1 2 3 4 UNITED STATES DISTRICT COURT 5 NORTHERN DISTRICT OF CALIFORNIA 6 7 DARRELL WILEY, Case No. 3:19-cv-02756-WHO

8 Plaintiff, ORDER EXPLAINING JURY 9 v. INSTRUCTION

10 UNUM LIFE INSURANCE COMPANY OF AMERICA, 11 Defendant.

12 This Order explains my resolution of a disputed jury instruction. 13 Plaintiff Darrell Wiley proposed a jury instruction about contract interpretation to which 14 defendant Unum Life Insurance Company of America (“Unum”) objected. See Dkt. Nos. 110, 15 115. The instruction Wiley proposed is improper. Contract interpretation is a matter of law for 16 the court, not the jury. Merced Mut. Ins. Co. v. Mendez,

(1989). 17 I drafted an instruction about causation to address the parties’ principal disagreement and 18 invited the parties to file briefs on it, which they have done. Unum does not object to my use of a 19 proximate cause test. See Dkt. No. 125. Wiley does, arguing that “any” contribution of the injury 20 suffices. See Dkt. No. 126. 21 A proximate cause test is appropriate. To the extent that Unum previously suggested that 22 injury needed to be the sole cause, I disagree. The insurance policy contemplates that a covered 23 disability can stem from multiple causes. See Dkt. No. 73-4 at 9 (“If, in any month, your disability 24 is the result of concurrent causes for which the Monthly Benefit is payable, we will pay the 25 Monthly Benefit which is more favorable to you.”); Kerns v. Nw. Mut. Life Ins. Co., No. 26 2:08CV02016GEBKJM,

, at *3 (E.D. Cal. May 27, 2010). Unum’s acceptance 27 of the proximate cause standard has now resolved that issue. 1 I also reyect Wiley’s position that an injury only need make “any contribution” to receive 2 || lifetime coverage. While the policy does not state a standard, insurance contracts have a thick 3 statutory overlay: the Insurance Code generally provides coverage when the covered event is the 4 || proximate cause, not just a remote cause. See

. In an analogous situation in 5 which there are concurrent causes, the California Supreme Court has understood that insurance 6 policies cover proximate ones. See State Farm Mut. Auto. Ins. Co. v. Partridge,

, 7 104 (1973). It also makes sense that the parties would intend to cover proximate causes both 8 || because that is the law’s usual cause standard and because a lesser standard would impose liability 9 on remote contributing factors. 10 Wiley’s counterargument depends on the general principle that ambiguities in insurance 11 contracts are to be interpreted in favor of the insured. But that principle has limits; the ambiguity 12 || must still be a reasonable interpretation of the contract. Here statutes and caselaw have 13 established background principles, the policy does not indicate intent to displace them, and a 14 || lower standard would lead to odd results. 3 15 Unum also proposed tweaking the language from “accident” to “injury.” The policy uses 16 || both terms at various places and it is unclear whether or why it would make a difference. We can 3 17 discuss this at the time of trial if Wiley has any objection. 18 Accordingly, I will use the jury instruction I proposed to the parties (with or without 19 || Unum’s proposed change), based on CACTI Instruction No. 2306 and adding the formulation of a 20 || “substantial factor” to mean proximate cause.! 21 IT IS SO ORDERED. . 22 Dated: May 18, 2022 23 United States mee Judge 24 25 26 07 ! Wiley objects that using an excluded risk instruction is inappropriate. But that type of instruction speaks of the “predominant” cause of the loss, while I conclude that any proximate 2g || cause (not just the predominant one) is sufficient, so the objection is misplaced. Unum’s acceptance of proximate cause forfeits any argument that the standard should be more demanding.