London Fischer prevails in published California decision: insurers cannot be liable for statutory insurance fraud

May 13, 2022

Attorneys Richard Endres and Patrick Bollig recently prevailed in a published decision by the Fourth District Court of Appeal of California, which held that insurers and claims administrators are not within the class of potential defendants under California’s Insurance Frauds Prevention Act.

In People ex rel. Ellinger v. Magill et al., the plaintiff alleged that London Fischer’s clients, a claims administrator and claims adjuster, concealed and failed to consider alleged facts or evidence that would have supported the plaintiff’s workers’ compensation claim.  The plaintiff asserted that the alleged conduct potentially rose to the level of insurance fraud and thereby exposed the defendants to civil and quasi-criminal liability, as well as statutory treble damages, under Insurance Code section 1871.7, known as the Insurance Frauds Prevention Act.  Before the trial court, London Fischer successfully obtained a judgment of dismissal in favor of its clients, following a successful demurrer on the grounds that the Insurance Frauds Prevention Act is a shield designed to protect insurers against fraud, not a sword that disgruntled claimants could wield against the very class of defendants (insurers) that the statute was designed to protect.  On appeal, the Fourth District Court of Appeal affirmed in a published decision, holding that “insurers and their agents are not proper defendants under the IFPA.”  The decision, linked below, is certified for publication and is favorable to insurers and insurance professionals in California.

View decision  below: