Petitioner Allen M. Entin owned two disability income insurance policies. In 2009, Entin filed a claim asserting that migraine headaches had rendered him totally disabled. Entin's insurer, respondent Provident Life and Accident Insurance Company, agreed to pay Entin benefits while investigating his claim. At the conclusion of its investigation, Provident filed a declaratory relief action seeking a determination that Entin was not totally disabled
Entin filed a petition for writ of mandate seeking an order directing the superior court to grant his request for a jury trial. We issued an order to show cause and now conclude that the trial court erred in denying Entin a jury trial. In the context of declaratory relief actions, the right to a jury trial depends on whether the issues raised in the complaint are legal or equitable in nature. Provident's declaratory relief claim raises factual questions pertaining to contractual rights, which are legal in nature. Although Provident has elected to pay Entin benefits while pursuing the action, that does not transform the nature of the dispute into one arising in equity. Entin is therefore entitled to a jury trial.
In 1991, petitioner Allen Entin purchased a disability income insurance policy that provided benefits of $20,000 per month in the event that he became totally disabled. Entin also purchased an "overhead expense disability policy" that provided benefits up to $360,000 in the event that he became totally disabled. Both polices defined the term "totally disabled" to mean: "(1) [the insured is] not able to perform the substantial and material duties of [his] occupation; and [¶] (2) [the insured is] receiving care by a [p]hysician which is appropriate for the condition causing the disability."
On September 3, 2009, Entin filed a claim alleging that migraine headaches had rendered him incapable of performing the substantial and material duties of his occupation as an obstetrician and gynecologist. Entin's insurer, Provident Life and Accident Insurance Company, reviewed the claim and began paying Entin disability benefits under a reservation of rights.
On August 31, 2010, Provident filed a declaratory relief action seeking a determination that Entin was not entitled to disability benefits. The complaint did not raise any issue regarding the construction of the insurance policies. Instead, it asserted that the parties disputed whether the evidence showed Entin was "totally ... disabled within the meaning of [those] [p]olicies." According to the allegations in the complaint, Entin informed Provident that
The complaint clarified that although Provident did not believe Entin was totally disabled, it would "continue[] to pay [his] disability claim ... until [the] Court issue[d] its determination of the rights and responsibilities of the parties ...." The complaint also stated that Provident "[would] not attempt[] to recoup any sums" paid prior to the entry of judgment.
Entin filed a cross-complaint for breach of the implied covenant of good faith and fair dealing alleging that Provident's declaratory relief action was part of a "scheme" to "forc[e] its insureds ... to settle otherwise legitimate claims for less than the value of the claim."
Provident demurred to the cross-complaint, arguing that Entin could not pursue a "claim for bad faith ... in the absence of a breach of the underlying insurance contract[s]." Provident contended that the allegations in the cross-complaint admitted Entin was still receiving disability benefits, thereby demonstrating that no breach had occurred. In his opposition, Entin asserted that regardless of whether he was still receiving benefits, he had properly stated a claim for breach of the implied covenant by alleging that Provident filed a "a sham Complaint for Declaratory Relief" that "placed a cloud on [his] disability benefits causing [him] to incur litigation expenses and emotional distress." The trial court sustained Provident's demurrer "without leave to amend."
Entin filed a petition for writ of mandate seeking an order from this court directing the superior court "to vacate its order ... granting ... a court trial" and "to enter a new and different order ... granting [Entin's] motion for a jury trial." We issued an order to show cause on April 10, 2012.
The issue of whether Entin is "constitutionally entitled to a jury trial ... is a pure question of law that we review de novo." (Caira v. Offner (2005) 126 Cal.App.4th 12, 23 [24 Cal.Rptr.3d 233] (Caira); see Jogani v. Superior Court (2008) 165 Cal.App.4th 901, 904 [81 Cal.Rptr.3d 503] ["[w]hether [plaintiff] is entitled to a jury trial is an issue of law that we review de novo"].)
Federal courts have employed a slightly different inquiry to aid in determining whether the right to a jury attaches in declaratory relief actions, asking "whether there would have been a right to a jury trial had the action proceeded without the declaratory judgment vehicle."
Several California decisions have addressed whether the right to a jury attaches in declaratory relief actions seeking a determination of insurance coverage. In State Farm etc. Ins. Co. v. Superior Court (1956) 47 Cal.2d 428 [304 P.2d 13] (State Farm), the insured was involved in an automobile collision that left several people injured. The insurer brought a declaratory relief action to determine whether its policy covered the incident. While the case was pending, the injured parties filed personal injury actions against the insured. The trial court concluded that the right to a jury applied in both actions and consolidated the matters for trial. The jury returned a verdict against the insurer. On appeal, the insurer argued that the court erred in consolidating the matters.
