{"id":1206,"date":"2021-10-25T03:50:34","date_gmt":"2021-10-25T03:50:34","guid":{"rendered":"https:\/\/crowdsourcelawyers.com\/judicial-council-california-civil-jury-instructions-caci\/?page_id=1206"},"modified":"2022-05-05T16:35:27","modified_gmt":"2022-05-05T16:35:27","slug":"caci-2332-bad-faith-first-party-failure-to-properly-investigate-claim-essential-factual-elements","status":"publish","type":"page","link":"https:\/\/crowdsourcelawyers.com\/judicial-council-california-civil-jury-instructions-caci\/caci-2332-bad-faith-first-party-failure-to-properly-investigate-claim-essential-factual-elements\/","title":{"rendered":"CACI 2332 Bad Faith (First Party)\u2014Failure to Properly Investigate Claim\u2014Essential Factual Elements"},"content":{"rendered":"\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-kum81q64-4ae3800fd7af58304d35d3de664fe3c1\">\n#top .av-special-heading.av-kum81q64-4ae3800fd7af58304d35d3de664fe3c1{\npadding-bottom:10px;\n}\nbody .av-special-heading.av-kum81q64-4ae3800fd7af58304d35d3de664fe3c1 .av-special-heading-tag .heading-char{\nfont-size:25px;\n}\n.av-special-heading.av-kum81q64-4ae3800fd7af58304d35d3de664fe3c1 .av-subheading{\nfont-size:15px;\n}\n<\/style>\n<div  class='av-special-heading av-kum81q64-4ae3800fd7af58304d35d3de664fe3c1 av-special-heading-h1 blockquote modern-quote  avia-builder-el-0  el_before_av_hr  avia-builder-el-first '><h1 class='av-special-heading-tag '  itemprop=\"headline\"  >CACI 2332 Bad Faith (First Party)\u2014Failure to Properly Investigate Claim\u2014Essential Factual Elements<\/h1><div class='av-subheading av-subheading_below'><p>California Civil Jury Instructions CACI<\/p>\n<\/div><div class=\"special-heading-border\"><div class=\"special-heading-inner-border\"><\/div><\/div><\/div>\n<div  class='hr av-av_hr-91d7ccd583a503147498e120fee2ff9b hr-default  avia-builder-el-1  el_after_av_heading  el_before_avia_sc_search '><span class='hr-inner '><span 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itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><ul>\n<li><a href=\"https:\/\/crowdsourcelawyers.com\/judicial-council-california-civil-jury-instructions-caci\/\">CACI Jury Instructions Index<\/a><\/li>\n<li><a href=\"https:\/\/caci-fillable-forms.crowdsourcelawyers.com\/\">App: CACI Jury Instructions Fillable Forms Word Format<\/a><\/li>\n<\/ul>\n<\/div><\/section>\n<div  class='hr av-av_hr-91d7ccd583a503147498e120fee2ff9b hr-default  avia-builder-el-4  el_after_av_textblock  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-kum8310g-04c8de0a20b675a4d46fe15aecac86ac\">\n#top .av_textblock_section.av-kum8310g-04c8de0a20b675a4d46fe15aecac86ac .avia_textblock{\nfont-size:20px;\n}\n<\/style>\n<section  class='av_textblock_section av-kum8310g-04c8de0a20b675a4d46fe15aecac86ac '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><h2 class=\"SS_Banner\">2332\u00a0Bad Faith (First Party)\u2014Failure to Properly Investigate Claim\u2014Essential Factual Elements<\/h2>\n<hr \/>\n<p><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">[<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Name of plaintiff<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">] claims that [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of defendant<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">] acted unreasonably, that is, without proper cause, by failing to conduct a proper investigation of [his\/her\/<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">nonbinary pronoun<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">\/its] claim. To establish this claim, [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of plaintiff<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">] must prove all of the following:<\/span><\/p>\n<p><span class=\"SS_ListLabel\"><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">1.<\/span><\/span><span class=\"SS_ListItemContent\"><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">That [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of plaintiff<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">] suffered a loss covered under an insurance policy issued by [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of defendant<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">];<\/span><\/span><\/p>\n<p><span class=\"SS_ListLabel\"><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">2.<\/span><\/span><span class=\"SS_ListItemContent\"><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">That [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of plaintiff<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">] properly presented a claim to [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of defendant<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">] to be compensated for the loss;<\/span><\/span><\/p>\n<p><span class=\"SS_ListLabel\"><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">3.<\/span><\/span><span class=\"SS_ListItemContent\"><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">That [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of defendant<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">], failed to conduct a full, fair, prompt, and thorough investigation of all of the bases of [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of plaintiff<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">]\u2019s claim;<\/span><\/span><\/p>\n<p><span class=\"SS_ListLabel\"><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">4.<\/span><\/span><span class=\"SS_ListItemContent\"><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">That [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of plaintiff<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">] was harmed; and<\/span><\/span><\/p>\n<p><span class=\"SS_ListLabel\"><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">5.<\/span><\/span><span class=\"SS_ListItemContent\"><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">That [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of defendant<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">]\u2019s failure to properly investigate the claim was a substantial factor in causing [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of plaintiff<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">]\u2019s harm.<\/span><\/span><\/p>\n<p><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">When investigating [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of plaintiff<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">]\u2019s claim, [<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">name of defendant<\/span><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\">] had a duty to diligently search for and consider evidence that supported coverage of the claimed loss. <br class=\"avia-permanent-lb\" \/><br class=\"avia-permanent-lb\" \/><\/span><\/p>\n<hr \/>\n<div class=\"SS_Note\">\n<h2 class=\"SS_HideShowSection SS_Expandable\"><\/h2>\n<div id=\"TRNotes_n_1\">\n<p><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">New September 2003; Revised December 2005, December 2007, April 2008, December 2015, June 2016 <br class=\"avia-permanent-lb\" \/><br class=\"avia-permanent-lb\" \/><\/span><\/p>\n<hr \/>\n<p><a href=\"https:\/\/crowdsourcelawyers.com\/\">Crowdsource Lawyers<\/a><\/p>\n<p><a href=\"https:\/\/crowdsourcelawyers.com\/judicial-council-california-civil-jury-instructions-caci\">https:\/\/crowdsourcelawyers.com\/judicial-council-california-civil-jury-instructions-caci<\/a><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\"><br class=\"avia-permanent-lb\" \/><\/span><\/p>\n<hr \/>\n<\/div>\n<\/div>\n<div class=\"SS_Note\">\n<h2 class=\"SS_HideShowSection SS_Expandable\">Directions for Use<\/h2>\n<div id=\"TRNotes_n_2\">\n<p>This instruction sets forth a claim for breach of the implied covenant of good faith and fair dealing based on the insurer\u2019s failure or refusal to conduct a proper investigation of the plaintiff\u2019s claim. The claim alleges that the insurer acted unreasonably, that is, without proper cause, by failing to properly investigate the claim. (See\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Rappaport-Scott v. Interinsurance Exch. of the Auto. Club<\/span>\u00a0(2007) 146 Cal.App.4th 831, 837 [53 Cal.Rptr.3d 245].)<\/p>\n<p>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.<\/p>\n<p>For instructions regarding general breach of contract issues, refer to the Contracts series (CACI No.\u2002300\u00a0et seq.). <br class=\"avia-permanent-lb\" \/><br class=\"avia-permanent-lb\" \/><\/p>\n<hr \/>\n<\/div>\n<\/div>\n<div class=\"SS_Note\">\n<h2 class=\"SS_HideShowSection SS_Expandable\">Sources and Authority<\/h2>\n<div id=\"TRNotes_n_3\">\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201c[A]n insurer may breach the covenant of good faith and fair dealing when it fails to properly investigate its insured\u2019s claim.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Egan v. Mutual of Omaha Insurance Co.