Opinion
Stuart Brehm IV appeals from the order of dismissal entered after the trial court sustained without leave to amend 21st Century Insurance Company’s demurrer to his second amended complaint for breach of the implied covenant of good faith and fair dealing. Brehm contends the trial court misapplied the genuine dispute rule, which protects an insurer from a bad faith claim when its denial of benefits was asserted in good faith and on reasonable grounds, and neither the express policy provision that authorizes the insurer to arbitrate uninsured motorist (UM) and underinsured motorist (UIM) claims nor Insurance Code section 11580.26, subdivision (b), 1 which bars a cause of action for exercising the right to request arbitration of a claim under an insured’s UM/UIM coverage, precludes this action based on allegations 21st Century unreasonably failed to make a good faith effort to obtain a prompt, fair and equitable settlement of Brehm’s claim for UIM benefits. We agree with Brehm on each of these points and, accordingly, reverse.
FACTUAL AND PROCEDURAL BACKGROUND
1. Brehm’s Accident and Demand for UIM Benefits
According to the facts alleged in Brehm’s second amended complaint, 2 Brehm, his father and his mother were all seriously injured in an August 2003 traffic accident caused by Natalie Aguirre, who struck the rear of the Brehm family’s 1999 Chrysler Concorde while it was stopped at a red light, waiting to make a left turn. In March 2004 Brehm and his parents settled with *1231 Aguirre’s insurance carrier for $30,000, her full policy limits; Brehm received $10,000; each of his parents also received $10,000.
In April 2004 Brehm made a written claim to 21st Century under the UIM provision of the automobile insurance policy issued by 21st Century to his parents, which covered the family’s 1999 Chrysler Concorde and included Brehm as an additional insured person. The policy, in effect at the time of the August 2003 accident, provided UIM benefits of $100,000 for one person and an additional $5,000 in medical benefits. Brehm submitted medical reports and assessments, bills and diagnostic test results to 21st Century that showed, as a result of the accident with Aguirre, he had suffered among other injuries, “a severe shoulder injury that would require costly surgery and related costs and expenses.”
After the parties failed to reach an agreement on Brehm’s claim—the issue apparently only being the extent of his injuries and thus the amount to which he was entitled—an arbitration was scheduled for November 2004. On September 9, 2004 Brehm made a statutory demand for $85,000 plus medical payments pursuant to Code of Civil Procedure section 998. 21st Century rejected the demand on October 27, 2004 and made a counteroffer of $5,000 plus previously paid medical benefits. In rejecting Brehm’s demand, 21st Century stated its position, based on an evaluation conducted by its medical expert, Dr. Joseph S. Swickard, was that Brehm’s injuries were limited to soft tissue and the surgeries recommended by Brehm’s medical provider (Dr. Hafezi) “are not necessary.” In his report Dr. Swickard asserted Brehm had only “subjective complaints with no objective evidence of injury or problem.”
To persuade 21st Century to pay a reasonable settlement, in mid-October 2004 Brehm submitted to “a truly independent medical examination” by a highly credentialed board-certified orthopedic surgeon, Dr. Ronald Glousman. Dr. Glousman’s report, provided to 21st Century on November 10, 2004, paired common stated Brehm had suffered a cervical strain, lumbar strain and right shoulder rotator cuff strain. Dr. Glousman opined Brehm needed further treatment and concluded it was “more likely than not” that surgery would be required on his right shoulder. Dr. Glousman estimated the surgery would cost $15,575 and postsurgical physiotherapy approximately $3,600.
Following a continuance of the November 2004 arbitration date to allow 21st Century to subpoena and review Dr. Glousman’s records, Brehm made a $90,000 policy limit demand ($100,000 less the $10,000 Brehm had recovered from Aguirre), plus $5,000 in medical payments. In response 21st Century offered $5,000 plus the balance of the full policy maximum of $5,000 in medical payments. Brehm rejected the counteroffer. On March 26, *1232 2005 Brehm received an arbitration award of $91,186; the award was reduced by stipulation to the $90,000 policy limit. 21st Century paid Brehm the $90,000 shortly after the award was made.
