ORDER GRANTING IN PART AND DENYING IN PART DEFENDANT’S MOTION FOR SUMMARY JUDGMENT OR PARTIAL SUMMARY JUDGMENT
(Docket No. 48)
Plaintiff Michelle Fanucci has filed suit against Defendant Allstate Insurance Company, asserting claims for breach of contract, negligence, and negligent misrepresentation.
1
Currently pending before
I. FACTUAL & PROCEDURAL BACKGROUND
In January 1997, Ms. Fanucci — at the time, only thirteen years old — was hit by a car driven by an underinsured motorist. Because the motorist was underinsured (ie., Ms. Fanucci’s damages exceeded the motorist’s auto policy), her parents submitted an uninsured motorist (“UIM”) claim to Allstate to make up the difference. Allstate contends that the Fanuccis only had UIM coverage under the auto policy they had with Allstate; in other words, Allstate only had to pay up to the auto policy limit. Ms. Fanucci asserts that the Fanuccis’ umbrella policy was supposed to provide for excess UIM coverage — that is, Allstate had to pay up to auto policy limit, plus the umbrella policy limit. Resolution of this dispute turns on what took place when the Fanuccis purchased the auto and umbrella policies from Allstate. ■
It is undisputed that the Fanuccis obtained the auto policy, which included UIM coverage, back in 1987. The parties dispute, however, when the Fanuccis obtained the umbrella policy. Ms. Fanucci contends that her parents obtained — or at least tried to obtain — the umbrella policy at the same time that they obtained the auto policy, ie., back in 1987. See Robert Fanucci Depo. at 55-58, 61. Allstate’s position is that there was no umbrella policy in place until 1993. 2 See Sisson Decl. ¶ 4; Robert Fanucci Depo., Ex. A (umbrella insurance application). In the end, the parties’ dispute as to when the umbrella policy was obtained is not dispositive, at least for purposes of the pending motion, because both parties agree that, at the time of Ms. Fanucci’s accident in January 1997, the umbrella policy was in place.
As to the umbrella policy that was in place at the time of the accident, the parties agree that, by its terms, it did not provide for coverage above the UIM limits. The policy covered only third-party claims for liability, not first-party claims for UIM coverage. See Davis Decl., Ex. A (declarations page and umbrella policy). In spite of this fact, Ms. Fanucci claims that Allstate is liable up to the coverage limit of the umbrella policy in excess of her UIM claim because Allstate’s agent, Mr. Baldwin, made representations on which her father, Robert Fanucci, relied. More specifically, Ms. Fanucci asserts that, back in 1987, Mr. Baldwin represented to her father that the umbrella policy would provide not only coverage with respect to third-party claims for liability but also UIM coverage. 3 Allstate disputes this.
Ms. Fanucci’s accident took place in January 1997. It appears that, soon after the accident, Ms. Fanucci’s father contacted Mr. Baldwin, and Mr. Baldwin “indicated that nothing further needed to be done at that time under [the Fanuccis’] insurance policy.” Robert Fanucci Depo., Ex. C (letter, dated 2/11/1998, from Robert Fanucci to Mr. Baldwin). Robert Fanucci contacted Mr. Baldwin again in February 1998. In a letter dated February 1, 1998, Mr. Fanucci noted:
At this time, we are not aware of the amount of insurance that the driver of the vehicle may have. In the event thatMichelle’s injuries exceed the policy limits of the driver’s insurance, it is my understanding that the uninsured motorist provisions of our automobile insurance would be applicable to cover any deficiency.
Robert Fanucci Depo., Ex. C (letter, dated 2/11/1998, from Robert Fanucci to Mr. Baldwin).
Some three years later — on or about March 7, 2001 — the Fanuccis had their lawyer, Peter Hinton of the Hinton & Alfert law firm, contact Mr. Baldwin once again. In the letter, Mr. Hinton noted that the Fanuccis had obtained “the $100,000 limits of liability coverage of Lucille Meyer, the driver who struck [Ms. Fanucci].” Hinton Depo., Ex. 1 (letter, dated 3/7/2001, from Mr. Hinton to Mr. Baldwin). However, the $100,000 did not fully compensate Ms. Fanucci for her injuries and damages and therefore the Fanuccis asked that “an underinsured claim be opened in this matter if that did not occur at the time of [Robert] Fanucci’s prior contacts.” Hinton Depo., Ex. 1 (letter, dated 3/7/2001, from Mr. Hinton to Mr. Baldwin). Implicitly acknowledging that the UIM claim had to be arbitrated as required by statute, see Cal. Ins.Code § 11580.2(f), 4 Mr. Hinton concluded the letter by stating that he was hopeful that the dispute could be resolved without the need to go to arbitration. See Hinton Depo., Ex. 1 (letter, dated 3/7/2001, from Mr. Hinton to Mr. Baldwin).