Subsequent decisions applying State Farm have concluded that there is a right to a jury in declaratory relief actions involving insurance coverage disputes. For example, in Allstate Ins. Co. v. Normandie Club (1963) 221 Cal.App.2d 103 [34 Cal.Rptr. 280] (Normandie), the defendant was involved
In Patterson v. Insurance Co. of North America (1970) 6 Cal.App.3d 310 [85 Cal.Rptr. 665] (Patterson), the insured was involved in an automobile collision and was sued by the occupants of the other vehicle. The insured tendered his defense to his insurer, which refused to accept the case and filed a cross-complaint "to determine coverage under [the] liability insurance policy." (Id. at p. 313.) The parties agreed to try the declaratory relief action first. The "crucial issue" was whether the insured's automobile had been acquired to replace an older, previously insured vehicle. (Ibid.) The trial court submitted the issue to a jury, which found that the automobile qualified for coverage.
Other cases have clarified that although there is generally a right to a jury trial in declaratory relief actions seeking a determination of insurance coverage, there is no reversible error in denying a jury trial if there are no factual issues for the jury to decide. For example, in Savior, supra, 51 Cal.App.3d 691, the defendant, Paul Savior, was involved in an accident with Anne Pisano, who owned an insurance policy. Pisano's insurer filed a declaratory relief complaint against Savior seeking a determination that the car Pisano was driving was not covered by her policy. The trial court granted the insurer's motion to strike Savior's jury demand and the case proceeded by
On appeal, Savior argued that "the [trial] court erred in depriving [him] of a jury trial." (Savior, supra, 51 Cal.App.3d at p. 693.) The appellate court held that although "the trial court committed error in denying a jury to appellant, it was not prejudicial error." (Id. at p. 694.) The court explained that numerous prior cases had made "clear that an action by an insurance company against its putative insured, seeking a declaration that no coverage exists, is one in which a jury trial is a matter of right, since the declaratory relief action has been substituted for an action at law for breach of contract." (Ibid.) Despite this finding, the court ruled that a reversal was unwarranted because the record showed the insurer had introduced evidence demonstrating the automobile was not insured when the accident occurred and the appellant had offered no evidence in rebuttal. Thus, according to the court, "there were no real issues to present to the jury." (Id. at p. 695.)
In California Casualty Indemnity Exchange v. Frerichs (1999) 74 Cal.App.4th 1446 [88 Cal.Rptr.2d 858] (Frerichs), the insurer brought an action for declaratory relief "concerning the interpretation of a policy of homeowners insurance." (Id. at p. 1448.) The defendant in the case was injured by Paul Hudson, who was the insured's son. At the time of the incident, Hudson was "house-sitting" for the insured, who was on vacation. The policy provided coverage to all "`residents of [the insured's] household.'" (Id. at p. 1449.) The issue in the case was whether the definition of the term "resident" extended to Hudson. The trial court concluded that the term was ambiguous and submitted a special verdict to the jury asking whether Hudson qualified as a resident of the home. The jury concluded that he did qualify as a resident and the court entered judgment against the insurer.
On appeal, the insurer argued that "the trial court erred in referring the question to the jury whether the policy term `resident' is ambiguous." (Frerichs, supra, 74 Cal.App.4th at p. 1499.) The appellate court explained that "[n]otwithstanding that an action for declaratory relief is characterized as an action in equity, there is a right to a jury trial of material triable issues of fact concerning an inchoate breach of contract claim. [Citation.] For example, if an insurance policy is ambiguous, and the resolution of the ambiguity turns on disputed extrinsic evidence, the dispute must be resolved by a jury upon demand." (Id. at p. 1450.) The court further concluded, however, that the undisputed facts demonstrated that the term "resident" was unambiguous and that Hudson did not qualify as a resident. As a result, there was no proper issue to present to the jury for decision.
Provident's complaint does not raise any dispute regarding the proper construction of the parties' insurance policies. Instead, it seeks a determination as to whether Entin is "totally disabled" within the meaning of those policies. To resolve this issue, the finder of fact will have to decide two matters that are currently in dispute: (1) whether Entin's migraine headaches have rendered him "[un]able to perform the substantial and material duties of [his] occupation" and (2) whether Entin is receiving "appropriate [care] for the condition."
