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The Collaborative Clearinghouse for Lawsuits and Other Claims Against ACE Group Insurance Companies

SANTOS v. ACE AMERICAN INSURANCE COMPANY

ATTENTION: It is possible that this information may no longer be current and therefore may be inaccurate. The index contains both open and closed cases and is not a complete list of cases in which an ACE Insurance Group company is involved. This information is provided to give interested persons an idea of the issues disputed in the indexed cases. For a full understanding of a case, one should read the rest of the court file, including the response. For the most up-to-date and complete information on a case, visit www.pacer.gov or contact the clerk of the relevant court.

Case Number: 
2:12-cv-02059 Search Pacer
ACE Group party(s): 
Opposing Party: 
Elizabeth Santos
Court Type: 
Federal
US District Court: 
Eastern District of California
Date Filed: 
Aug 7 2012

"1. Plaintiff is a citizen of the State of California. Defendant is a corporation incorporated under the laws of the State of Pennsylvania having its principal place of business in Pennsylvania. The amount in controversy exceeds $75,000.00, exclusive of interest and costs, the sum specified by 28 U.S.C. §1332.

2. Plaintiff, Elizabeth Santos, hereinafter to be, referred as the insured or as Plaintiff, was and is at all times material herein an individual who at the time of the automobile accident referenced herein was an employee of Boehringer Ingelheim and was therefore insured under policy #ISAH08250418 issued by Ace American Insurance to Boehringer Ingelheim.

3. At all times material herein, Jessica Amber Waterman, Valerie Kosak and Wayne Griffith were insured under Progressive Insurance Policy 0900424-0 with policy limits of $15,000.00. Jessica Amber Waterman was operating the Progressive insured automobile on July 14, 2009 when it collided with an automobile drive by Plaintiff, herein Elizabeth Santos.

4. The true names and identities and capacities of Does 1 through 20, inclusive, are presently unknown to the Plaintiff Santos. Therefore, Plaintiff sues these Defendants by such fictitious names. When Plaintiff has learned the true names and identities and capacities of said Defendants sued herein as Does 1 through 20, inclusive, Plaintiff will amend the complaint to set forth their true names and identities and capacities. Plaintiff is informed and believes and based upon this information and belief alleges that the fictitiously named Defendants have made or will make claims under and by virtue of the Ace American Policy, hereinafter referred to and issued by Ace American Insurance to Plaintiffs employer, Boehringer Ingelheim, as the named insured. The identity of Doe Defendants may be determined by discovery (Wakefield v Thompson, 177 F3d 1160 (9th Cir.1999)).

5. Plaintiff Santos is informed and believes and based upon such information and belief alleges that the Defendants and each of them issued a policy of insurance toPlaintiff's employer, Boehringer Ingelheim. Prior to 14th of July, 2009, Defendant, Ace American, issued an automobile liability policy to Boehringer Ingelheim as the named insured. This policy is designated policy number ISAH08250418. The policy provided automobile liability coverage for a 2008 Saturn Aura which was operated by Plaintiff in the course of her employment. Attached hereto and labeled Exhibit "A" is a true and correct copy of said policy coverage sheet. Said policy was in full force on July 14, 2009, and covered Plaintiff for underinsured motorist benefits as an employee of Boehringer Ingelheim.

6. Plaintiff Santos is informed and believes and thereon alleges that on or about July 14, 2009, one Jessica Amber Waterman was operating a motor vehicle owned by Valerie Kosak and/or Wayne Griffith and covered by Progressive Policy 0900424-0. As a result of the injury sustained by Elizabeth Santos, Jessica Amber Waterman paid the policy limits under her policy. Thereafter, Plaintiff, Elizabeth Santos, made a demand on Ace American Insurance for coverage pursuant to underinsured motorist benefits. On or about September 24, 2010, a claims adjustor, one Steven Beech, representing Ace American through ESIS HEL Claims of Scranton, Pennsylvania, sent a letter confirming the existence of $1,000,000 in underinsured motorist coverage. A copy of said letter is attached and marked as Exhibit "B".

7. On January 21 of 2011 the Plaintiff, Elizabeth Santos, petitioned the Butte County Superior Court in Elizabeth Santos v. Ace American Insurance Company, Case Number 152742, for an order compelling underinsured motorist arbitration. Without conducting discovery and without hearing evidence, the Butte County Superior Court rejected the Plaintiff's request for an order and denied Petitioner's Petition and Supplemental Petition to compel arbitration on January 31, 2012. It therefore became necessary for the Plaintiff to file this complaint for declaratory relief. California decisional law does not consider the denial of a Motion to Compel Arbitration to be a decision on the 9 merits (Fleur Du Lac Estates Association v Mansouri, 205 Cal.App.4th 249 (2012».

8. An actual controversy has arisen and now exists between Plaintiff, Elizabeth Santos and Defendants, and each of them, regarding the issue of whether the Ace American Insurance policy referred to herein provides underinsured motorist coverage for the claims which have arisen outof the accident of July 14, 2009.

9. Although Ace American coverage sheet states that a $1,000,000 coverage for underinsured motorist incidents is provided with its policy, Ace American has refused to honor the policy of insurance and refused to provide such coverage. The contentions between the two parties require resolution by a court.

10. Defendants, Ace American, and each of them dispute the contentions of Plaintiff, Elizabeth Santos, and contends alternatively that Boehringer Ingelheim has not subscribed to a policy coverage for underinsured motorist, that it was not charged for a policy of underinsured motorist benefits and therefore none exists, despite the printed coverage sheet included with its policy and the affirmation of such coverage in the letter from Defendant, Ace American's insurance claims representative.

11. Plaintiff, Elizabeth Santos, seeks a judicial determination of whether the Ace American policy referred to herein provides underinsured motorist coverage for claims arising out of the events of July 14, 2009.

12. Plaintiff, Elizabeth Santos, seeks a judicial declaration of Ace American's rights, duties and obligations, if any, with regard to the claims arising out of the events of July 14, 2009.

13. Wherefore, Plaintiff, Elizabeth Santos requests this Court issue its judgment in favor of Plaintiff, Elizabeth Santos, and against Defendants and each of them in further declaring Ace American's rights, duties and obligations, if any, with respect to the claims which arose out of the events of July 14, 2009.

14. Plaintiff, Elizabeth Santos, requests that this Court issue its judgment declaring that Ace American sold to Boehringer Ingelheim a policy which included therein coverage for underinsured motorist benefits that applied directly to the vehicle Plaintiff was operating in the course and scope of her employment with Boehringer Ingelheim and that Plaintiff was a covered insured subject to all of the benefits conferred under the policy including underinsured motorist coverage up to the sum of $1 ,000,000.

15. Plaintiff, Elizabeth Santos, further requests that this Court award her its costs of suit incurred herein and for such further relief as the Court may deem proper."

The provided text is an excerpt from a document filed in this case. For a full understanding of the case, one should read the complete court file, including the response.

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