reimbursement claim (California) · Go Syfert
← California issues

reimbursement claim in California

53 California opinions name it 4 courts 1970–2026 13 in the last five years

The cases below were cited by California courts in a sentence that names this issue. Sides come from how each citing opinion treated the case (Syfertize flag on that citation), so a case can appear on both: that is where the law is contested. A red or yellow chip is the case's own overall treatment.

Followed or applied (29)

CaseFollowedCited
California School Boards Ass'n v. Stategreen
calctapp · 2011 · cited in 2 California opinions naming this issue, 2018–2018
2 sentences

2018Assn. v. State of California (2011) 192 Cal.App.4th 770, 798 (CSBA II).) B.

2018Assn. v. State of California (2011) 192 Cal.App.4th 770, 798 (CSBA II).) B.

22
California Insurance Guarantee Ass'n v. Workers' Compensation Appeals Boardgreen
calctapp · 2005 · cited in 2 California opinions naming this issue, 2007–2007
2 sentences

2007(Hooten, supra, 128 Cal.App.4th at p. 572.) The WCJ stated that Insurance Code section 1063.1, subdivision (c)(5) concerned contribution by a solvent insurance carrier in a single case arising out of a single incident, and section 1063.1, subdivision (c)(9) only concerns a person, not some other entity.

2007(Hooten, supra, 128 Cal.App.4th at p. 572, 27 Cal.Rptr.3d 205 .) The WCJ stated that Insurance Code section 1063.1, subdivision (c)(5) concerned contribution by a solvent insurance carrier in a single case arising out of a single incident, and section 1063.1, subdivision (c)(9) only concerns a person, not some other entity.

22
Buss v. Superior Courtgreen
cal · 1997 · cited in 2 California opinions naming this issue, 1998–1998
2 sentences

1998The court stated, "If the reservation of rights agreement contains a reimbursement clause, the carrier retains its right to seek reimbursement for payments expended if noncoverage is ultimately proven." ( Id. at p. 994, 59 Cal.Rptr.2d 529 ; see Buss v. Superior Court, supra, 16 Cal.4th at p. 61, fn. 27 , 65 Cal.Rptr.2d 366 , 939 P.2d 766 [insurer may unilaterally reserve its right to seek reimbursement of defense costs from the insured]; Frank and Freedus v. Allstate Ins.

1998The court stated, "If the reservation of rights agreement contains a reimbursement clause, the carrier retains its right to seek reimbursement for payments expended if noncoverage is ultimately proven." ( Id. at p. 994, 59 Cal.Rptr.2d 529 ; see Buss v. Superior Court, supra, 16 Cal.4th at p. 61, fn. 27 , 65 Cal.Rptr.2d 366 , 939 P.2d 766 [insurer may unilaterally reserve its right to seek reimbursement of defense costs from the insured]; Frank and Freedus v. Allstate Ins.

22
Block v. California Physicians' Servicegreen
calctapp · 1966 · cited in 2 California opinions naming this issue, 1984–1984
2 sentences

1984At pages 465-466, the court states: “As argued by plaintiffs, it is well established in California that an assignment of a cause of action for personal injuries is void and in the absence of statutory authority, a cause of action for personal injury is not subject to subrogation. {Block v. Cal. Physicians’ Service (1966) 244 Cal.App.2d 266, 270 [ 53 Cal.Rptr. 51 ].) However, the court in Block stated, at page 273: ‘By becoming a member of the plan under a Group Health Service agreement plaintiff has voluntarily associated himself with the public policy of this state.

1984At pages 465-466, the court states: “As argued by plaintiffs, it is well established in California that an assignment of a cause of action for personal injuries is void and in the absence of statutory authority, a cause of action for personal injury is not subject to subrogation. {Block v. Cal. Physicians’ Service (1966) 244 Cal.App.2d 266, 270 [ 53 Cal.Rptr. 51 ].) However, the court in Block stated, at page 273: ‘By becoming a member of the plan under a Group Health Service agreement plaintiff has voluntarily associated himself with the public policy of this state.

22
San Diego Unified School District v. Commision on State Mandatesgreen
cal · 2004 · cited in 2 California opinions naming this issue, 2022–2023
2 sentences

2023Code, § 17551.)” (San Diego Unified School Dist. v. Commission on State Mandates (2004) 33 Cal.4th 859, 872 (SDUSD).) An initial reimbursement claim filed by a local government or school district is known as a test claim.

2022(See id. at p. 742 [“activities undertaken at the option or discretion of a local government entity . . . do not trigger a state mandate and hence do not require reimbursement of funds — even if the local entity is obliged to incur costs as a result of its discretionary decision to participate in a particular program or practice”]; but see San Diego Unified School Dist. v. Commission on State Mandates (2004) 33 Cal.4th 859, 887 [declining to adopt a bright-line rule precluding reimbursement “whenever an entity makes an initial discretionary decision that in turn triggers mandated costs”].) Ker

12
Swan Magnetics, Inc. v. Superior Court of Santa Clara Countygreen
calctapp · 1997 · cited in 2 California opinions naming this issue, 1998–1998
2 sentences

1998The phrase “subject to” means “subordinate to.” (See Swan Magnetics, Inc. v. Superior Court (1997) 56 Cal.App.4th 1504, 1510 [ 66 Cal.Rptr.2d 541 ].) “Subordinate” means “inferior in order, nature, dignity, power, importance, or the like . . . .” (Black’s Law Dict. (6th ed. 1990) p. 1426, col. 1.) On its face, subdivision (b) of section 3860 gives the employer’s reimbursement claim priority, after payment of litigation costs and attorney fees where appropriate.

1998The phrase “subject to” means “subordinate to.” (See Swan Magnetics, Inc. v. Superior Court (1997) 56 Cal.App.4th 1504, 1510 [ 66 Cal.Rptr.2d 541 ].) “Subordinate” means “inferior in order, nature, dignity, power, importance, or the like . . . .” (Black’s Law Dict. (6th ed. 1990) p. 1426, col. 1.) On its face, subdivision (b) of section 3860 gives the employer’s reimbursement claim priority, after payment of litigation costs and attorney fees where appropriate.

12
Frank and Freedus v. Allstate Ins. Co.green
calctapp · 1996 · cited in 2 California opinions naming this issue, 1998–1998
2 sentences

1998Co. (1996) 45 Cal.App.4th 461, 474 , 52 Cal.Rptr.2d 678 ["The law permits an insurance company to condition an acceptance of defense on a later right to contest coverage or to seek reimbursement of defense costs" (italics added)]; see generally Vol's Painting & Drywall, Inc. v. Allstate Ins.

1998Co. (1996) 45 Cal.App.4th 461, 474 , 52 Cal.Rptr.2d 678 ["The law permits an insurance company to condition an acceptance of defense on a later right to contest coverage or to seek reimbursement of defense costs" (italics added)]; see generally Vol's Painting & Drywall, Inc. v. Allstate Ins.

12
In Re Marriage of Mixgreen
cal · 1975 · cited in 1 California opinions naming this issue, 2023–2023
1 sentence

2023(In re Marriage of Mix (1975) 14 Cal.3d 604, 614 (Mix).) Analyzing the payments, accountant Yip testified at trial “that the total of $114,952 is Dr. Yang’s separate property income” but went to Jacqueline’s separate property account, giving rise to a reimbursement claim.

11
Tristani Ex Rel. Karnes v. Richmangreen
ca3 · 2011 · cited in 1 California opinions naming this issue, 2021–2021
2 sentences

2021Instead, the statute simply requires states to consider any known third-party liability as an asset of the individual in determining eligibility, and to seek reimbursement when liability is discovered after medical assistance payments have been made.” (Id. at p. 373.) The court turned finally to the assignment clause, which requires beneficiaries “to assign the State any rights, of the individual or of any other person who is eligible for medical assistance under this title and on whose behalf the individual has the legal authority to execute an assignment of such rights, . . . to payment for

