Insurance Agent's Failure to Deliver the Agreed-Upon Coverage
An insurance agent has an "obligation to use reasonable care, diligence, and judgment in procuring the insurance requested by an insured." ( Jones v. Grewe (1987) 189 Cal. App. 3d 950, 954 [234 Cal. Rptr. 717].)
The law is well established in California that an agent's failure to deliver the agreed-upon coverage may constitute actionable negligence and the proximate cause of an injury.
(See Desai v. Farmers Ins. Exchange (1996) 47 Cal. App. 4th 1110, 1120 [55 Cal. Rptr. 2d 276];
Clement v. Smith (1993) 16 Cal. App. 4th 39, 45 [19 Cal. Rptr. 2d 676];
Kurtz, Richards, Wilson & Co. v. Insurance Communicators Marketing Corp. (1993) 12 Cal. App. 4th 1249, 1257 [16 Cal. Rptr. 2d 259] [broker negligently represented that insured was not subject to Medicare provisions of federal statute];
Free v. Republic Ins. Co. (1992) 8 Cal. App. 4th 1726, 1730 [11 Cal. Rptr. 2d 296] [negligent failure of agent to respond to homeowner's inquiry concerning adequacy of coverage limits to rebuild home];
Westrick v. State Farm Insurance (1982) 137 Cal. App. 3d 685, 692 [187 Cal. Rptr. 214];
Jackson v. Aetna Life & Casualty Co. (1979) 93 Cal. App. 3d 838, 840, 848 [155 Cal. Rptr. 905] [negligent failure of agent to add lessor as additional insured party];
Greenfield v. Insurance Inc. (1971) 19 Cal. App. 3d 803 [97 Cal. Rptr. 164] [negligent failure of agent to obtain the coverage requested by client];
Eddy v. Sharp (1988) 199 Cal. App. 3d 858, 866 [245 Cal. Rptr. 211] [negligent failure of agent to include loss due to water backing up through drains or sewers in cover letter's listed exclusions].)
In Desai v. Farmers Ins. Exchange, supra, 47 Cal. App. 4th 1110 (Desai), a homeowner requested insurance from his agent that would fully protect the home he bought.
Based on the agent's oral representation that a policy offered by Farmers Insurance Group would provide " '100 coverage for the costs of repairs and/or replacement of the improvements to the property including any and all increases in costs of repair or rebuilding in the event of a loss' ( id. at p. 1114), the insured purchased the policy.
Before the policy issued, the agent inspected the property to determine the amount of coverage needed to fill the insured's stated requirements. the policy was renewed annually.
The insured sustained damages in excess of $ 500,000 from a fire and an earthquake and submitted his claim. Farmers paid only $ 158,734 as allegedly dictated by the terms of the policy. ( Id. at p. 1115.)
The Desai court described this as "a 'failure to deliver the agreed-upon coverage' case" (Desai, supra, 47 Cal. App. 4th at p. 1119) and held the agent's failure to obtain the insurance requested was actionable negligence, and the insurer was vicariously liable. ( Id. at pp. 1119-1120.)
Based on the facts alleged, "the reasonable expectations of the insured would be that he was completely covered for the replacement cost of the structures, regardless of the policy limits." ( Id. at p. 1114.)