Lead Opinion
Joan Amadeo filed this suit after Principal Mutual Life Insurance Company (“Principal”) denied her benefits under her disability income insurance policy. Principal based its denial on its contention that Amadeo’s “regular occupation ... just pri- or to her disability” was “unemployed,” despite Amadeo’s 20 year career in the securities industry before she became unemployed during a period of severe depression. The district court granted partial summary adjudication against Amadeo on her claim that Principal breached the implied covenant of good faith and fair dealing (“bad faith claim”) because it found that Principal’s denial of benefits was rеasonable as a matter of law.
First, as a matter of our jurisdiction, we hold that Amadeo’s voluntary dismissal of her breach of contract claim does not preclude her from pursuing her appeal of the district court’s ruling on the bad faith claim. Second, we reverse the district court’s grant of summary judgment on the bad faith claim. Amadeo presented sufficient evidence from which a jury could conclude that Principal’s denial of benefits to Amadeo was based on a bad faith interpretation of its policy and an inadequate investigation into the basis of Amadeo’s claim.
I. BACKGROUND
Amadeo began working in the securities industry in the mid 1970s, rising to the position of a securitiеs compliance officer in 1986. In 1987 she purchased a disability income insurance policy from Principal (“the policy”). Amadeo continued to be employed in the field of securities compliance for the next seven years, including as vice president of compliance for Liberty Securities Corporation between 1991 and 1993 and as vice president for compliance at Griffin Securities Corporation in 1994.
In 1992 or 1993, Amadeo began treatment with a therapist, Dr. Cassel, for depression. Dr. Cassel attributed Amadeo’s condition to the jailing of her grandson Vinny, who had been in Amadeo’s custody since being removed by court order from her daughter who abused drugs. Ama-deo’s condition worsened in 1994, when Vinny was charged with first degree murder for killing a prison guard. That year, Amadeo told Griffin Securities about the charges against Vinny and the president allegedly told her that “we don’t need people like you around,” after which Amadeo left her job.
Amadeo continued to consult with Dr. Cassel through March 1995, when Cassel recommended that, due to the increasing severity of Amadeo’s depression, she see a psychiatrist for a medical-consultation. In January 1996, Amadeo began treatment with Dr. Lovelace, a psychiatrist, and Dr. Klemp, a therapist. Dr. Lovelace recorded that Amadeo was suffering from symptoms including “sadnеss, insomnia, lethargy, panic attacks, headaches, poor concentration,[and] flashbacks” that “first appeared in a milder form in 1991.” He diagnosed her as suffering from severe Post Traumatic Stress Disorder (PTSD) and depression. In his recommended treatment plan, he stated that “work is not appropriate” but noted that Amadeo was experiencing a delusion that she was able to work.
Amadeo’s disability income insurance policy provided that a monthly premium would be paid to Amadeo if, “[sjolely due to Injury or Sickness, you are unable to perform the substantial and material duties of your regular occupation in which you were engaged just prior to the disability.” Dr. Gallagher, Principal’s reviewing psychiatrist, examined Amadeo’s application, including the records of her treatment, several times. In his first memorandum to Principal’s claims adjusters, he reported that “it appears [Amadeo] has a past history of depression or panic attacks some years ago, approximately 1990 or 1991.” He indicated that “[t]here are a great number of stressors at this time, the most obvious of which is her grandson being charged with attempted murder.” He also noted that Amadeo was subjected to physical abuse by her husband for many years, “thus, the origin of the diagnosis of PTSD,” and was “apparently being stalked by the son of the man that [Vinny] is accused of murdering.” Finally, he stated that the symptoms listed by Dr. Lovelace “would suggest that this patient was not able to work at the timе.”
After more complete records were received, Dr. Gallagher reviewed Amadeo’s application a second time. Apparently at the instruction of one of Principal’s claims adjusters, he conducted this review solely on the assumption that her “regular occupation” under the policy was “an unemployed person.” He concluded that, “reviewing the file more fully and from the vantage point of an unemployed person, it would seem that, although distressed, she was capable of carrying on her activities of daily living” and therefore “was -not evidently disabled from her occupation as an unemployed person.” Prinсipal thereupon denied Amadeo’s claim for payment of benefits because “we must consider your [regular] occupation as that of an unemployed person” and “you have been able to continue many of your daily activities as an unemployed person.”
