsbreak.com https://www.newsbreak.com/@c/1653419?s=01; Go to Barry Zalma videos at Rumble.com at https://rumble.com/account/content?type=all; Go to Barry Zalma on YouTube- https://www.youtube.com/channel/UCysiZklEtxZsSF9DfC0Expg
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