NOT FOR PUBLICATION
UNITED STATES COURT OF APPEALS FILED
FOR THE NINTH CIRCUIT OCT 25 2013
MOLLY C. DWYER, CLERK
U.S. COURT OF APPEALS
FARAH SAYARI, an individual, No. 12-55101
Plaintiff - Appellant, D.C. No. 2:10-cv-09404-SVW-
JCG
v.
METROPOLITAN LIFE INSURANCE MEMORANDUM*
COMPANY, a New York corporation
qualified to do business in California,
Defendant - Appellee.
Appeal from the United States District Court
for the Central District of California
Stephen V. Wilson, District Judge, Presiding
Submitted October 10, 2013**
Pasadena, California
Before: PAEZ and HURWITZ, Circuit Judges, and ERICKSON, Chief District
Judge.***
*
This disposition is not appropriate for publication and is not precedent
except as provided by 9th Cir. R. 36-3.
**
The panel unanimously concludes this case is suitable for decision
without oral argument. See Fed. R. App. P. 34(a)(2).
***
The Honorable Ralph R. Erickson, Chief District Judge for the U.S.
District Court for the District of North Dakota, sitting by designation.
Farah Sayari (“Sayari”) appeals the district court’s order granting summary
judgment to Metropolitan Life Insurance Company (“MetLife”). We have
jurisdiction under 28 U.S.C. § 1291, and we reverse.
Under California law, the statute of limitations begins when an insured
incurs a loss, but it is equitably tolled from the date the insured gives timely notice
of the claim until the date the insurance company “formally denies the claim in
writing.” Prudential-LMI Com. Ins. v. Superior Court, 798 P.2d 1230, 1232 (Cal.
1990). California’s appellate courts have construed “formal denial” to require
“unequivocal denial” in writing. Migliore v. Mid-Century Ins. Co., 97 Cal. App.
4th 592, 604 (2002); Aliberti v. Allstate Ins. Co., 74 Cal. App. 4th 138, 146-47
(1999).
MetLife argues that its May 15, 2006 letter (“May 15 letter”) to Sayari was
an unequivocal denial of her claim. The first part of the operative sentence at the
end of the May 15 letter—“we must conclude that the death of our insured has not
been established and we can give your claim no further consideration . . .” —seems
to communicate finality. This sentence, however, ends with an important
qualifier—“. . . without conclusive evidence of death”—which suggests that
MetLife’s conclusion is conditional. Webster’s Third New International
2
Dictionary defines “unequivocal,” in part, as “expressing finality: carrying no
implication of later change or revision.” The operative sentence in the May 15
letter, taken as a whole, carries the reasonable implication of later change or
revision pending submission of conclusive evidence of death.
The May 15 letter also lacks several attributes that would characterize an
unequivocal denial. For instance, California insurance regulations require that the
denial of a claim include
written notification . . . that, if the claimant believes all or part of the claim
has been wrongfully denied or rejected, he or she may have the matter
reviewed by the California Department of Insurance, and shall include the
address and telephone number of the unit of the Department which reviews
claims practices.
Cal. Code Regs. tit. 10, § 2695.7(b)(3); see also 1231 Euclid Homeowners Ass'n v.
State Farm Fire & Cas. Co., 135 Cal. App. 4th 1008, 1015 n.11 (2006) (providing
example of a letter fulfilling insurance company’s obligation under §
2695.7(b)(3)). Unlike the denial letter in Migliore, the May 15 letter does not
include this language. See 97 Cal. App. 4th at 599. Further, it is notable that the
May 15 letter is not on MetLife letterhead and comes from a consultant, Juan
Conde, not a MetLife employee or decision maker.
3
Accordingly, we reverse the district court’s grant of summary judgment
because there is a triable issue of material fact as to whether MetLife’s May 15
letter to Sayari constituted an unequivocal denial.1
REVERSED.
1
Because we conclude that there is a material triable issue of fact that
requires reversal, we need not address Sayari’s other arguments raised on appeal.
4