insuring clause in California

2017Exchange, Inc. (1995) 11 Cal.4th 1 , 18, 44 Cal.Rptr.2d 370 , 900 P.2d 619 ( Waller ).) "The policy is written in two essential parts: the insuring agreement, which states the risk or risks covered by the policy, and the exclusion clauses, which remove coverage for risks that would otherwise fall within the insuring clause." ( Waller, supra, 11 Cal.4th at p. 16 , 44 Cal.Rptr.2d 370 , 900 P.2d 619 .) In general, "CGL policies are limited to providing coverage for accidental occurrences, and do not provide coverage for professional negligence claims. [Citation.]" ( Tradewinds Escrow, Inc. v. Tru

2017Exchange, Inc. (1995) 11 Cal.4th 1 , 18, 44 Cal.Rptr.2d 370 , 900 P.2d 619 ( Waller ).) "The policy is written in two essential parts: the insuring agreement, which states the risk or risks covered by the policy, and the exclusion clauses, which remove coverage for risks that would otherwise fall within the insuring clause." ( Waller, supra, 11 Cal.4th at p. 16 , 44 Cal.Rptr.2d 370 , 900 P.2d 619 .) In general, "CGL policies are limited to providing coverage for accidental occurrences, and do not provide coverage for professional negligence claims. [Citation.]" ( Tradewinds Escrow, Inc. v. Tru

2023The Summary Judgment Was Correct Introduction The burden is on the insured “to prove facts establishing the claimed loss falls within the coverage provided by the policy’s insuring clause.” (MRI, supra, 187 Cal.App.4th at p. 777 .) As our Supreme Court has described, the insured’s burden is “to establish that the occurrence forming the basis of its claim is within the basic scope of insurance coverage.” (Aydin Corp. v. First State Ins.

2023Co. (1998) 18 Cal.4th 1183, 1188 .) Here, as quoted, the insuring clause in the Stillwater policy provided that “we insure for sudden and accidental direct physical loss to property described in Coverage C caused by any of the following perils . . . unless the loss is excluded in Section I.” So here, as in MRI, the “accidental direct physical loss requirement is part of the policy’s insuring clause and accordingly falls within the [insured’s] burden of proof.” (MRI, supra, 187 Cal.App.4th at p. 778 .) This, the Wongs failed to meet, beginning with their inability to demonstrate a direct “physi

2013(Montrose Chemical Corp. v. Superior Court (1993) 6 Cal.4th 287, 299-300 [ 24 Cal.Rptr.2d 467 , 861 P.2d 1153 ].) Though the insurer’s duty to defend is broad, it “is not absolute but is measured by the nature and kinds of risks covered by the policy.” (Rosen, supra, 56 Cal.App.4th at p. 1497 .) Insurance policies contain two parts, the insuring clause defining the type of risks covered, and the exclusions, which *77 remove coverage for certain risks initially within the insuring clause.

2013Co., supra, 18 Cal.4th at p. 1188 .) Lexington must demonstrate Valley cannot meet its burden by presenting evidence sufficient to show "that the underlying claim cannot come within the policy coverage by virtue of the scope of the insuring clause" (Montrose I, supra, 6 Cal.4th at p. 301 ), and it is therefore entitled to summary judgment as a matter of law.

1995Co. (1984) 163 Cal.App.3d 263, 270 [ 209 Cal.Rptr. 266 ].) “Second, although exclusions are construed narrowly and must be proven by the insurer, the burden is on the insured to bring the claim within the basic scope of coverage, and (unlike exclusions) courts will not indulge in a forced construction of the policy’s insuring clause to bring a claim within the policy’s coverage.” (Collin v. American Empire Ins.

1995Co. (1984) 163 Cal.App.3d 263, 270 [ 209 Cal.Rptr. 266 ].) “Second, although exclusions are construed narrowly and must be proven by the insurer, the burden is on the insured to bring the claim within the basic scope of coverage, and (unlike exclusions) courts will not indulge in a forced construction of the policy’s insuring clause to bring a claim within the policy’s coverage.” (Collin v. American Empire Ins.

2017Co. v. Superior Court (1990) 51 Cal.3d 807 , 826, 274 Cal.Rptr. 820 , 799 P.2d 1253 ( AIU ); Powerine Oil Co., Inc. v. Superior Court (2005) 37 Cal.4th 377 , 385, 396-397, 33 Cal.Rptr.3d 562 , 118 P.3d 589 ["damages" in an insuring clause covers court-awarded "direct and consequential damages"].) Here, the 131 days of remediation was time Kadena could have spent completing the project had the units' interiors not been damaged.