Subsequently, on or about May 7, 2001, Allstate’s counsel, Mark Goodman of the Haskell & Goodman law firm, sent a letter to Mr. Hinton. His letter stated in relevant part:
. It is my understanding that your client, Michelle Fanucci, is making an underinsured motorist claim through her parents[’] automobile insurance policy with Allstate. It is also my understanding that the Fanueci[s’] auto policy has limits of $250,000 [per person]/$500,000 [per incident].
In light of the fact that Ms. Fanucci has recently been paid the sum of $100,000 from [the underinsured motorist’s] carrier, the policy limits in Ms. Fanucci’s claim with Allstate have been reduced to $150,000.00. Hinton Depo., Ex. 1 (letter, dated 5/7/2001, from Mr. Goodman to Mr. Hinton).
It appears that, thereafter, the parties entered into a mediation in the attempt to settle their dispute. On or about January 16, 2002, Mr. Hinton (the Fanuccis’ counsel) sent a letter to Mr. Goodman (Allstate’s counsel), disputing a statement made by Allstate in its mediation brief— ie., the statement that Ms. Fanucci had made a policy limits demand of $250,000. Mr. Hinton stated that this was not true— that the full policy limits under the Fanuccis’ UIM coverage included the umbrella limit.
In addition to the specific underinsured motorist coverage in the auto policy of $250,000, the Fanucci[s’] have an excess policy which Allstate has acknowledged is applicable in the amount of $1,000,000. Therefore the “full policy limits available to [Ms. Fanucci] under the Fanueci[s’] underinsured motorist coverage” is $1,250,000 less the $100,000 received from the driver of [t]he offending vehicle, or a net of $1,150,000.
At the mediation which took place the next day (i.e., on January 17, 2002), Allstate informed the Fanuccis that the umbrella policy provided for excess insurance for liability to third parties only. See Hovanec Depo., Ex. 4 (computer notes, dated 1/18/2002). Several months later, on or about March 5, 2002, Allstate’s new counsel (also litigation counsel of record) provided the same information to the Fanuccis. Michael Barnes of the Sonnenschein law firm noted that Mr. Goodman would “continue to represent Allstate on issues relating to the underinsured’s liability and damages” but that the Sonnenschein law firm would represent Allstate regarding the claim made pursuant to the umbrella policy. Hinton Depo., Ex. 1 (letter, dated 3/5/2002, from Mr. Barnes to Mr. Alfert). Mr. Barnes stated:
Allstate’s umbrella policy contains no UM or UIM coverage. Indeed, it is a liability policy, not a first-party auto policy. This should be obvious from the contract’s language, which is in your clients’ possession. To my knowledge, there is no Allstate umbrella policy that affords UM or UIM coverage. If you would like to discuss the Fanuccis’ umbrella policy, I would be happy to listen to your theories. The UIM arbitration is not the place for such a discussion, however, and efforts to obtain information about Allstate’s coverage through the discovery process of the UIM .proceeding will be resisted strenuously.
Hinton Depo., Ex. 1 (letter, dated 3/5/2002, from Mr. Barnes to Mr. Alfert).
The evidence of record does not reflect that Ms. Fanucci, her parents, or their counsel took issue with or ever responded to Mr. Barnes’s letter. In fact, it was not until sometime in 2005 — after the parties proceeded to arbitration for the UIM claim and the arbitrator had issued his decision on the claim' — that the Fanuccis alerted Allstate for the first time that it was their position that there was UIM coverage under the umbrella policy because Mr. Baldwin, Allstate’s agent, had represented that there was such coverage when they purchased the policy.
Meanwhile, the UIM arbitration proceeded. See Hovanec Depo., Ex. 7 (computer notes, dated 10/3/2002) (indicating that in or about October 2002 Allstate made the decision to move the case into arbitration); Hovanec Depo., Ex. 9 (computer notes, dated 8/17/2004) (noting that arbitrator was selected). Importantly, as Ms. Fanucci conceded at the hearing, the Fanuccis did not raise during the arbitration the issue of UIM coverage under the umbrella policy. Instead, the arbitration focused on the extent of injury and whether it was causally related to the auto accident. On or about September 1, 2005, the arbitrator determined that Ms. Fanucci was entitled to more than $1.4 million in damages. More specifically, the arbitrator awarded Ms. Fanucci approximately $68,000 in special damages and $1.35 million in general damages. The arbitrator noted that “$1,350,000 is reasonable compensation for the shock, pain and fear [Ms. Fanucci] suffered during and immediately after the accident, for the pain and suffering suffered during the time of recuperation to date and for the next 60 years of future pain and suffering due to her mild to moderate permanent condition and residual injuries and deficits.” Martin Decl., Ex. E (arbitrator’s decision, dated 9/1/2005).
Thereafter, on November 16, 2005, Allstate filed in state court a petition for correction of the award. See id. at *2-3, 2007 Cal.App. Unpub. LEXIS 10452 at *7. In response, the Fanuccis took the position that Allstate’s request should be denied because Allstate’s agent, Mr. Baldwin, had told Robert Fanucci at the time that he purchased the umbrella policy .that it would include UIM coverage. Robert Fanucci submitted a declaration to this effect. See id. at *3, 2007 Cal.App. Unpub. LEXIS 10452 at *8-9. As noted above, this was the first time that Allstate was made aware of the Fanuccis’ claim that Mr. Baldwin had misrepresented the coverage available under the umbrella policy.
Initially, the trial court refused to grant Allstate’s request to- limit the award to $150,000. Instead, the court agreed with the Fanuccis and held that Allstate was estopped from denying UIM coverage under the umbrella policy. The trial court therefore reduced the arbitrator’s award to only $1,150,000 (in recognition of the $100,000 already paid by the underinsured motorist). See id. at *4, 2007 Cal.App. Unpub. LEXIS 10452 at *13-14. Allstate then filed a motion to vacate the judgment and enter a different judgment. The trial court granted this second motion. The court stated, in effect, that it had reconsidered its earlier ruling and concluded that it had exceeded the extent of its authority to correct the award. The court noted that the arbitrator was deciding only whether Ms. Fanucci was entitled to recover against the underinsured motorist and, if so, the amount of damages; the arbitrator was not deciding the amount of coverage available for payment of the damages. See id. at *4, 2007 Cal.App. Unpub. LEXIS 10452 at'*14. Accordingly, the trial court granted Allstate’s motion and entered a new judgment of $150,000. The court specifically stated that this ruling was without prejudice to the Fanuccis’ right to file a declaratory relief to determine coverage under the umbrella policy. See id. at *4-5, 2007 Cal.App. Unpub. LEXIS 10452 at *15-16.
The Fanuccis appealed. On appeal, the trial court’s ruling was affirmed.
See id.
at *10, 2007 Cal.App. Unpub. LEXIS 10452 at *32-33. The appellate court explained that the lower court properly corrected the award, from $1.4 million to $150,000, because “the arbitrator exceeded his powers by making an award in excess of the auto policy limits for underinsured motorist coverage.”
Id.
at *7,
Approximately three months later, on March 12, 2008, Ms. Fanucci initiated the instant litigation.
II. DISCUSSION
A. Legal Standard
Federal Rule of Civil Procedure 56(c) provides that summary judgment shall be rendered “if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(c). An issue of fact is genuine only if there is sufficient evidence for a reasonable jury to find for the nonmoving party.
See Anderson v. Liberty Lobby, Inc.,
Where the plaintiff has the ultimate burden of proof, the defendant may prevail on a motion for summary judgment simply by pointing to the plaintiffs failure “to make a showing sufficient to establish the existence of an element essential to [the plaintiffs] ease.”
Celotex Corp. v. Catrett, 477
U.S. 317, 322,
B. Statute of Limitations
In her complaint, Ms. Fanucci has asserted claims for declaratory relief, breach of contract, breach of the implied covenant of good faith and fair dealing, negligence, and negligent misrepresentation. By stipulation, Ms. Fanucci withdrew her claim for breach of the implied covenant of good faith and fair dealing. She also withdrew that part of her breach-of-contract claim that alleged bad faith. See Martin Decl., Ex. F (stipulation). Thus, at this juncture of the proceedings, the claims at issue are breach of contract, negligence, and negligent misrepresentation. Allstate argues that each of these claims should be dismissed based on the statute of limitations.
A claim that a cause of action is barred by the statute of limitations is an affirmative defense.
See Aerojet Gen. Corp. v. Superior Court, 177
Cal.App.3d 950, 953,
1. Accrual
In its motion, Allstate asserts that the breach-of-contract and negligence claims accrued by 1987 (ie., when the Fanuccis purchased the auto policy), 1993 (ie., when, under Allstate’s version of the facts, the Fanuccis purchased the umbrella policy), or 2002 at the latest (ie., when Robert Fanucci asserted in a letter to his own attorney that Mr. Baldwin was grossly negligent). Each of the claims has a statute of limitations that is four years or fewer. 5 Thus, according to Allstate, Ms. Fanucci should have filed suit by 2006 at the latest. Ms. Fanucci, however, did not initiate the instant lawsuit until March 12, 2008. See Docket No. 1 (complaint, originally filed in state court).
The Court rejects Allstate’s contention that the claims accrued by 1987 or 1993. “Generally speaking, a cause of action accrues at ‘the time when the cause of action is complete with all of its elements.’ ”
Fox v. Ethicon Endo-Surgery, Inc.,
[i]n so using the term “elements,” we do not take a hypertechnical approach to the application of the discovery rule. Rather than examining whether the plaintiffs suspect facts supporting each specific legal element of a particular cause of action, we look to whether theplaintiffs have reason to at least suspect that a type of wrongdoing has injured them.
Id.
In the instant case, the claims could not have accrued by 1987 or 1993 because, even though the alleged wrongdoing had taken place by that point
(ie.,
an umbrella policy providing for additional UIM coverage had not been issued contrary to alleged representation of Allstate’s agent), all of the elements of the claims for breach of contract and negligence claims were not yet
complete
— ie., Ms. Fanucci had not yet sustained any injury or damage. The accident did not take place until January 1997. Thus, there was no possible claim under the umbrella policy back in 1987 or 1993.
