California Civil Jury Instructions (CACI) (2017)

2303. Affirmative Defense—Insurance Policy Exclusion

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2303.Affirmative Defense—Insurance Policy Exclusion
[Name of defendant] claims that [name of plaintiff]’s [liability/loss] is not
covered because it is specifically excluded under the policy. To succeed,
[name of defendant] must prove that [name of plaintiff]’s [liability/loss]
[arises out of/is based on/occurred because of] [state exclusion under the
policy]. This exclusion applies if [set forth disputed factual issues that jury
must determine].
New September 2003; Revised October 2008, June 2014
Directions for Use
The instructions in this series assume the plaintiff is the insured and the defendant
is the insurer. The party designations may be changed if appropriate to the facts of
the case.
Give this instruction if the court has determined that an exclusionary clause in an
insurance policy might apply to foreclose coverage, but the applicability turns on a
question of fact. This instruction can be used in cases involving either a third party
liability or a first party loss policy.
Sources and Authority
• “The burden of bringing itself within any exculpatory clause contained in the
policy is on the insurer.” (Clemmer v. Hartford Insurance Co. (1978) 22 Cal.3d
865, 880 [151 Cal.Rptr. 285, 587 P.2d 1098].)
• “The burden is on an insured to establish that the occurrence forming the basis
of its claim is within the basic scope of insurance coverage. And, once an
insured has made this showing, the burden is on the insurer to prove the claim
is specifically excluded.” (Aydin Corp. v. First State Insurance Co. (1998) 18
Cal.4th 1183, 1188 [77 Cal.Rptr.2d 537, 959 P.2d 1213].)
• Once the insurer proves that the specific exclusion applies, the insured “should
bear the burden of establishing the exception because ‘its effect is to reinstate
coverage that the exclusionary language otherwise bars.’ ” (Aydin Corp.,supra,
18 Cal.4th at p. 1188.)
• “The interpretation of an exclusionary clause is an issue of law subject to this
court’s independent determination.” (Marquez Knolls Property Owners Assn.,
Inc. v. Executive Risk Indemnity, Inc. (2007) 153 Cal.App.4th 228, 233 [62
Cal.Rptr.3d 510].)
• “[T]he question of what caused the loss is generally a question of fact, and the
loss is not covered if the covered risk was only a remote cause of the loss, or
the excluded risk was the efficient proximate, or predominate cause.” (State
Farm Fire & Casualty Co. v. Von Der Lieth (1991) 54 Cal.3d 1123, 1131–1132
[2 Cal.Rptr.2d 183, 820 P.2d 285].)
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Secondary Sources
2 Witkin, Summary of California Law (10th ed. 2005) Insurance, § 64
Croskey et al., California Practice Guide: Insurance Litigation, Ch. 15-I, Practice
And Procedure—Trial, ¶¶ 15:911–15:912 (The Rutter Group)
1 California Liability Insurance Practice: Claims & Litigation (Cont.Ed.Bar)
Analyzing Coverage: Reading and Interpreting Insurance Policies, § 3.63
26 California Forms of Pleading and Practice, Ch. 308, Insurance, § 308.502
(Matthew Bender)
INSURANCE LITIGATION CACI No. 2303
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