California Court of Appeal
Barnes v. Western Heritage Ins. Co., C066002
Summary judgment for defendant-insurer on plaintiff's claims for breach of contract and breach of the implied covenant of good faith and fair dealing based on the denial of his request for medical payment coverage is reversed and remanded, where: 1) collateral estoppel does not bar the present action because the issues asserted in this action were not litigated or determined in the prior third party personal injury action; 2) a recovery in this action would not amount to an impermissible double recovery because plaintiff now sues defendant-insurer alleging that it breached its direct duty to plaintiff under the medical payment provision of the insurance policy, a duty distinct from the obligation defendant owed the third party-insured under the liability provision of the policy; and 3) there is a triable issue of material fact regarding whether defendant-insurer is equitably estopped to assert the policy’s one-year deadline as a defense.
- Decided 06/18/2013
- Published 06/18/2013
- California Court of Appeal