California Landmark Cases on Insurers Have a Duty to Defend

"It has long been a fundamental rule of law that an insurer has a duty to defend an insured if it becomes aware of, or if the third party lawsuit pleads, facts giving rise to the potential for coverage under the insuring agreement. This duty, which applies even to claims that are 'groundless, false, or fraudulent,' is separate from and broader than the insurer's duty to indemnify." (Waller v. Truck Ins. Exchange, Inc. (1995) 11 Cal.4th 1, 19.) "Courts first determine whether insurers have a duty to defend by 'comparing the allegations of the complaint with the terms of the policy.' Regarding the policy, contract terms are interpreted in their '"'ordinary and popular sense.'"' Any ambiguous terms are resolved in the insureds' favor, consistent with the insureds' reasonable expectations. Ambiguous terms are those capable of two or more reasonable constructions." (Kazi v. State Farm & Casualty Co. (2001) 24 Cal.4th 871, 879 (Kazi).) "Regarding the complaint, insurers must defend a lawsuit that 'potentially seeks damages within the coverage of the policy.' The insurers' duty to defend does not depend on whether damages are ultimately awarded. In fact, the duty to defend may '"'exist even where coverage is in doubt and ultimately does not develop,'"' and it continues until there is no potential for coverage. Any doubt as to whether the facts establish that the duty to defend exists must be resolved in the insured's favor. When '"'there is no possibility of coverage, there is no duty to defend . . . .'"'" (Kazi, supra, 24 Cal.4th at pp. 879-880.) Accordingly, to prevail on the issue of whether the insurer owes a duty to defend, "the insured must prove the existence of a potential for coverage, while the insurer must establish the absence of any such potential. In other words, the insured need only show that the underlying claim may fall within policy coverage; the insurer must prove it cannot. Facts merely tending to show that the claim is not covered, or may not be covered, but are insufficient to eliminate the possibility that resultant damages (or the nature of the action) will fall within the scope of coverage, therefore add no weight to the scales." (Montrose Chemical Corp. v. Superior Court (1993) 6 Cal.4th 287, 300.) "In 'determining whether a particular policy provides a potential for coverage and a duty to defend, we are guided by the principle that interpretation of an insurance policy is a question of law.'" (Kazi, supra, 24 Cal.4th at p. 880.) Accordingly, we are not bound by the trial court's construction of the policy, but must independently interpret the policy provisions. (Fire Ins. Exchange v. Superior Court (2004) 116 Cal.App.4th 446, 453.) "Our goal is to determine the mutual intention of the parties at the time the policy was created, and such intent should be inferred, if possible, solely from the written terms of the policy. 'The "clear and explicit" meaning of these provisions, interpreted in their "ordinary and popular sense," unless "used by the parties in a technical sense or a special meaning is given to them by usage" , controls judicial interpretation. '" (Ibid.) "An insurer has a duty to defend when the policy is ambiguous and the insured would reasonably expect the insurer to defend him or her against the suit based on the nature and kind of risk covered by the policy, or when the underlying suit potentially seeks damages within the coverage of the policy. The duty to defend is 'a continuing one, arising on tender of defense and lasting until the underlying lawsuit is concluded , or until it has been shown that there is no potential for coverage . . . .' " (Foster-Gardner, Inc. v. National Union Fire Ins. Co. (1998) 18 Cal.4th 857, 869, 959 P.2d 265.) "Implicit in this rule is the principle that the duty to defend is broader than the duty to indemnify; an insurer may owe a duty to defend its insured in an action in which no damages ultimately are awarded. " ( Horace Mann Ins. Co. v. Barbara B. (1993) 4 Cal.4th 1076, 1081, 846 P.2d 792.) "The determination whether the insurer owes a duty to defend usually is made in the first instance by comparing the allegations of the complaint with the terms of the policy." (Horace Mann Ins. Co. v. Barbara B., supra, 4 Cal.4th at p. 1081.) An insurer, however, "cannot construct a formal fortress of the third party's pleadings and retreat behind its walls. The pleadings are malleable, changeable and amendable. . . . Courts do not examine only the pleaded word but the potential liability created by the suit." (Gray v. Zurich Insurance Co. (1966) 65 Cal.2d 263, 276, 54 Cal. Rptr. 104, 419 P.2d 168.) Furthermore, "facts known to the insurer and extrinsic to the third party complaint can generate a duty to defend, even though the face of the complaint does not reflect a potential for liability under the policy. . . . The third party plaintiff cannot be the arbiter of coverage." (Montrose Chemical Corp. v. Superior Court (1993) 6 Cal.4th 287, 296, 861 P.2d 1153.)