The legal nature of Provident's claim is also demonstrated by the fact that, without the declaratory relief mechanism, this matter would have proceeded as an action at law. Provident has not identified any form of equitable claim that would have permitted it to obtain a binding ruling as to whether its decision to deny Entin future benefits would constitute a breach of the insurance policies. Instead, Provident would have had to decide whether to continue paying Entin benefits under the policies or to deny the claims, thereby forcing Entin to pursue a legal claim for breach of contract. Thus, without the declaratory relief mechanism, Entin would be entitled to have a jury decide whether he was totally disabled. Provident may not utilize the declaratory relief action to circumvent that right.
Provident raises two additional arguments in support of its assertion that Entin is not entitled to a jury trial. First, it contends that its claim is akin to a request for specific performance, which is an equitable remedy. Second, it argues that because neither party has sought monetary damages, its claim cannot be legal in nature.
Caira, supra, 126 Cal.App.4th 12, involved a dispute over the ownership of a family company named "Platypus Wear." Laurens Offner founded Platypus Wear and owned two-thirds of its shares; his two siblings owned the remaining shares. In 1986, Laurens entered into a written agreement to transfer 49 percent of Platypus Wear stock to his father, Franklin Offner, in exchange for a loan. The agreement described various contingencies that would revert the stock to Laurens. After Franklin died, Laurens and his siblings filed competing declaratory relief actions seeking a determination as to who owned the stock at issue in the 1986 agreement. The siblings argued that the 1986 agreement effectively transferred the stock to Franklin and that it remained the property of Franklin's estate. Laurens, however, argued that he owned the stock because the 1986 agreement had never been formalized and, even if it had, the contingencies necessary to reverse the transfer had been fulfilled. The case was submitted to a jury, which returned a ruling in favor of Laurens. The trial court, however, determined that the jury's findings
On appeal, Laurens argued that "he had the right, under the California Constitution, to a jury trial on the issue of the ownership of Platypus's common stock." (Caira, supra, 126 Cal.App.4th at p. 23.) Laurens argued that his siblings were using the declaratory relief action "in the place of a breach of contract action for damages." (Id. at p. 26.) The appellate court rejected the argument, explaining that the declaratory relief claims were "akin" to "[a]n action to quiet title ... in that the plaintiff seeks a judgment declaring ... rights in relation to a piece of property." (Id. at p. 24.) The court further explained that, to the extent the siblings' suit could be characterized as a contractual claim, "the gist of their action would be for specific performance of the 1986 Agreement" because they were seeking a declaration vesting title to the stock described in that agreement in Franklin's estate. (Id. at p. 27.) The court concluded that because actions to quiet title and claims for specific performance were historically treated as equitable matters, Laurens had no right to a jury.
Caira does not support the proposition that any declaratory relief action seeking a determination of prospective rights under a contract "is equivalent to one for specific performance." Cairamerely concluded that the action before it was akin to either an action to quiet title or one for specific performance, which are both equitable in nature. Provident's declaratory relief claim, in contrast, does not seek to settle ownership over any piece of property nor does it seek to compel Entin to perform under the terms of the contract. (See Behniwal v. Mix (2007) 147 Cal.App.4th 621, 638 [54 Cal.Rptr.3d 427] ["an action for specific performance affirms the contract and asks that it be performed" (italics omitted)]; Code Civ. Proc., § 760.020, subd. (a) [providing for "action ... to establish title against adverse claims to real or personal property"].) Instead, it seeks a declaration that excuses its performance because Entin is not totally disabled within the meaning of the insurance contracts.
The second decision cited by Provident, Amadei Sand, supra, 742 A.2d 550, has even less in common with this case. In Amadei Sand, the New Jersey Supreme Court considered whether its prior holding in In re Environmental Ins. Declaratory Judgment Actions (1997) 149 N.J. 278 [693 A.2d 844] (Environmental Ins.) applied to the facts before it.
The plaintiffs in Environmental Ins. filed a declaratory relief claim seeking a judgment that would require their insurers to pay for the environmental remediation of over 100 contaminated industrial sites located in 30 different states. The plaintiffs sought a determination that their insurers were required
The New Jersey Supreme Court began its analysis by explaining that, "[i]n a declaratory judgment action, the right to a jury trial depends on whether the action is the counterpart to one in equity or in law." (Environmental Ins., supra, 693 A.2d at p. 850.) The court further explained that, under New Jersey law, "[c]haracterization of the cause of action depends on the dominant relief sought and the nature of the proceeding that would provide the most complete resolution of the issues." (Id. at p. 852.)
