Insurance Coverage Related Matters

The following summaries are cases handled by PL personnel. They are provided to give you a basic understanding of the kinds of cases our personnel have been comfortable with handling in the past, and the results achieved for these former clients. Please understand that we cannot make any guarantees about how your matter may turn out, and the similarity between the facts of your matter and any of these summaries does not mean you will get the same result. All litigation is very fact-specific, and the facts of your case will dictate the results that can be achieved.

Liability Insurance Matters

Waller, et al. vs. Truck Insurance Exchange and Farmers Insurance Exchange, Orange County Superior Court.

Neil Pedersen was one of two trial attorneys for the lead plaintiff in this insurance coverage and bad faith case. Waller alleged the insurance company knowingly refused to defend him for a covered lawsuit, and did so to avoid payment of substantial defense fees. This ten week jury trial ended in a $62 million jury verdict, $58 million of which was upheld by the trial judge -- at the time the largest jury punitive award to reach appellate scrutiny in the history of California. The award was subsequently overturned by the California Supreme Court in an opinion elucidating no less than five new concepts of insurance law.

Orange County Manufacturing Company vs. Liability Insurance Co., Orange County Superior Court.

Customer sued client in three separate states alleging clientís high technology product was defective and caused damage to the customerís products and operations. Clientís insurer defended very poorly under a significant reservation of rights and refused to allow independent counsel to be involved in litigation in any significant manner. Upon settlement of the underlying case, the insurer provided insured client with releases of the insurerís liability as a quid pro quo for settling the underlying cases, and did so without informing insuredís independent counsel. Our firm successfully established the insurerís duty to defend and to provide independent counsel, as well as the voidability of the releases signed by the insured in the bifurcated first part of the trial. We were also consulted during trial regarding specific legal issues and jury instructions. The matter ended with a jury verdict in excess of $9 million, and a subsequent confidential settlement.

Roofing contractor vs. Lloyd's of London, Los Angeles County Superior Court.

Customer sued client roofing contractor for damage caused to his building during an unpredicted rain storm. Clientís insurer refused to defend or cover the loss claiming it was excluded from coverage. Trial of the underlying matter resulted in a significant adverse judgment against client. Following judgment, client came to us and explained that the judgment was threatening the very existence of his business. We commenced insurance coverage and bad faith litigation against insurer which resulted in a favorable settlement. Insurer paid the entire adverse judgment amount, all attorneys fees incurred to defend the case, and all attorneys fees incurred by client to procure the coverage.

Medical Device Manufacturer v. Liability Insurer, Los Angeles Federal Court.

An insured manufacturer was sued by a competitor asserting, among other things, injury caused by certain claims made in advertising the client's product. The liability insurer refused to defend the litigation. The amount in controversy was well in excess of $400,000 not counting attorney fee and punitive damage exposure. After significant coverage and bad faith litigation, the insurer settled for an amount that must remain confidential.

Liability Insurer vs. Manufacturer, Orange County.

An insured manufacturer was sued by its insurer seeking roughly $1 million in reimbursement of defense fees paid by the insurer to defend against a patent infringement litigation. Firm negotiated dismissal of the litigation without any payment by the insured.

Large Developer of Condominiums vs. Many Liability Insurers, Los Angeles County.

The developer client was sued in a class-action litigation related to allegations of substantial construction defects. Neil Pedersen headed an extensive tender of defense to the insurers of the developer client, including coordination of identification of each insurer. Over one-hundred separate tenders were required, and over forty insurers representing in excess of two-hundred policies were implicated by the litigation.

Clothing Manufacturer vs. Liability Insurer, Los Angeles County.

The client shoe manufacturer was sued by a large, international shoemaker alleging trade dress infringement. Neil Pedersen negotiated a defense of the matter which assured that the insured faced no liability for a future reimbursement action, and then assisted defense counsel in a formal mediation to settle the case using insurer funds.

Major Orange County Architectural Firm vs. Design Professional Insurance Co., Orange County Superior Court.

This case involved insurance coverage for claims arising out of the design and construction of the John Wayne Airport in an amount exceeding $1 million. Neil Pedersen spearheaded plaintiffís successful motion for summary adjudication on the issue of coverage, thereby leaving only the issue of damages to be determined at trial. The case settled prior to trial.

