Friday, February 11, 2005

Retaliation in Employment Case: Yanowitz v. L'Oreal USA, Inc.

OPINION

GEORGE, C. J.-

Plaintiff Elysa J. Yanowitz was a regional sales manager employed by defendant L'Oreal USA, Inc. (L'Oreal), a prominent cosmetics and fragrance company. Yanowitz alleges that after she refused to carry out an order from a male supervisor to terminate the employment of a female sales associate who, in the supervisor's view, was not sufficiently sexually attractive or "hot," she was subjected to heightened scrutiny and increasingly hostile adverse treatment that undermined her relationship with the employees she supervised and caused severe emotional distress that led her to leave her position. In bringing this action against L'Oreal, Yanowitz contended, among other matters, that L'Oreal's actions toward her constituted unlawful retaliation in violation of the provisions of Government Code section 12940, subdivision (h) (section 12940(h)), which forbids employers from retaliating against employees who have acted to protect the rights afforded by the California Fair Employment and Housing Act (FEHA) (Gov. Code, § 12900 et. seq). fn. 1

II.

[2] Past California cases hold that in order to establish a prima facie case of retaliation under the FEHA, a plaintiff must show (1) he or she engaged in a "protected activity," (2) the employer subjected the employee to an adverse employment action, and (3) a causal link existed between the protected activity and the employer's action. ( Iwekaogwu v. City of Los Angeles (1999) 75 Cal.App.4th 803 , 814-815; Flait v. North American Watch Corp . (1992) 3 Cal.App.4th 467 , 476 [adopting the title VII (Civil Rights Act of 1964, 42 U.S.C. § 2000e et seq.) burden-shifting analysis of McDonnell Douglas Corp. v. Green (1973) 411 U.S. 792, 802-805].) Once an employee establishes a prima facie case, the employer is required to offer a legitimate, nonretaliatory reason for the adverse employment action. ( Morgan v. Regents of University of California (2000) 88 Cal.App.4th 52 , 68.) If the employer produces a legitimate reason for the adverse employment action, the presumption of retaliation "drops out of the picture," and the burden shifts back to the employee to prove intentional retaliation. ( Ibid. )

As the United States Supreme Court recognized in interpreting and applying the provisions of title VII in Harris v. Forklift Sys., Inc. (1993) 510 U.S. 17, the statutory language protecting employees against racial or sexual discrimination in compensation or in the terms, conditions, or privileges of employment is not limited to adverse employment actions that impose an economic detriment or inflict a tangible psychological injury upon an employee. In Harris (a sexual harassment case), after quoting the language of title VII (42 U.S.C. 2000e-§ 2(a)(1)) making it an unlawful employment practice " 'to discriminate against any individual with respect to his compensation, terms, conditions, or privileges of employment,' " the high court went on to explain that "this language 'is not limited to "economic" or "tangible" discrimination. The phrase "terms, conditions, or privileges of employment" evinces a congressional intent "to strike at the entire spectrum of disparate treatment of men and women" in employment,' which includes requiring people to work in a discriminatorily hostile or abusive environment. [Citations.] When the workplace is permeated with 'discriminatory intimidation, ridicule, and insult' [citation] that is 'sufficiently [36 Cal.4th 1053] severe or pervasive to alter the conditions of the victim's employment and create an abusive working environment' [citation], Title VII is violated. This standard, which we reaffirm today, takes a middle path between making actionable any conduct that is merely offensive and requiring the conduct to cause a tangible psychological injury. As we pointed out in Meritor [ Sav. Bank, FSB v. Vinson (1986) 477 U.S. 57, 67], 'mere utterance of an . . . epithet which engenders offensive feelings in an employee,' . . . does not sufficiently affect the conditions of employment to implicate Title VII. . . . [¶] But Title VII comes into play before the harassing conduct leads to a nervous breakdown. A discriminatorily abusive work environment, even one that does not seriously affect employees' psychological well-being, can and often will detract from employees' job performance, discourage employees from remaining on the job, or keep them from advancing in their careers. . . . [¶] . . . Certainly Title VII bars conduct that would seriously affect a reasonable person's psychological well-being, but the statute is not limited to such conduct. So long as the environment would reasonably be perceived, and is perceived, as hostile or abusive [citation], there is no need for it also to be psychologically injurious. [¶] This is not, and by its nature cannot be, a mathematically precise test. We need not answer today all the potential questions it raises . . . . But we can say that whether an environment is 'hostile' or 'abusive' can be determined only by looking at all the circumstances. These may include the frequency of the discriminatory conduct; its severity; whether it is physically threatening or humiliating, or a mere offensive utterance; and whether it unreasonably interferes with an employee's work performance. The effect on the employee's well-being is, of course, relevant to determining whether the plaintiff actually found the environment abusive. But while psychological harm, like any other relevant factor, may be taken into account, no single factor is required." ( Harris , supra , 510 U.S. at pp. 21-23, fns. omitted, italics added.)

