With a wildfire season in full swing, it is worth reviewing the laws regarding the deadlines for bringing actions and to ensure that the coverage advisor correctly writes the lawsuit to avoid dismissal. Last week, a federal court ruled that an insured lawsuit was initiated too late because of the allegations made by the insured himself. The court ruled, in accordance with California law, that the time limit is fixed and that the lack of time limit hinders the lawsuit. The case is Rosenberg-Wohl v. State Farm Fire & Casualty Company . 1
Before we jump into the actual case, it is important that we go through the basic rules. If you open your long insurance and face the end, you will probably find a section titled "Terms". Within that, you will almost certainly see a clause entitled "Suit Against Us" or "Suit Limits". These sections state that the insured must bring an action within a certain period of time after the date of loss. The date of loss is the date on which the damage occurred that is the subject of the claim. Most California policies limit the time limit to one or two years from the expiration date. Thus, these policies state that the applicant must bring an action within one or two years from the date on which the damage occurred which is the subject of the claim. California law is clear that these are almost always enforceable if they provide at least one year. 2
If you think one or even two years is too strict ̵1; because most claims are not resolved within one or even two years when considering the redevelopment phase – you should think consistently with California courts. California law also states that the time limit begins on the expiration date but is paused (or "charged") when the claim is filed. In other legal terms, the time limit is limited "from the time an insured person notifies the insurer of the damage, in accordance with applicable policy notices, until coverage is denied." 3 We like to think of a stopwatch – you start when the loss occurs, and you pause when you make the claim. When the claim is closed or denied, press the start button again and continue to run the time from the point where it was paused at the application. The stopwatch can be paused again if the claim is formally reopened, but this must be done before the stopwatch ends. 4 The only other way to revive the right to bring an action is to get the insurance company to formally agree. that they reset the time limit for bringing an action. In our experience, many insurance companies will agree to this if they really reconsider the claim.
In the most recent decision Rosenberg-Wohl the insured submitted her case too late and her lawsuit was dismissed. In particular, the trial was dismissed immediately after the insured filed it, as the court found that the insured's own allegations showed that her case was pending. In the complaint, the insured claimed that she owned a home and insured it with State Farm, with an assurance that the insured has one year to submit an application from the date of loss. 5 She claimed that around 2019 she started noticing problems with stairs in front of her house that made older visitors lose their balance and fall. 6 She claimed that she contacted State Farm on April 23, 2019 or so and reported that the stairs "just settled." 7 She claimed that on July 23, 2019 a "representative" of State Farm very briefly inspected the site; that on August 9, 2019, she formally opened the claim; and that on August 26, 2019, State Farm denied the claim with reference to exceptions for, among other things, wear and tear, demolition and solution. 8 She claimed that she followed up with a "request" on August 24, 2020, in which the representative of State Farm allegedly claimed that the claim was "reopened." 9 After this, she claimed that State Farm again denied the claim with a letter from the same date 10
By applying the rules discussed above, the Court found that the case was precluded even though he accepted the insured's allegations as true. years had passed before the lawsuit was filed, even given California's laws on fees. The court found that the one-year deadline began to run on April 23, 2019, the inspection date, although the claim was not formally opened yet, as the policy language said that the stopwatch runs from the loss date, not the date the claim is opened. 11 The court further held that the one-year stopwatch began running on April 23, 2019; was paused (or "charged") for 17 days from August 9 to August 26, 2019, when the claim was filed and then denied; and that the stopwatch then ran again from the time it had been paused and expired long before the insured filed the lawsuit on October 22, 2020, more than 17 months later. .
The Insured argued in response that State Farm waived (or knowingly waived its right to enforce) the suit restriction clause by resuming the claim during the alleged telephone conversation on August 24, 2020. The court dismissed the argument, citing well-established California law. The court declared: "It is a statutory law that an exception exists when an insurer intentionally waives its right to rely on a limitation clause in an insurance contract." 13 "For example, if the insurer expressly extends the -year provision during its claims investigation, the insurer waives its right to bring an up-to-date defense against the insured's action has expired – for example not to state the limitation provision when it denies the claim, fails to inform the insured that the limitation provision exists or does not specifically invoke the time limit as a defense – cannot legally, constitute an exception or overprint. " 15 By applying this law to the facts, the court considered , "The resumption of the claim thus took place after the one-year period had expired. It can not constitute an exception in law. 16
The decision in Rosenberg-Wohl reminds us that the law on deadlines for filing lawsuits must never be missed.They are tough and fast – not something that can be forgiven or excused even by caregivers öshet. The case proves why the insured must be careful not only to adhere to the rules that set the deadline for the application, but also that their lawyers must be careful about how they prepare lawsuits. This is also another example in a long line of unfortunate cases where the insurance law is unique, complicated and therefore choosing an expert who only works in this area gives a clear advantage.
1 Rosenberg-Wohl v. State Farm Fire & Cas. Co. No. 20-cv-09316, 2021 WL 4243389 (N.D. Cal., September 17, 2021).
2 Id. at 6; C&H Foods Co. v. Hartford Ins. Co. 163 cal. App. 3d 1055, 1064 (1984).
3 Id. at 6; Prudential-LMI Com. Ins. v. Superior Ct. 51 cal. 3d 674, 693 (1990).
4 Id. at * 6, with reference to Prudential-LMI 51 cal. 3d at 689.
5 Id. at * 1.
8 Id. at * 1-2.
9 Id. at * 6.
11 Id. at * 6.
12 Id. at * 5-6.
13 Id. at * 6, with reference to Prudential-LMI 51 cal. 3d at 689.
14 Id. with reference to Prudential-LMI, 51 Cal. 3d at 690.
15 Id. at 690 n.5 (original emphasis) (referring to Becker v. State Farm Fire & Casualty Co. 664 F. Supp. 460, 461-62 (ND Cal. 1987)) ; se Safeco Ins. Co. v. Morrell 936 F.2d 579, 1991 WL 106292, * 2 (9th Cir. 18 June 1991) (contained the letter which "seemed to [the plaintiff] delay the application for the application" Could not have resulted in exception or suspension in respect of the 12-month limitation period in which the letter “was written after the expiry of the 12-month limitation period” (citation omitted)).
16 Id. Se Prudential-LMI 51 Cal. 3d at 690 n.5; Gordon v. Deloitte & Touche, LLP Grp. Long Term Disability Plan 749 F.3d 746, 752 (9th Cir. 2014) (which states that "[u] under California law, an insurance company may not waive the limitation period after the limitation period has expired." (With reference to to Aceves v. Allstate Ins. Co. 68 F.3d 1160, 1163 (9th Cir. 1995)). documents — such as promising to pay the claim or refusing to provide the insured with a copy of the insurance showing the twelve-month field — to cause the insured to delay the application beyond the limitation period. ” Stinson v. Home Ins. Co. 690 F. Supp. 882, 885 (ND Cal. 1988) (with reference to Muraoka v. Budget Rent – A – Car 160 Cal. App. 3d 107, 116 (1984)).