Apartment Building Owner vs. Project Developer and General Contractor, Los Angeles Superior Court.

Client developer and general contractor of an apartment complex was sued by a subsequent purchaser of the building for allegations of substantial construction defects and fraud exceeding $5 in damages. Two law firms attempted to procure coverage for client, but client was ultimately left undefended by insurers. Client selected our firm as independent counsel, and with Neil Pedersenís assistance, client received an insurance-funded defense from two insurers. Under Neilís guidance, the case settled prior to trial with money exclusively provided by five separate insurers, ensuring the client paid no money out of pocket to settle the matter.

Construction Subcontractor vs. General Contractor, Orange County Superior Court, Los Angeles Superior Court, Riverside County Superior Court.

Neil Pedersen has represented various subcontractors (e.g. drywall, framing, walls) as independent counsel in construction defect litigation. In every instance, the subcontractor was provided with an insurer-funded defense, and the case was settled without payment by the subcontractor.

An Individual vs. Various Attorneys, Los Angeles Superior Court and United States District Court for the Central District of California.

The client was an attorney sued by an individual not his client for breach of implied covenant, malpractice and breach of fiduciary duty. The amount in controversy exceeded $700,000. The client-attorney was then also sued by his insurer who claimed it owed no duty to defend the attorney. Neil Pedersen procured an insurer-funded defense and a stay of the insurance company proceeding, and thereafter defended the attorney as his independently-selected counsel. Neil then successfully extricated the attorney defendant from the first lawsuit by motion for non-suit at close of plaintiff's opening statement at trial. Thereafter, Mr. Pedersen negotiated a dismissal of the insurance company action against the client-attorney whereby the client's insurer agreed to pay all expenses related to the defense of the first action.

Espinoza v. Infinity Insurance Company, Los Angeles Superior Court.

Clientís automobile was stolen from the front of her home. Insurer refused to pay the theft claim, and instead tried to implicate the client in the theft although there was no evidence of complicity. Our firm co-tried the matter to a jury who found breach of contract, bad faith, malice, fraud, and oppression (the precursor to a punitive award). Immediately following the interim verdict, insurer settled the matter for $240,000, almost fifteen times the value of the stolen car.

First Party Insurance Issues

Individual vs. Home Owners Insurance Company, Orange County.

Client lost a valuable piece of jewelry but when she turned to her homeowner's insurer with the claim, it denied the claim asserting a failure by the insured to properly document the item at the outset of the policy. After substantial negotiation and threat of litigation, insurer was convinced to pay the claim in its entirety.

Company vs. Fire Insurance Company, Riverside Superior Court

One of client's investment residences was totaled in a fire. Fire insurer paid a very small percentage of the overall money required under the fire policy and then significantly delayed resolution of the dispute over the remaining money, costing the client attorney fees and other consequential losses associated with the loss of use of the property. After litigation was commenced, a settlement was reached that fully compensated the client for its losses.

Individual vs. Life Insurer, Northern California.

Client's lifetime partner was killed in automobile accident before being able to fill out appropriate beneficiary forms, thereby causing employer and its insurer to refuse to pay life insurance benefits to client. After substantial efforts to establish client's right to receive the money and the threat of litigation, the insurer paid the full policy benefits to the client.

Life, Health & Disability Insurance Matters

Individual medical policy holder vs. HMO, Orange County Superior Court

HMO rescinded client's medical insurance shortly after client was diagnosed with a serious, eventually fatal, medical condition, based simply on a review of medical records. No attempt was made to interview client to explain clearly explainable mistakes that insurer had made. Within 30 days of serving the bad faith complaint, the insurer settled on terms that are to remain confidential.

Individual disability policy holder vs. Former employer's long-term disability plan, Los Angeles Central Federal District Court

Client started experiencing significant signs of the onset of MS while employed with former employer. After departing, the MS rendered him totally disabled. Insurer has refused to pay the long-term disability benefits claiming client was not disabled during its policy period. A confidential settlement has been reached in this matter.