[11] As the high court concluded in Harris with respect to the comparable language embodied in Title VII, we believe that the language in section 12940(a) making it an unlawful employment practice for an employer to discriminate against an employee on the basis of race, sex, or the other enumerated characteristics "in compensation or in the terms, conditions, and privileges of employment" properly must be interpreted broadly to further the fundamental antidiscrimination purposes of the FEHA. fn. 12 Appropriately viewed, this provision protects an employee against unlawful discrimination [36 Cal.4th 1054] with respect not only to so-called "ultimate employment actions" such as termination or demotion, but also the entire spectrum of employment actions that are reasonably likely to adversely and materially affect an employee's job performance or opportunity for advancement in his or her career. [12] Although a mere offensive utterance or even a pattern of social slights by either the employer or co-employees cannot properly be viewed as materially affecting the terms, conditions, or privileges of employment for purposes of section 12940(a) (or give rise to a claim under section 12940(h)), fn. 13 the phrase "terms, conditions, or privileges" of employment must be interpreted liberally and with a reasonable appreciation of the realities of the workplace in order to afford employees the appropriate and generous protection against employment discrimination that the FEHA was intended to provide. fn. 14

California Ins. Guarantee Assn. v. Superior Court (Jakes at the Shore, Inc.)

CROSKEY, J.

Petitioner California Insurance Guarantee Association (CIGA) seeks a writ of mandate directing the respondent court to vacate its order staying the trial of a declaratory relief action commenced by CIGA to determine issues of coverage under a liability policy issued by a now insolvent insurer. As we conclude that CIGA has no better or greater right to a trial preference for resolution of disputed coverage issues than does an ordinary insurer, we deny the writ.

Factual and Procedural Background

Prior to June 11, 1986, Mary Collins (Collins) brought an action (herein the underlying action) against her former employer, Jakes at the Shore, Inc. (Jakes) and one Noah Peete (Peete) who had been her supervisor at Jakes where she had worked as a waitress. On that date she filed a first amended complaint in which she alleged causes of action for (1) wrongful discharge, (2) breach of the implied covenant of good faith and fair dealing, (3) intentional infliction of emotional distress, (4) unlawful discrimination against a physically and medically handicapped person, (5) sexual harassment and (6) age discrimination. fn. 1

In summary, fn. 2 Collins alleged in her complaint that (1) she had been employed by Jakes on the understanding that she would continue to be employed as long as she properly performed her duties and would not be terminated except for just cause; (2) she worked at Jakes from November 9, 1983, until she was terminated on September 20, 1985; (3) she was never, during that period, reprimanded for poor job performance; (4) in June of 1984 she was diagnosed as having breast cancer and underwent a mastectomy; (5) as a result she was on sick leave from June until July 1984 when she returned to work; (6) prior to August 29, 1985, she advised Peete that she [231 Cal.App.3d 1621] was going to have reconstructive surgery on her breasts; (7) she was again placed on sick leave with the understanding that she would return to work on September 20, 1985; (8) she was terminated on that date despite her willingness and ability to return to work following the reconstructive surgery; (9) such termination was in violation of the implied promise that she would not be terminated except for just cause and was in violation of the California Fair Employment and Housing Act (FEHA); fn. 3 (10) she was terminated because of her mastectomy and reconstructive surgery rather than for any failure on her part to perform or comply with her employer's policies or requirements; (11) following her original surgery she was repeatedly subjected to pervasive, derogatory, degrading and disparaging references by Peete to her body, physical condition and age, fn. 4 which remarks were made in a sexually slanderous way; and (12) she was subjected to malicious, intentional, extreme and outrageous conduct which caused her to suffer severe physical and emotional distress.

Jakes fn. 5 tendered the defense of this action to its general liability insurer, Integrity Insurance Company (Integrity) and to its workers' compensation carrier, West American Insurance Company (West American). fn. 6 Integrity undertook to provide a defense to Jakes under a reservation of rights; West American refused to provide Jakes with any defense whatsoever.

On March 9, 1987, Integrity was declared insolvent by an order of the superior court. Pursuant to the provisions of Insurance Code section 1063 et seq., CIGA became responsible for discharging the responsibilities of Integrity with respect to all "covered claims." On June 8, 1988, CIGA filed its second amended complaint for declaratory relief against Jakes, Peete and West American who are the real parties in interest herein (hereinafter collectively real parties). fn. 7 By this action, CIGA sought a judicial determination that the claim asserted by Collins against Jakes, given the provisions of Integrity's policy, fn. 8 as not a "covered claim" as that term is defined by the [231 Cal.App.3d 1622] relevant provisions of the Insurance Code and that, in any event, there was coverage under the West American policy which, if true, would mean, pursuant to statute, that CIGA had no responsibility for coverage.

CIGA moved for summary judgment or, in the alternative, summary adjudication of issues. The alternative motion was granted on October 15, 1990, as to those claims asserted by Collins in the underlying action relating to wrongful termination and breach of the implied covenant of good faith. The court held that, as a matter of law, those allegations did not describe an "occurrence" as that term was defined in Integrity's policy. Therefore, there was no coverage under the policy for those claims and CIGA was entitled to a summary adjudication thereon.

West American and Jakes then brought a joint motion seeking a stay of further proceedings in the declaratory relief action pending the trial and determination of the underlying action. They claimed, and the trial court apparently concluded, that the declaratory relief action (1) would require findings of fact which would necessarily be required in the underlying action fn. 9 and (2) a risk existed that inconsistent findings might result. [231 Cal.App.3d 1623] Therefore, the court granted the motion on October 18, 1990. At the same time it vacated the then pending trial date of the declaratory relief action.