2021The dissent noted that the reimbursement clause requires states to take all reasonable measures to collect sufficient information to enable the state “to ascertain the legal liability of third parties,” and further to submit a plan for “pursuing claims against such third parties.” (Tristani, supra, 652 F.3d at p. 379 (dis. opn. of Pollak, J.).) The statute also requires beneficiaries to “assist the State in pursuing . . . any third party who may be liable to pay for care and services available under the plan.” (Id. at p. 380.) These provisions, the dissent said, envision “an active role in lit

11
Marine Forests Society v. California Coastal Commissiongreen
cal · 2005 · cited in 1 California opinions naming this issue, 2019–2019
1 sentence

2019(See California Redevelopment Assn. v. Matosantos (2011) 53 Cal.4th 231, 254 [the Legislature “ ‘may exercise any and all legislative powers which are not expressly or by necessary implication denied to it by the Constitution’ ”]; Marine Forests Society v. California Coastal Com. (2005) 36 Cal.4th 1, 31 [the Legislature wields “plenary legislative authority except as specifically limited by the California Constitution”].) Contrary to what CSBA suggests, the appropriation of new funding is not the only means by which the Legislature may approach its reimbursement obligations under article XIII

11
California Redevelopment Ass'n v. Matosantosgreen
cal · 2011 · cited in 1 California opinions naming this issue, 2019–2019
1 sentence

2019(See California Redevelopment Assn. v. Matosantos (2011) 53 Cal.4th 231, 254 [the Legislature “ ‘may exercise any and all legislative powers which are not expressly or by necessary implication denied to it by the Constitution’ ”]; Marine Forests Society v. California Coastal Com. (2005) 36 Cal.4th 1, 31 [the Legislature wields “plenary legislative authority except as specifically limited by the California Constitution”].) Contrary to what CSBA suggests, the appropriation of new funding is not the only means by which the Legislature may approach its reimbursement obligations under article XIII

11
People v. Smithgreen
calctapp · 2000 · cited in 1 California opinions naming this issue, 2010–2010
11
San Diego County Department of Social Services v. Randgreen
calctapp · 1996 · cited in 1 California opinions naming this issue, 2010–2010
11
People v. Whisenandgreen
calctapp · 1995 · cited in 1 California opinions naming this issue, 2010–2010
11
Animal Legal Defense Fund v. Mendesgreen
calctapp · 2008 · cited in 1 California opinions naming this issue, 2008–2008
11
Hayes v. Commission on State Mandatesgreen
calctapp · 1992 · cited in 1 California opinions naming this issue, 2007–2007
11
Lucia Mar Unified School District v. Honiggreen
cal · 1988 · cited in 1 California opinions naming this issue, 2007–2007
11
County of Fresno v. State of Californiagreen
cal · 1991 · cited in 1 California opinions naming this issue, 2007–2007
11
Old Republic Insurance v. FSR Brokerage, Inc.green
calctapp · 2000 · cited in 1 California opinions naming this issue, 2000–2000
11
Stevens v. Drugggreen
mass · 1943 · cited in 1 California opinions naming this issue, 1999–1999
11
Herrick Corp. v. Canadian Ins. Co. of Cal.green
calctapp · 1994 · cited in 1 California opinions naming this issue, 1998–1998
11
In Re Marriage of Griffisgreen
calctapp · 1986 · cited in 1 California opinions naming this issue, 1995–1995
11
People v. Silverbrandgreen
calctapp · 1990 · cited in 1 California opinions naming this issue, 1992–1992
11
Dyna-Med, Inc. v. Fair Employment & Housing Commissionred
cal · 1987 · cited in 1 California opinions naming this issue, 1992–1992
11
Kramer v. Cedu Foundation, Inc.green
calctapp · 1979 · cited in 1 California opinions naming this issue, 1984–1984
11
Associated Constr. & Eng'g v. WORKERS'COMP. APP. BD.green
cal · 1978 · cited in 1 California opinions naming this issue, 1981–1981
11
Bennett v. Ungergreen
calctapp · 1969 · cited in 1 California opinions naming this issue, 1970–1970
11
Garrett v. Shenson Meat Co.green
calctapp · 1970 · cited in 1 California opinions naming this issue, 1970–1970
11
LaBorde v. McKesson & Robbins, Inc.green
calctapp · 1968 · cited in 1 California opinions naming this issue, 1970–1970
11

