coverage clause in California

2025Corp. v. Ledesma & Meyer Construction Co. (2018) 5 Cal.5th 216, 221 (Liberty Surplus), quoting Delgado v. Interinsurance Exchange of Automobile Club of Southern California (2009) 47 Cal.4th 302, 308 (Delgado).) “ ‘[T]he word “accident” in the coverage clause of a liability policy refers to the conduct of the insured for which liability is sought to be imposed.’ ” (Liberty Surplus, supra, 5 Cal.5th at p. 221 .) “When an insured intends the acts resulting in the injury or damage, it is not an accident ‘merely because the insured did not intend to cause injury. . . .

2025Although not defined in the policies, “the meaning of the term ‘accident’ in a liability insurance policy is settled in California.” (Ledesma, supra, 5 Cal.5th at p. 221 .) “ ‘[A]n accident is “ ‘an unexpected, unforeseen, or undesigned happening or consequence from either a known or an unknown cause.’ ” ’ ” (Ibid., quoting Delgado v. Interinsurance Exchange of Automobile Club of Southern California (2009) 47 Cal.4th 302 , 15 308 (Delgado).) In the coverage clause of a liability policy, the word “ ‘ “[a]ccident” . . . refers to the conduct of the insured for which liability is sought to be imp

2024Under the genuine dispute rule, “ ‘an 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.’ [Citation.]” (Wilson, supra, 42 Cal.4th at p. 723 .) However, “[t]he genuine dispute rule does not relieve an insurer from its obligation to thoroughly and fairly investigate, process and evaluate the insured’s claim.

2023The insurer may not just focus on those facts which justify denial of the claim.’ ” ( Wilson, supra, 42 Cal.4th at pp. 720-721.) “[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 Assn. v. Associated Internat.

2007Under these facts the damages to Vanida are, under the language of the homeowner's coverage clause, `sums which the Insured ... (became) legally obligated to pay" because of the negligent filing of the trigger mechanism...." ( Partridge, supra, 10 Cal.3d at p. 103 , 109 Cal.Rptr. 811 , 514 P.2d 123 .) Thus, the Partridge court interpreted the phrase "all sums which the Insured shall become legally obligated to pay as damages" to mean all amounts for which the insured would be held liable in a tort action.

2007Under these facts the damages to Vanida are, under the language of the homeowner's coverage clause, `sums which the Insured ... (became) legally obligated to pay" because of the negligent filing of the trigger mechanism...." ( Partridge, supra, 10 Cal.3d at p. 103 , 109 Cal.Rptr. 811 , 514 P.2d 123 .) Thus, the Partridge court interpreted the phrase "all sums which the Insured shall become legally obligated to pay as damages" to mean all amounts for which the insured would be held liable in a tort action.

2020Co. (2001) 90 Cal.App.4th 335, 347 [(Chateau Chamberay)].) This ‘genuine dispute’ or ‘genuine issue’ rule was originally invoked in cases involving disputes over policy interpretation, but in recent years courts have applied it to factual disputes as well. [Citations.] “The genuine dispute rule does not relieve an insurer from its obligation to thoroughly and fairly investigate, process and evaluate the insured’s claim.

2008Exchange (1986) 42 Cal.3d 208, 214-215 [ 228 Cal.Rptr. 160 , 721 P.2d 41 ].) “As a close corollary of that principle, it has been said that ‘an 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.’ ” (Wilson, at p. 723, quoting Chateau Chamberay, supra, 90 Cal.App.4th at p. 347 .) Relying on Chateau Chamberay , the trial court accepted 21st Century’s argument tha

2025Co. (2009) 180 Cal.App.4th 1319, 1327 [“If the language of the policy is not ambiguous, then the coverage inquiry ends, and the court determines coverage by applying the plain meaning of the unambiguous provisions of the policy.”].) However, “ ‘[e]ven if a contract appears unambiguous on its face, a latent ambiguity may be exposed by extrinsic evidence which reveals more than one possible meaning to which the language of the contract is yet reasonably susceptible.’ ” (Dore, supra, 39 Cal.4th at p. 391 .) “ ‘The test of admissibility of extrinsic evidence to explain the meaning of a written ins

2000Thus, the injury did not “aris[e] out of . . . infringement of title [of literary or artistic works] or slogan” (the coverage clause); rather, the claims are within the trademark exclusion, because the injury “ar[ose] out of . . . infringement of trademark . . . other than titles [of literary or artistic works] or slogans.” Appellants contend, however, that they also recovered in the federal action for unfair competition in relation to their trade dress and that this claim is covered by the portion of the Canadian policy defining “advertising injury” as “injury arising out of . . . unfair comp

2025Co. (2009) 180 Cal.App.4th 1319, 1327 [“If the language of the policy is not ambiguous, then the coverage inquiry ends, and the court determines coverage by applying the plain meaning of the unambiguous provisions of the policy.”].) However, “ ‘[e]ven if a contract appears unambiguous on its face, a latent ambiguity may be exposed by extrinsic evidence which reveals more than one possible meaning to which the language of the contract is yet reasonably susceptible.’ ” (Dore, supra, 39 Cal.4th at p. 391 .) “ ‘The test of admissibility of extrinsic evidence to explain the meaning of a written ins

2025Co. (2009) 180 Cal.App.4th 1319, 1327 [“If the language of the policy is not ambiguous, then the coverage inquiry ends, and the court determines coverage by applying the plain meaning of the unambiguous provisions of the policy.”].) However, “ ‘[e]ven if a contract appears unambiguous on its face, a latent ambiguity may be exposed by extrinsic evidence which reveals more than one possible meaning to which the language of the contract is yet reasonably susceptible.’ ” (Dore, supra, 39 Cal.4th at p. 391 .) “ ‘The test of admissibility of extrinsic evidence to explain the meaning of a written ins

1990Co. v. TAC Exterminators, Inc. (1985) 172 Cal.App.3d 564, 579 [ 218 Cal.Rptr. 407 ]) particularly where, as here, the basic insuring language purports to include nonowned automobiles generally.

1987Co. v. TAC Exterminators, Inc., supra, 172 Cal.App.3d at p. 577 ) and that general coverage clauses are interpreted broadly to afford the greatest possible protection to the insured (ibid.), a coverage clause cannot be analyzed in a vacuum. “ ‘An insurance policy, like any other contract, must be construed in its entirety, with each clause lending meaning to the other.’ [Citations.]” (Producers Dairy Delivery Co. v. Sentry Ins.

2015Co. v. Whitaker (1986) 181 Cal.App.3d 532, 537 , fn. omitted [ 226 Cal.Rptr. 435 ].) “In the context of liability insurance, an accident is ‘ “an unexpected, unforeseen, or undesigned happening or consequence from either a known or an unknown cause.” ’ [Citation.]” (Delgado, at p. 308.) The term “accident” refers to the nature of the insured’s conduct, and not to its unintended consequences.

2015Co. v. Whitaker (1986) 181 Cal.App.3d 532, 537 , fn. omitted [ 226 Cal.Rptr. 435 ].) “In the context of liability insurance, an accident is ‘ “an unexpected, unforeseen, or undesigned happening or consequence from either a known or an unknown cause.” ’ [Citation.]” (Delgado, at p. 308.) The term “accident” refers to the nature of the insured’s conduct, and not to its unintended consequences.

2025Corp. v. Ledesma & Meyer Construction Co. (2018) 5 Cal.5th 216, 221 (Liberty Surplus), quoting Delgado v. Interinsurance Exchange of Automobile Club of Southern California (2009) 47 Cal.4th 302, 308 (Delgado).) “ ‘[T]he word “accident” in the coverage clause of a liability policy refers to the conduct of the insured for which liability is sought to be imposed.’ ” (Liberty Surplus, supra, 5 Cal.5th at p. 221 .) “When an insured intends the acts resulting in the injury or damage, it is not an accident ‘merely because the insured did not intend to cause injury. . . .

