Insured's Duty to Read His Policy
In H v. National Casualty Co., supra, 189 Cal. App. 3d 1102, a doctor ordered a "Defendants Reimbursement Policy," which was promoted with a brochure stating that the policy will pay the insured $ 200 " 'for each full day spent in court as a defendant' " and that it will " 'cover any suit . . . involving either professional acts or automobiles . . . .' " ( Id. at p. 1106.)
The two-page policy's coverage agreement stated the company would pay " 'for each day the insured is required to attend the trial of a civil suit for damages against the insured alleged to have been caused by malpractice in the practice of the profession of the insured . . . .' " ( Id. at p. 1107, italics in original.)
Dr. H was charged with gross negligence and incompetence by the Board of Medical Quality Assurance, which required him to attend 39 days of hearings before an administrative law judge.
He remembered that the agent had said the policy would cover any suit filed against him, even on matters other than malpractice, and he sought reimbursement.
When the insurer denied coverage, Dr. H sued for bad faith and fraud.
The court noted that the brochure stated it was an outline and referred the reader to the policy for complete details, and the policy proclaimed in bold letters: " 'Please Read Your Policy.' " ( Id. at p. 1112.)
Dr. H admitted that the agent never told him the policy provided coverage for administrative hearings.
Under these facts, the court found the insured had a duty to read his policy. H is distinguishable from the case at bar, because the insured there was not misled by the agent or the insurer.