Distinguished, questioned or overruled (2)

CaseNegativeCited
San Diego Unified School District v. Commision on State Mandatesgreen
cal · 2004 · cited in 2 California opinions naming this issue, 2022–2023
2 sentences

2023Code, § 17551.)” (San Diego Unified School Dist. v. Commission on State Mandates (2004) 33 Cal.4th 859, 872 (SDUSD).) An initial reimbursement claim filed by a local government or school district is known as a test claim.

2022(See id. at p. 742 [“activities undertaken at the option or discretion of a local government entity . . . do not trigger a state mandate and hence do not require reimbursement of funds — even if the local entity is obliged to incur costs as a result of its discretionary decision to participate in a particular program or practice”]; but see San Diego Unified School Dist. v. Commission on State Mandates (2004) 33 Cal.4th 859, 887 [declining to adopt a bright-line rule precluding reimbursement “whenever an entity makes an initial discretionary decision that in turn triggers mandated costs”].) Ker

12
People v. McDowellgreen
calctapp · 1977 · cited in 1 California opinions naming this issue, 2010–2010
2 sentences

2010(People v. Smith (2000) 81 Cal.App.4th 630, 642 [ 96 Cal.Rptr.2d 856 ]; see, e.g., Conservatorship of Rand (1996) 49 Cal.App.4th 835, 842 [ 57 Cal.Rptr.2d 119 ] [bank account]; People v. Whisenand (1995) 37 Cal.App.4th 1383, 1394 [ 44 Cal.Rptr.2d 501 ] [real property]; but see People v. McDowell (1977) 74 Cal.App.3d 1, 4 [ 141 Cal.Rptr. 124 ] [possibility of a future insurance recovery cannot be considered].) Section 987.8, subdivision (a) (hereafter subdivision (a)), on which the trial court relied in denying a hearing on defendant’s ability to pay, addresses security for the reimbursement of

2010(People v. Smith (2000) 81 Cal.App.4th 630, 642 [ 96 Cal.Rptr.2d 856 ]; see, e.g., Conservatorship of Rand (1996) 49 Cal.App.4th 835, 842 [ 57 Cal.Rptr.2d 119 ] [bank account]; People v. Whisenand (1995) 37 Cal.App.4th 1383, 1394 [ 44 Cal.Rptr.2d 501 ] [real property]; but see People v. McDowell (1977) 74 Cal.App.3d 1, 4 [ 141 Cal.Rptr. 124 ] [possibility of a future insurance recovery cannot be considered].) Section 987.8, subdivision (a) (hereafter subdivision (a)), on which the trial court relied in denying a hearing on defendant’s ability to pay, addresses security for the reimbursement of

11

Also cited on this issue (43)

CaseCitedYears
Crawford v. Weather Shield Mfg., Inc. green
cal · 2008
2 sentences

2026(Crawford, supra, 44 Cal.4th at p. 564 ; see pt.

2026(Crawford, supra, 44 Cal.4th at p. 564 ; see pt.

22026–2026
Walrath v. Walrath green
calctapp · 1998
2 sentences

2021(Walrath, supra, 17 Cal.4th at p. 920 .) Similarly, the fact that separate and community property interests have been commingled in an asset does not defeat a reimbursement claim, if the separate property interest “can be traced to its separate property source.” (Cochran, supra, 87 Cal.App.4th at p. 1057 .) We understand the trial court’s statement that Duerkson “did not adequately unravel” the separate and community property interests in Windsor Way to be a factual finding that Husband did not 16 adequately trace his separate property contributions from Cebolla and Kazan to Windsor Way.

2021(Walrath, supra, 17 Cal.4th at p. 920 .) Similarly, the fact that separate and community property interests have been commingled in an asset does not defeat a reimbursement claim, if the separate property interest “can be traced to its separate property source.” (Cochran, supra, 87 Cal.App.4th at p. 1057 .) We understand the trial court’s statement that Duerkson “did not adequately unravel” the separate and community property interests in Windsor Way to be a factual finding that Husband did not 16 adequately trace his separate property contributions from Cebolla and Kazan to Windsor Way.

22021–2021
Lucy v. Cochran green
calctapp · 2001
2 sentences

2021(Walrath, supra, 17 Cal.4th at p. 920 .) Similarly, the fact that separate and community property interests have been commingled in an asset does not defeat a reimbursement claim, if the separate property interest “can be traced to its separate property source.” (Cochran, supra, 87 Cal.App.4th at p. 1057 .) We understand the trial court’s statement that Duerkson “did not adequately unravel” the separate and community property interests in Windsor Way to be a factual finding that Husband did not 16 adequately trace his separate property contributions from Cebolla and Kazan to Windsor Way.

2021(Walrath, supra, 17 Cal.4th at p. 920 .) Similarly, the fact that separate and community property interests have been commingled in an asset does not defeat a reimbursement claim, if the separate property interest “can be traced to its separate property source.” (Cochran, supra, 87 Cal.App.4th at p. 1057 .) We understand the trial court’s statement that Duerkson “did not adequately unravel” the separate and community property interests in Windsor Way to be a factual finding that Husband did not 16 adequately trace his separate property contributions from Cebolla and Kazan to Windsor Way.

22021–2021
Memorial Hospital System v. Northbrook Life Insurance Company green
ca5 · 1990
2 sentences

2018As we have said, a misrepresentation claim is not preempted if a plan or administrator makes a representation to a healthcare provider that services will be covered, the provider relies on that representation and provides services, and the plan later denies a reimbursement claim after determining the services are not covered. ( Memorial Hospital, supra , 904 F.2d at p. 250 ; Silver, supra , 2 Cal.App.5th at pp. 805-806, 206 Cal.Rptr.3d 461 .) In that instance, the provider's suit does not relate to the ERISA plan precisely because the services provided are not covered under the plan.

2018(Memorial Hospital, supra, 904 F.2d at p. 250 ; Silver, supra, 2 Cal.App.5th at pp. 805– 806.) In that instance, the provider’s suit does not relate to the ERISA plan precisely because the services provided are not covered under the plan.

22018–2018
County of San Diego v. State green
cal · 1997
2 sentences

2018(County of San Diego, supra, 15 Cal.4th at p. 81 ; §§ 17551, 17555.) “The state shall reimburse each local agency and school district for all ‘costs mandated by the state.’ ” (§ 17561, subd. (a).) If the Commission determines a statute or executive order imposes state-mandated costs, it must “adopt parameters and guidelines for reimbursement of any claims relating to the statute or executive order.” (§ 17557, subd. (a).) In adopting parameters and guidelines, the Commission “may adopt a reasonable reimbursement methodology.” (§ 17557, subd. (b).) The Commission submits the adopted parameters a

2018(County of San Diego, supra, 15 Cal.4th at p. 81 ; §§ 17551, 17555.) “The state shall reimburse each local agency and school district for all ‘costs mandated by the state.’ ” (§ 17561, subd. (a).) If the Commission determines a statute or executive order imposes state-mandated costs, it must “adopt parameters and guidelines for reimbursement of any claims relating to the statute or executive order.” (§ 17557, subd. (a).) In adopting parameters and guidelines, the Commission “may adopt a reasonable reimbursement methodology.” (§ 17557, subd. (b).) The Commission submits the adopted parameters a

22018–2018
West v. State Farm Mutual Automobile Insurance green
calctapp · 1973
2 sentences

1984Co. (1973) 30 Cal.App.3d 562 [ 106 Cal.Rptr. 486 ].)” (Italics added.) In accordance with Lee we find the reimbursement clause contained in the policy before us to be valid and enforceable.

