Court Opinion

ID: 9745142
Source: CourtListenerOpinion
Date Created: 2023-08-26 22:37:16.884419+00
Date Added: 2024-06-11T07:24:56.759491
License: Public Domain

RAMIREZ, P. J., Dissenting.
Today the majority holds that each of the injuries alleged in the underlying complaint arose from the alleged *812intentional sexual misconduct of defendant Daniel Briones, Jr., (Briones) and based thereon concludes that there was no potential that he might be covered for his acts under the policy of insurance he purchased from plaintiff Northland Insurance Company (Northland). I certainly agree with the majority that the acts Briones is alleged to have engaged in are reprehensible, especially in light of the position of trust that he held among a group of perhaps particularly vulnerable young people. However, because of the procedural posture in which this case comes before us, we are required by law to broadly construe the allegations of the underlying complaint in favor of Briones, and to resolve any doubts as to whether the facts give rise to a duty to defend in his favor. (Horace Mann Ins. Co. v. Barbara B. (1993) 4 Cal.4th 1076, 1081, 1084 [17 Cal.Rptr.2d 210, 846 P.2d 792] (Horace Mann); Oliver v. .County of Los Angeles (1998) 66 Cal.App.4th 1397, 1403 [78 Cal.Rptr.2d 641].) Thus, for the reasons that follow, I respectfully dissent.
Northland claims that the acts alleged in the underlying complaint are all intentional and thus do not constitute “accidents” or “occurrences” in the insurance context. Neither term is defined in the policy. However, developed case law holds that an accident is an event that occurs unexpectedly, by chance, or without intent, foresight or expectation. (Geddes & Smith, Inc. v. St. Paul Mercury Indemnity Co. (1959) 51 Cal.2d 558, 563 [334 P.2d 881]; St. Paul Fire & Marine Ins. Co. v. Superior Court (1984) 161 Cal.App.3d 1199, 1202 [208 Cal.Rptr. 5].) Cases also hold that if an insured intends to do an act that results in injury, whether or not there was any expectation or intent that harm would result from the act, there is no covered “accident” or “occurrence” under the policy. (David Kleis, Inc. v. Superior Court (1995) 37 Cal.App.4th 1035, 1047 [44 Cal.Rptr.2d 181].)
Northland also relies on an exclusion to coverage contained in Briones’s policy that provides, “[t]his insurance does not apply to any ‘bodily injury,’ ‘property damage,’ ‘personal injury,’ or ‘medical expense’ arising out of:
“1. Physical abuse, sexual abuse, sexual molestation or sexual harassment by anyone; . . .
“This exclusion applies whether damages arise from an insured’s act or failure to act.” Northland urges, and the majority accepts, that all of the claims in the underlying complaint involve intentional acts of sexual abuse, molestation and/or harassment. Thus, there can be no coverage under the policy as a matter of law.
I do not dispute that the great majority of the allegations in the first amended complaint are not covered acts, either because they are necessarily *813intentional or because they constitute sexual abuse, molestation and/or harassment. However, an insurance company must defend even a suit that only potentially seeks damages within the coverage of the policy. (Horace Mann, supra, 4 Cal.4th at p. 1081.) In Gray v. Zurich Insurance Co. (1966) 65 Cal.2d 263 [54 Cal.Rptr. 104, 419 P.2d 168], the court found there was a duty to defend even when the complaint alleged bodily injury as the result of only intentional conduct, because it was conceivable that it could be amended to allege merely negligent conduct. (Id. at p. 277.) The duty exists even when coverage is in doubt and is ultimately not established, and even when noncovered acts predominate the third party complaint. (Horace Mann, supra, 4 Cal.4th at pp. 1081, 1084; Waller v. Truck Ins. Exchange, Inc. (1995) 11 Cal.4th 1, 19 [44 Cal.Rptr.2d 370, 900 P.2d 619].)
Keeping these rules in mind and also keeping in mind that this court must make all possible inferences and resolve all doubts in favor of Briones, both because he is the insured and because he is the party opposing a motion for summary judgment, I cannot agree with the majority’s interpretation of the underlying complaint or its consequent affirmance of the summary judgment. In the sixth cause of action of the underlying complaint, for negligent infliction of emotional distress, it is alleged that Briones, “while teaching karate to Plaintiff Connie L[.], . . . from time to time and on numerous occasions, negligently made contact with Plaintiff Connie L[.]’s buttocks and genital area, on the outside of her clothing . . . .” I do not believe that the only possible conclusion that may be drawn from this allegation is that the conduct was either intentional or constituted molestation.
