CACI No. 2320. Affirmative Defense - Failure to Provide Timely Notice

Judicial Council of California Civil Jury Instructions (2020 edition)

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2320.Affirmative Defense - Failure to Provide Timely Notice
[Name of defendant] claims that it does not have to pay the [judgment
against/settlement by] [name of plaintiff] because it did not receive timely
notice of the [lawsuit/[insert other]]. To succeed, [name of defendant] must
prove both of the following:
1. That [name of plaintiff] did not give [name of defendant] notice [or
that [name of defendant] did not receive notice by some other
means] [within the time specified in the policy/within a reasonable
time] of the [lawsuit/[insert other]]; and
2. That [name of defendant] was prejudiced by [name of plaintiff]’s
failure to give timely notice.
To establish prejudice, [name of defendant] must show a substantial
likelihood that, with timely notice, it would have [taken steps that would
have substantially reduced or eliminated [name of plaintiff]’s liability] [or]
[settled for a substantially smaller amount].
New September 2003
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.
This instruction is intended for use by an insurer as a defense to a breach of
contract action based on a third party liability policy. The defense does not apply to
“claims made” policies (see Pacific Employers Insurance Co. v. Superior Court
(1990) 221 Cal.App.3d 1348, 1357-1360 [270 Cal.Rptr. 779]). This instruction also
may be modified for use as a defense to a judgment creditor’s action to recover on a
liability policy.
Sources and Authority
• “The right of an injured party to sue an insurer on the policy after obtaining
judgment against the insured is established by statute. An insurer may assert
defenses based upon a breach by the insured of a condition of the policy such as
a cooperation clause, but the breach cannot be a valid defense unless the insurer
was substantially prejudiced thereby. Similarly, it has been held that prejudice
must be shown with respect to breach of a notice clause.” (Campbell v. Allstate
Insurance Co. (1963) 60 Cal.2d 303, 305-306 [32 Cal.Rptr. 827, 384 P.2d 155],
internal citations omitted.)
• “The burden of establishing prejudice is on the insurance company, and
prejudice is not presumed by delay alone. To establish prejudice, the ‘ “insurer
must show it lost something that would have changed the handling of the
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underlying claim.” ’ ” (Lat v. Farmers New World Life Ins. Co. (2018) 29
Cal.App.5th 191, 196-197 [239 Cal.Rptr.3d 796], internal citations omitted.)
• “[P]rejudice is not shown simply by displaying end results; the probability that
such result could or would have been avoided absent the claimed default or error
must also be explored.” (Clemmer v. Hartford Insurance Co. (1978) 22 Cal.3d
865, 883, fn. 12 [151 Cal.Rptr. 285, 587 P.2d 1098].)
• “If the insurer asserts that the underlying claim is not a covered occurrence or is
excluded from basic coverage, then earlier notice would only result in earlier
denial of coverage. To establish actual prejudice, the insurer must show a
substantial likelihood that, with timely notice, and notwithstanding a denial of
coverage or reservation of rights, it would have settled the claim for less or
taken steps that would have reduced or eliminated the insured’s liability.”
(Safeco Ins. Co. of America v. Parks (2009) 170 Cal.App.4th 992, 1004 [88
Cal.Rptr.3d 730].)
• “Under the notice prejudice rule, an insurance company may not deny an
insured’s claim under an occurrence policy based on lack of timely notice or
proof of claim unless it can show actual prejudice from the delay. The rule is
based on the rationale that ‘ “[t]he primary and essential part of the contract [is]
insurance coverage, not the procedure for determining liability . . .” [citations],
and that “the notice requirement serves to protect insurers from prejudice, . . .
not . . . to shield them from their contractual obligations” through “a technical
escape-hatch”.’ ” (Lat, supra, 29 Cal.App.5th at p. 196, internal citations
omitted.)
• “[The notice-prejudice rule] does not apply to every time limit on any insurance
policy. [¶] Where the policy provides that special coverage for a particular type
of claim is conditioned on express compliance with a reporting requirement, the
time limit is enforceable without proof of prejudice. Such reporting time limits
often are found in provisions for expanded liability coverage that the insurer
usually does not cover. The insurer makes an exception and extends special
coverage conditioned on compliance with a reporting requirement and other
conditions. The reporting requirement becomes ‘the written notice necessary to
trigger the expanded coverage afforded’ by the special policy provision.”
(Venoco, Inc. v. Gulf Underwriters Ins. Co. (2009) 175 Cal.App.4th 750, 760 [96
Cal.Rptr.3d 409], internal citations omitted.)
• “With respect to notice provisions, one Court of Appeal has explained: ‘[A]n
“occurrence” policy provides coverage for any acts or omissions that arise
during the policy period even though the claim is made after the policy has
expired.’ . . . [¶] . . . [¶] Occurrence policies were developed to provide
coverage for damage caused by collision, fire, war, and other identifiable
events. . . . Because the occurrence of these events was relatively easy to
ascertain, the insurer was able to ‘conduct a prompt investigation of the incident
. . . .’ . . . Notice provisions contained in such occurrence policies were
‘included to aid the insurer in investigating, settling, and defending claims[.]’
. . . If an insured breaches a notice provision, resulting in substantial prejudice
CACI No. 2320 INSURANCE LITIGATION
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to the defense, the insurer is relieved of liability.” (Belz v. Clarendon America
Ins. Co. (2007) 158 Cal.App.4th 615, 626 [69 Cal.Rptr.3d 864], internal citation
omitted.)
• “The ‘general rule’ is that an insurer is not bound by a judgment unless it had
notice of the pendency of the action. . . . However, if an insurer denies coverage
to the insured, the insured’s contractual obligation to notify the insurer ceases.”
(Samson v. Transamerica Insurance Co. (1981) 30 Cal.3d 220, 238 [178
Cal.Rptr. 343, 636 P.2d 32], internal citations omitted.)
Secondary Sources
Croskey et al., California Practice Guide: Insurance Litigation (The Rutter Group)
¶¶ 15:917-15:920
1 California Liability Insurance Practice: Claims & Litigation (Cont.Ed.Bar)
Identifying Sources of Coverage, §§ 8.24-8.26
4 California Insurance Law & Practice, Ch. 41, Liability Insurance in General,
§ 41.65[1]-[9] (Matthew Bender)
26 California Forms of Pleading and Practice, Ch. 308, Insurance, § 308.500
(Matthew Bender)
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