1984Co. (1973) 30 Cal.App.3d 562 [ 106 Cal.Rptr. 486 ].)” (Italics added.) In accordance with Lee we find the reimbursement clause contained in the policy before us to be valid and enforceable.

21984–1984
Lee v. State Farm Mutual Automobile Insurance green
calctapp · 1976
2 sentences

1984Co. (1976) 57 Cal.App.3d 458 [ 129 Cal.Rptr. 271 ], at issue was the language of a reimbursement clause in an insurance policy that is virtually identical with the language in the clause contained in the policy before us.

1984Co. (1976) 57 Cal.App.3d 458 [ 129 Cal.Rptr. 271 ], at issue was the language of a reimbursement clause in an insurance policy that is virtually identical with the language in the clause contained in the policy before us.

21984–1984
In Re Marriage of Dekker green
calctapp · 1993
2 sentences

2025In a footnote, the trial court rejected “Laurie’s contention” that LBS was “a community asset and/or that a Pereira interest should apply to LBS.” The trial court explained: “[A] fair reading of Pereira supports the view that where more than minimal community effort combines with a separate capital investment to increase the value of the separate investment, the court must determine the amount of the increase attributable to the capital, and the amount attributable to community effort.” (See generally Dekker, supra, 17 Cal.App.4th at p. 852 .) Although the trial court acknowledged that “commun

2025In a footnote, the trial court rejected “Laurie’s contention” that LBS was “a community asset and/or that a Pereira interest should apply to LBS.” The trial court explained: “[A] fair reading of Pereira supports the view that where more than minimal community effort combines with a separate capital investment to increase the value of the separate investment, the court must determine the amount of the increase attributable to the capital, and the amount attributable to community effort.” (See generally Dekker, supra, 17 Cal.App.4th at p. 852 .) Although the trial court acknowledged that “commun

12025–2025
Travelers Property Casualty Co. of America v. Superior Court green
calctapp · 2013
1 sentence

2024(Travelers Property Casualty Co. of America v. Superior Court (2013) 215 Cal.App.4th 561, 574 .) DISCUSSION The Sotos argue that the Education Code sections on which CalSTRS relies do not authorize a reimbursement claim against the Sotos as opposed to the third-party tortfeasors who injured Arasely.

12024–2024
In Re Marriage of Braud green
calctapp · 1996
2 sentences

2023The court found that such evidence did “not provide substantial evidence for tracing Husband’s separate property because it is unclear what amount of money from the sale of the [separate property house] was used to pay for construction.” (Id. at pp. 274–275, italics added.) Similarly, in Braud, supra, 45 Cal.App.4th 797 , the wife’s admission that “some payments were made” from a commingled account for improvements to the family home was inadequate to support the husband’s reimbursement claim because there was no proof of the amounts expended on the improvements nor any other evidence about fu

2023The court found that such evidence did “not provide substantial evidence for tracing Husband’s separate property because it is unclear what amount of money from the sale of the [separate property house] was used to pay for construction.” (Id. at pp. 274–275, italics added.) Similarly, in Braud, supra, 45 Cal.App.4th 797 , the wife’s admission that “some payments were made” from a commingled account for improvements to the family home was inadequate to support the husband’s reimbursement claim because there was no proof of the amounts expended on the improvements nor any other evidence about fu

12023–2023
In re Acknowledgment Cases green
calctapp · 2015
1 sentence

2023(Id. at pp. 1501–1502.) Officers challenged the reimbursement requirement under section 2802, arguing “the cost of the academy is a necessary expenditure incurred as a direct consequence of the discharge of the officer’s duties.” (Id. at p. 1505.) The city argued the statute did not apply “because the training recruits receive is mandated by law under the peace officer standards and training (POST) legislation.” (Ibid.) The court of appeal concluded section 2802 was ambiguous as to an employer’s responsibility for “training costs.” (Acknowledgment Cases, supra, 239 Cal.App.4th at p. 1505 .) Th

12023–2023
Department of Finance v. Commission on State Mandates green
cal · 2003
1 sentence

2022In rejecting the districts’ reimbursement claim for those new open meeting requirements, we explained that because the “notice and agenda provisions [were merely] mandatory elements of [voluntary] programs” (Kern, supra, 30 Cal.4th at p. 731 ), the districts were not legally compelled to comply with those provisions.