In Horace Mann, as here, the insurer attempted to convince the Supreme Court that all of the alleged misconduct was either sexual molestation or directly related to the sexual molestation. (Horace Mann, supra, 4 Cal.4th at p. 1082.) The court found this argument flawed because it required an “unsupported assumption that the other alleged misconduct necessarily was part of the molestation.” (Ibid.) The court recognized that “it is not always easy for a court to draw the line between appropriate and inappropriate interaction [between people]. Neither precedent nor logic dictates that a molester cannot also be liable for torts of negligence against the victim which are apart from, and not integral to, the molestation.” (Id. at p. 1083.) Here, as in Horace Mann, “[t]he record is devoid of evidence which establishes the chronology or sequence of events comprising the alleged misconduct or that these actions were integral to the molestation.” (Id. at pp. 1083-1084.)
It is not inconceivable that while engaging in a contact sport such as karate, one might unintentionally come into contact with virtually any part of *814the coparticipant’s body. Further, the record is completely silent regarding when these negligent contacts took place in the context of the other allegations. Therefore, it is possible that some or all of them occurred before any sort of sexual relationship developed between Briones and Connie L. Thus, there is some possibility that the acts described above, both as alleged and in light of additional facts that may later be revealed, would not be found to constitute either intentional or sexual misconduct. Under such circumstances this court is compelled to reverse the summary judgment. To do otherwise would violate the standard of review imposed by California law. (Horace Mann, supra, 4 Cal.4th at pp. 1081, 1084; Oliver v. County of Los Angeles, supra, 66 Cal.App.4th at p. 1403.)
As was the insurer in Horace Mann, the majority here is concerned with the fact that the plaintiffs in the underlying case have attempted to “plead around” the policy’s exclusions by crafting allegations of conduct that does not rise to the level of sexual molestation. This concern should not affect the result in this case.
In the first instance, in Horace Mann, the Supreme Court recognized that the insurer’s argument missed the point, concluding that “[i]f the parties to a declaratory relief action dispute whether the insured’s alleged misconduct should be viewed as essentially a part of a . . . sexual molestation, or instead as independent of it and so potentially within the policy coverage, . . . then factual issues exist precluding summary judgment in the insurer’s favor. Indeed, the duty to defend is then established. . . . [Citation.]” (Horace Mann, supra, 4 Cal.4th at p. 1085, original italics.) The Supreme Court reemphasized that the focus is not on whether the underlying claims are legitimate in Waller v. Truck Ins. Exchange, Inc., supra, 11 Cal.4th at page 19, when it again held that the duty to defend applies even to claims that are “ ‘groundless, false, or fraudulent.’ ” Hence, while the court “do[es] not sanction relabeling child molestation as negligence,” it recognizes that the proper inquiry is simply whether there is a possibility of coverage based on the allegations of the underlying complaint. It does not hold that courts may grant declaratory relief on summary judgment by concluding that the claims are unsupportable. (Horace Mann, supra, 4 Cal.4th at p. 1086.) Indeed, if Connie L.’s claims were “so insubstantial as not to warrant any damages, [the insurer] should have raised that defense in the underlying action for [the insured’s] benefit, rather than in this declaratory relief action to his detriment. [Citation.]” (Ibid.)
Second, reaching the conclusion that the allegation is necessarily an attempt to “plead around” the policy exclusions is contrary to our standard of review, which requires that we make all inferences in Briones’s favor. *815(Horace Mann, supra, 4 Cal.4th at pp. 1081, 1084; Oliver v. County of Los Angeles, supra, 66 Cal.App.4th at p. 1403.) We must consider not whether it is possible that Connie L. has attempted to “plead around” the exclusions, but rather, whether it is possible that her claims may be legally and factually supported. In such circumstances the only reasonable conclusion is to accept the latter of the two propositions. Having thus accepted that the claims may be supported, it must be concluded that the possibility for coverage exists. (Horace Mann, supra, 4 Cal.4th at p. 1081.)
As the Supreme Court observed in Horace Mann, supra, 4 Cal.4th at pages 1086-1087, “[s]ome may consider the result in this case . . . to be unfortunate. No one, of course, wants to provide aid and comfort to child molesters. But courts cannot allow legal reasoning to yield to emotionalism when determining the extent of an insurance carrier’s defense duty.” Because we are constrained by our standard of review to broadly construe the allegations of the underlying complaint in favor of Briones, and to resolve any doubts as to whether the facts give rise to a duty to defend in his favor, my review of the record mandates that the underlying complaint be interpreted as giving rise to the possibility of coverage. Therefore, summary judgment was not properly granted and must be reversed.
On July 7, 2000, the opinion was modified to read as printed above. Appellant’s petition for review by the Supreme Court was denied September 27, 2000. Mosk, J., and Kennard, J., were of the opinion that the petition should be granted.