Cent. Nat'l Ins. v. California Ins. Guarantee, 165 Cal. App. 3d 453 (Cal. Ct. App. 1985). · Go Syfert
Cent. Nat'l Ins. v. California Ins. Guarantee, 165 Cal. App. 3d 453 (Cal. Ct. App. 1985). Cases Citing This Book View Copy Cite
37 citation events (15 in the last 25 years) across 2 distinct courts.
Strongest positive: Moncada v. West Coast Quartz Corp. CA6 (calctapp, 2013-10-28)
Treatment trajectory · 1986 → 2026 · click a year to view as-of
1986 2006 2026
Top citers, strongest first. 14 distinct citers.
discussed Cited as authority (rule) Moncada v. West Coast Quartz Corp. CA6
Cal. Ct. App. · 2013 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 460 [ 211 Cal.Rptr. 435 ] [equitable estoppel ‘must be pleaded . . . either as a part of the cause of action or as a defense’].) As a stand-alone cause of action for equitable estoppel will not lie as a matter of law . . . .” (Id. at p. 1463.) As estoppel in pais cannot be stated as an independent cause of action in California, the trial court was correct in sustaining defendant’s demurrer to this allegation in the original complaint.
discussed Cited as authority (rule) Minish v. Hanuman Fellowship
Cal. Ct. App. · 2013 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 460 [ 211 Cal.Rptr. 435 ] [equitable estoppel “must be pleaded, either as a part of the cause of action or as a defense” (italics added)]; Mills v. Forestex Co. (2003) 108 Cal.App.4th 625, 641 [ 134 Cal.Rptr.2d 273 ].) Defendants did not plead equitable estoppel as an affirmative defense or otherwise plead the facts necessary to establish it.
discussed Cited as authority (rule) Transport Insurance v. TIG Insurance
Cal. Ct. App. · 2012 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 460 [ 211 Cal.Rptr. 435 ] [equitable estoppel “must be pleaded, either as a part of the cause of action or as a defense”]; Mills v. Forestex Co. (2003) 108 Cal.App.4th 625, 641 [ 134 Cal.Rptr.2d 273 ].) Transport’s complaints did not plead any facts as to estoppel or identify any statement of fact made by either of the reinsurers that Transport reasonably relied upon to its detriment.
discussed Cited as authority (rule) Behnke v. State Farm General Insurance
Cal. Ct. App. · 2011 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 460 [ 211 Cal.Rptr. 435 ] [equitable estoppel “must be pleaded . . . either as a part of the cause of action or as a defense”].) As a stand-alone cause of action for equitable estoppel will not lie as a matter of law, the court properly sustained State Farm’s general demurrer to Behnke’s equitable estoppel claim. 3.
discussed Cited as authority (rule) Stonelight Tile, Inc. v. California Insurance Guarantee Ass'n
Cal. Ct. App. · 2007 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 458 [ 211 Cal.Rptr. 435 ].) “CIGA assesses its members when another member becomes insolvent, thereby establishing a fund from which insureds whose insurers become insolvent can obtain financial and legal assistance. [Citation.] Member insurers then recoup assessments paid to CIGA by means of a surcharge on *32 premiums to their policy holders. (§ 1063.14, subd. (a).) In this way the insolvency of one insurer does not impact a small segment of insurance consumers, but is spread throughout the insurance consuming public, which in effect subsidizes C…
discussed Cited as authority (rule) California Insurance Guarantee Ass'n v. Workers' Compensation Appeals Board
Cal. Ct. App. · 2003 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 458 [ 211 Cal.Rptr. 435 ].) “Cases interpreting [section 1063.1(c)(9)] have established that where an insured has overlapping insurance policies and one insurer becomes insolvent, the other insurer, even if only a secondary or excess insurer, is responsible for paying the claim.
discussed Cited as authority (rule) Mercury Insurance v. Enterprise Rent-A-Car Co.
