GAETON ST. CYR et al., Plaintiffs and Appellants, v. CALIFORNIA FAIR PLAN ASSOCIATION, Defendant and Respondent; GARY REISENWEBER, Plaintiff and Appellant, v. CALIFORNIA FAIR PLAN ASSOCIATION, Defendant and Respondent; IVANA NOELL, Plaintiff and Appellant, v. CALIFORNIA FAIR PLAN ASSOCIATION, Defendant and Respondent.
No. B243159
Second Dist., Div. Four.
Jan. 31, 2014.
223 Cal. App. 4th 786
GARY REISENWEBER, Plaintiff and Appellant, v. CALIFORNIA FAIR PLAN ASSOCIATION, Defendant and Respondent.
IVANA NOELL, Plaintiff and Appellant, v. CALIFORNIA FAIR PLAN ASSOCIATION, Defendant and Respondent.
COUNSEL
Law Office of Denise Jarman, Denise Jarman; Kreindler & Kreindler and Gretchen M. Nelson for Plaintiffs and Appellants Gaetan St. Cyr, Doug Pace, Julie Pace, Marc Musicant, Mark Kofler and Chris Walden.
Ball & Roberts, Stephen C. Ball and John A. Roberts for Plaintiffs and Appellants Gary Reisenweber and Ivana Noell.
Lewis Brisbois Bisgaard & Smith, Raul L. Martinez and Elise D. Klein for Defendant and Respondent.
OPINION
MANELLA, J.—In 1968, the Legislature enacted the California FAIR Plan (FAIR Plan) to provide property insurance to the otherwise uninsurable. Appellants, who lived in high fire risk areas, were insured under the FAIR Plan. Following the loss of their homes and other tangible property following wildfires, appellants were paid the full amount of their policy limits. Appellants contend, however, that they were entitled to additional payments. The trial court disagreed, determining that respondent California FAIR Plan Association had met its contractual and statutory obligations to them. The court dismissed appellants’ actions against respondent, after sustaining a demurrer to their first amended complaints. Appellants contend the trial court erred, as they were entitled to the protections provided in the standard form fire policy set forth in
PROCEDURAL HISTORY
Beginning in September 2009, appellants filed several complaints against respondent.2 In their first amended complaints, appellants admitted that respondent paid them the “actual cash value” (ACV) of their respective policies within weeks of their losses. However, they alleged that the amount was insufficient to cover their total losses, and that in issuing such policies, respondent had provided less protection than statutorily mandated by the “Basic Property Insurance Inspection and Placement Plan,”
One complaint (the St. Cyr complaint) alleged class action claims pursuant to the unfair competition law (UCL),
The trial court determined that the complaints were related, and ordered all counsel to engage in a common meet and confer. On May 21, 2010,
On September 10, 2010, the trial court denied respondent‘s motion to dismiss, but granted its motion to stay the related actions. In its order, the court also referred four issues to the Commissioner to determine. On January 4, 2012, the Department of Insurance (Department) informed the court and the parties that: “The issues presented do not appear to involve issues of primary jurisdiction with the Commissioner. The Department did approve the FAIR Plan‘s rate filing based upon the forms submitted to the Department, and there is no information presented to show that any changes to the forms resulted in a change to their rate impact. If forms are changed and there is a rate impact, the FAIR Plan would need to submit those to the Department for review and approval. . . . It is not clear how the FAIR Plan could issue an HO-3 form since it was not submitted as part of its rate plan nor is the FAIR Plan authorized to issue some of the coverages offered under that form.” Subsequently, on January 30, 2012, the court ordered respondent to file new demurrers and/or other filings, and set a briefing schedule.
On March 5, 2012, respondent filed a demurrer to the complaints. The demurrer asserted that appellants had failed to state a cause of action for bad faith breach of contract, for breach of contract, or for unfair business practice, because (1) the Commissioner had approved all of the challenged features of the FAIR Plan, (2) the FAIR Plan satisfied the statutory requirements for “basic property insurance,” and (3) under the statutory scheme, the Commissioner, not the court, must determine whether the FAIR Plan should have expanded coverage beyond that presently provided in the plan.