See Cleveland v. Internet Specialties West, Inc.,
However, the Court agrees with Allstate that, by early 2002 at the latest, Ms. Fanucci had been injured. By January 17, 2002, Ms. Fanucci’s accident had taken place and she had asserted that the umbrella policy provided for additional UIM coverage in excess of the Fanuccis’ auto policy — an assertion squarely rejected by Allstate. See Hovanec Depo., Ex. 4 (computer notes, dated 1/18/2002) (indicating that, on January 17, 2002, Allstate informed the Fanuccis that the umbrella policy provided for excess insurance for liability to third parties only); Hinton Depo., Ex. 1 (letter, dated 3/5/2002, from Mr. Barnes to Mr. Alfert) (stating that “Allstate’s umbrella policy contains no UM or UIM coverage” and that “it is a liability policy, not a first-party auto policy”). Furthermore, there is no dispute that, by January 17, 2002, Ms. Fanucci believed that her damages exceeded the $250,000 limit of her parents’ auto policy, as evidenced by Mr. Hinton’s letter of January 16, 2002, stating the Fanuccis’ position that they were entitled to more than $1 million. In short, by January 17, 2002, Ms. Fanucci had all the elements to file suit for Allstate’s failure to provide the allegedly promised UIM coverage under the umbrella policy.
Ms. Fanucci argues, however, that she did not actually suffer damage until December 21,
2007
— ie., when the state appellate court affirmed the trial court’s decision limiting her arbitration award to $150,000. According to Ms. Fanucci, “[ujntil the appellate court rejected [her] position [that she was entitled to $1 million] and upheld the superior court’s reduction of the arbitrator’s award to $150,000, [she] had not been damaged by Allstate’s failure to secure the additional $1 million of [UIM] coverage.” Opp’n at 8-9. In support of this position, Ms. Fanucci relies on
Walker v. Pacific Indemnity Co.,
In
Walker,
an individual by the name of Merrill ordered an insurance policy from the defendant-broker covering operation of his logging truck.
See Walker,
On appeal, the defendant argued that the plaintiffs claim was barred by the statute of limitations. According to the defendant, the cause of action accrued in 1952, either when he procured for Merrill the policy having limits of $15,000 instead of $50,000 or when the accident involving Merrill and the plaintiff occurred.
See id.
The court disagreed. It noted that the defendant’s
wrongdoing
— i.e., negligently procuring a policy in the wrong amount— took place in 1952 but there was no injury or damage to Merrill at that point.
See id.
at 516,
he was exposed to liability in excess of $15,000.... Unless he showed that his credit rating was adversely affected by the mere existence of the unindemnified liability, or that some other special situation imposed present damage, he had not yet suffered a loss which would sustain an action against the [defendant] broker.
Id. The court underscored that Merrill’s exposure to liability was “a mere possibility that he might suffer liability beyond the indemnity afforded him.” Id. Whether he suffered injury depended on (1) whether liability would be imposed and, if so, (2) “determination of the amount of liability to which the indemnity applied.” Id. The court acknowledged that “it is the uncertainty as to the fact of damage, rather than its amount, which negatives the existence of a cause of action. [But] [i]n the case at bar, the fact of any damage at all was completely uncertain until judgment in the personal injury action [involving Merrill and the plaintiff].” Id. (emphasis added).
As indicated by the above discussion,
Walker
does not support Ms. Fanucci’s contention that she suffered no injury until the state appellate court decision in December 2007.
Walker
involved potential liability to a third party. There was no action that Merrill, the insured, could bring against the defendant-broker until he was judged to be liable to the plaintiff in the first place.
See id.
at 519,
Ms. Fanucci argues still that she was effectively prevented from suing Allstate under the umbrella policy because she was obligated to see what would happen first with respect to her UIM claim, which was in arbitration as required by statute. Ms. Fanucci notes that, under the California Insurance Code, the amount of damages suffered as a result of the accident involving the underinsured motorist and claimed under a UIM policy must be arbitrated.
See
Cal. Ins.Code § 11580.2(f) (providing that “[t]he policy or an endorsement [for uninsured or underinsured motorist coverage] added thereto shall provide that the determination as to whether the insured shall be legally entitled to recover damages, and if so entitled, the amount thereof, shall be made by agreement between the insured and the insurer or, in the event of disagreement, by arbitration”). Ms. Fanucci argues that only if the arbitrator concluded that the amount of damages exceeded $150,000 (the remaining limits under the UIM policy) would she be able to maintain an'action against Allstate to recover under the umbrella policy. If the damages were less than $150,000, any claim related to the failure to provide the umbrella policy coverage would be moot. The Court does not find this argument convincing because it is the fact of damage, not the amount, that is critical in determining when a claim accrues.
See Walker,
To be sure, Ms. Fanucci contends that bringing suit in 2002 for misrepresentation and estoppel could have resulted in inefficiency and unnecessary duplication of effort. As discussed infra, there is a substantial likelihood that, in view of the impending arbitration pursuant to the UIM policy, any suit against Allstate on the umbrella limit would have been stayed. But this does not negate the fact that her claim accrued in 2002. Instead, this argument has relevance to the issue of equitable tolling, discussed infra.
2. Equitable Tolling
Ms. Fanucci argues that, even if her claim under the umbrella policy accrued in early 2002, the statute of limitations was equitably tolled while the arbitration and related state court proceedings were pending.
See
Opp’n at 9. As noted above, ordinarily, a defendant moving for summary judgment based on an affirmative defense “must establish beyond peradventure
all
of the essential elements of the ... defense to warrant judgment in [its] favor.”
Martin,
The equitable tolling of statutes of limitations is a judicially created, non-statutory doctrine. It is “designed to prevent unjust and technical forfeitures of the right to a trial on the merits when the purpose of the statute of limitations — timely notice to the defendant of the plaintiffs claims — has been satisfied.” Where applicable, the doctrine will “suspend or extend a statute of limitations as necessary to ensure fundamental practicality and fairness.”
McDonald v. Antelope Valley Community College Dist.,
It is clear that, “[w]here exhaustion of an administrative remedy is mandatory prior to filing suit, equitable tolling is automatic .... ”
McDonald,
Even if completion of the arbitration were not deemed mandatory for pur
a line of relatively recent California cases which points toward the principle that regardless of whether the exhaustion of one remedy is a prerequisite to the pursuit of another, if the defendant is not prejudiced thereby, the running of the limitations period is tolled “[w]hen an injured person has several legal remedies and, reasonably and in good faith, pursues one.”
Id.
at 414,
Following
Elkins,
the California Supreme Court has stated that, for equitable tolling to apply in a nonmandatory situation, a plaintiff must establish three elements: (1) timely notice to the defendant, (2) lack of prejudice to the defendant, and (3) reasonable and good faith conduct on the part of the plaintiff.
See McDonald,
The timely notice requirement essentially means that the [plaintiffs] first claim must have been filed within the statutory period. Furthermoref,] the filing of the first claim must alert the defendant in the second claim of the need to begin investigating the facts which form the basis for the second claim. Generally this means that the defendant in the first claim is the same one being sued in the second. The second prerequisite essentially translates to a requirement that the facts of the two claims be identical or at least so similar that the defendant’s investigation of the first claim will put him in a position to fairly defend the second. The third prerequisite of good faith and reasonable conduct on the part of the plaintiff is less clearly defined in the cases. But ... the Supreme Court [has indicated that this factor is met if] the plaintiff filed his second claim a short time after tolling ended.
Id.
at 102 n. 2,
Allowing equitable tolling if the above three factors are satisfied serves
several important policy considerations. First, it serves the fundamental purpose of the statute of limitations by providing timely notice of claims to defendants, without imposing the costs of forfeiture on plaintiffs. Second, it avoids the hardship of compelling plaintiffs to pursue several duplicative actions simultaneously on the same set of facts. Third, it lessens the costs incurred by courts andother dispute resolution tribunals, because disposition of a case filed in one forum may render proceedings in the second unnecessary or easier and less expensive to resolve.
Downs v. Department of Water & Power of City of Los Angeles,
In the instant case, the Court finds that the third factor is satisfied. There is no evidence that Ms. Fanucci has acted in bad faith.
See, e.g., Collier v. City of Pasadena,
Regarding the first factor, there is no contention by Allstate that it was not timely notified of the first claim,
i.e.,
the claim under the auto policy. The evidence of record also, indicates that Allstate was timely notified of the UIM claim.
9
On the other hand, the filing of the auto policy claim did not alert Allstate of the need to begin investigating the facts which formed the basis of the contract and negligence claims. In other words, the initiation of the auto policy claim alone should not have caused Allstate to investigate the representations that its agent, Mr. Baldwin, made about the auto policy, let alone the umbrella policy. Even when the Fanuccis’ counsel, Mr. Hinton, asserted in early 2002 that the umbrella policy provided for cov
This omission ties in to the second factor which is more problematic. The second factor “ ‘essentially translates to a requirement that the facts of the two claims be identical or at least so similar that the defendant’s investigation of the first claim will put him in a position to fairly defend the second.’ ”
Downs,
Nonetheless, the Court finds this problem is not fatal to equitable tolling. The overarching point of the first and second factors is to insure that the defendant is not prejudiced by any delay in filing suit.
See McDonald,
Furthermore, for the reasons stated above, Ms. Fanucci’s decision to wait to file suit until after the arbitration and related state court proceedings were completed before initiating the instant lawsuit was reasonable (if not mandatory).
See McDonald,
Accordingly, the Court concludes that, as a matter of law, equitable tolling in the instant case is appropriate and therefore Ms. Fanucci’s claims are not barred by the statute of limitations.
