Ninth Circuit Ruling Emphasizes the Importance of Acting Reasonably in Insurance Disputes

A recent ruling from the Ninth Circuit Court of Appeals is a good reminder that, as we’ve observed before, the “moral high ground” is crucial in insurance bad faith disputes.

The Ninth Circuit (the federal appeals court with jurisdiction over Washington and other west coast states) recently upheld the dismissal of insurance bad faith claims in Pureco v. Allstate, Case No. 19-55061. The ruling is unpublished and applied California law, so it is not precedent in Washington State. But it’s still helpful in seeing how courts treat insurance issues.

The upshot of the dispute was Pureco’s allegation Allstate failed to make a reasonable settlement offer in response to the settlement demand Pureco’s lawyer sent Allstate’s adjuster. Pureco was injured in a car crash with David Carillo. Carillo was covered under an Allstate car insurance policy. Pureco’s lawyer sent Allstate information showing the extent of Pureco’s injuries and demanded Allstate pay to settle the claim before Pureco sued Carillo.

When Allstate refused to pay by the deadline provided by Pureco’s lawyer, Pureco sued Carrillo and was awarded $5 million. Pureco and Carillo reached an agreement to settle the case in exchange for Carillo assigning his rights under the Allstate insurance policy to Pureco. Pureco then sued Allstate asserting Carrillo’s rights under the insurance policy, claiming Allstate’s failure to pay the demand before Pureco sued Carrillo was bad faith.

But, like most insurance disputes, the devil is in the details. Allstate had actually responded to Pureco’s lawyer and offered to pay Carrillo’s policy limit just one day after the deadline. The reason for Allstate’s delay was that Pureco’s lawyer waited to send Allstate all the information about Pureco’s injuries until the Friday afternoon where the deadline expired on Monday. Allstate’s adjuster had been on vacation that Friday. He responded and offered to pay the policy limits the following Tuesday.

The Ninth Circuit concluded Allstate had no liability. The court determined that Allstate may have made a mistake by failing to pay the policy limits sooner, but it did not act “in a deliberate manner that would support a finding of bad faith.” The court emphasized that the information Pureco’s attorney initially provided to Allstate did not put Allstate on notice that Pureco’s injuries were significant enough to risk an excess verdict against Carrillo, and Allstate paid the claim just a few days after receiving the additional information.

Although the court never comes right out and says it, the crux of the case seems to have been the court’s perception that Pureco’s attorney was not being forthright. Implicit in the court’s ruling is the fairly unremarkable conclusion that sending somebody information on Friday and expecting a decision the next Monday is fairly unreasonable, especially when you know they’re out of the office.

The upshot is that policyholders in disputes with their insurers rarely help their case by making unreasonable demands. Policyholders have broad legal protections under Washington law. Acting unreasonably often gives the insurer an out where the policyholder otherwise would have a strong case.

 

One thought on “Ninth Circuit Ruling Emphasizes the Importance of Acting Reasonably in Insurance Disputes

  1. Pingback: Court Confirms Health Insurers Can’t Sell Discriminatory Insurance Policies – Seattle Insurance and ERISA Blog

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