2025Although not defined in the policies, “the meaning of the term ‘accident’ in a liability insurance policy is settled in California.” (Ledesma, supra, 5 Cal.5th at p. 221 .) “ ‘[A]n accident is “ ‘an unexpected, unforeseen, or undesigned happening or consequence from either a known or an unknown cause.’ ” ’ ” (Ibid., quoting Delgado v. Interinsurance Exchange of Automobile Club of Southern California (2009) 47 Cal.4th 302 , 15 308 (Delgado).) In the coverage clause of a liability policy, the word “ ‘ “[a]ccident” . . . refers to the conduct of the insured for which liability is sought to be imp

2018Co . (1973) 9 Cal.3d 566 , 573-574, 108 Cal.Rptr. 480 , 510 P.2d 1032 , italics omitted.) In the context of a bad faith claim, "an insurer's denial of or delay in paying benefits gives rise to tort damages only if the insured shows the denial or delay was unreasonable." ( Wilson , supra , 42 Cal.4th at p. 723 , 68 Cal.Rptr.3d 746 , 171 P.3d 1082 .) Under this standard, "an 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 b

2018Co . (1973) 9 Cal.3d 566 , 573-574, 108 Cal.Rptr. 480 , 510 P.2d 1032 , italics omitted.) In the context of a bad faith claim, "an insurer's denial of or delay in paying benefits gives rise to tort damages only if the insured shows the denial or delay was unreasonable." ( Wilson , supra , 42 Cal.4th at p. 723 , 68 Cal.Rptr.3d 746 , 171 P.3d 1082 .) Under this standard, "an 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 b

2013An “exception to a policy exclusion does not create coverage not otherwise available under the coverage clause.” (Hurley Construction Co. v. State Farm Fire & Casualty Company Co. (1992) 10 Cal.App.4th 533, 540 .) 7 Here, Mr. Cancimilla’s conduct of beating and injuring Mr. Noll in the men’s room of the bar was not an “accident” within the meaning of the Mercury Insurance Policy, regardless of his mistaken belief in the need for self-defense, or the fact that he did not intend to harm Mr. Noll.

1998“Ordinarily, an exception to a policy exclusion does not create coverage not otherwise available under the coverage clause.” (Hurley Construction Co. v. State Farm Fire & Casualty Co. (1992) 10 Cal.App.4th 533, 540 [ 12 Cal.Rptr.2d 629 ]; St.

2017Co. v. Moorefield Construction, Inc. (2016) 6 Cal.App.5th 1258 , 1275, 212 Cal.Rptr.3d 231 ( Navigators ).) In Navigators , the insured, a general contractor, made the deliberate decision to have flooring tiles installed in a building despite knowing that the concrete slab on which the tiles were to be installed emitted moisture vapor in excess of specifications. ( *1039 Navigators, supra , 6 Cal.App.5th at pp. 1262, 1266-1268, 212 Cal.Rptr.3d 231 .) The insured knew the excess moisture vapor could cause the flooring tiles to fail, but believed there was low to no risk of that happening. ( Id.

2017Co. v. Moorefield Construction, Inc. (2016) 6 Cal.App.5th 1258 , 1275, 212 Cal.Rptr.3d 231 ( Navigators ).) In Navigators , the insured, a general contractor, made the deliberate decision to have flooring tiles installed in a building despite knowing that the concrete slab on which the tiles were to be installed emitted moisture vapor in excess of specifications. ( *1039 Navigators, supra , 6 Cal.App.5th at pp. 1262, 1266-1268, 212 Cal.Rptr.3d 231 .) The insured knew the excess moisture vapor could cause the flooring tiles to fail, but believed there was low to no risk of that happening. ( Id.