<\/span>\u00a0(1979) 24 Cal.3d 809, 817 [169 Cal.Rptr. 691, 620 P.2d 141].)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cTo fulfill its implied obligation, an insurer must give at least as much consideration to the interests of the insured as it gives to its own interests. When the insurer unreasonably and in bad faith withholds payment of the claim of its insured, it is subject to liability in tort. And an insurer cannot reasonably and in good faith deny payments to its insured without fully investigating the grounds for its denial.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Frommoethelydo v. Fire Insurance Exchange<\/span>\u00a0(1986) 42 Cal.3d 208, 214\u2013215 [228 Cal.Rptr. 160, 721 P.2d 41], internal citation omitted.)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cTo protect [an insured\u2019s] interests it is essential that an insurer fully inquire into possible bases that might support the insured\u2019s claim. Although we recognize that distinguishing fraudulent from legitimate claims may occasionally be difficult for insurers,\u2009\u2026 an insurer cannot reasonably and in good faith deny payments to its insured without thoroughly investigating the foundation for its denial.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Egan, supra,<\/span>\u00a024 Cal.3d at p. 819.)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cWhen investigating a claim, an insurance company has a duty to diligently search for evidence which supports its insured\u2019s claim. If it seeks to discover only the evidence that defeats the claim it holds its own interest above that of the insured.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Mariscal v. Old Republic Life Ins. Co.<\/span>\u00a0(1996) 42 Cal.App.4th 1617, 1620 [50 Cal.Rptr.2d 224].)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cAn insurer is not permitted to rely selectively on facts that support its position and ignore those facts that support a claim. Doing so may constitute bad faith.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Mazik v. Geico General Ins. Co<\/span>. (2019) 35 Cal.App.5th 455, 462 [247 Cal.Rptr.3d 450].)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cWhile we agree with the trial court \u2026 that the insurer\u2019s interpretation of the language of its policy which led to its original denial of [the insured]\u2019s claim was reasonable, it does not follow that [the insurer]\u2019s resulting claim denial can be justified in the absence of a full, fair and thorough investigation of\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">all<\/span>\u00a0of the bases of the claim that was presented.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Jordan v. Allstate Ins. Co.<\/span>\u00a0(2007) 148 Cal.App.4th 1062, 1066 [56 Cal.Rptr.3d 312], original italics.)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cAn unreasonable failure to investigate amounting to \u2026 unfair dealing may be found when an insurer fails to consider, or seek to discover, evidence relevant to the issues of liability and damages.\u2009\u2026 [\u00b6] The insurer\u2019s willingness to reconsider its denial of coverage and to continue an investigation into a claim has been held to weigh in favor of its good faith.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Shade Foods, Inc. v. Innovative Products Sales &amp; Marketing, Inc.<\/span>\u00a0(2000) 78 Cal.App.4th 847, 880 [93 Cal.Rptr.2d 364], internal citation omitted.)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201c[The insurer], of course, was not obliged to accept [the doctor]\u2019s opinion without scrutiny or investigation. To the extent it had good faith doubts, the insurer would have been within its rights to investigate the basis for [plaintiff]\u2019s claim by asking [the doctor] to reexamine or further explain his findings, having a physician review all the submitted medical records and offer an opinion, or, if necessary, having its insured examined by other physicians (as it later did). What it could not do, consistent with the implied covenant of good faith and fair dealing, was\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">ignore<\/span>\u00a0[the doctor]\u2019s conclusions without any attempt at adequate investigation, and reach contrary conclusions lacking any discernable medical foundation.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Wilson v. 21st\u00a0<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Century Ins. Co.