It is from this order that CIGA seeks relief by writ of mandamus. In order to address the issue raised by CIGA's claim to a special preference, we issued an alternative writ on February 1, 1991.

Contentions of the Parties

CIGA contends that (1) by virtue of its special statutory character and responsibilities it should not be treated like any other insurance company, and (2) if the stay is not lifted, the prior trial of the underlying action will cause irreparable injury to CIGA in that it will be required to incur the unrecoverable cost of defending that action even though it may have no obligation to do so. fn. 10

West American and Jakes on the other hand, argue that (1) the trial court has the discretion to determine the priority of trial for a declaratory relief action raising insurance coverage issues, (2) the trial of the declaratory relief action will necessarily depend upon and thus require findings of fact to be made in the underlying action, and (3) a possibility of inconsistent findings will exist unless the underlying action is tried first since Collins is not a party to the declaratory relief action.

Discussion

1. The Court Has Discretion to Set the Priority of a Declaratory Relief Action

[1] Generally, an action in declaratory relief will not lie to determine an issue which can be determined in the underlying tort action. "The [231 Cal.App.3d 1624] declaratory relief statute should not be used for the purpose of anticipating and determining an issue which can be determined in the main action. The object of the statute is to afford a new form of relief where needed and not to furnish a litigant with a second cause of action for the determination of identical issues." (General of America Ins. Co. v. Lilly (1968) 258 Cal.App.2d 465 , 470 [65 Cal.Rptr. 750].) "Under section 1061 of the Code of Civil Procedure the court may refuse to exercise the power to grant declaratory relief where such relief is not necessary or proper at the time under all of the circumstances. The availability of another form of relief that is adequate will usually justify refusal to grant declaratory relief. The refusal to exercise the power is within the court's legal discretion and will not be disturbed on appeal except for abuse of discretion. (Girard v. Miller [1963] 214 Cal.App.2d 266 , 277. ...)" (Id. at p. 471; see also, State Farm etc. Ins. Co. v. Superior Court (1956) 47 Cal.2d 428 , 433 [304 P.2d 13].)

[2a] It appears that the trial court concluded that the prior determination of CIGA's declaratory relief action would contravene this general rule as it would necessitate the resolution of one or more factual issues which would have to be determined in the underlying action (see fn. 9, ante, p. 1622). Since such a result could be prejudicial to Jakes and West American, the trial court exercised its discretion to stay CIGA's action. Given the prospect of inconsistent verdicts with respect to factual issues common to both matters, we would have no trouble concluding that the trial court did not abuse its discretion if the insurer seeking the declaratory relief were other than CIGA. The question before us is whether a different result is compelled because of CIGA's special status.

2. CIGA Is Not an Ordinary Insurer but Nonetheless Has Many of the Same Burdens

CIGA was created by legislative act in 1969 (Ins. Code, § 1063 et seq.) to establish a fund from which insureds could obtain both "financial and legal assistance in the event their insurers became insolvent, [that is] 'to provide insurance against "loss arising from the failure of an insolvent insurer to discharge its obligations under its insurance policies." (Ins. Code, § 119.5.)' (Biggs v. California Ins. Guarantee Assn. (1981) 126 Cal.App.3d 641 , 644 [179 Cal.Rptr. 16]. ...)" (Isaacson v. California Ins. Guarantee Assn. (1988) 44 Cal.3d 775 , 784 [244 Cal.Rptr. 655, 750 P.2d 297].)

[3] "As other courts have recognized, CIGA is not, and was not created to act as, an ordinary insurance company. [Citation.] It is a statutory entity that depends on the Guarantee Act for its existence and for a definition of the scope of its powers, duties, and protections. 'CIGA is an involuntary, [231 Cal.App.3d 1625] unincorporated association of insurers admitted to transact business in California. Each insurer is required to participate in CIGA as a condition of doing business in this state. The statutory purpose of CIGA is to provide for each insurer member insolvency insurance to pay the claims arising out of policies issued by an [insurer who becomes insolvent]. ... Funds for the payment of such claims are obtained by collecting premium payments from its members. ... CIGA is limited to the payment of "covered claims" ....' [Citation.]" (Isaacson v. California Ins. Guarantee Assn., supra, 44 Cal.3d at p. 786, quoting from In re Imperial Ins. Co. (1984) 157 Cal.App.3d 290 , 293 [203 Cal.Rptr. 664].)

CIGA is correct when it argues that its liability is statutorily limited (Ins. Code, § 1063.12, subd. (a)) to the amount of "covered claims." Thus, it is fair to say that CIGA's role "differs from that of the ordinary insurer. It was created to provide relief in the case of an insurance carrier becoming insolvent [citation] and in so doing is given certain powers and certain protections. CIGA, however, does not 'stand in the shoes' of the insolvent insurer for all purposes." (Biggs v. California Ins. Guarantee Assn. (1981) 126 Cal.App.3d 641 , 645 [179 Cal.Rptr. 16].) (Italics in the original.)

"CIGA is authorized only to 'pay and discharge covered claims.' (Ins. Code, § 1063.2, subd. (a).) It is only 'in connection therewith' that CIGA is to 'pay for or furnish loss adjustment services and defenses of claimants when required by policy provisions. ...' (Ibid., italics added.) In addition, CIGA 'shall be a party in interest in all proceedings involving a covered claim, and shall have the same rights as the insolvent insurer would have had if not in liquidation ....' (Ins. Code, § 1063.2, subd. (b), italics added.) It is unequivocally clear the scope of CIGA's rights and duties turns on the definition of 'covered claim.'

"Subdivision (c)(1) of Insurance Code section 1063.1 defines 'covered claims' as 'the obligations of an insolvent insurer, (i) imposed by law and arising out of an insurance policy of the insolvent insurer; (ii) which were unpaid by the insolvent insurer; (iii) which are presented as a claim to the ... association ... (v) for which the assets of the insolvent insurer are insufficient to discharge in full ....' The remainder of subdivision (c) enumerates nine separate categories of claims clearly 'arising out of an insurance policy of the insolvent insurer' which nevertheless are not 'covered claims.' Since 'covered claims' are not coextensive with an insolvent insurer's obligations under its policies, CIGA cannot and does not ' "stand in the shoes" of the insolvent insurer for all purposes.' (Biggs v. California Ins. Guarantee Assn. (1981) 126 Cal.App.3d 641 , 645 ....) Indeed, CIGA is 'expressly forbidden' to do so except where the claim at issue is a 'covered [231 Cal.App.3d 1626] claim.' (E. L. White, Inc. v. City of Huntington Beach (1982) 138 Cal.App.3d 366 , 370-371 ....) It necessarily follows that CIGA's first duty is to determine whether a claim placed before it is a 'covered claim.' " (Saylin v. California Ins. Guarantee Assn. (1986) 179 Cal.App.3d 256 , 262 [224 Cal.Rptr. 493], italics added to this paragraph and to the last sentence of the prior paragraph.) But what happens when the discharge of CIGA's "first duty" requires a resolution of factual issues which are also present in the underlying action upon which CIGA's alleged liability is based? We have discovered no case which addresses this question.

[4] In our view, a determination of this issue must begin with a recognition that in spite of the statutory limitations on CIGA's liability it still has substantial obligations to the insureds of the insolvent insurer. As the Supreme Court stated, in a different but relevant context, "the scope of [CIGA's] obligation to pay and defend claims is defined in terms of the underlying insurance policy provisions." (Isaacson v. California Ins. Guarantee Assn., supra, 44 Cal.3d at p. 791.) CIGA's statutory duties can best be defined by examining the contractual duties which were imposed upon the now insolvent insurer either by law or such policy provisions. (Ibid.)

An insurer has "a duty to defend its insured whenever it ascertains facts which give rise to the potential of liability under the policy." (Gray v. Zurich Insurance Co. (1966) 65 Cal.2d 263 , 276-277 [54 Cal.Rptr. 104, 419 P.2d 168].) A wrongful failure to provide coverage or defend a claim is a breach of the insurance contract. (California Shoppers, Inc. v. Royal Globe Ins. Co. (1985) 175 Cal.App.3d 1 , 15 [221 Cal.Rptr. 171].) The obligations of CIGA are necessarily coextensive with those burdens imposed on all insurers. Thus, "if CIGA improperly denies coverage or refuses to defend an insured on a 'covered claim' arising under an insolvent insurer's policy, it breaches its statutory duties under the Guarantee Act." (Isaacson v. California Ins. Guarantee Assn., supra, 44 Cal.3d at p. 792.)

[5] Where an insurer questions the existence of coverage as CIGA does here, the alternative of an early declarative determination of the issue exists. (See State Farm Mut. Auto Ins. Co. v. Allstate Ins. Co. (1970) 9 Cal.App.3d 508 , 527 [88 Cal.Rptr. 246].) This right, however, is not without its limitations. While a declaratory relief action is normally entitled to a priority in trial setting (Code Civ. Proc., § 1062.3, subd. (a)), if the underlying action has an approaching trial date an insurer has no right to seek a delay of that trial pending a resolution of the coverage issue in a separate declaratory relief action. [231 Cal.App.3d 1627]

In addition, as we have already generally discussed, a separate declaratory action where the coverage question turns on facts to be litigated in the underlying action (e.g., whether the insured acted "intentionally") is not permitted. This is so because the insurer may well owe a defense in the underlying action even if the facts ultimately determined in that action show that there was no coverage. If the rule were otherwise, "any time an insurance company had a questionable claim due to an uncertain exclusion clause, it could defend, under a reservation of rights, and immediately bring an action for declaratory relief seeking to rid itself of the arguable duty to defend. As a result, the duty to defend would eventually be no broader than the duty to indemnify.

" * * *

"[A]n insurer [can] not rely on an exclusion limiting liability assumed under contract where the validity of the [contract] was at issue in the very action for which a defense was sought. [Citation.]" (Cal-Farm Ins. Co. v. TAC Exterminators, Inc. (1985) 172 Cal.App.3d 564 , 580-581 [218 Cal.Rptr. 407]; italics added.)

[2b] We see no reason for the result to be different here merely because CIGA is the insuring entity. There does not appear to be any policy reason why CIGA should be entitled to a stay of the underlying action brought by Collins so that coverage under the Jakes policy can first be resolved. CIGA argues it will suffer serious prejudice if it is required to provide a defense, the cost of which may not be recoverable and that such an expenditure will unnecessarily drain the limited funds available to pay claims. However, that unpleasant prospect is one that is routinely faced by all insurers whenever a potential for coverage exists. Since we cannot determine from this record that coverage does not exist, CIGA has a duty to defend. Pending the resolution of threshold factual questions the potential for coverage is clearly present.

If we were to recognize, simply because the insuring entity is CIGA, an exception to the general rule restricting declaratory relief actions where coverage turns upon facts to be litigated in the liability action, a very substantial and prejudicial burden would be imposed upon the insured. As Jakes argues, it could be exposed to inconsistent judgments which impose liability to Collins in the underlying action, but determine the absence of coverage in the declaratory relief action. Such a result runs entirely counter to the whole purpose and philosophy behind CIGA which is to protect [231 Cal.App.3d 1628] insureds, not place upon them unusual risks they would not have faced if their insurer had not become insolvent. fn. 11

We therefore conclude that, in spite of CIGA's burden to make the earliest possible determination as to the existence of "covered claims," no different or special rule is appropriate to the trial scheduling of a declaratory relief action to determine coverage merely because CIGA is the insurer seeking to resolve the issue. Where, as here, the question of coverage turns upon one or more factual issues which will necessarily be resolved in the underlying action, then it was entirely appropriate for the trial court to stay the declaratory relief action pending resolution of those issues. There was no abuse of discretion.

Disposition

The alternative writ is discharged. The peremptory writ is denied.

Klein, P. J., and Hinz, J., concurred.

­ FN 1. The action is entitled Collins v. Jakes at the Shore and bears Los Angeles Superior Court case number SWC 85009. The record does not disclose when the original complaint was filed or how or in what manner its allegations differed, if at all, from those of the first amended pleading.

­ FN 2. The allegations of Collins's complaint are only generally set forth. We have no need to reach either the merits or the adequacy of these allegations, but describe them only with that particularity necessary to illuminate the coverage issues raised by CIGA's action.

­ FN 3. Government Code section 12900 et seq.

­ FN 4. Collins was 51 years of age on the date of her termination.

­ FN 5. Presumably, whatever decision is made with respect to coverage for Jakes's liability will also be relevant to those allegations regarding Peete's conduct, at least to the extent that Jakes's has potential liability therefore. In addition, the Integrity policy includes as "insureds" officers, directors and employees.

­ FN 6. West American, a member of The Ohio Casualty Group of Insurance Companies, was erroneously sued herein as Ohio Casualty Company.

­ FN 7. As was the case with Collins, the record does not disclose the contents or date of filing of CIGA's earlier pleadings in this action.

­ FN 8. The relevant portions of Integrity's policy, relied upon by CIGA, provide:

a. Section II, part 1, the basic insuring provision states: "The company will pay on behalf of the insured all sums which the insured shall become legally obligated to pay as damages because of [¶] bodily injury or [¶] property damage [¶] to which this insurance applies, caused by an occurrence, ... and the company shall have the right and duty to defend any suit against the insured seeking damages on account of such bodily injury or property damage ...." (Italics added.)

b. The word "occurrence" is defined as "an accident, including continuous or repeated exposure to conditions, which results in bodily injury or property damage neither expected nor intended from the standpoint of the insured." (Italics added.)

c. Exclusion (j) provides in pertinent part: "This insurance does not apply: ... [¶] to bodily injury to any employee of the insured arising out of and in the course of his employment by the insured or to any obligation of the insured to indemnify another because of damages arising out of such injury" (Italics added.)

d. Integrity's policy provisions regarding "personal injury liability" states in pertinent part: "The company will pay on behalf of the insured all sums which the insured shall become legally obligated to pay as damages because of injury (herein called 'personal injury') sustained by any person or organization arising out of one or more of the following offenses committed in the conduct of the named insured's business: ... [¶] Group B-the publication or utterance of a libel or slander or of other defamatory or disparaging material, or a publication or utterance in violation of an individual's right of privacy ...." (Italics added.)

e. Exclusion (c) to the personal injury coverage provides: "This insurance does not apply: ... [¶] To personal injury sustained by any person as a result of an offense directly or indirectly related to the employment of such person by the named insured." (Italics added.)

­ FN 9. In order to prevail in its declaratory relief action, CIGA must establish that (1) it has no duty to defend Jakes under the terms of the Integrity policy or (2) Collins's claim is covered under the West American policy and is therefore not a "covered claim." With respect to the first alternative, CIGA claims that coverage does not exist because Collins's claim of "bodily injury" necessarily occurred in the course of her employment by Jakes and that the alleged disparaging remarks are not covered under the "personal injury" portion of the policy due to application of an exclusion relating to matters occurring during employment. As factual disputes exist with respect to these issues, they must be resolved before the legal issues regarding coverage can be decided. This is true whether the issue is CIGA's duty (1) to defend (where potential coverage need only be shown) or (2) to indemnify (where actual coverage is the issue). Likewise, CIGA's argument that it is statutorily absolved of coverage liability because West American, a solvent insurer, has coverage, also depends on factual questions regarding Collins's alleged injuries and whether they occurred in the course of employment or arose out of her employment. West American is Jakes's workers' compensation carrier and the extent of its responsibility, if any, clearly will depend upon the resolution of these factual issues.