12022–2022
People v. Hume green
calctapp · 2011
2 sentences

2022(Hove, supra, 76 Cal.App.4th at p. 1272 ; Hume, supra, 196 Cal.App.4th at p. 1000 .) Moreover, similar to Hove and Hume, J.M.’s payments may be subject to a reimbursement claim by Kaiser.

2022(Hove, supra, 76 Cal.App.4th at p. 1272 ; Hume, supra, 196 Cal.App.4th at p. 1000 .) Moreover, similar to Hove and Hume, J.M.’s payments may be subject to a reimbursement claim by Kaiser.

12022–2022
SS v. State green
utah · 1998
1 sentence

2021(See also S.S. v. State (Utah 1998) 972 P.2d 439 , 442 [“Payments made by a third party do not legally become the property of the recipient until after a valid settlement, which necessarily must include reimbursement to Medicaid.”].) Our conclusion is reenforced by the reimbursement clause of the Medicaid Act, which specifically requires states, in any case in which a third party has been found legally liable for medical assistance paid for by the state’s Medicaid program, to “seek reimbursement for such assistance to the extent of such legal liability.” (42 U.S.C. § 1396a(a)(25)(B), italics a

12021–2021
Morris B. Silver M.D., Inc. v. International Longshore & Warehouse Union-Pacific Maritime Ass'n Welfare Plan green
calctapp · 2016
2 sentences

2018As we have said, a misrepresentation claim is not preempted if a plan or administrator makes a representation to a healthcare provider that services will be covered, the provider relies on that representation and provides services, and the plan later denies a reimbursement claim after determining the services are not covered. ( Memorial Hospital, supra , 904 F.2d at p. 250 ; Silver, supra , 2 Cal.App.5th at pp. 805-806, 206 Cal.Rptr.3d 461 .) In that instance, the provider's suit does not relate to the ERISA plan precisely because the services provided are not covered under the plan.

2018As we have said, a misrepresentation claim is not preempted if a plan or administrator makes a representation to a healthcare provider that services will be covered, the provider relies on that representation and provides services, and the plan later denies a reimbursement claim after determining the services are not covered. ( Memorial Hospital, supra , 904 F.2d at p. 250 ; Silver, supra , 2 Cal.App.5th at pp. 805-806, 206 Cal.Rptr.3d 461 .) In that instance, the provider's suit does not relate to the ERISA plan precisely because the services provided are not covered under the plan.

12018–2018
Shewry v. BEGIL green
calctapp · 2005
1 sentence

2016Finally, because no creditor claims proceeding under Part 8 of the Probate Code was instituted, the three-year limitation period of Code of Civil Procedure section 338, subdivision (a), applied to the Department’s reimbursement claim (Maxwell-Jolly, supra, 198 Cal.App.4th at p. 363 ), with the three-year period beginning upon proper notice to the Department of the decedent’s death in compliance with section 215. ( Shewry, supra, 128 Cal.App.4th at pp. 645-646.) The Department filed its lawsuit on March 29, 2013, within three years of the Holloway letter (April 6, 2010).

12016–2016
Maxwell-Jolly v. Martin green
calctapp · 2011
1 sentence

2016Finally, because no creditor claims proceeding under Part 8 of the Probate Code was instituted, the three-year limitation period of Code of Civil Procedure section 338, subdivision (a), applied to the Department’s reimbursement claim (Maxwell-Jolly, supra, 198 Cal.App.4th at p. 363 ), with the three-year period beginning upon proper notice to the Department of the decedent’s death in compliance with section 215. ( Shewry, supra, 128 Cal.App.4th at pp. 645-646.) The Department filed its lawsuit on March 29, 2013, within three years of the Holloway letter (April 6, 2010).

