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■ Elkman v. National States Ins. Co., No. B205919

Plaintiff and appellant Esther Elkman (Elkman) appeals an order granting a motion to quash service of summons and complaint filed by defendant and respondent National States Insurance Company (National).[1]

            National, an out-of-state insurer which is not licensed or authorized to do business in California, receives insurance premiums from California and processes and pays claims submitted by its insureds who are domiciled in this state.  The essential issue presented is whether such circumstances provide a basis to justify the imposition of either general or specific jurisdiction over National in California.

We conclude no basis is present here.  National did not subject itself to either general or specific jurisdiction in California merely by accepting premium payments from California and by processing and paying claims submitted by its California insureds for services rendered in this state.  Thus, the trial court properly found National lacks sufficient contacts with California for jurisdiction to attach.  Therefore, the order granting the motion to quash is affirmed.

FACTUAL AND PROCEDURAL BACKGROUND

1.         Overview.

            In 1998, National, a Missouri corporation, issued a long term care insurance policy to Elkman.  The policy was delivered to Elkman at her residence in Pompano Beach, Florida.

            The policy contained a provision stating “Policy guaranteed renewable for life at your option subject to our table of premium rates in effect at time of renewal.”  The “guaranteed renewable” provision was mandated by Florida law.[2]

In December 2001, Elkman relocated to Sherman Oaks, California.

In April 2004, Elkman made a claim to National for benefits under the policy.  The policy’s schedule of benefits specifies a home care benefit maximum of 24 months.  For a two-year period, National paid for home health care services needed by Elkman pursuant to its contractual obligations under the policy.

At the end of the two-year period, on May 17, 2006, National’s claims department sent a letter to Elkman stating she had reached the maximum benefit limit of her policy.  The letter explained “Generally, you must have a period of at least 180 consecutive days during which you require no assistance and/or receive no care or services, in order for benefits to be restored.”  The letter advised:  “If you anticipate recovery or an improvement in your condition, and feel there is a possibility you may be able to meet the policy requirements to restore your benefits at some time in the future, then you may want to continue to pay premiums to keep the coverage in force.  If you do not feel you will be able to meet those requirements, and therefore would not be able to derive any future benefits from your policy, you may decide it is in your best interest to cancel the policy.  It is entirely your choice.  The policy is guaranteed renewable, which means you have the right to continue this policy as long as you pay your premiums on time.”

■ Held:

In a breach of contract action involving health insurance benefits, trial court's grant of defendant-insurer's motion to quash service of summons and complaint is affirmed where the court properly found defendant lacked the sufficient contacts with California for jurisdiction to attach as defendant did not subject itself to either general or specific jurisdiction in California by accepting premium payments from California or by processing and paying claims submitted by its California insureds for services rendered in-state.
Elkman v. National States Ins.-B205919- 5/14/09 CA2/3
Elkman v. National States Ins.-B205919- 5/14/09 CA2/3-PDF

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