The court concluded that the plaintiffs' declaratory relief claim exhibited characteristics that were more consistent with the equitable remedy of specific performance than the traditional legal remedy of damages. First, the court noted that "issues in environmental coverage actions are uniquely complex" and frequently require "creative procedural responses" that are more appropriate to equitable proceedings. Environmental Ins., supra, 693 A.2d at pp. 851-852.) Second, the court explained that the plaintiffs sought a remedy that would apply to numerous different insurers and industrial sites. According to the court, "if left to their legal remedy, [plaintiffs] would be required to file multiple future breach-of-contract actions each time an insurer refuses to defend or indemnify them. Only specific performance can place [plaintiffs] in the position they assert they would have been, had the defendant-insurers performed their contractual obligations. [¶] As the doctrine of ancillary equitable jurisdiction illustrates, avoidance of a multiplicity of lawsuits appropriately limits the right to a jury trial. If an action is primarily equitable, a court of equity may assume jurisdiction over ancillary legal issues. [Citation.] The exercise of ancillary equitable jurisdiction avoids a multiplicity of actions and permits a court to do complete justice. [Citation.]" (Id. at p. 852.)
Third, the court concluded that the plaintiffs' claim was akin to a request for specific performance because it was impossible to put a monetary value on the request for declaratory relief: "[Plaintiffs] seek substantial future damages. The amount of the damages, however, are both uncertain and unknown. When a court cannot reasonably ascertain the amount of damages, specific performance emerges as the more appropriate remedy." (Environmental Ins., supra, 693 A.2d at p. 852.)
Two years after issuing Environmental Ins., the New Jersey Supreme Court revisited that decision in Amadei Sand, supra, 742 A.2d 550. The issue presented in Amadei Sand was whether the right to a jury applied when the insurer, rather than the insured, initiated a declaratory relief action to determine coverage for future environmental remediation costs. The court explained that, in Environmental Ins., it had concluded that "[t]he issues framed in [a declaratory relief action seeking coverage for environmental remediation] make it inappropriate for jury consideration because of the uncertainty regarding potential damages, and thus, the inadequacy of the potential remedy at law." (Id. at p. 555.) The court concluded that the same rationale applied regardless of whether the insurer or the insured initiated the action: "In either factual matrix, the essential determination is whether the insurer must indemnify the insured for future, uncertain remediation costs." (Ibid.)
The case before us has little in common with Environmental Ins. or Amadei Sand. The issues presented here do not involve environmental remediation nor are they "uniquely complex." (Environmental Ins., supra, 693 A.2d at p. 851.) The case does not involve multiple insurers, multiple insureds or multiple insurance policy provisions.
Provident also argues that, even if its remedy cannot be characterized as a request for specific performance, cases from other jurisdictions demonstrate
Second, the two cases on which Provident relies — Travelers Indemnity v. Cochrane (1951) 155 Ohio St. 305 [98 N.E.2d 840] (Cochrane) and Jensen Internat. Inc. v. Kelly (2001) 29 Kan.App.2d 836 [32 P.3d 1205] (Jensen) — did not hold that there was no right to a jury trial based solely on the fact that neither party sought monetary damages. In Cochrane, an insurer brought a declaratory relief action seeking a determination whether the insured had engaged in conduct that invalidated his automobile insurance policy. Although the defendant denied that his conduct had invalidated the policy, he did not file a cross-complaint for damages.
The court concluded that there were two reasons why the insured was not entitled to a jury. First, the court explained that Ohio's general code required that "`[i]ssues of fact arising in actions for the recovery of money only ... shall be tried by a jury .... [¶] ... [¶] `All other issues of fact shall be tried by the court, subject to its power to order any issue to be tried by a jury ....'"
The above summary makes clear that the holding in Cochrane was predicated on two factors that are inapplicable here: an Ohio statute, which has no relevance in this California proceeding, and the nature of the issues raised in the dispute, which were questions of law rather than questions of fact.
In Jensen, supra, 32 P.3d 1205, the plaintiff brought a declaratory relief action seeking a determination that the defendants had violated a covenant not to compete, thereby invalidating their right to collect annual payments described in a settlement agreement. The Kansas appellate court concluded that the plaintiff was not entitled to a jury because the predominant issue before the trial court involved the "construction of the agreement and the covenants" and because "no monetary damages [were] involved." (Id. at p. 1212.) In support of its ruling, the court cited a decision from the Kansas Supreme Court explaining that no right to a jury attached in a declaratory judgment action in which the plaintiff had sought the "proper interpretation" of a contract and in which neither party had sought monetary relief.
The petition for writ of mandate is granted. The trial court is directed to vacate its order denying Entin's request for a jury trial and enter a new order granting the request. Petitioner shall recover his costs in this proceeding.
Perluss, P. J., and Woods, J., concurred.