12016–2016
Peet v. Peet green
calctapp · 1978
2 sentences

2010Martha contends that under In re Marriage of Peet (1978) 84 Cal.App.3d 974 [ 149 Cal.Rptr. 108 ] (Peet) the court had discretion to deny the reimbursement claim.

2010Martha contends that under In re Marriage of Peet (1978) 84 Cal.App.3d 974 [ 149 Cal.Rptr. 108 ] (Peet) the court had discretion to deny the reimbursement claim.

12010–2010
Heppler v. J.M. Peters Co. green
calctapp · 1999
12006–2006
Gribaldo, Jacobs, Jones & Associates v. Agrippina Versicherunges A. G. green
cal · 1970
12006–2006
County of Los Angeles v. Commission on State Mandates green
calctapp · 1995
12004–2004
County of Sonoma v. Commission on State Mandates green
calctapp · 2000
12003–2003
Krieger v. Krauskopf green
nyappdiv · 1986
12002–2002
Pereira v. Pereira green
· 1909
12001–2001
Jefferson-Pilot Life Insurance v. Krafka green
calctapp · 1996
12000–2000
In Re Marriage of Heikes green
cal · 1995
11998–1998
Truck Insurance Exchange v. Superior Court green
calctapp · 1996
11998–1998
Board of Administration v. Glover green
cal · 1983
11996–1996
Gray v. Zurich Insurance Co. green
cal · 1966
11996–1996
In Re Marriage of Fabian green
cal · 1986
11995–1995
In Re Marriage of Hilke green
cal · 1992
11995–1995
Nelson v. Lake Hemet Water Co. neutral
cal · 1931
11995–1995
Hartford Accident & Indemnity Co. v. Gropman green
calappdeptsuper · 1984
11993–1993
Hartford Accident & Indemnity Co. v. Gropman green
calctapp · 1984
11993–1993
In Re Marriage of Robinson green
calctapp · 1976
11992–1992
Todd v. Todd green
calctapp · 1969
11986–1986
In Re Marriage of Aufmuth green
calctapp · 1979
11986–1986
Aceves v. Regal Pale Brewing Co. green
cal · 1979
11984–1984
Roe v. Workmen's Compensation Appeals Board green
cal · 1974
11984–1984
Witt v. Jackson green
cal · 1961
11984–1984

Statutes the citing opinions construe

CA § Cal. Government Code § 17500 (6) CA § Cal. Government Code § 17551 (5) CA § Cal. Government Code § 17557 (5) CA § Cal. Family Code § 2640 (4) CA § Cal. Government Code § 17514 (4) CA § Cal. Government Code § 17521 (4) CA § Cal. Government Code § 17556 (4) CA § Cal. Government Code § 17559 (4) CA § Cal. Civil Code § 2782 (3) CA § Cal. Civil Code § 3532 (3) CA § Cal. Education Code § 51225.3 (3) CA § Cal. Government Code § 17561 (3)

Counted by distinct opinions that both name this issue and are annotated to the section; sections every opinion cites regardless of issue are not filtered here, so read the counts against the total above.

Where else courts name it

TX 97 (1981–2025) CA 53 (1970–2026) LA 32 (1977–2025) IL 18 (1985–2015) AZ 11 (1992–2026) NY 9 (1988–2015) FL 8 (1980–2021) NJ 8 (1954–2017) WA 7 (1997–2022) MI 5 (1968–2009) IA 5 (2017–2020) AL 5 (2003–2024) OK 5 (1997–2008) NM 4 (1985–2018) OH 4 (1999–2006) IN 4 (1998–2018) WI 3 (1986–2020) AK 3 (1987–2013) MS 3 (2007–2011) MA 3 (1961–2026) MD 3 (1993–2012) UT 2 (2011–2013) TN 2 (1999–2021) VT 2 (2013–2013) MO 2 (1988–2012) PA 2 (1977–1977) KS 2 (1989–1994) VA 2 (1996–2017) SD 2 (2019–2019)

Opinions by the citing court's state. A doctrine retained in one state and abandoned in another shows up here as a year span that stalls.

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