Petitioner insured sought a writ of mandate to direct respondent Superior Court of Los Angeles County (California) to vacate its order that compelled arbitration in an action arising from a denial of coverage by real party in interest health insurer. Petitioner contended that he had a right to bring his action in a court of law and that the documents and representations of real party in interest's agents concerning his rights were ambiguous.

Overview: constructive fraud real estate

Petitioner insured brought an action against real party in interest health insurer to contest a denial of benefits. Real party in interest petitioned the trial court to compel arbitration of the dispute, and the petition was granted. Petitioner then sought a writ of mandate to direct the trial court to vacate the order compelling arbitration. The court granted the writ and directed the trial court to vacate the order. The court found that the information provided to petitioner in writing, in the form of a brochure and a certificate of insurance, and the oral representations of the agent differed as to the remedies available to petitioner to contest the denial of coverage. The court determined that the discrepancies created an ambiguity concerning procedures to contest denial of coverage that had to be resolved against real party in interest. The court concluded that the resolution of ambiguous information against real party in interest constituted a waiver of the right to arbitrate and that petitioner was entitled to have his action heard in a court of law. The court found that the trial court abused its discretion in compelling arbitration and directed it to vacate its order.

The court found that the trial court abused its discretion in entering an order compelling arbitration in the action of petitioner insured against real party in interest health insurer, finding that an ambiguity existed between the documents provided to petitioner and representations by an agent concerning petitioner's recourse for denial of coverage, and that ambiguity had to be resolved against real party in interest.