2017Co. v. Superior Court (1990) 51 Cal.3d 807 , 826, 274 Cal.Rptr. 820 , 799 P.2d 1253 ( AIU ); Powerine Oil Co., Inc. v. Superior Court (2005) 37 Cal.4th 377 , 385, 396-397, 33 Cal.Rptr.3d 562 , 118 P.3d 589 ["damages" in an insuring clause covers court-awarded "direct and consequential damages"].) Here, the 131 days of remediation was time Kadena could have spent completing the project had the units' interiors not been damaged.

2015Co. v. Barbara B., supra, 4 Cal.4th at p. 1081.)” “If an exclusion is not ambiguous, however, it will prevail over the insuring clause and preclude coverage.” (ML Direct, Inc. v. TIG Specialty Ins.

1994As we said in Horace Mann, supra, 4 Cal.4th at page 1085, when the evidence adduced in the declaratory relief action does not permit the court to eliminate the possibility that the insured’s conduct falls within the coverage of the policy, ‘the duty to defend is then established, absent additional evidence *1781 bearing on the issue.’ (Ibid.) If the insurer, having defeated the insured’s motion for summary judgment, seeks to escape the defense duty altogether, it must present proof of the kind described in the preceding paragraph, i.e., evidence that the underlying claim cannot come within the

1995Co. v. Whitaker (1986) 181 Cal.App.3d 532, 537 [ 226 Cal.Rptr. 435 ], fn. omitted.) Because any damage to the fence could not have arisen from an accidental “occurrence” within the meaning of the insuring clause, any anticipated property damage claims arising from appellants’ act would not be covered under the terms of the Policy.

1995Co. v. Whitaker (1986) 181 Cal.App.3d 532, 537 [ 226 Cal.Rptr. 435 ], fn. omitted.) Because any damage to the fence could not have arisen from an accidental “occurrence” within the meaning of the insuring clause, any anticipated property damage claims arising from appellants’ act would not be covered under the terms of the Policy.

2014Co. (1994) 21 Cal.App.4th 787, 802-803 .) A court first " 'examine[s] the coverage provisions to determine whether a claim falls within the potential ambit of the insurance.' " (Id. at p. 803.) The burden is on "the insured to bring the claim within the basic scope of coverage, and . . . courts will not indulge in a forced construction of the policy's insuring clause to bring a claim within the policy's coverage." (Ibid.) "Once the insured has made that showing, the burden is on the insurer to prove the claim is specifically excluded." (MRI Healthcare Center of Glendale, Inc. v. State Farm Gen

2013Co. v. Superior Court (1988) 201 Cal.App.3d 1014, 1017 .) The burden is on “the insured to bring the claim within the basic scope of coverage, and . . . courts will not indulge in a forced construction of the policy’s insuring clause to bring a claim within the policy’s coverage.” ( Collin, supra, at p. 803 .) “Once the insured has made that showing, the burden is on the insurer to prove the claim is specifically excluded.” (MRI Healthcare Center of Glendale, Inc. v. State Farm General Ins.

2009Co. (1998) 18 Cal.4th 857, 869 [ 77 Cal.Rptr.2d 107 , 959 P.2d 265 ].) Accordingly, an insuring clause is interpreted broadly, and an exclusion from coverage otherwise within the scope of an insuring clause must be clear and unmistakable to be given effect. ( MacKinnon v. Truck Ins.

2009Co. (1998) 18 Cal.4th 857, 869 [ 77 Cal.Rptr.2d 107 , 959 P.2d 265 ].) Accordingly, an insuring clause is interpreted broadly, and an exclusion from coverage otherwise within the scope of an insuring clause must be clear and unmistakable to be given effect. ( MacKinnon v. Truck Ins.

2008Exchange (2002) 97 Cal.App.4th 704, 713 [ 118 Cal.Rptr.2d 561 ] (Tradewinds).) “The policy is written in two essential parts: the insuring agreement, which states the risk or risks covered by the policy, and the exclusion clauses, which remove coverage for risks that would otherwise fall within the insuring clause.” (Waller, at p. 16.) “[P]olicy exclusions are strictly construed [citations], while exceptions to exclusions are broadly construed in favor of the insured . . . .” (E.M.M.I.

2008Exchange (2002) 97 Cal.App.4th 704, 713 [ 118 Cal.Rptr.2d 561 ] (Tradewinds).) “The policy is written in two essential parts: the insuring agreement, which states the risk or risks covered by the policy, and the exclusion clauses, which remove coverage for risks that would otherwise fall within the insuring clause.” (Waller, at p. 16.) “[P]olicy exclusions are strictly construed [citations], while exceptions to exclusions are broadly construed in favor of the insured . . . .” (E.M.M.I.

