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Burden to prove follow-up with insurance guarantee



Insurance guarantees are essential promises from an insured who is essential for effective insurance. Failure to comply with the warranty is a breach of a material condition that applies to the right to benefits promised by the insurance policy.

In Rocky Wright, Individual and as Trustee, etc. Against Walter Johnson, Star Insurance Company, Real Party of Interest, E068412, Appeal Court of California, California, Fourth Appeal District Division Two (April 8, 2019) attempted collecting from the insurer of a decedent failed due to the failure case to prove that the deed had fulfilled the guarantee before it crashed an aircraft into the plaintiff's property.

FACTS

In September 201

1, Walter Johnson, the deceased, piloted a Cessna P210 model airplane over Tehachapi in Kern County when the plane crashed, killed Johnson and his passengers and lit a fire that spread to the plaintiff and complainant, Rocky Wrights property. The fire destroyed personal characteristics, luminaires and growing crops (timber) on Wright's real estate. Wright sued Johnson's estate and attempted to recover at least $ 1.75 million in damage to Wright's real and personal traits from Johnson's aircraft liability insurance company and real party in the interest and defendant, Star Insurance Company (Star), according to Probate Code Section 550. [19659002] The Court of Justice initiated a summary judgment in favor of Star on Wright's first amended complaint for negligence in itself and the offense because Wright could not prove to be an essential element of his insurance claim against Star, namely that Johnson had complied with the "pilot guarantee approval" or "PWE "of his aircraft liability insurance with Star.

Wright appealed and claimed that the trial wrongly put the burden on Wright to show that Johnson had fulfilled the annual MFG school's demands, rather than putting on the burden Star to show that Johnson had not met the annual MFG school requirement and therefore states Wright's damages a gaining Johnson was not covered by the policy.

ANALYSIS

Proving that Johnson had completed PWE's annual MFG school requirements was an important feature of Wright's insurance claim against Star. In an attempt, Wright would have burdened the evidence that Johnson had fulfilled the requirement. Star had the first burden of showing Wright could not prove that Johnson had fulfilled the requirement. Star met this burden. Star evidence shifted the burden to Wright to show that Johnson had fulfilled the requirement or to raise a question as to whether Johnson had met the requirement.

Aircraft Insurance Policy (issued by Star to Johnson)

In November 2010, Star issued an "Airline Insurance" to The Walter Johnson Family Trust, which the Insured provided. The policy included liability insurance for Cessna for a year, including September 4, 2011, the date the plane crashed in Tehachapi and its pilot Johnson and his passengers were killed. Johnson settled and the flight originated from San Bernardino County.

The pilot's pilot warranty permit, or PWE, included an "Annual MFG school requirement" which required that any pilot in Cessna, including Johnson, should have "completed the aircraft manufacturer's approved basic and flight training school or equivalent as approved by air traffic controllers in the insured mark and model aircraft." during the previous 12 months of the intended flight. "

Wright's First Operational Modified Complaint

Probate Code Section 550 allows a plaintiff to sue a deceased's estate without naming the estate's personal representative to" determine the deputy's responsibility for which the case was protected by insurance ".

Wright filed a first amended complaint (FAC) against Johnson's estate, according to the Probate Code Section 550, which seeks to determine Johnson's liability and Star's liability under its a liability insurance with Johnson, for the damage caused by Wright as of September 4, 2011, air crash. FAC is seeking $ 1.5 million in damages to Wright's growing crops, $ 250,000 in damages for Wright's lost profits and lost use of his property, and additional damages under evidence.

Star's Motion for Summary Judgment / Judgment and Judicial Court Investigation [19659010] Star moved for summary assessment on the FAC, or summary assessment of each cause of action, for two reasons: (1) Johnson had not met the requirements of the policy's pilot guarantees or PWE, and (2) the coverage of the crash is excluded in accordance with "Exclusion 1" of the policy, which excludes coverage when the flight is "for illegal purpose".

Star presented uncontested evidence on October 13, 2010. On November 9, 2010, Johnson Star & # 39; s terms accepted by requesting the policy to be issued on November 10. On November 30, Falcon filed an insurance application, signed by Johnson, confirming that the policy was subject to "Minimu m Pilot Requirements" and also contained "Special Pilot Requirements: Annual Ground & Flight Training." In response to Star & # 39; s motion, Wright offered no evidence that Johnson, who piloted Cessna on September 4, 2011, had completed the PWE requirements. 19659002] Star showed Wright in written discovery response that Wright had no evidence that Johnson or his passengers had followed PWE.

The Court of Appeal concluded that the trial properly put the burden on Wright to prove that Johnson had completed the Annual MFG School Requirements, Wright did not, and conviction was correctly judged in favor of Star.

Applying the insurance burden to make sure that "set up coverage" according to the insurance policy or to show that the terms of an insurance "coverage" clause have been met, is consistent with an insured's general obligation to establish coverage where it would otherwise not exist. Wright had burden of proof trying to prove that Johnson had met PWE's annual MFG school requirements.

Johnson's failure to comply with PWE's annual MFG school requirements was not an affirmative defense to coverage or exclusion coverage. The star did not have the first burden to show that Johnson did not comply with PWE's annual MFG school requirements. Rather, PWE's annual MFG school requirements were a guarantee provision in Johnson's insurance contract with Star and a condition governing the Star agreement to cover Johnson for September 4, 2011, the flight and Johnson were required to fulfill this guarantee fee as a condition for having Wrights claims covered by the star's insurance policy with Johnson.

Strict compliance with pilot guarantees is a necessary consequence of aviation insurance. Pilot qualifications and experience are obviously factors that directly depend on the insurer's risk insurer's risk. Thus, Star included the compliance with PWE and its annual MFG school requirements, as a condition of the Star Agreement to cover Johnson's liability to Wright for Wright's negligence claim against Johnson.

The verdict was confirmed, and Star recovered its costs in the appeal.

Insurance guarantees are ancient forms that require the insured to fulfill an essential promise of the insured to ensure the benefits that are promised. That is the basis of the risk that the insurer takes. Failure to prove strict compliance with the pilot guarantee deprives the insured – and in this case the person who suits his property – of the coverage. In that regard, California provides code 449 for insurance coverage: "A non-fraud breach of warranty only excludes an insurer from the time of its occurrence or if the warranty is breached at the start, preventing the policy from adding to the risk." Because there was no evidence that Johnson participated in the course, the policy was never tied to the risk.


© 2019 – Barry Zalma

This article and all the blog posts on this site, melt and summarize issues published by the courts of the various states and the United States. The court decisions have been modified from the actual language of the court decisions, condensed to facilitate reading and convey the author's views in each individual case.

Barry Zalma, Esq., CFE, now limits his practice to service as an insurance consultant specializing in insurance coverage, insurance management, bad faith assurance, and insurance fraud nearly equal for insurers and policyholders. He also serves as an arbitrator or mediator for insurance-related disputes. He practiced law in California for more than 44 years as an insurance cover and law firm and more than 50 years in the insurance industry. He is available at http://www.zalma.com and zalma@zalma.com.

Mr. Zalma is the first recipient of the first annual liability magazine / ACE Legend Award.

Over the past 51 years, Barry Zalma has put his life on insurance, insurance claims and the need to defeat insurance fraud. He has created the following library of books and other materials to enable insurers and their claims to become insurance managers.

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