C. Negligence Claims
Allstate argues that, even if Ms. Fanucci’s claims are not barred by the statute of limitations, it is still entitled to summary judgment with respect to each of the remaining claims in the action. The Court addresses first Ms. Fanucci’s negligence claims.
Ms. Fanucci has asserted both a claim for negligence and a claim for negligent misrepresentation. In the first claim, she alleges that “[Mr.] BALDWIN negligently failed to secure umbrella or excess [UIM] coverage even though Robert Fanucci demanded umbrella limits which matched his underlying ALLSTATE primary auto coverages.” Compl. ¶ 41. In the second claim, she alleges that Mr. Baldwin negligently misrepresented that the “umbrella policy applied to [UIM] coverage.” Compl. ¶ 44.
Ms. Fanucci’s allegations are supported by evidence, in particular, the deposition testimony of her father, Robert Fanucci. See, e.g., Robert Fanucci Depo. at 57-58 (“I specifically advised [Mr. Baldwin] that I — that I wanted a personal umbrella policy, and that I wanted a million dollars— that I thought a million dollars of coverage was — would be adequate for — for liability uninsured motorist and homeowners. And he agreed to that.... [¶] And he basically then told — you know, said this is how, you know, we do it. We went down a list of all the coverages. [¶] And he said, this is what you — what you need to have the umbrella apply.”). Therefore, it appears that there is a genuine dispute of material fact on the negligence claims that would preclude summary judgment.
Defendants argue, however, that, as a matter of law, the claims cannot succeed because there was no justifiable reliance by the
Fanuccis
— i.e., because the umbrella policy on its face clearly excluded coverage for damage to any insured.
See Conroy v. Regents of University of Cal.,
Hadland,
however, is a questionable decision. The court in
Hadland
relied in large part on
Hackethal v. National Casualty Co.,
Moreover,
Hadland
is not dispositive because there is contrary case law, most notably,
Clement v. Smith,
When dealing with a contract as adhesive as the typical insurance policy, we are unwilling to impose on the insured so onerous a burden as would automatically defeat any agent’s liability for misrepresentation. Certainly an insured cannot remain intentionally ignorant of the terms of his or her policy. Here, however, we have a factual finding by the trial court that [the plaintiff] reasonably relied on [the agent’s] representation of coverage. That finding is supported by substantial evidence where the record shows [the agent’s] representations were in no way cautionary or equivocal. Absent some notice or warning, an insured should be able to rely on an agent’s representations of coverage without independently verifying the accuracy of those representations by examining the relevant policy provisions. This is particularly true in view of the understandable reluctance of an insured to commence a study of the policy terms where even the courts have recognized that few if any terms of an insurance policy can be clearly and completely understood by persons untrained in insurance law.
Clement,
In
Paper Savers,
the court concluded that there were triable issues of fact precluding summary judgment as to whether the insurance company’s agent made certain representations about coverage to the plaintiff “and thereby assumed a special duty to [the plaintiff] to ensure it had the coverage it thought it had purchased.”
Paper Savers,
Essentially the issue whether an insured has a duty to read his policy and whether in not reading his policy he is, nonetheless, bound by its terms, is a complex one and not one that can be stated baldly without an analysis of the surrounding facts. In the instant case the same disputed facts return to the forefront to dispose of this issue. If [the agent] held himself out as an adviser to [the plaintiff] and interpreted the coverage in a way different from what the language of the policy indicated, [the plaintiff] is simply saying that [the agent] may be liable for his negligence, if proved. In this, he is correct.
Id.
at 1104,
Allstate argues that, even if there is a fact-based inquiry as to whether reliance was reasonable in spite of clear policy language to the contrary, they should be entitled to summary judgment because no reasonable jury could find in Ms. Fanucci’s favor based on the evidence submitted— namely, the sophistication of Robert Fanucci, an attorney with experience in financial planning (including insurance needs), the clear language of the policy (only eleven pages long), and the clear language used in the declarations page.
See Omni Home Financing, Inc. v. Hartford Life and Annuity Ins. Co.,
D. Breaclu-of-Contract Claim
In her complaint, Ms. Fanucci alleges that Allstate should be equitably estopped
1. Estoppel
As to the first theory, Allstate argues that it must be rejected because, as a matter of law, “ ‘estoppel cannot be used to create coverage under an insurance policy where such coverage did not originally exist.’ ” Mot. at 11-12 (quoting
Miller v. Elite Ins. Co.,
The Court acknowledges the case law cited by Allstate but finds such law in tension with
Graneo.
Moreover, the main cases cited by Allstate,
Miller
and
Man-neck,
are problematic.
Miller
and
Manneck
rely on
Aetna Casualty & Surety Co. v. Richmond,
Furthermore, the
Aetna
court relied on the American Jurisprudence treatise to support the above statement.