2016Co. v. Superior Court (1988) 201 Cal.App.3d 1014, 1017 [ 247 Cal.Rptr. 638 ].) “[W]hen an occurrence is clearly not included within the coverage afforded by the insuring clause, it need not also be specifically excluded.” (Glavinich v. Commonwealth Land Title Ins.

2016Co. v. Superior Court (1988) 201 Cal.App.3d 1014, 1017 [ 247 Cal.Rptr. 638 ].) “[W]hen an occurrence is clearly not included within the coverage afforded by the insuring clause, it need not also be specifically excluded.” (Glavinich v. Commonwealth Land Title Ins.

2004Anyone using a vehicle without a reasonable belief that the person is entitled to do so.” Exclusion clauses “remove coverage for risks that would otherwise fall within the insuring clause. [Citation.]” ( Waller, supra, 11 Cal.4th. at p. 16.) “Before ‘even considering exclusions, a court must examine the coverage provisions to determine whether a claim falls within [the policy terms].’ [Citation.]” (Ibid.) “[Exclusionary clauses are interpreted narrowly, whereas clauses identifying coverage are interpreted broadly. [Citation.]” (Garvey v. State Farm Fire & Casualty Co. (1989) 48 Cal.3d 395, 406

2004Anyone using a vehicle without a reasonable belief that the person is entitled to do so.” Exclusion clauses “remove coverage for risks that would otherwise fall within the insuring clause. [Citation.]” ( Waller, supra, 11 Cal.4th. at p. 16.) “Before ‘even considering exclusions, a court must examine the coverage provisions to determine whether a claim falls within [the policy terms].’ [Citation.]” (Ibid.) “[Exclusionary clauses are interpreted narrowly, whereas clauses identifying coverage are interpreted broadly. [Citation.]” (Garvey v. State Farm Fire & Casualty Co. (1989) 48 Cal.3d 395, 406

2017Co. (1997) 53 Cal.App.4th 250, 255 [ 61 Cal.Rptr.2d 442 ].) The parties disagree about whether the nonowned auto provision is part of the GEICO policy’s insuring clause defining the coverage or is an exclusion clause.

2017Co. (1997) 53 Cal.App.4th 250, 255 [ 61 Cal.Rptr.2d 442 ].) The parties disagree about whether the nonowned auto provision is part of the GEICO policy’s insuring clause defining the coverage or is an exclusion clause.

2014Co. (1961) 190 Cal.App.2d 226, 230 ; see Croskey, Heeseman & 11 Johnson, Cal. Practice Guide: Insurance Litigation (The Rutter Group 2013), ¶ 7:2370, p. 7J-27 [the care, custody or control exclusion “precludes coverage for property held by the insured under bailment”]; see also Meyer Koulish Co. v. Cannon (1963) 213 Cal.App.2d 419, 427 [describing a bailment as “‘a delivery of personalty for some particular purpose, or on mere deposit, upon a contract, express or implied, that after the purpose has been fulfilled it shall be redelivered to the person who delivered it, or otherwise dealt with a

2014Co. (1961) 190 Cal.App.2d 226, 230 ; see Croskey, Heeseman & 11 Johnson, Cal. Practice Guide: Insurance Litigation (The Rutter Group 2013), ¶ 7:2370, p. 7J-27 [the care, custody or control exclusion “precludes coverage for property held by the insured under bailment”]; see also Meyer Koulish Co. v. Cannon (1963) 213 Cal.App.2d 419, 427 [describing a bailment as “‘a delivery of personalty for some particular purpose, or on mere deposit, upon a contract, express or implied, that after the purpose has been fulfilled it shall be redelivered to the person who delivered it, or otherwise dealt with a

2009It argued that there was no coverage under the insuring clause in the Cargo Coverage Form because there was no court judgment holding Superior liable to a third party for damages, citing Certain Underwriters at Lloyd's of London v. Superior Court (2001) 24 Cal.4th 945 [ 103 Cal.Rptr.2d 672 , 16 P.3d 94 ] ( Powerine I ) and San Diego Housing Com. v. Industrial Indemnity Co. (1998) 68 Cal.App.4th 526 [ 80 Cal.Rptr.2d 393 ] ( San Diego Housing ).

2009It argued that there was no coverage under the insuring clause in the Cargo Coverage Form because there was no court judgment holding Superior liable to a third party for damages, citing Certain Underwriters at Lloyd's of London v. Superior Court (2001) 24 Cal.4th 945 [ 103 Cal.Rptr.2d 672 , 16 P.3d 94 ] ( Powerine I ) and San Diego Housing Com. v. Industrial Indemnity Co. (1998) 68 Cal.App.4th 526 [ 80 Cal.Rptr.2d 393 ] ( San Diego Housing ).