Obviously, all of these factual issues will necessarily be resolved in the underlying action to which Collins is a party. If resolved first in the declaratory relief action, Collins would not be bound thereby and could conceivably try them to a different conclusion in her action, to the very substantial prejudice of Jakes.

­ FN 10. Other issues raised by CIGA go directly to the ultimate issue of whether the claims raised by Collins are "covered claims" within the meaning of applicable Insurance Code sections. As those issues necessarily involve unresolved questions of fact, we cannot determine or address them here. We decide only the questions surrounding the trial court's refusal to give a priority to the trial of CIGA's declaratory relief action.

­ FN 11. That an insured should not be placed in a worse position by the accident of insurer insolvency was recognized in E. L. White, Inc. v. City of Huntington Beach (1982) 138 Cal.App.3d 366 [187 Cal.Rptr. 879]. In rejecting an indemnity claim (by a subrogated insurer of a codefendant) against an insured whose insurer had became insolvent the court stated: "To the extent that the CIGA legislation discriminates between subrogation plaintiffs with claims against insureds of insolvent insurers and subrogation plaintiffs with claims against insureds of solvent insurers or against those who are uninsured, the classification certainly has a fair relationship to the statutory purpose. If such a classification were not made, there would be situations where the person meant to be protected by the CIGA legislation would be left vulnerable just because his insurer had become insolvent." (Id. at p. 373.) (Italics added.)

Miller v. Department of Corrections

OPINION

GEORGE, C. J.-

Plaintiffs, two former employees at the Valley State Prison for Women, claim that the warden of the prison at which they were employed accorded unwarranted favorable treatment to numerous female employees with whom the warden was having sexual affairs, and that such conduct constituted sexual harassment in violation of the California Fair Employment and Housing Act (FEHA). (Gov. Code, § 12900 et seq.) The trial court granted summary judgment in favor of defendants, concluding that the conduct in question did not support a claim of sexual harassment, and the Court of Appeal affirmed. We must determine whether, in light of the evidence presented in support of and in opposition to the summary judgment [36 Cal.4th 451] motion, the lower courts properly found that plaintiffs failed to present a prima facie case of sexual harassment under the FEHA.

B

The FEHA expressly prohibits sexual harassment in the workplace. fn. 5 It is an unlawful employment practice "[f]or an employer . . . because of . . . [36 Cal.4th 461] sex . . . to harass an employee . . . ." (Gov. Code, § 12940, subd. (j)(1).) The FEHA also provides that "[sexual] [h]arassment of an employee . . . by an employee, other than an agent or supervisor, shall be unlawful if the entity, or its agents or supervisors, knows or should have known of this conduct and fails to take immediate and appropriate corrective action." ( Ibid .) For the purposes of the relevant provisions of the FEHA, " 'harassment' because of sex includes sexual harassment, gender harassment, and harassment based on pregnancy, childbirth, or related medical conditions." ( Id ., § 12940, subd. (j)(4)(C).)

[3] According to the Fair Employment and Housing Commission (FEHC), the agency charged with administering the FEHA, harassment on any basis prohibited by the FEHA includes (but is not limited to) verbal harassment , including "epithets, derogatory comments or slurs on a basis enumerated in the Act"; physical harassment , including "assault, impeding or blocking movement, or any physical interference with normal work or movement, when directed at an individual on a basis enumerated in the Act"; and visual harassment , including "derogatory posters, cartoons, or drawings on a basis enumerated in the Act." (Cal. Code Regs., tit. 2, § 7287.6, subd. (b)(1)(A),(B) & (C).) The regulations also specify that "[u]nwanted sexual advances which condition an employment benefit upon an exchange of sexual favors" constitute harassment. ( Id ., § 7287.6, subd. (b)(1)(D).) In the specific context of sexual discrimination, prohibited harassment may include "verbal, physical, and visual harassment, as well as unwanted sexual advances." ( Id ., § 7291.1 subd. (f)(1).)

[4] Past California decisions have established that the prohibition against sexual harassment includes protection from a broad range of conduct, ranging from expressly or impliedly conditioning employment benefits on submission to or tolerance of unwelcome sexual advances, to the creation of a work environment that is hostile or abusive on the basis of sex. ( Fisher v. San Pedro Peninsula Hospital (1989) 214 Cal.App.3d 590 , 607-608; see also Mogilefsky v. Superior Court (1993) 20 Cal.App.4th 1409 , 1414-1415.) fn. 6 Such a hostile [36 Cal.4th 462] environment may be created even if the plaintiff never is subjected to sexual advances. ( Mogilefsky v. Superior Court , supra , 20 Cal.App.4th at pp. 1414-1415.) In one case, for example, a cause of action based upon a hostile environment was stated when the plaintiff alleged she had been subjected to long-standing ridicule, insult, threats, and especially exacting work requirements by male coworkers who evidently resented a female employee's entry into a position in law enforcement. ( Accardi v. Superior Court , supra , 17 Cal.App.4th at p. 347-348.)

[5] We have agreed with the United States Supreme Court that, to prevail, an employee claiming harassment based upon a hostile work environment must demonstrate that the conduct complained of was severe enough or sufficiently pervasive to alter the conditions of employment and create a work environment that qualifies as hostile or abusive to employees because of their sex. (See Aguilar v. Avis Rent A Car System, Inc. , supra, 21 Cal.4th at p. 130, relying upon Harris v. Forklift Systems, Inc. (1993) 510 U.S. 17, 21.) The working environment must be evaluated in light of the totality of the circumstances: "[W]hether an environment is 'hostile' or 'abusive' can be determined only by looking at all the circumstances. These may include the frequency of the discriminatory conduct; its severity; whether it is physically threatening or humiliating, or a mere offensive utterance; and whether it unreasonably interferes with an employee's work performance." ( Harris v. Forklift Systems, Inc. , supra , 510 U.S. at p. 23.)

Thursday, February 10, 2005

Transcript of CNN Report of how AllState and State Farm screw everyone

COOPER: Before the break, we introduced you to a woman who said
she was dragged through the ringer by car insurance giant Allstate.
She said that Allstate wanted her to settle for thousands of dollars
less than what she was entitled to. She refused the deal they offered
her and went to court.
And that's where she says the battle got even tougher. Her case
is not an isolated one, however. As our reporting reveals, accident
victims across the country are fighting back against the insurance
companies they thought would protect them.
Once again CNN's Drew Griffin.
(BEGIN VIDEOTAPE)
GRIFFIN (voice-over): When Ann Taylor's car was rear ended...
ANN TAYLOR, ACCIDENT VICTIM: I woke up the next morning, I
couldn't move. I had severe pain in my back. Down both legs were
numb and tingly.
GRIFFIN: The doctor diagnosed herniated disk muscle tears. And
the treatment would mean time off work, therapy and medical bills.
The person who hit her was a State Farm employee driving a State
Farm car. So Taylor thought at least financially she'd be covered.
It added up, said Taylor, to $15,000.
But after dragging out her claim, State Farm offered her only
$2,000.
TAYLOR: I was just very insulted.
GRIFFIN: Taylor hired Attorney Jeff Cook and decided she would
fight. It turned into a major legal battle eventually ending up in
this courtroom.
Taylor's case is an example of how the two largest auto insurance
companies, State Farm and Allstate, have changed the way they handle
claims when people are hurt in minor impact crashes.
CNN's investigation reveals a strategy to increase profits by
limiting payments to accident victims. And former insurance insiders
say most of the industry has adopted the strategy. Allstate and State
Farm, the industry leaders, would not talk to CNN for this report.
But Jim Mathis, a former insurance company insider, who now
testifies against the insurance business in court, did. And he says
cutting payments to people like Taylor has meant billions for the
insurance companies.
MATHIS: It's not based on what should be a settlement value or
offer to this claim. It is not based on ethics. It's based on --
it's not based on profits. It's based on how much profit.
GRIFFIN: Taylor's case finally got to court three years after
her accident. The lawyer brought in medical testimony. To present its
case, State farm just dug deep into Ann Taylor's past.
JEFFREY COOKE, TAYLOR'S ATTORNEY: The lawyer stands up and says
to Ann Taylor during her cross-examination, tell the jury about your
back injury when you were 16 years old.
GRIFFIN: In fact, the attorney for State Farm raised questions
about Ann Taylor falling off a horse when she was in high school. And
the lawyer also asked Taylor, a nurse, about throwing out her back
when she moved a patient.
(On camera): The attorney even brought up personal things that
Ann Taylor had to sell a horse, that Ann Taylor had to sell her house,
that Ann Taylor had even broken up with a longtime boyfriend. And
couldn't all these things add to stress and that could have caused her
back pain?
TAYLOR: They didn't have any expert testimony. They never had a
physician look at me.
GRIFFIN: They tried to make you out to be a liar.
TAYLOR: Exactly.
GRIFFIN (voice-over): The attorney for State Farm did produce
one piece of evidence -- very large photos of two slightly damaged
cars.
TAYLOR: They expected the jury to see those and to say, she
really wasn't hurt.
GRIFFIN: Michael Freeman is a crash expert, often called in to
testify when insurance companies are trying to use photos to deny a
crash victim was injured.
How did the insurance companies use photos? Well, take a look at
a photo of a car with minimal damage, he says, and convince the jury
what they probably were already thinking. That doesn't look like
much. How could that person be hurt?
MICHAEL FREEMAN, FORENSIC EPIDEMIOLOGIST: You're eventually
being judged by what your car looks like, not by what your doctor
says. Or by what the impact of a particular crash has had or an
injury has had on your life. That's not fair. It's not right. It's
fraud.
GRIFFIN: What stunned Taylor in the end is that State Farm's
strategy worked. The jury didn't believe she was hurt. They awarded
her just $1,500, less than what State Farm originally offered.
We contacted three of the jurors. They said this photo played a
big part in their verdict. And they thought the insurance company had
already paid its share and Taylor was only trying to get more.
Why did they look at her and must have assumed this lady is
trying to rip off the insurance companies, she's a fraud?
COOKE: When she walked in the courtroom and she walked to the
jury box and she walked to the testimony box and she walked out of the
courtroom at lunch and at the end of a day, they assumed that she was
not significantly injured.
GRIFFIN: It's a case straight out of the McKinsey playbook, the
three D's. By denying her claim, State Farm forced Taylor to hire an
attorney and sue. After a three year delay, Taylor walked into a
courtroom with no noticeable pain. And by defending the case for
years, State Farm forced her attorney to front expensive litigation
costs, which in the end, he didn't get back.
FREEMAN: They make these cases so expensive to litigate, that
attorneys won't want to take them.
GRIFFIN: Indianapolis Superior Court Judge David Dreyer says he
hears it from colleagues across the country, courts bogged down with
minor impact cases. He says the insurance companies' own lawyers
admit to him they're being forced to drag the cases out.
JUDGE DAVID DREYER, INDIANAPOLIS SUPERIOR COURT: They've
confided to me that they would rather settle a case and that they
aren't allowed to settle by the insurance companies that of course
control the defense.
GRIFFIN: It's a strategy spelled out in this affidavit from a
former Allstate attorney in a lawsuit against Allstate. She explains
how 10 years ago the insurance giant was changing the way it did
business, driving lawyers out.
The former Allstate attorney says Allstate's strategy was to make
fighting the company, quote, "so expensive and so time-consuming that
lawyers would start refusing to help clients." The president of the
Insurance Information Institute says the change was need.
HARTWIG: We have a group of attorneys, quite frankly, who are
very upset because, guess what, the gravy train has ended.
MARTINEZ: She had like taken off the other way.
GRIFFIN: Remember Roxanne Martinez from the beginning of our
investigation? She was sideswiped and Allstate offered her $15,000 to
cover her medical bills and lost wages. Her case also dragged on for
years.
But after listening to what her lawyer said was a deliberate
attempt to drag Martinez through the ringer, her jury awarded $167,000
plus interest.
MARTINEZ: You know, I was happy. I thought, well, you know, all
my bills are getting paid.
GRIFFIN: Industry insiders say 80 percent to 90 percent of
accident victims don't fight. They take what the insurance company
offers.
Drew Griffin, CNN, Santa Fe, New Mexico.
(END VIDEOTAPE)
COOPER: Interesting. You might think all the savings would mean
lower premiums for drivers. Well, guess again. The Insurance
Information Institute says auto insurance rates have actually gone up
30 percent over the 10 years since this went into effect. The
president of that institute told us rates would actually be much
higher if the companies hadn't cracked down on fraud.
How much you pay per year on car insurance depends on where you
live in many cases. Here's the raw data. Last year the five cities
with the most expensive auto insurance rates were Detroit,
Philadelphia, Newark, New York and Los Angeles. The least expensive
city was Roanoke at just over $900, followed by Chattanooga;
Nashville; Green Bay, Wisconsin; and Raleigh, North Carolina.