Appellants opposed the demurrer, arguing that respondent is statutorily mandated to write a policy no more restrictive than the “California Standard Form Fire Policy” set forth in
In reply, respondent contended that appellants are bound by the terms and conditions of their policies, that its fire policy complied with the requirements of
On June 8, 2012, a judgment of dismissal against appellants and in favor of respondent was entered. Appellants filed notices of appeal from the judgment. The appeals were consolidated September 13, 2012. On October 31, 2013, appellants filed a request for judicial notice, asking this court to take judicial notice of respondent‘s July 31, 2009 rate filing. On January 8, 2014, this court granted the request for judicial notice.
DISCUSSION
A. Standard of Review
“In reviewing an order sustaining a demurrer, we assume well-pleaded factual allegations to be true and examine the complaint de novo to determine whether it alleges facts sufficient to state a cause of action on any legal theory. [Citation.]” (Kyablue v. Watkins (2012) 210 Cal.App.4th 1288, 1292 [149 Cal.Rptr.3d 156].) Because the demurrer was sustained based upon an interpretation of certain provisions of the Insurance Code, we must determine whether the trial court‘s interpretation was correct. “Statutory interpretation is a question of law subject to our independent review.” (Honig v. San Francisco Planning Dept. (2005) 127 Cal.App.4th 520, 524 [25 Cal.Rptr.3d 649].) “As in any case involving statutory interpretation, our fundamental task here is to determine the Legislature‘s intent so as to effectuate the law‘s purpose. [Citation.] We begin by examining the statute‘s words, giving them a plain and commonsense meaning. [Citation.] We do not, however, consider the statutory language ‘in isolation.’ [Citation.] Rather, we look to ‘the entire substance of the statute . . . in order to determine the scope and purpose of the provision. . . . [Citation.]’ [Citation.]” (People v. Murphy (2001) 25 Cal.4th 136, 142 [105 Cal.Rptr.2d 387, 19 P.3d 1129].)
B. The California FAIR Plan
In response to insurers’ reluctance to write basic property insurance for homeowners who live in high risk or otherwise uninsurable areas, in 1968,
“Basic property insurance” is defined as “insurance against direct loss to real or tangible personal property at a fixed location in those geographic or urban areas designated by the commissioner, from perils insured under the standard fire policy and extended coverage endorsement and vandalism and malicious mischief and such other insurance coverages as may be added with respect to such property by the industry placement facility with the approval of the commissioner or by the commissioner, but shall not include insurance on automobile or farm risks. [¶] For the purposes of earthquake coverage that is provided as a component of basic property insurance, the association shall sell only the policy described in Section 10089. In force policies of basic property insurance that include earthquake coverage shall be renewed with the coverage specified in Section 10089, and the association shall comply with the notice requirements of paragraph (2) of subdivision (a) of Section 10086.” (
Under the statutory scheme, respondent is an involuntary joint reinsurance association of all insurers authorized to “write and engage[] in writing in [California], on a direct basis, basic property insurance or any component thereof in multiperil policies.” (
Respondent is statutorily mandated to propose a plan of operation that provides, among other things, for the allocation of profits and losses arising from the FAIR Plan among the insurers, based upon the respective insurer‘s proportion of the California insurance market. (
The Commissioner is authorized to review and approve (or disapprove) respondent‘s plan of operation. The statute provides: “The plan shall be subject to the approval of the commissioner and shall go into effect upon the tentative approval of the commissioner. The commissioner may, at any time, withdraw his or her tentative approval or he or she may, at any time after he or she has given his or her final approval, revoke that approval if he or she feels it is necessary to carry out the purposes of the chapter. The withdrawal or revocation of that approval shall not affect the validity of any policies executed prior to the date of the withdrawal. If the commissioner disapproves or withdraws or revokes his or her approval to all or any part of the plan of operation, the association shall, within 30 days, submit for review an appropriately revised plan or part thereof, and, if the association fails to do so, or if the revised plan so filed is unacceptable, the commissioner shall promulgate a plan of operation or part thereof as he or she may deem necessary to carry out the purpose of this chapter.” (
