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News & Press: Court Cases


Tuesday, October 16, 2018  
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Pacificare Life and Health Insurance Company v. Jones
Cal.App. 4th Dist., Div. 3 (G053914) 9/20/18

The court held that:

  1. Insurance Code Section 790.03(h) defines an unfair claims settlement practice to be either an insurer's single knowing commission of the described conduct, or its performance of the conduct "with such frequency as to indicate a general business practice."
  2. California Code of Regulations Section 2695.2(l) is valid. It defines "knowingly committed" to mean acts performed with actual, implied or constructive knowledge.
  3.  CCR Section 2695.2(y) is valid. It states that "Willful" or "Willfully" when applied to the intent with which an act is done or omitted means simply a purpose or willingness to commit the act, or make the omission, and does not require any intent to violate law, or to injure another, or to acquire any advantage.


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