Dr. Gallagher reviewed the file again when Amadeo appealed Principal’s initial decision. At that time, Amadeo submitted additional evaluations from Drs. Lovelace and Klemp and the Social Security Administration’s grant of disability benefits. Dr. Gallagher recorded that “[i]t is clearly stated in [Dr. Klemp’s letter] that this woman is incapable of working which, given the symptoms and [Global Assessment of Functioning of 35], seems to be so. However, I don’t know that this information changes our original opinion about her disability status as an unemployed person.” On June 25, 1997, Principal rejected Amadeo’s appeal based on its continued position that she was not too disabled to perform the substantial duties of her regular occupation of unemployment.
Amadeo filed this action against Principal in California state court for tortious bad faith and breach of contract. Principal removed the action to federal court on the basis of diversity jurisdiction and filed a motion for partial summary adjudication of Amadeo’s bad faith claim and prayer for punitive damages. The district court granted Principal’s motion, finding as a matter of law that Principal’s denial of disability benefits to Amadeo was
II. JURISDICTION
Principal argues that we lack jurisdiction to hear this appeal because the voluntary dismissal of Amadeo’s breach of contract claim had the effect of barring her bad faith claim. We disagree.
“There is an implied covenant of good faith and fair dealing in every contract that neither party will do anything which will injure the right of the other to receive the benefits of the agreement. This principle is applicable to policies of insurance.” Comunale v. Traders & General Ins. Co.,
Amadeo initially brought this action alleging both breach of contract and tortious bad faith. Principal argues that because the parties agreed to dismiss Amadeo’s breach of contract claim “with prejudice” under Rule 41(a)(1), we must proceed as if a finding was rendered that Amadeo’s insurance contract did not require the payment of disability benefits to her, and therefore Principal’s denial of benefits could not have been in bad faith. This argument has no merit.
Principal is correct that the “precise nature and extent of the duty imposed by [the] implied promise will depend on the contractual purposes,” Egan,
Claim preclusion, or res judicata, bars “successive litigation of the very same claim” following a final adjudication on the merits involving the same parties or their privies. New Hampshire v. Maine,
There are important policy reasons why a court should not apply preclusion doctrine to bar the appeal of claims after alternative claims are dismissed. Preclusion doctrine is intended to promote judicial efficiency and the finality of judgments by requiring that all related claims be brought together or forfeited (claim preclusion) and by prohibiting any party from litigating an issue that has been fully litigated previously (issue preclusion). As the Fourth Circuit explained in ITCO Corp. v. Michelin Tire Corp.,
Had ITCO not dismissed its federal claim and not sought an appeal, but, instead, taken its Sherman Act claim to trial, the prospect of wastefully duplicitous litigation would have arisen. Suppose, for instance, that the factfinder at that hypothеsized trial were to reject ITCO’s allegation of a price-fixing conspiracy [entitling Michelin to a judgment in its favor].... ITCO, on an ensuing appeal, would be free to challenge the correctness of the summary judgment granted Michelin on the state law claim.... A reversal, a remand, and a second trial in its entirety [could] thus be required.
Id. Thus, the court concluded that “[o]nly an application of res judicata in a fashion which has lost sight of that doctrine’s underlying principles and purposes could prevent ITCO from pursuing its price-fixing theory on remand as a legitimate theory of liability....” Id. at 50. “Such an application of res judicata would defeat the very purposes the doctrine is intended to serve.” Id. at 52.