2017Co. v. Superior Court (1990) 51 Cal.3d 807 , 826, 274 Cal.Rptr. 820 , 799 P.2d 1253 ( AIU ); Powerine Oil Co., Inc. v. Superior Court (2005) 37 Cal.4th 377 , 385, 396-397, 33 Cal.Rptr.3d 562 , 118 P.3d 589 ["damages" in an insuring clause covers court-awarded "direct and consequential damages"].) Here, the 131 days of remediation was time Kadena could have spent completing the project had the units' interiors not been damaged.

2017Co. v. Superior Court (1990) 51 Cal.3d 807 , 826, 274 Cal.Rptr. 820 , 799 P.2d 1253 ( AIU ); Powerine Oil Co., Inc. v. Superior Court (2005) 37 Cal.4th 377 , 385, 396-397, 33 Cal.Rptr.3d 562 , 118 P.3d 589 ["damages" in an insuring clause covers court-awarded "direct and consequential damages"].) Here, the 131 days of remediation was time Kadena could have spent completing the project had the units' interiors not been damaged.

2013(Montrose Chemical Corp. v. Superior Court (1993) 6 Cal.4th 287, 299-300 [ 24 Cal.Rptr.2d 467 , 861 P.2d 1153 ].) Though the insurer’s duty to defend is broad, it “is not absolute but is measured by the nature and kinds of risks covered by the policy.” (Rosen, supra, 56 Cal.App.4th at p. 1497 .) Insurance policies contain two parts, the insuring clause defining the type of risks covered, and the exclusions, which *77 remove coverage for certain risks initially within the insuring clause.

2005Co. (1997) 56 Cal.App.4th 1489, 1497 , 66 Cal.Rptr.2d 714 .) Nothing in the "limits of liability" provision of the Ace policy purports to expand Ace's indemnification obligation, once triggered, to anything other than "damages." These two distinctions were not lost on the Court of Appeal below, which court, in the course of rejecting the County's argument for an expansive construction of indemnity coverage under the Ace policy, distinguished the policy language in Powerine II when observing, "In contrast to Powerine II, the Ace policy's insuring clause does not include the term `expenses' to b

1992No duty to defend arose unless the third party claim involved an "occurrence" neither expected nor intended from the standpoint of the insured. ( Giddings v. Industrial Indemnity Co., supra, 112 Cal. App.3d 213, 219 ; Economy Lumber Co. v. Insurance Co. of North America (1984) 157 Cal. App.3d 641, 647-648 [ 204 Cal. Rptr. 135 ].) Since the Fireman's Fund complaint was predicated on the allegation that Hurley conspired to engage in fraudulent billing practices, none of the damages asserted arose from an accidental "occurrence" within the meaning of the insuring clause.

1992(Giddings v. Industrial Indemnity Co., supra, 112 Cal.App.3d 213, 219 ; Economy Lumber Co. v. Insurance Co. of North America (1984) 157 Cal.App.3d 641, 647-648 [ 204 Cal.Rptr. 135 ].) Since the Fireman’s Fund complaint was predicated on the allegation that Hurley conspired to engage in fraudulent billing practices, none of the damages asserted arose from an accidental “occurrence” within the meaning of the insuring clause.

2025THE EXCLUSION WAS NOT AMBIGUOUS, AND IS NOT CONTRARY TO PUBLIC POLICY “An exclusionary clause ‘must be conspicuous, plain and clear.’ (Steven v. Fidelity & Casualty Co. (1962) 58 Cal.2d 862, 878 , italics added.) ‘A conspicuous, unambiguous applicable exclusion will override the insuring clause and eliminate coverage the policy might otherwise afford. [Citation.]’ (American Star Ins.

2025THE EXCLUSION WAS NOT AMBIGUOUS, AND IS NOT CONTRARY TO PUBLIC POLICY “An exclusionary clause ‘must be conspicuous, plain and clear.’ (Steven v. Fidelity & Casualty Co. (1962) 58 Cal.2d 862, 878 , italics added.) ‘A conspicuous, unambiguous applicable exclusion will override the insuring clause and eliminate coverage the policy might otherwise afford. [Citation.]’ (American Star Ins.