2. Brehm’s Lawsuit for Breach of the Implied Covenant of Good Faith
Brehm filed a complaint against 21st Century on January 31, 2006 and, after the court sustained a demurrer, a first amended complaint on July 24, 2006, asserting causes of action for breach of the implied covenant of good faith and fair dealing and breach of contract, alleging 21st Century had unreasonably failed to make a good faith effort to resolve Brehm’s UIM claim after its liability for payment of benefits was clear. On November 7, 2006 the trial court sustained 21st Century’s demurrer to the first amended complaint with leave to amend, suggesting at the hearing that Brehm needed to plead a sufficient factual basis for asserting the failure to settle his UIM claim was the result of something more than a genuine dispute between the parties as to the amount of damages to which he was entitled.
On November 14, 2006 Brehm filed his second amended complaint for breach of the implied covenant of good faith and fair dealing, breach of contract and fraud. In addition to the factual allegations described above, Brehm alleged the medical evidence in 21st Century’s possession at the time it rejected Brehm’s policy limit demand and made a $5,000 counteroffer showed its offer was “extremely unrealistic”; 21st Century knew from the information it had received Brehm was entitled to the full policy limits based on the injuries sustained in the accident with Aguirre and also knew any fair arbitration would likely award that sum to Brehm. Nonetheless, 21st Century made an unreasonably low offer to delay paying his legitimate claim and in the hope of compelling him to accept less than the full amount he was due. Brehm further alleged Dr. Swickard, a nonpracticing professional expert witness, was known to the insurance industry to be biased in favor of the defense and was retained, not to objectively and fairly evaluate Brehm’s shoulder injury, but with the intent that he minimize its seriousness to make it appear—falsely—there was a genuine dispute about the extent of that injury. Indeed, contrary to Dr. Swickard’s conclusion regarding “subjective complaints with no objective evidence of injury or problem,” his report actually noted Brehm had demonstrated restricted motion and “occasional crepitus [a grating or crackling feeling or sound] in the right shoulder that was not present on the left.” Yet Dr. Swickard and 21st Century deliberately ignored these facts in order to deprive Brehm of his contractual rights.
*1233 3. The Trial Court’s Ruling Sustaining the Demurrer Without Leave to Amend
21st Century demurred to the second amended complaint, insisting Brehm had simply alleged “a classic ‘genuine dispute’ as to the value of a UIM claim” and arguing under
Chateau Chamberay Homeowners Assn.
v.
Associated Internal Ins. Co.
(2001)
The trial court sustained the demurrer without leave to amend in an order that incorporated its written tentative ruling. The court found 21st Century had a contractual right to challenge the amount of loss claimed under its UIM coverage and to submit any dispute with its insured over UIM damages to arbitration. Accordingly, Brehm could not argue 21st Century had breached the contract as a result of properly exercising its rights under the contract. The court further ruled a breach of the covenant of good faith and fair dealing “necessarily requires that there be a breach of the underlying insurance contract.” Accordingly, because the court had concluded the breach of contract cause of action was without merit, the claim for breach of the implied covenant necessarily failed as well. Quoting from
Chateau Chamberay, supra,
The court’s February 14, 2007 minute order sustaining 21st Century’s demurrer without leave to amend also states, “[o]n oral motion of Defendant .. . [p]ursuant to Section 581(f)(1) of the California Code of Civil *1234 Procedure the above-entitled case is hereby ordered dismissed.” 4 The minute order is signed by the court (or at least stamped with a replica of the trial judge’s signature), making it an appealable order under Code of Civil Procedure section 58Id. 5 Brehm filed a timely notice of appeal.
CONTENTIONS
Insisting his second amended complaint properly pleaded a cause of action for breach of the implied covenant of good faith and fair dealing,
6
Brehm contends the trial court erred in concluding a claim for insurance bad faith requires the insured to separately allege a breach of an express term of the policy and misapplied the genuine dispute rule of
Chateau Chamberay, supra,
*1235 DISCUSSION
1. Standard of Review
On appeal from an order dismissing a complaint after the sustaining of a demurrer, we independently review the pleading to determine whether the facts alleged state a cause of action under any possible legal theory.