See id.
at 653,
There are some eases that support the view, either expressly or by implication, that an insurer may waive or be es-topped from asserting particular policy provisions even though the effect may be to bring within the coverage of the policy risks not covered by its terms, or expressly excluded therefrom. Specifically, promissory estoppel may create insurance coverage where to refuse to do so would sanction fraud or other injustice. Thus, for example, where an insurer or its agent misrepresents, even though innocently, the coverage of the insurance contract, or exclusions therefrom, to the insured before or at theinception of the contract, and the insured reasonably relies thereupon to his or her ultimate detriment, the insurer is estopped to deny coverage after a loss or a risk from a peril actually not covered by the terms of the policy. The fact that the insured has not read the insurance policy “word for word” is not, as a matter of law, an absolute bar to his or her theory of estoppel.
43 Am. Jur. 2d, Ins. § 481; see also 44A Am. Jur. 2d, Ins. § 1548 (noting the same).
Finally, it is notable that Ms. Fanucci has cited at least one California case that, contrary to
Miller
and
Manneck,
acknowledges the validity of an estoppel theory based on fraud.
See Hartford Fire Ins. Co. v. Spartan Realty Int’l, Inc.,
Finally, Allstate contends that
Watson v. United States Fid. & Guar. Co.,
the only dispute here is the limits applicable to a covered risk. Here coverage for the [UIM] risk existed, but not in the amount Robert Fanucci requested. Assuming that the trier of fact accepts Mr. Fanucci’s testimony that he was promised $1,250,000 of [UIM] coverage but received on $250,000, estoppel can be applied as an equitable remedy, since such a finding would not extend the policy to an uncovered risk.
Opp’n at 15-16. Ms. Fanucci’s distinction is not persuasive; the issue here is not the extent of the UIM coverage under the umbrella policy but whether the umbrella policy — a separate insurance policy — provides for UIM coverage in the first place. That being said,
Watson
is nonetheless distinguishable. In
Watson,
there does not appear to have been any affirmative misrepresentation by the insurance agent which would justify an estoppel.
See Watson,
In sum, the Court rejects Allstate’s motion for summary judgment on the estoppel theory.
2. Reformation
As a preliminary matter, the Court notes that, in her complaint, Ms. Fanucci contends that the terms of the umbrella policy should be reformed because of a mutual mistake made by the parties,
see
Compl. ¶ 31 (“alleging] that the contract should be reformed to be consistent with the
mutual
intentions of BALDWIN and Robert — to wit, that the umbrella policy would provide underinsured and uninsured motorist coverage”) (emphasis added), and not because of a unilateral mistake.
See
Cal. Civ.Code § 3399 (providing that a contract may be revised “[w]hen, through fraud or a mutual mistake of the parties, or a mistake of one party, which the other at the time knew or suspected, a written contract does not truly express the intention of the parties”);
Burdick v. Union Sec. Ins. Co.,
No. CV 07-4028 ABC (JCx),
To the extent Ms. Fanucci now relies on a theory of unilateral mistake to support her reformation-based contract claim, as reflected in her opposition, the Court also finds that Allstate is entitled to partial summary judgment. 14
A unilateral mistake by one party may be the basis of a reformation only when the other party, at the time, knew of or suspected the mistake.
See
Cal. Civ.Code § 3399. In the instant case, Ms. Fanucci’s position is that her father made a mistake in 1987 about the coverage available under the umbrella policy and that Mr. Baldwin, Allstate’s agent, knew about the mistake at the time because he represented to her father during their 1987 meeting that the umbrella policy would provide coverage for a UIM claim. The problem for Ms. Fanucci is that, based on the undisputed evidence of record, no umbrella policy actually existed until 1993. In other words, some six years had passed with the Fanuecis making payment on the auto policy only (not any umbrella policy) and without the Fanuccis ever questioning why they had not received a copy of the umbrella policy. From Allstate’s perspective, whatever the reason, no umbrella policy was in place for six years. Ms. Fanucci has presented no evidence of any further communication between Mr. Fanucci and Mr. Baldwin or Allstate about the umbrella policy or its scope occurring after 1987. Nothing in the record suggests Allstate had reason to believe that Mr. Fanucci was still acting under a mistake when the policy was finally put in place in 1993, six years after the alleged misrepresentation
Accordingly, the Court grants Allstate’s motion for partial summary judgment on the contract claim to the extent it is based on a reformation theory.
III. CONCLUSION
For the foregoing reasons, the Court grants in part and denies in part Allstate’s motion for summary judgment. The ease shall proceed to trial on both negligence claims as well as the claim for breach of contract based on an estoppel theory. The claim for breach of contract based on a reformation theory is dismissed.
This order disposes of Docket No. 48.
IT IS SO ORDERED.
Notes
. Originally, Ms. Fanucci sued not only Allstate but also Michael B. Baldwin, Allstate’s agent who sold an auto policy and an umbrella policy to Ms. Fanucci’s parents. Ms. Fanucci voluntarily dismissed her claims against Ms. Baldwin in June 2008. See Docket No. 15 (order, filed on 6/6/2008).
. Allstate provides uncontradicted evidence that no umbrella policy was actually issued until 1993.
. Ms. Fanucci asserts only that representations made in 1987, not 1993, as the basis of her claim.