<\/span>\u00a0(2007) 42 Cal.4th 713, 722 [68 Cal.Rptr.3d 746, 171 P.3d 1082], original italics.)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201c[W]hether an insurer breached its duty to investigate [is] a question of fact to be determined by the particular circumstances of each case.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Paulfrey v. Blue Chip Stamps<\/span>\u00a0(1983) 150 Cal.App.3d 187, 196 [197 Cal.Rptr. 501].)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201c[L]iability in tort arises only if the conduct was unreasonable, that is, without proper cause.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Rappaport-Scott, supra<\/span>, 146 Cal.App.4th at p. 837.)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201c[W]ithout actual presentation of a claim by the insured in compliance with claims procedures contained in the policy, there is no duty imposed on the insurer to investigate the claim.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">California Shoppers, Inc. v. Royal Globe Insurance Co.<\/span>\u00a0(1985) 175 Cal.App.3d 1, 57 [221 Cal.Rptr. 171].)<\/span><\/p>\n<p><span class=\"SS_ListLabel\">\u2022<\/span><span class=\"SS_ListItemContent\">\u201cIt would seem reasonable that any responsibility to investigate on an insurer\u2019s part would not arise unless and until the threshold issue as to whether a claim was filed, or a good faith effort to comply with claims procedure was made, has been determined. In no event could an insured fail to keep his\/her part of the bargain in the first instance, and thereafter seek recovery for breach of a duty to pay seeking punitive damages based on an insurer\u2019s failure to investigate a nonclaim.\u201d (<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Paulfrey, supra,<\/span>\u00a0150 Cal.App.3d at pp. 199\u2013200.) <br class=\"avia-permanent-lb\" \/><br class=\"avia-permanent-lb\" \/><\/span><\/p>\n<hr \/>\n<\/div>\n<\/div>\n<h2 class=\"SS_Heading\"><span class=\"SS_bf\" data-housestyle=\"EMPHASIS_bf\"><span class=\"SS_ib\" data-housestyle=\"EMPHASIS_ib\">Secondary Sources<\/span><\/span><\/h2>\n<div>2 Witkin, Summary of California Law (11th ed. 2017) Insurance, \u00a7\u2009348<\/div>\n<div>Croskey et al., California Practice Guide: Insurance Litigation, Chapter 12C-D,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Bad Faith<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">\u2014First Party Cases\u2014<\/span><span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Application\u2014Matters Held \u201cUnreasonable\u201d<\/span>, \u00b6\u00b6\u200912:848\u201312:904 (The Rutter Group)<\/div>\n<div>1 California Liability Insurance Practice: Claims &amp; Litigation (Cont.Ed.Bar) Investigating the Claim, \u00a7\u00a7\u20099.2, 9.14\u20139.22<\/div>\n<div>2\u00a0California Insurance Law &amp; Practice, Ch. 13,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Claims Handling and the Duty of Good Faith<\/span>, \u00a7\u200913.04[1]\u2013[3]\u00a0(Matthew Bender)<\/div>\n<div>2 California Uninsured Motorist Law, Ch. 24,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Bad Faith in Uninsured Motorist Law<\/span>, \u00a7\u200924.11 (Matthew Bender)<\/div>\n<div>26\u00a0California Forms of Pleading and Practice, Ch. 308,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Insurance<\/span>, \u00a7\u2009308.24\u00a0(Matthew Bender)<\/div>\n<div>12 California Points and Authorities, Ch. 120,\u00a0<span class=\"SS_it\" data-housestyle=\"EMPHASIS_it\">Insurance<\/span>, \u00a7\u00a7\u2009120.153,\u00a0120.184\u00a0(Matthew Bender)<\/div>\n<div class=\"SS_Note\">\n<div id=\"TRNotes_n_3\"><\/div>\n<\/div>\n<\/div><\/section>\n<div  class='hr av-ti1ye-4664bfcc50d7f2752eff43484a43f4a1 hr-default  avia-builder-el-6  el_after_av_textblock  el_before_av_textblock '><span class='hr-inner '><span class=\"hr-inner-style\"><\/span><\/span><\/div>\n\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-61zod2-eea62c9bc3a1085090009caea7612900\">\n#top .av_textblock_section.av-61zod2-eea62c9bc3a1085090009caea7612900 .avia_textblock{\nfont-size:22px;\n}\n<\/style>\n<section  class='av_textblock_section av-61zod2-eea62c9bc3a1085090009caea7612900 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p><a href=\"https:\/\/crowdsourcelawyers.com\/\">CrowdSourceLawyers.com<\/a><\/p>\n<\/div><\/section>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1206","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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