2008Co. (2000) 81 Cal.App.4th 1282, 1293 [ 97 Cal.Rptr.2d 386 ] [“[w]here the parties rely on expert opinions, even a substantial disparity in estimates [of the value of the insured’s claim] does not, by itself, suggest the insurer acted in bad faith”]); and, then, by emphasizing its settlement offer of $5,000 plus the remaining sum available under the medical payment limits, together with the $10,000 Brehm received from Aguirre’s carrier, would have given Brehm essentially the sum his expert had opined was needed for shoulder surgery and postoperation physiotherapy ($19,175).

2008Co. (2000) 81 Cal.App.4th 1282, 1293 [ 97 Cal.Rptr.2d 386 ] [“[w]here the parties rely on expert opinions, even a substantial disparity in estimates [of the value of the insured’s claim] does not, by itself, suggest the insurer acted in bad faith”]); and, then, by emphasizing its settlement offer of $5,000 plus the remaining sum available under the medical payment limits, together with the $10,000 Brehm received from Aguirre’s carrier, would have given Brehm essentially the sum his expert had opined was needed for shoulder surgery and postoperation physiotherapy ($19,175).

2008Exchange (1986) 42 Cal.3d 208, 214-215 [ 228 Cal.Rptr. 160 , 721 P.2d 41 ].) “As a close corollary of that principle, it has been said that ‘an 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.’ ” (Wilson, at p. 723, quoting Chateau Chamberay, supra, 90 Cal.App.4th at p. 347 .) Relying on Chateau Chamberay , the trial court accepted 21st Century’s argument tha

2008Exchange (1986) 42 Cal.3d 208, 214-215 [ 228 Cal.Rptr. 160 , 721 P.2d 41 ].) “As a close corollary of that principle, it has been said that ‘an 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.’ ” (Wilson, at p. 723, quoting Chateau Chamberay, supra, 90 Cal.App.4th at p. 347 .) Relying on Chateau Chamberay , the trial court accepted 21st Century’s argument tha

2006It states: “The company will pay . . . the ultimate net loss . . . which the insured shall become legally obligated to pay . . . as damages.” (Cf. Powerine I, supra, 24 Cal.4th at p. 961 [“In its language, especially ‘damages,’ the provision imposing the duty to indemnify is clear in its limitation to money ordered by a court”].) We disagree with plaintiffs that the phrase “ultimate net loss” in the coverage clause expands the definition of damages when the ultimate-net-loss definition clause is taken into consideration.

2006Indeed, we did not even consider the issue.” (Powerine I, supra, 24 Cal.4th at p. 966 .) We decline to consider whether the coverage clause might be construed in the way plaintiffs urge when the loss-payable clause is taken into consideration.

2003Noting that its task was not merely to construe the word collapse in isolation, but rather to construe the total coverage clause, the Court of Appeal held that the coverage clause before it "cannot be said to be clear, explicit, and unambiguous, and thus must be interpreted to protect the objectively reasonable expectations of the insured. [Citation.]" ( Doheny West, supra, 60 Cal. App.4th at p. 405 , 70 Cal.Rptr.2d 260 .) With these principles in mind, the Court of Appeal stated: "It is undisputed that the clause covers `collapse of a building,' that is, that there is coverage if a building f

2003Noting that its task was not merely to construe the word collapse in isolation, but rather to construe the total coverage clause, the Court of Appeal held that the coverage clause before it "cannot be said to be clear, explicit, and unambiguous, and thus must be interpreted to protect the objectively reasonable expectations of the insured. [Citation.]" ( Doheny West, supra, 60 Cal. App.4th at p. 405 , 70 Cal.Rptr.2d 260 .) With these principles in mind, the Court of Appeal stated: "It is undisputed that the clause covers `collapse of a building,' that is, that there is coverage if a building f

2001Co., supra, 25 Cal.App.4th at p. 1281.) It is now settled law in California that an 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.

2001Co., supra, 25 Cal.App.4th at p. 1281 , 31 Cal.Rptr.2d 433 .) It is now settled law in California that an 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. ( Fraley v. Allstate Ins.