Cal. Ct. App. · 2000 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 460-461 [ 211 Cal.Rptr. 435 ].) Mercury contends it is entitled to subrogation against CIGA pursuant to the exception to that general rule contained in section 1063.2, subdivision (c)(1), which provides in part: “A member insurer may recover in subrogation from the association only one-half of any amount paid by such insurer under uninsured motorist coverage for bodily injury or wrongful death (and nothing for payment for anything else), in those cases where the injured person insured by such an insurer has proceeded under his or her uninsured motor…
cited Cited as authority (rule) Industrial Indemnity Co. v. WKRS.'COMP. APP. BD.
Cal. Ct. App. · 1997 · confidence medium
Guarantee Assn. (1985) 165 Cal. App.3d 453, 458 [ 211 Cal. Rptr. 435 ]; Interstate Fire & Casualty Ins.
cited Cited as authority (rule) Indus. Indem. Co. v. Workers' Comp. Appeals Bd.
Cal. Ct. App. · 1997 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 458 [ 211 Cal.Rptr. 435 ]; Interstate Fire & Casualty Ins.
discussed Cited as authority (rule) California Insurance Guarantee Ass'n v. Workers' Compensation Appeals Board
Cal. Ct. App. · 1992 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 459-460 [ 211 Cal.Rptr. 435 ].) 8 California Constitution, article XIV, section 4, provides in pertinent part: “The Legislature is hereby expressly vested with plenary power ... to create, and enforce a complete system of workers’ compensation, by appropriate legislation ....
discussed Cited as authority (rule) R. J. Reynolds Co. v. California Insurance Guarantee Ass'n
Cal. Ct. App. · 1991 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 458 [ 211 Cal.Rptr. 435 ]; §§ 1063.14; 1063, subd. (a).) Its purpose is “to provide insurance against loss arising from the failure of an insolvent insurer to discharge its obligations under its insurance policies.” (Middleton v. Imperial Ins.
discussed Cited as authority (rule) California Insurance Guarantee Ass'n v. Liemsakul
Cal. Ct. App. · 1987 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 458 [ 211 Cal.Rptr. 435 ].) 3 UM coverage includes protection for an accident involving “an insured motor vehicle where the liability insurer thereof is unable to'make payment with respect to the legal liability of its insured within the limits specified therein because of insolvency.” (Ins.
discussed Cited as authority (rule) Phoenix Insurance v. United States Fire Insurance
Cal. Ct. App. · 1987 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 458 [ 211 Cal.Rptr. 435 ]; footnote omitted.) 2 All statutory references are to the Insurance Code. 3 Under the heading of Insuring Agreements, paragraph five of Phoenix’s policy stated in relevant part: “This policy applies only to acts or omissions committed anywhere in the world (a) during the policy period, and/or (b) prior to the policy period if claim is made or suit is brought against the insured during the policy period and such insured at the effective date of the insurance did not know or could not have reasonably foreseen that such acts…
discussed Cited as authority (rule) Bunner v. Imperial Insurance
Cal. Ct. App. · 1986 · confidence medium
Guarantee Assn. (1985) 165 Cal.App.3d 453, 458 [ 211 Cal.Rptr. 435 ].) The legislative intent was to create a protection for the public against insolvent insurers when no secondary insurer is available.
CENTRAL NATIONAL INSURANCE COMPANY OF OMAHA, Cross-Complainant and Appellant,
v.
CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, Cross-Defendant and Respondent
B006061.
California Court of Appeal.
Feb 22, 1985.
165 Cal. App. 3d 453
Counsel, Karma, Coleite & Bence, Arthur Karma, Stanley R. Coleite and Randall M. Nunn for Cross-complainant and Appellant., Clausen, Harris & Campbell, Lon Harris and Stanley T. Gilliam for Cross-defendant and Respondent.
Shumsky.
Cited by 18 opinions  |  Published