2009The insurance company in Gray contended that it was not obligated to defend its insured against a claim of assault because the policy excluded coverage for “ ‘bodily injury or property damages caused intentionally by or at the direction of the insured.’ ” (Gray, supra, 65 Cal.2d at p. 267 .) “ ‘[Although exclusions are construed narrowly and must be proven by the insurer, the burden is on the insured to bring the claim within the basic scope of coverage, and (unlike exclusions) courts will not indulge in a forced construction of the policy’s insuring clause to bring a claim within the policy’s

1985Co. (1980) 100 Cal.App.3d 739, 752 [ 161 Cal.Rptr. 322 ]), or in a section labeled “ ‘General Limitations’ ” but in a “ ‘dense pack’ ” format (Ponder v. Blue Cross of Southern California (1983) 145 Cal.App.3d 709, 722 [ 193 Cal.Rptr. 632 ]), or hidden in a subsequent section of the policy bearing no clear relationship to the insuring clause and concealed in fine print (Gray v. Zurich Insurance Co., supra, 65 Cal.2d at p. 273 ).

2007Co. v. Superior Court (1998) 66 Cal.App.4th 128, 144 [ 77 Cal.Rptr.2d 642 ], disapproved on other grounds in Vandenberg v. Superior Court (1999) 21 Cal.4th 815 [ 88 Cal.Rptr.2d 366 , 982 P.2d 229 ].) If we analyze the Essex policy in this manner, the Essex policy covered the Navarro lawsuit.

2007Co. v. Superior Court (1998) 66 Cal.App.4th 128, 144 [ 77 Cal.Rptr.2d 642 ], disapproved on other grounds in Vandenberg v. Superior Court (1999) 21 Cal.4th 815 [ 88 Cal.Rptr.2d 366 , 982 P.2d 229 ].) If we analyze the Essex policy in this manner, the Essex policy covered the Navarro lawsuit.

2024(Ibid. [cleaned up].) The “ ‘language in a contract must be construed in the context of that instrument as a whole, and in the circumstances of that case, and cannot be found to be ambiguous in the abstract.’ ” (Bank of the West, supra, 2 Cal.4th at p. 1265 , italics omitted.) “The insured has the initial burden of showing that a claim falls within the scope of coverage, and a court will not indulge in a forced construction of the policy’s insuring clause to bring a claim within the policy’s coverage.” (Dua, supra, 91 Cal.App.5th at p. 136 [cleaned up].) “But the burden is on the insurer to sh

2010Co. v. Superior Court (1990) 51 Cal.3d 807, 822 [ 274 Cal.Rptr. 820 , 799 P.2d 1253 ].) If the policy language “is clear and explicit, it governs.” (Bank of the West v. Superior Court (1992) 2 Cal.4th 1254, 1264 [ 10 Cal.Rptr.2d 538 , 833 P.2d 545 ].) When an issue of coverage exists, the burden is on the insured to prove facts establishing that the claimed loss falls within the coverage provided by the policy’s insuring clause.

2022Accordingly, Division One of this district held, in rejecting the insured’s claim for losses incurred as a result of its pandemic-related business closure, “even assuming Musso & Frank could bring itself within the insuring clause, the virus exclusion would bar coverage.” (Id. at p. 761; accord, Mudpie, supra, 15 F.4th at p. 893 [the policy’s virus exclusion, which provided, “[Travelers] will not pay for loss or damage 25 caused by or resulting from any virus, bacterium or other microorganism that induces or is capable of inducing physical distress, illness or disease,” bars coverage for Mudpi

2022“Where, as here, a policy covers ‘direct physical loss of or damage to’ property, the ‘direct physical loss requirement is part of the policy’s insuring clause and accordingly falls within [the insured’s] burden of proof.’ ” (Mudpie, supra, 15 F.4th at p. 890 , citing MRI Healthcare Center of Glendale, Inc. v. State Farm General Ins.

2014No duty to defend arose unless the third party claim involved an ‘occurrence’ neither expected nor intended from the standpoint of the insured. [Citations.] Since the [underlying] complaint was predicated on the allegation that [the insured] conspired to engage in fraudulent billing practices, none of the damages asserted arose from an accidental ‘occurrence’ within the meaning of the insuring clause. ‘An intentional act is not an “accident” within the plain meaning of the word. [Citations.]’ [Citation.] Any insured who participates in a conspiracy to defraud, as here alleged, cannot reasonabl

2014No duty to defend arose unless the third party claim involved an ‘occurrence’ neither expected nor intended from the standpoint of the insured. [Citations.] Since the [underlying] complaint was predicated on the allegation that [the insured] conspired to engage in fraudulent billing practices, none of the damages asserted arose from an accidental ‘occurrence’ within the meaning of the insuring clause. ‘An intentional act is not an “accident” within the plain meaning of the word. [Citations.]’ [Citation.] Any insured who participates in a conspiracy to defraud, as here alleged, cannot reasonabl