The statute also authorizes the Commissioner to review any act or decision by respondent, subject to judicial review. (
C. Order Sustaining the Demurrer to the First Amended Complaints
The trial court determined that appellants had not stated a cause of action against respondent, as respondent had fulfilled its contractual obligations under the written insurance policy, and the policy complied with the applicable requirements of the Insurance Code. On appeal, appellants contend (1) that respondent breached its duty under
1. Section 10100.2
2. Sections 2070 and 2082
Appellants next contend that under
Read in conjunction,
3. Section 2071
Under the enabling statute of the FAIR Plan, respondent is statutorily mandated to provide coverage for “perils insured under the standard fire policy.” (
Under the plain language of the standard form fire policy, an insurer must insure, “to an amount not exceeding ____ dollars,” the insured‘s property at the location of the property from all loss caused by fire or lightning and any other covered perils, to the extent of the ACV of the property at the time of loss, but not exceeding the cost to repair or replace the property, without including an allowance for increased costs due to building ordinances, and without compensation for loss from interruption of business; nor, in any event, for more than the interest of the insured. The phrase “to an amount not exceeding ____ dollars” precedes all further descriptions of coverage provided and thus, by its terms, fixes the maximum amount due under the policy. If,
For similar reasons, appellants were not entitled to additional coverages in excess of their policy limits. For example, coverage for “Other Structures” or “trees and shrubs” is subject to the overarching policy limit set forth in the “amount not exceeding ____ dollars.” Coverage for debris removal and for additional living expenses is not mentioned in the standard form. To the extent such coverage can be implied as part of the cost to repair or replace the property, which we specifically decline to find, such coverage is also subject to the policy limits.5 Finally, coverage for building code upgrades or for loss of rental value was specifically excluded from the calculation of the ACV of the insured property; moreover, were such coverage included, it would be subject to the policy limits. In short, appellants have failed to show they were statutorily entitled to recover for losses in excess of their policy limits.6,7
Appellants argue that our interpretation would effectively write out of the statute the phrase “to the extent of the actual cash value of the property at the time of loss.” Not so. That phrase would take effect if the policy limits
For the first time, in its reply brief, appellants argue that
Moreover, appellants’ interpretation runs afoul of the statutorily defined “measure of indemnity” under an “open policy” set forth in
“Under an open policy that requires payment of actual cash value, the measure of the actual cash value recovery, in whole or partial settlement of the claim, shall be determined as follows:
“(1) In case of total loss to the structure, the policy limit or the fair market value of the structure, whichever is less.
“(2) In case of a partial loss to the structure, or loss to its contents, the amount it would cost the insured to repair, rebuild, or replace the thing lost or injured less a fair and reasonable deduction for physical depreciation based upon its condition at the time of the injury or the policy limit, whichever is less. . . .”
In sum, respondent fulfilled its contractual and statutory obligations to appellants by timely paying them the full amount of their policy limits. Thus, appellants have failed to state a cause of action against respondent under any theory of liability. Accordingly, the trial court properly sustained respondent‘s demurrer to appellants’ first amended complaints.
DISPOSITION
The judgment is affirmed. Respondent is awarded its costs on appeal.
Willhite, Acting P. J., and Edmon, J.,* concurred.
The petition of all appellants for review by the Supreme Court was denied May 14, 2014, S217103.
Willhite, Acting P. J., and Edmon, J.,* concurred.
*Judge of the Los Angeles Superior Court, assigned by the Chief Justice pursuant to article VI, section 6 of the California Constitution.
