Property insurer's fire investigator changes his initial report after second inspection of RV; insurer then denies claim.
- Case Name: Octavio Lopez v. National General Assurance Company
- Court and Case Number: Riverside Superior Court / RIC1808643
- Date of Verdict or Judgment: Monday, November 25, 2019
- Date Action was Filed: Wednesday, May 30, 2018
- Type of Case: Breach of Good Faith, Insurance – Bad Faith, Claims Handling
- Judge or Arbitrator(s): Hon. Chad Firetag
Plaintiffs: Octavio Lopez
Defendants: National General Assurance Company
- Type of Result: Jury Verdict
- Gross Verdict or Award: $8,463,833
Contractual damages: $147,333
- Trial or Arbitration Time: 11 days.
- Jury Deliberation Time: 2 hours for Phase 1; 4 hours for Phase 2 (punitive damages).
- Jury Polls: 12-0 Phase 1; 9-3 Phase 2 (punitive damages).
Attorney for the Plaintiff:
Schwartzberg & Luther, APC by Sagi Schwartzberg, Rancho Cucamonga.
Attorney for the Defendant:
Murchison & Cumming LLP by Jean M. Daly and Tyler E. Sanchez, Los Angeles.
Plaintiff's Technical Expert(s):
Daina Dillabough, Fair Claims Act, standard of care.
Daniel Bonelli, fire investigations.
Defendant's Technical Expert(s):
Lola Hogan, Fair Claims Act, standard of care.
K.C. Hester, fire investigations.
Facts and Background
Facts and Background:
After plaintiff's RV caught on fire, he made a claim with National General for coverage under his RV insurance policy.
National General opened an investigation as to the cause of the fire. Initially, National General's fire investigator determined that the fire was electrical and there was no sign of arson and closed the investigation.
Approximately one week later, the fire investigator requested to conduct another inspection, wherein he discovered another point of origin. Three weeks after that he authored a report that the fire was intentionally set by an unknown person.
National General then conducted plaintiff's Examination Under Oath, wherein two of National General's Special Investigation Unit investigators questioned plaintiff. Two days after the Examination Under Oath, National General denied the claim based on alleged material misrepresentations.
Plaintiff claimed that, after the fire investigator reported that the fire was clearly an electrical fire, National General discovered that plaintiff had a purchase price guarantee endorsement which provided coverage up to the amount plaintiff purchased his RV for instead of actual cash value.
It was shortly thereafter that the fire investigator sought to re-examine the RV and concluded it was an intentional fire. Plaintiff further claimed that National General believed that he set the RV on fire prior to his Examination Under Oath based on their fire investigator's report, and used the Examination Under Oath as a setup to fabricate and manufacture material misrepresentations to deny his claim, which they did only a few days later.
Plaintiff lastly claimed that National General failed to consider his interest, failed to diligently search for and consider evidence that would support coverage, and acted with malice, oppression or fraud during the investigation and ultimate denial.
Defendant claimed that it acted reasonably based on the information it had at the time, and that plaintiff's statements during his Examination Under Oath and during the entirety of the investigation were material misrepresentations which allowed them to deny the claim. Defendant claimed that it properly investigated the fire loss and reasonably relied on their fire expert's investigation and conclusion, and therefore acted in good faith in adjusting plaintiff's claim.
Injuries and Other Damages
Physical Injuries claimed by Plaintiff: