Court Evaluates Possible Willful Insurance Misrepresentations With Sacramento Accident Victims, Part 10 of 11

(Please note: the names and locations of all parties have been changed to protect the confidentiality of the participants in this automobile accident/insurance coverage case and its proceedings.)

Blue Shield’s argument that this court should conformist ruling on this motion to a statement of decision recently signed by a Los Angeles County Superior Court Judge in another Blue Shield case is specious. The facts of the two cases are entirely dissimilar. Further, the court in that case did not consider the Court of Appeal’s directive that plans must investigate outside the applications before making initial coverage decisions. His statement that the Lawrence decision “does not require a plan to check every statement in every application to determine whether the applicant is lying” entirely misses the mark.

The opinion merely requires plans to make a reasonable inquiry outside the application. Whether a plan did that in a particular case will be a question of fact for the jury. Next, the Los Angeles case is now on appeal. Finally, as explained above and elsewhere in this opposition, the Court of Appeal has determined that the material issues presented in this case are disputed and require trial on their merits. They cannot be resolved on summary judgment.

PLAINTIFFS HAVE DEMONSTRATED THEIR ENTITLEMENT TO A TRIAL ON THE ISSUE OF PUNITIVE DAMAGES.It is clear that Blue Shield conducted business in 2000 just as it had before the enactment of Health and Safety Code section 1389.3. It did not change its underwriting practices in the slightest manner in the nine years preceding the plaintiffs’ application.

It ignored the statute’s requirements to the detriment of all the people it underwrote. However, as the Court of Appeal in Lawrence has made clear, it assumed the risk by doing so. (See Part 11 of 11.)

For more information you are welcome to contact Sacramento personal injury lawyer, Moseley Collins.

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