California Civil Jury Instructions (CACI) (2017)

2322. Affirmative Defense—Insured’s Voluntary Payment

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2322.Affirmative Defense—Insured’s Voluntary Payment
[Name of defendant] claims that it does not have to pay [specify, e.g., the
amount of the settlement] because [name of plaintiff] made a voluntary
payment. To succeed on this defense, [name of defendant] must prove the
following:
1. [Select either or both of the following:]
1. [That [name of plaintiff] made a payment to [name of third party
claimant] in [partial/full] settlement of [name of third party
claimant]’s claim against [name of plaintiff]; [or]]
1. [That [name of plaintiff] [made a payment/ [or] assumed an
obligation/ [or] incurred an expense] to [name] with regard to
[name of third party claimant]’s claim against [name of plaintiff]];
1. AND
2. That [name of defendant] did not give its consent or approval for
the [payment/ [or] obligation/ [or] expense].
New April 2007
Directions for Use
The instructions in this series assume that 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. This instruction also may be
modified for use as a defense to a judgment creditor’s action to recover on a
liability policy. This defense is not available if the insurer refused to defend before
the voluntary payment was made. (See 21st Century Ins. Co. v. Superior Court
(Tapia) (2015) 240 Cal.App.4th 322, 328 [192 Cal.Rptr.3d 530].)
A voluntary-payments clause in an insurance policy typically provides that the
insured may not voluntarily make a payment, assume an obligation, or incur an
expense without the insurer’s consent. (See, e.g., Truck Ins. Exchange v. Unigard
Ins. Co. (2000) 79 Cal.App.4th 966, 976 [94 Cal.Rptr.2d 516].) In element 1, select
the appropriate options depending on the acts alleged. Modify, as necessary,
depending on the actual language of the policy. Use the first option if the insured
has made a payment in settlement of the claim. Use the second option if the
insured has made a payment, assumed an obligation, or incurred an expense for
other reasons, such as to an attorney for legal services, or to a creditor of the
claimant, such as a provider of medical or repair services.
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Sources and Authority
• “The general validity of no-voluntary-payment provisions in liability insurance
policies is well established. . . . [S]uch clauses are common ‘to prevent
collusion as well as to invest the insurer with the complete control and direction
of the defense or compromise of suits or claims.’ ” (Insua v. Scottsdale Ins. Co.
(2002) 104 Cal.App.4th 737, 742 [129 Cal.Rptr.2d 138], internal citations
omitted.)
• “California law enforces . . . no-voluntary-payments provisions in the absence
of economic necessity, insurer breach, or other extraordinary circumstances.
They are designed to ensure that responsible insurers that promptly accept a
defense tendered by their insureds thereby gain control over the defense and
settlement of the claim. That means insureds cannot unilaterally settle a claim
before the establishment of the claim against them and the insurer’s refusal to
defend in a lawsuit to establish liability . . . . [T]he decision to pay any
remediation costs outside the civil action context raises a ‘judgment call left
solely to the insurer.’ In short, the provision protects against coverage by fait
accompli.” (Low v. Golden Eagle Ins. Co. (2003) 110 Cal.App.4th 1532, 1544
[2 Cal.Rptr.3d 761], internal citations omitted.)
• “ ‘Typically, a breach of that provision occurs, if at all, before the insured has
tendered the defense to the insurer.’ . . . [A voluntary-payments] provision is
[also] enforceable posttender until the insurer wrongfully denies tender. ‘[I]t is
only when the insured has requested and been denied a defense by the insurer
that the insured may ignore the policy’s provisions forbidding the incurring of
defense costs without the insurer’s prior consent and under the compulsion of
that refusal undertake his own defense at the insurer’s expense.’ ” (Low, supra,
110 Cal.App.4th at pp. 1546–1547, original italics, internal citations omitted.)
• “ ‘[T]he existence or absence of prejudice to [the insurer] is simply irrelevant to
[its] duty to indemnify costs incurred before notice. The policy plainly provides
that notice is a condition precedent to the insured’s right to be indemnified; a
fortiori the right to be indemnified cannot relate back to payments made or
obligations incurred before notice.’ . . . The prejudice requirement . . . applies
only to the insurer’s attempt to assert lack of notice as a policy defense against
payment even of losses and costs incurred after belated notice.” (Jamestown
Builders, Inc. v. General Star Indemnity Co. (1999) 77 Cal.App.4th 341, 350
[91 Cal.Rptr.2d 514], original italics, internal citations omitted.)
• “ ‘There may be exceptions to the prohibition on voluntary payments, as where
the insured is unaware of the identity of the insurer, the payment is necessary
for reasons beyond the insured’s control, or the insured faces a situation
requiring an immediate response to protect its legal interests.’ In a circumstance
of that nature, the insured’s payment is considered involuntary.” (Belz v.
Clarendon America Ins. Co. (2007) 158 Cal.App.4th 615, 628 [69 Cal.Rptr.3d
864], original italics, internal citation omitted.)
• “If an insurer refuses to defend, the insured is free to enter into a non-collusive
CACI No. 2322 INSURANCE LITIGATION
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settlement and then maintain or assign an action against the insurer for breach
of the duty to defend. In the subsequent action the amount of the settlement will
be presumptive evidence of the amount of the insured’s liability.” (21st Century
Ins. Co.,supra, 240 Cal.App.4th at p. 328, original italics.)
Secondary Sources
2 Witkin, Summary of California Law (10th ed. 2005) Insurance, § 320
Croskey et al., California Practice Guide: Insurance Litigation ¶¶ 7:439.5–7:439.10
(The Rutter Group)
California Liability Insurance Practice: Claims and Litigation (Cont.Ed.Bar) §§ 2.7,
3.27, 8.32, 11.14, 23.38
25 California Forms of Pleading and Practice, Ch. 300, Indemnity and
Contribution, § 300.73[6] (Matthew Bender)
26 California Forms of Pleading and Practice, Ch. 308, Insurance, §§ 308.500,
308.502 (Matthew Bender)
2323–2329. Reserved for Future Use
INSURANCE LITIGATION CACI No. 2322
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