Opinion

SHUMSKY, J. *

Appellant and cross-complainant, The Central National Insurance Company of Omaha (Central National) appeals the sustaining of[*457] a demurrer without leave to amend pursuant to California Code of Civil Procedure section 430.10, subdivision (e) [1] in favor of respondent and cross-defendant, California Insurance Guarantee Association (CIGA). A partial dismissal was then granted. We affirm.

Appellant, "together with Signal Insurance Company (Signal) and various other insurers, issued certain insurance policies naming Leonard M. Ross and Rossco Inc. [2] as insured parties. Subsequently, more than 23 lawsuits, some still pending, were filed by various parties against Ross.

Appellant entered into a settlement agreement as to some of the lawsuits (Goodrich v. Marlin actions) for $1.5 million. Signal had become insolvent and appellant requested CIGA to contribute the excess over the aggregate policy limit to the settlement pool. CIGA refused and appellant paid the agreed upon $1.5 million. Central National also assumed the defense in another group of Ross actions {Willow Ridge actions). American Home Assurance Company, who had provided the defense in a different group of actions, filed a complaint requesting declaratory relief, and named both Central National and Ross, among others, as defendants. Central National filed a cross-complaint for declaratory relief, naming CIGA as a cross-defendant, to which CIGA demurred.

Central National appeals, raising the following issues:

I. Whether or not Central National, an insurer, can have a “covered claim.”
II. Should CIGA be estopped from asserting that Central National has no standing to bring an action for declaratory relief?
HI. Whether the trial court abused its discretion by refusing Central National leave to amend its pleading to formally allege estoppel.

[*458] In order to determine whether or not an insurer can have a “covered claim,” [3] it is necessary to look to the legislative intent of the statute. CIGA was enacted in 1969 as a compulsory association requiring most state-regulated insurance companies to be members. (§§ 1063-1063.14; 1063, subd. (a).) [4]

“Its purpose is to provide insurance against loss arising from the failure of an insolvent insurer to discharge its obligations under its insurance policies.” (Middleton v. Imperial Ins. Co. (1983) 34 Cal.3d 134, 137 [193 Cal.Rptr. 144, 666 P.2d 1]; California Union Ins. Co. v. Central National Ins. Co. (1981) 117 Cal.App.3d 729, 734 [173 Cal.Rptr. 35].)

The legislative intent was to create a protection for the public against insolvent insurers when no secondary insurer is available.

“[W]hen a secondary insurer is available in the event of an insolvent primary insurer, the secondary insurer should be responsible in the absence of specific language to the contrary. [§ 1063.1, subd. (c)(7)(a).] The secondary insurer has received a premium for the risk and thus the secondary insurer and not CIGA, should be responsible for the coverage of the loss.” (Ross v. Canadian Indemnity Ins. Co. (1983) 142 Cal.App.3d 396, 404 [191 Cal.Rptr. 99].)

“The Legislature chose to provide a limited form of protection for the public, not a fund for the protection of other insurance companies from the insolvencies of fellow members.” (California Union Ins. Co. v. Central National Ins. Co., supra, 117 Cal.App.3d at p. 734.)

[*459] CIGA is only authorized to pay the “covered claims” of an insolvent insurer. The statute excludes from “covered claims” any obligations to insurers or any claim asserted by an assignee or one claiming by right of subrogation. (§ 1063.1, subd. (c)(4), and § 1063.1, subd. (c)(7)(b).) Applying both the case law and the plain meaning of the statutory language, Central National, a solvent insurance carrier, falls clearly in the excluded class and cannot directly nor indirectly through assignment or subrogation be found to be one with a covered claim payable by CIGA.

We next examine whether CIGA should be estopped from applying section 1063.1, subdivision (c)(4), and section 1063.1, subdivision (c)(7)(a) and (b).

Central National sets forth two bases for application of equitable estoppel. Central National first contends CIGA’s refiisal to contribute to the settlement pool in the Goodrich actions was a failure to perform a statutory duty. Because CIGA did not assume the rights and obligations of Signal at the time of Signal’s insolvency, Central National contends it was forced to pay 1.5 million dollars to settle the claims. Secondly, Central National argues that CIGA had a statutory obligation to assume the defense in the Willow Ridge actions and CIGA’s failure to do so caused Central National to tender the defense. By applying the principle of estoppel, Central National would thereby have a “covered claim” against CIGA. Central National relies primarily on Middleton v. Imperial Insurance Co., supra, 34 Cal.3d at page 137 and Biggs v. Cal. Ins. Guarantee Association (1981) 126 Cal.App.3d 641 [179 Cal.Rptr. 16], for this proposition.

“Whenever a party has, by his own statement or conduct, intentionally and deliberately led another to believe a particular thing true and to act upon such belief, he is not, in any litigation arising out of such statement or conduct, permitted to contradict it.” (City of Long Beach v. Mansell (1970) 3 Cal.3d 462, 488-489 [91 Cal.Rptr. 23, 476 P.2d 423].)

For equitable estoppel to lie, five elements must be established. They are: “(1) [A] representation or concealment of material facts (2) made with knowledge, actual or virtual, of the facts (3) to a party ignorant, actually and permissibly, of the truth (4) with the intention, actual or virtual, that the latter act upon it; and (5) the party must have been induced to act upon it. [Citations.]” (7 Witkin, Summary of Cal. Law (8th ed. 1974) Equity, § 132, pp. 5351-5352, italics omitted.)