Applying preclusion doctrine to the dismissal of one alternative claim in a single lawsuit to bar another claim in the same suit would impede judicial efficiency, forcing litigants to adjudicate claims of secondary importance to their interests only to
Because applying either claim or issue preclusion in this case would be contrary to both the doctrinal elements and the policies of preclusion doctrine, we reject Principal’s argument. The dismissal of alternative claims in a single suit does not bar the appeal of other claims in the same suit. Courts may properly exercise appellate jurisdiction under 28 U.S.C. § 1291 when a partial summary judgment is followed by a dismissal of all remaining claims, even if those claims are dismissed “with prejudice.” We therefore proceed to the merits of the grant of summary judgment, which we review de novo. Weiner v. San Diego County,
III. BAD FAITH CLAIM
The covenant of good faith and fair dealing has “particular application” to insurers because they are “invested with a discretionary power affecting the rights of another,” Carma Developers (Cal.), Inc. v. Marathon Dev. Cal., Inc.,
“The key to a bad faith claim is whether or not the insurer’s denial of coverage was reasonable.” Guebara v. Allstate Ins. Co.,
The genuine issue rule in the context of bad faith claims allows a district court to grant summary judgment when it is undisputed or indisputable that the basis for the insurer’s denial of benefits was reasonable — for example, where even under the plaintiffs version of the facts there is a genuine issue as to the insurer’s liability under California law. Safeco Ins. Co. of Am. v. Guyton,
In Lunsford, relied upon by the district court, we applied the genuine issue rule to affirm a grant of summary judgment because the insurer adopted “a reasonable construction of the policy” in the context of unsettled law and it was not disputed that the insurer conducted an adequate investigation of the claim. Lunsford,
Although summary judgment may be awarded under the genuine issue rule where the insurer reasonably construes ambiguous language in its policy, see Guebara, 237 F.3d at 993 (discussing cases), summary judgment is not appropriate when the insurer’s interpretation of the policy is sufficiently “arbitrary or unreasonable” that a jury could conclude it was adopted in bad faith. Franceschi v. Am. Motorists Ins. Co.,
Under California law, a reasonable interpretation of an insurance contract accords “the meaning a layperson would ordinarily attach to it,” Waller,
Principal’s interpretation of its contract was not within Amadeo’s objectively reasonable expectations under California law. “As insurers are well aware, the major motivation for obtaining disability insurance is to provide ... peace of mind and security in the event the insured is unable to work.” Egan, 169 Cal.Rptr.691,
There is also sufficient evidence from which a jury could conclude that Principal’s interpretation of its policy was arbitrary — “[depending on individual discretion ... rather than ... fixed rules, procedures, or law.” Black’s Law Dictionary 100 (7th ed.1999). Principal’s claims adjusters testified that Principal had no guidelines for establishing when it would consider someone’s regular occupation as unemployment and that the application of the policy’s language in the context of an unemployed insured was “subjective.” Principal points to no law supporting its position. An insurеr cannot escape bad faith liability by adopting an interpretation of its policy grounded only in the subjective perceptions of its unguided claims adjusters. Arbitrary interpretation of insurance contracts is the antithesis of the reasonable dealing required by the covenant of good faith.
Even if a jury were to conclude that Principal’s interpretation of the policy was not adopted in bad faith, it could find that Principal failed to conduct an adequate investigation as to whether Amadeo was due benefits under that interpretation. See Egan,
Principal’s decision that Amadeo became disabled in 1996 was based primarily on Amadeo’s expression of a willingness and ability to work in an unemployment application after she left Griffin in 1994 and the start of treatment by Drs. Klemp and Lovelace in 1996. A jury could conclude that the weight of evidence available to Principal supported а contrary conclusion. Mariscal v. Old Republic Life Ins. Co., 42
In sum, we believe there is sufficient evidence from which a jury could find that Principal lacked any legitimate reason for denying Amadeo’s claim. We therefore reverse the district court’s award of summary judgment for Principal on the bad faith claim.
IV. PUNITIVE DAMAGES
Because an action for bad faith sounds in tort, the general rules of tort damages apply. See Crisci,
In Egan, the California Supreme Court explained that “[t]he availability of punitive damages is ... compatible with recognition of insurers’ underlying public obligations and reflects an attempt to restore balance in the contractual relationship.”
“Determinations related to assessment of punitive damages have traditionally been left to the discretion of the jury.” Egan,
CONCLUSION
For these reasons, we REVERSE the district court’s grant of summary adjudication against Amadeo and REMAND for further proceedings.
Notes
. When a party who has suffered an adverse partial judgment subsequently dismisses remaining claims, the judgment entered is final for purposes of appeal under 28 U.S.C. § 1291. See Concha v. London,
. Amadeo did not cross-move for summary judgment and we therefore do not reach the question of whether she is entitled to judg-menl as a matter of law based on the undisputed facts in the record.
Dissenting Opinion
Dissenting:
I dissent from the decision to overturn the district court’s grant of summary judgment in favor of Principal Mutual Life Insurance on Amadeo’s claims for tоrtious breach of the covenant of good faith and fair dealing, and for punitive damages.
After the district court granted summary judgment on the above mentioned claims, Amadeo voluntarily dismissed her claim for breach of contract with prejudice, which had the undeniable effect of determining that claim on the merits in favor of Principal. See Commercial Space Mgmt. Co., Inc. v. The Boeing Co., Inc.,
Thus, I respectfully dissent.
. Because Amadeo dismissed with prejudice after the district court had ruled, it did not base its decision on that ground, but we still can do so. See Olson v. Morris,