Tuesday, February 08, 2005

Insurance Companies Screw Everyone!!!

From CNN's Website

Insurance companies fight paying billions in claims


Put yourself in the driver's seat of this accident. You are heading down the street when a truck comes out of nowhere and slams into the right side of your car. The damage to the vehicle is obvious: dents across the passenger door.

You are hurt too, thought it's not obvious how much: a slight cut above your eye, an ache in the neck.

Your doctor says your spine was injured, you have soft muscle tears, and the pain in your neck mostly likely is whiplash.

It's going to need therapy, she says, and some time off work to heal. And in the end it's going to cost you $15,000 in medical payments and another $10,000 in lost wages, because you took so much time off work.

But when you send the $25,000 bill to the insurance company of the person who hit you, the insurance company says it's only going to pay you $15,000. You can take it or leave it.

What do you do?

That's what producer Kathleen Johnston and I have been investigating for the last 18 months -- accidents most of us don't pay attention to, the fender-benders we pass by without even slowing down. In part, we looked at how Allstate handled the claim of one woman, Roxanne Martinez. Her car was hit in Santa Fe, New Mexico. Her medical bills and lost wages added up to $25,000.

Allstate offered $15,000 to settle. Roxanne Martinez didn't know what to do.

Sure, she could try to find a lawyer. But if you were in her shoes, would you? After all, you are fighting insurance giant Allstate over a $10,000 difference. What attorney is going to take on that case?

Martinez's case represents what 10 of the top 12 auto insurance companies are doing to save money. And if you are in a minor impact crash and get hurt, former insurance industry insiders say, insurance companies will most likely try doing the same thing to you: delay handling your claim, deny you were hurt and defend their decision in drawn-out court battles. It's the three Ds: delay, deny and defend.

That, in a nutshell, is the strategy adopted by several major auto insurance companies over the past ten years, a lot of lawyers, former insurance company insiders and others tell CNN.

With nowhere to go, Allstate and others bet you'll take what they offer and walk away. It's right in the training manuals we obtained from Allstate: force "smaller walk-away settlements."

Shannon Kmatz, a former claims adjuster for Allstate, told us she would offer as little as $50 dollars in some cases. Poor people would take it, she said, fearing that if they didn't, they'd get nothing at all.

Roxanne Martinez didn't take it. She sued and a jury awarded her $167,000 dollars. But that verdict took three years.

Allstate is betting you won't wait, you won't sue and you'll take what you get and walk-away. And that, say our experts, has been a good bet for Allstate and others. Accident victims have been walking away from billions of dollars that insurers now keep for themselves.

Allstate would not grant an interview or answer our questions. Instead, they sent an e-mail saying they didn't think CNN would deliver a fair report. I hope you will watch our report tonight and decide for yourself who is being fair.