(McCall v. PacifiCare of Cal., Inc.
(2001)
2. Breach of an Express Contract Term Is Not a Prerequisite to Maintaining an Action for Breach of the Implied Covenant of Good Faith and Fair Dealing
California law recognizes in every contract, including insurance policies, an implied covenant of good faith and fair dealing.
(Wilson
v.
21st Century Ins. Co.
(2007)
As a general rule, as the trial court recognized, there can be no breach of the implied covenant of good faith and fair dealing if no benefits are due under the policy: “[T]he covenant is based on the contractual relationship between the insured and the insurer. . . . Absent that contractual right [to policy benefits], the implied covenant has nothing upon which to act as a supplement, and ‘should not be endowed with an existence independent of its contractual underpinnings.’ ”
(Waller v. Truck Ins. Exchange, Inc., supra,
Thus, in
Waller
v.
Truck Ins. Exchange, supra,
21st Century essentially concedes the trial court erred in sustaining its demurrer on this ground, acknowledging “a cause of action may lie for breach of an implied covenant in the absence of an express breach of contract.” Instead, it urges alternative grounds for affirming the trial court’s order (cf.
D’Amico v. Bd. of Medical Examiners
(1974)
3. The Genuine Dispute Rule Does Not Protect an Insurer Whose Position Is Not Maintained in Good Faith and on Reasonable Grounds
A delay in payment of benefits due under an insurance policy gives rise to tort liability only if the insured can establish the delay was unreasonable.
(Wilson, supra,
21st Century attempts to support the trial court’s ruling sustaining its demurrer on this ground, first, by reviewing case law holding bad faith liability cannot be predicated on the insurer’s mistake or even negligence (see, e.g.,
State Farm Fire & Casualty Co. v. Superior Court
(1996)
21st Century’s summary of the governing case law fails to acknowledge an important limitation on the genuine dispute rule or to recognize the significance of the trial court’s dismissal of Brehm’s bad faith claim while it was still at the pleading stage. In
Wilson, supra,
In
Wilson, supra,
Wilson
is distinguishable from the case at bar, of course, because 21st Century did have Brehm examined by Dr. Swickard following Brehm’s submission of his medical information and it was Dr. Swickard, not a claims examiner, who asserted Brehm did not need surgery and had only “subjective complaints with no objective evidence of injury or problem.” But Brehm has alleged that Dr. Swickard’s examination was a sham; that he was retained by 21st Century with the intention he prepare a report that falsely minimized the seriousness of Brehm’s injury precisely so that 21st Century could argue there was a “genuine dispute” as to the value of the claim; and that Dr. Swickard did exactly as he was expected to do. Although his examination revealed restricted motion and “occasional crepitus in the right shoulder,”
*1240
Dr. Swickard allegedly ignored those objective facts—as well as the medical evidence submitted by Brehm—and concluded without any factual basis Brehm had not suffered any significant shoulder injury in the automobile accident and would not require future surgery. Although we may entertain some skepticism as to the nature of the competent and credible proof Brehm will be able to offer in support of these allegations, the issue before us is not whether his evidence will be sufficient but whether his allegations of intentional misconduct and bad faith are. Under
Wilson, supra,
Brehm’s bad faith claim also differs from Wilson’s because 21st Century did not deny his UIM claim. Indeed, 21st Century asserts its relatively modest offer of $5,000 plus remaining medical benefits (totaling something less than $10,000), although much lower than the ultimate arbitration award, was sufficient to cover the projected medical expenses identified by Dr. Glousman and, therefore, could not have been made in bad faith as a matter of law. Brehm’s second amended complaint, however, alleges the amount offered by 21st Century was unreasonably low in light of the medical evidence in its possession at that time. Moreover, Brehm notes that, even if 21st Century’s offer, together with the Aguirre settlement, would cover future medical expenses as estimated by Dr. Glousman, it provided nothing at all for past expenses, lost earnings or pain and suffering, all items recoverable in an action against Aguirre and, therefore, covered by the UIM provisions of his parents’ policy. The reasonableness of 21st Century’s settlement counteroffer at the time it was made is simply not a question that can be resolved at the pleading stage.
7
(See
Shade Foods, Inc. v. Innovative Products Sales &
*1241
Marketing, Inc.
(2000)
4. 21st Century’s Contractual Right to Arbitrate UIM Claims Does Not Relieve It from Its Obligation to Deal with Its Insured in Good Faith
The 21st Century policy expressly grants the parties the right to arbitrate any dispute regarding a UM or UIM claim: “If we and a person insured do not agree as to whether he or she is legally entitled to recover damages from an Uninsured Motorist or the amount of such damages, then upon written demand of either, the disagreement shall be submitted to a single neutral Arbitrator for decision in accordance with the law of California.” In sustaining the demurrer to Brehm’s now abandoned breach of contract claim, the trial court, after quoting this provision, ruled, “[P]er the foregoing, Defendant properly exercised its rights under the contract since the contract specifically notes that in the event of a dispute between the parties re: damages, such damages shall be determined by an arbitrator. That is exactly what happened per the contract.”
Echoing this conclusion, 21st Century posits a simple syllogism: It had a contractual right to arbitrate Brehm’s UIM claim. The implied covenant of good faith and fair dealing cannot prohibit a contracting party from doing that which is expressly permitted by the agreement itself (here, the insurance policy).
(Carma Developers (Cal.), Inc. v. Marathon Development California, Inc., supra,
*1242
21st Century’s deceptively simple analysis fundamentally misconceives the relevant inquiry. The issue is not whether, having failed to reach an agreement with Brehm as to the extent of his injuries and, therefore, the value of his UIM claim, 21st Century had an absolute right to demand arbitration—it did—but whether 21st Century had an implied obligation to honestly assess Brehm’s claim and to make a reasonable effort to resolve any dispute with him as to the amount of his damages before invoking that right. An insurer’s duty to thoroughly investigate and fairly evaluate its insured’s UIM claim, so forcefully recognized in
Wilson, supra,
42 Cal.4th at pages 720 to 723, has no meaning unless the answer to that question is yes. (See
Rappaport-Scott v. Interinsurance Exchange of the Automobile Club, supra,
Indeed, by making lack of agreement as to the value of the claim an express precondition to demanding arbitration, the policy itself contemplates the parties will first make an affirmative effort to resolve their dispute, in effect creating a contractual duty to discuss the claim to which the implied covenant of good faith and fair dealing properly attaches. The implied covenant imposes on a contracting party not only a duty to refrain from acting in a manner that frustrates performance of the contract “ ‘but also the duty to do everything that the contract presupposes that he will do to accomplish its purpose.’ ”
(Pasadena Live
v.
City of Pasadena
(2004)
*1243 5. Insurance Code Section 11580.26, Subdivision (b), Does Not Immunize an Insurer from Tort Liability for Bad Faith Handling of a UIM Claim
The contractual provision for arbitration of UM and UIM claims disputes in 21st Century’s policy is mandated by the statutory scheme requiring UM and UIM coverage. Section 11580.2, subdivision (a), originally enacted in 1959 (Stats. 1959, ch. 817, § 1, pp. 2835-2836), requires all automobile insurance liability policies to include coverage for bodily injury or wrongful death caused by a collision with an uninsured or underinsured motorist. (See
Mercury Ins. Group v. Superior Court
(1998)
In 1983 the Legislature expanded the scope of mandatory UM and UIM coverage by adding section 11580.26 to the Insurance Code, requiring insurers to offer coverage for property damage caused by uninsured or underinsured motorists to policyholders without collision coverage (§ 11580.26, subd. (a)(2)) and to offer additional (“first dollar”) coverage that would waive the deductible on collision insurance when the insured has been struck by an uninsured or underinsured motorist (§ 11580.26, subd. (a)(1)). (See Stats. 1983, ch. 1252, § 1, p. 4938.) 9 As originally enacted, section 11580.26, subdivision (b), provided for payment of UM and UIM claims under the new property damages provisions in subdivision (a)(1) and (2) when the insured satisfied certain reporting requirements and “it is determined by the insured and insurer or, in the event of disagreement, by arbitration . . . that the insured is legally entitled to recover the amount of such payments for property damage from the owner or operator of the uninsured motor vehicle.” 10 The following sentence provided, “No cause of action shall exist against either an insured or insurer from exercising the right to request arbitration of a claim under this section or Section 11580.2.”
*1244
Describing this second sentence of section 11580.26, subdivision (b)—which has not been modified since its adoption in 1983—as a grant of complete immunity for its decision to arbitrate Brehm’s UIM claim, 21st Century argues Brehm’s cause of action for breach of the implied covenant and good faith necessarily fails. A similar argument was considered and rejected by Division Three of this court in
Hightower v. Farmers Ins. Exchange
(1995)
Despite the fact
Hightower v. Farmers Ins. Exchange, supra,
We, of course, agree with 21st Century that the fundamental task of statutory interpretation is to determine the Legislature’s intent so as to effectuate the purpose of the law.
(Olson v. Automobile Club of Southern California
(2008)
The primary flaw in 21st Century’s narrow and literal reading of the second sentence of section 11580.26, subdivision (b), is that it disregards the preceding sentence of the subdivision concerning arbitration of collision damage claims in UM/UIM cases, as well as the comparable mandatory arbitration language in section 11580.2, subdivision (f). Neither provision grants the insurer the unfettered right to demand arbitration as soon as a UM/UIM claim is filed; both obligate the insurer to attempt to reach an agreement with its insured before it may invoke arbitration as a means of resolving any disagreement. Section 11580.2, subdivision (f), requires any questions concerning liability or the amount of damages to be decided “by agreement between the insured and the insurer”; only “in the event of disagreement” may the dispute be resolved by arbitration. Similarly, under section 11580.26, subdivision (b), arbitration is available “in the event of disagreement” between the insurer and the insured as to whether the insured is legally entitled to recover the property damages sought. This duty to attempt to agree before arbitrating, clearly imposed by the Legislature, invokes a corresponding duty to do so in good faith.
(Wilson, supra,
But, 21st Century protests, if it faces potential tort liability for acting unreasonably regarding the payment of UM and UIM benefits due under its policies—-that is, for failing to conduct a thorough investigation or fair evaluation of its insured’s claim before denying it and proceeding to arbitration—then section 11580.26, subdivision (b)’s language that no cause of action shall exist “from exercising the right to request arbitration” provides no protection at all, impermissibly rendering the statute “nugatory, inoperative and meaningless.” 21st Century’s concern that our agreement with the analysis and conclusion in
Hightower v. Farmers Ins. Exchange, supra,
As 21st Century suggests, although the legislative history is silent on this point, it is plausible the second sentence in section 11580.26, subdivision (b), was enacted in response to the Supreme Court’s landmark decision five years earlier in
Neal
v.
Farmers Ins. Exchange
(1978)
Justice Richardson in his dissenting opinion explained the insurer had offered its insured, Mrs. Neal, a 50 percent settlement, in contrast to her demand for full UM benefits, and stated, in his view, the question of bad faith was “very close” based on the serious question whether there was any negligence on the part of the uninsured motorist and, therefore, whether Mrs. Neal, who had been severely injured, was entitled to any payment at all under the general UM coverage.
(Neal, supra,
In adopting the “[n]o cause of action shall exist” language in section 11580.26, subdivision (b), the Legislature may well have been mindful of the concern voiced by Justice Clark in his dissenting opinion in
Neal
that an insurer should not be penalized for “guess [ing] wrong” and losing an arbitration—although, if so, it is surely odd that the
Neal
decision is nowhere mentioned in any of the relevant legislative history. (See
Regency Outdoor Advertising, Inc.
v.
City of Los Angeles
(2006)
DISPOSITION
The order dismissing the action is reversed, and the cause remanded for further proceedings not inconsistent with this opinion. Brehm is to recover his costs on appeal.
Zelon, J., and Jackson, J., concurred.
On October 6, 2008, the opinion was modified to read as printed above.
Notes
Statutory references are to the Insurance Code unless otherwise indicated.
We accept as true all facts properly pleaded in the second amended complaint to determine whether the demurrer should have been sustained or overruled.