. Section 11580.2(f) provides in relevant part that "[t]he policy or an endorsement [for uninsured or underinsured motorist coverage] added thereto shall provide that the determination as to whether the insured shall be legally entitled to recover damages, and if so entitled, the amount thereof, shall be made by agreement between the insured and the insurer or, in the event of disagreement, by arbitration.” Cal. Ins.Code § 11580.2(f).
. A claim for breach of contract has a four-year statute of limitations. See Cal.Code Civ. Proc. § 337 (providing that "[a]n action upon any contract ... founded upon an instrument in writing” must be commenced "[w]ithin four years”).
A negligence claim as pled in the instant
case
— i.e., a claim for professional negligence — has a two-year statute of limitations.
See Hydro-Mill Co., Inc. v. Hayward, Tilton & Rolapp Ins. Associates, Inc.,
A negligent misrepresentation claim has either a two- or three-year statute of limitations.
Compare Ventura County Nat’l Bank v. Macker,
. In this regard, Ms. Fanucci’s case against Allstate on the umbrella policy, which was factually conditioned on her ability to prove damages over $150,000 (i.e., in excess of the UIM policy limit), is analogous to an insured making a first-party claim under an insurance policy with a deductible where there is a factual question as to whether the damage exceeds the deductible. If the insurer rejects coverage, so long as the insured has a reasonable basis for believing that rejection is erroneous and that her damages exceed the deductible, the insured may bring suit.
. There is no evidence that the umbrella policy had an arbitration clause.
. If Ms. Fanucci's contract and negligence claims accrued in early 2002 and the statute of limitations was tolled during the arbitration and related state court proceedings
(i.e.,
from October 2002 to December 2007), then . Ms. Fanucci still had more than a year after the state appellate court decision to initiate the instant lawsuit for the professional negligence claim (having a two-year statute of limitations) — and even more time for the breach of contract and negligent misrepresentation claims (having a four- and three-year statute of limitations respectively).
See Barnett v. Evans,
No. C 06-1093 CW (PR),
. Ms. Fanucci’s accident took place in January 1997. It appears that, soon after the accident, Ms. Fanucci’s father contacted Mr. Baldwin, and Mr. Baldwin “indicated that nothing further needed to be done at that time under [the Fanuccis’] insurance policy.” Robert Fanucci Depo., Ex. C (letter, dated 2/11/1998, from Robert Fanucci to Mr. Baldwin). Robert Fanucci contacted Mr. Baldwin again in February 1998, noting in a letter that,
[a]t this. time, we are not aware of the amount of insurance that the driver of the vehicle may have. In the event that Michelle’s injuries exceed the policy limits of the driver's insurance, it is my understanding that the uninsured motorist provisions of our automobile insurance would be applicable to cover any deficiency.
Robert Fanucci Depo., Ex. C (letter, dated 2/11/1998, from Robert Fanucci to Mr. Baldwin). In March 2001, the Fanuccis’ lawyer contacted Mr. Baldwin again, explaining that the underinsured motorist had paid out $100,000 but that this sum did not fully compensate Ms. Fanucci for her injuries and damages. The attorney thus asked that “an underinsured claim be opened in this matter if that did not occur at the time of [Robert] Fanucci’s prior contacts.” Hinton Depo., Ex. 1 (letter, dated 3/7/2001, from Mr. Hinton to Mr. Baldwin).
. Allstate has not, as part of this motion for summary judgment, made any argument that the Fanuccis should have raised the issue of coverage under the umbrella policy back in 1997, when they first broached the subject of making an auto policy claim. Furthermore, it was not actually until 2001 that any auto policy claim actually needed to be made as it was only then that the Fanuccis learned that the motorist involved in the accident was underinsured.
. The exact language in Hackethal on unjustifiable reliance is as follows:
Dr. Hackethal admitted the Nettleship agent never told him the policy provided coverage for administrative hearings like that before which he was required to appear by BMQA. Given the particular circumstances of this case, when Dr. Hackethal renewed the National policy for the 1976/1977 term, we cannot see how anything the agent said nine years earlier would have caused him to reasonably believe that his contract covered hearings like those before BMQA. If he did rely on the statements of the Nettleship agent in forming such belief, and for that reason renewed the policy, his reliance was unjustifiable as a matter of law.
Hackethal,
. See Robert Fanucci Depo. at 57-58 (“I specifically advised [Mr. Baldwin] that I — that I wanted a personal umbrella policy, and that I wanted a million dollars — that I thought a million dollars of coverage was- — would be adequate for — for liability uninsured motorist and homeowners. And he agreed to that.... [¶] And he basically then told — you know, said this is how, you know, we do it. We went down a list of all the coverages. [¶] And he said, this is what you — what you need to have the umbrella apply.”)
. Furthermore, Ms. Fanucci has presented no evidence of a mutual mistake. There is no evidence that Allstate believed the umbrella policy provided coverage for first-party UIM claims.
. Allstate has not made any contention that it was not put on sufficient notice of the unilateral mistake theory.