There can be no estoppel where one of these elements is missing. (Johnson v. Johnson (1960) 179 Cal.App.2d 326, 330 [3 Cal.Rptr.[*460] 575].) In applying the argument of Central National to the essential elements necessary to establish estoppel, we find the very first element is missing. CIGA made no representation or concealment of material facts. The allegation of the cross-complaint which is taken as true for the purpose of demurrer is that CIGA refused to acknowledge any statutory duty regarding the Goodrich or Willow Ridge actions. This is proper inasmuch as Central National at all times qualified as “other insurance” as set forth in section 1063.1, subdivision (c)(7)(a) and could not step into the shoes of the insured by application of section 1063.1, subdivision (c)(4) and (c)(7)(b).

Our conclusion is not swayed by reviewing both Middleton, supra, and Biggs, supra, for it should be noted that in both cases there was no solvent carrier factually involved and the claims were brought by the insured. Further, in Middleton, supra, a statutory technical procedural duty of the liquidator owed to the insured was not satisfied and estoppel was applied. In Biggs, the decision was not based upon an estoppel theory.

Here, other insurance was available in the form of Central National and the defense of Ross had been undertaken. CIGA was prohibited by statute from either contributing to the settlement pool or tendering a defense. Thus, estoppel will not lie and CIGA could apply section 1063.1, subdivision (c)(4) and section 1063.1, subdivision (c)(7)(a) and (b).

As to the last contention, whether the trial court abused its discretion by refusing Central National leave to amend its pleading to formally allege estoppel, we think not. Central National argues that estoppel is a factual issue for the trier of fact to decide, and that it should have its day in court.

A general demurrer should not be sustained if the pleading, liberally construed, states a cause of action on any theory.

Whether there is an estoppel is chiefly a question of fact, and normally it must be pleaded, either as a part of the cause of action or as a defense. (General Motors Accept. Corp. v. Gandy (1927) 200 Cal. 284, 295 [253 P. 137].)

“Leave to amend should be denied where the facts are not in dispute, and the nature of the plaintiff’s claim is clear, but, under the substantive law, no liability exists. Obviously, no amendment would change the result. (Routh v. Quinn (1942) 20 Cal.2d 488, 493.)” (3 Witkin, Cal. Procedure (2d ed. 1971) Pleading, § 847, p. 2451.)

[*461] Here, it is undisputed that Central National is a solvent insurer who has received compensation for potential risks from Ross and that CIGA receives no compensation and discharges its obligations through member assessment. (§ 1063.5.) The further fact that the purpose of CIGA is to protect a segment of the insured public against insolvent insurers, is not in issue. It is also a fact that CIGA refused involvement in Goodrich and Willow Ridge actions. Under the substantive law, solvent carriers will not be reimbursed directly as insurers nor indirectly under the theories of assignment or subrogation. For estoppel to apply, there must be representation or concealment of material fact.

It is clear appellant would not be able to state facts sufficient to support a cause of action under the most liberal construction.

We, therefore, hold that the demurrer was properly sustained without leave to amend.

The judgment is affirmed.

Kingsley, Acting P. J. and Arguelles, J., concurred.

*

Assigned by the Chairperson of the Judicial Council.

1

California Code of Civil Procedure section 430.10, subdivision (e), states in pertinent part: “The party against whom a complaint or cross-complaint has been filed may object by demurrer ...(e) The pleading does not state facts sufficient to constitute a cause of action.”

2

Hereinafter referred to collectively as Ross.

3

“ ‘Covered claims’ means the obligations of an insolvent insurer, including the obligation for unearned premiums, (i) imposed by law and arising out of an insurance policy of the insolvent insurer; (ii) which were unpaid by the insolvent insurer; (iii) which are presented as a claim to the liquidator in this state or to the association on or before the last date fixed for the filing of claims in the domiciliary liquidating proceedings; (iv) which were incurred prior to, on, or within 30 days after the date the liquidator was appointed; (v) for which the assets of the insolvent insurer are insufficient to discharge in full; ...” (Ins. Code, § 1063.1, subd. (c)(1).)

“ ‘Covered claims’ shall not include any obligations to insurers, insurance pools, or underwriting associations, except as otherwise provided in this chapter.” (§ 1063.1, subd. (c)(4).)

“ ‘Covered claims’ shall not include (a) any claim to the extent it is covered by any other insurance of a class covered by the provisions of this article available to the claimant or insured nor (b) any claim by any person other than the original claimant under the insurance policy in his or her own name, his or her executor, administrator, guardian or other personal representative or trustee in bankruptcy and shall not include any claim asserted by an assignee or one claiming by right of subrogation, except as otherwise provided in this chapter.” (§ 1063.1, subd. (c)(7).)

4

A11 code references, unless otherwise noted, will be to the California Insurance Code.