(Caliber Bodyworks, Inc. v. Superior Court
(2005)
21st Century argued the fraud cause of action-—which had been added to the second amended complaint—was not pleaded with the requisite specificity. The trial court sustained 21st Century’s demurrer to this cause of action. On appeal Brehm has abandoned any contention the trial court erred in dismissing the fraud claim.
At the hearing on the demurrer, the court stated, “The ruling [sustaining the demurrer without leave to amend] stands, and the tentative will become the final and made part of the file.” Counsel for 21st Century responded, “Thank you, Your Honor. I’ll prepare a judgment.” The clerk then inquired, “Can I dismiss it pursuant to 581(f)(2), which provides for it?” The court replied, “Yes. The matter will be dismissed pursuant to CCP section 581(f)(2) or 581 et seq., the applicable code provisions.”
We understand, informally, it is not an unusual practice in the Los Angeles Superior Court for the clerk to stamp a minute order dismissing an action with the judge’s signature, sometimes below the statement “it is so ordered,” to satisfy the requirements of Code of Civil Procedure section 581d (“All dismissals ordered by the court shall be in the form of a written order signed by the court and filed in the action and those orders when so filed shall constitute judgments and be effective for all purposes . . .”). While this practice arguably complies with the literal requirements of section 58 Id, it does little to further the rationale for requiring final orders of dismissal to be accomplished by written, signed court order rather than by minute order.
Asked by the court to be prepared to address at oral argument whether a dismissal had been entered that complies with the requirements of Code of Civil Procedure section 581d, counsel for Brehm obtained a new order of dismissal, actually signed by the court and dated September 3, 2008 (two days prior to oral argument), but effective February 14, 2007 on a nunc pro tunc basis. Although we were prepared, albeit reluctantly, to conclude the February 14, 2007 minute order itself was “in the form of a written order” and “signed by the court,” the September 3, 2008 order eliminates any question whether there is an appealable final order in this case. We encourage trial courts to avoid this issue in the future by using a separate written order of dismissal, signed by the court and filed in the action, to conclude a case, rather than relying on a signed or stamped minute order.
On appeal Brehm does not argue his separate cause of action for breach of contract was improperly dismissed by the trial court.
In
Rappaport-Scott v. Interinsurance Exchange of the Automobile Club
(2007)
Although the question whether an insurer failed to accept a reasonable settlement offer within policy limits of a third party claim against its insured is analytically distinct from the question whether an insurer unreasonably withheld benefits due under the policy in a first party coverage context (see, e.g.,
Rappaport-Scott
v.
Interinsurance Exchange of the Automobile Club, supra,
146 Cal.App.4th at pp. 836-837), both turn on the reasonableness of the insurer’s position, which is ordinarily an issue to be determined by the trier of fact. (See
Jordan v. Allstate Ins. Co.
(2007)
The legislation (Sen. Bill No. 808, approved by Governor, Sept. 30, 1983, Sen. Final Hist. (1983-1984 Reg. Sess.) p. 504) also provided any judgment or settlement obtained by an uninsured motorist would be reduced by the amount paid to the insured motorist under his or her UM/UIM coverage and further mandated a one-year suspension of an uninsured motorist’s driver’s license if the motorist was involved in an accident causing bodily injury or property damage in excess of $500 and could not respond in damages.
Minor stylistic amendments were made in 1984 (see Stats. 1984, ch. 263, § 1, p. 1295; Stats. 1984, ch. 1196, § 1, p. 4109), but substantively the provision is unchanged.
The policyholder in
Hightower v. Farmers Ins. Exchange, supra,
21st Century raised the same argument before the Supreme Court in
Wilson, supra,
Strikingly, there is no discussion of the second sentence of section 11580.26, subdivision (b), in any of the legislative history we have found regarding Senate Bill No. 808 (1983-1984 Reg. Sess.), which was enacted as chapter 1252, Statutes 1983. It is not mentioned in the Legislative Counsel’s Digest in any version of the bill, nor is it addressed in the analyses or summaries of the bill or its amendments prepared by the Legislative Analyst, the Senate Committee on Insurance, Claims, and Corporations, the Assembly Committee on Finance and Insurance, the Assembly Committee on Ways and Means or the Assembly Office of Research.
