Marquez v. Blue Cross of California doing business as Anthem Blue Cross, et al.

Jennifer Williams's renewed motion is denied.

Department 516 Hearing Date: August 26, 2026 Case Name: Marquez v. Blue Cross of California doing business as Anthem Blue Cross, et al. Case No.: 25STCV30462 Matter: Demurrer with Motion to Strike Moving Party: Defendant Blue Cross of California doing business as Anthem Blue Cross Responding Party: Plaintiff Fernando Marquez Tentative Ruling: Defendant Blue Cross of California doing business as Anthem Blue Cross's demurrer is sustained. Defendant Blue Cross of California doing business as Anthem Blue Cross's motion to strike is rendered moot.

On October 17, 2025, Plaintiff Fernando Marquez ("Plaintiff") filed this action against Defendants Blue Cross of California doing business as Anthem Blue Cross ("Anthem"), Dignity Health Medical Foundation ("Dignity Health") (collectively "Defendants"), and Does 1 through 20. The Complaint alleged a cause of action for breach of implied covenant of good faith against Anthem, and a cause of action for negligence against Dignity Health. On May 6, 2026, the Court sustained Anthem's demurrer with leave to amend and rendered moot its motion to strike.

On June 4, 2026, Plaintiff filed a First Amended Complaint ("FAC") realleging the samecause of action. Anthem demurs to Plaintiff's cause of action for breach of implied covenant of good faith and fair dealing. Anthem also moves to strike portions of the FAC. Plaintiff opposes.

Legal Standard

A demurrer is an objection to a pleading, the grounds for which are apparent from either the face of the complaint or a matter of which the court may take judicial notice.¿(Code Civ. Proc., Sec. 430.30, subd. (a); see also Blank v. Kirwan (1985) 39 Cal.3d 311, 318.)¿The purpose of a demurrer is to challenge the sufficiency of a pleading by raising questions of law.¿(Postley v. Harvey (1984) 153 Cal.App.3d 280, 286.)¿"In the construction of a pleading, for the purpose of determining its effect, its allegations must be liberally construed, with a view to substantial justice between the parties." (Code Civ. Proc., Sec. 452.)¿The court " ' "treat[s] the demurrer

as admitting all material facts properly pleaded, but not contentions, deductions or conclusions of fact or law . . . ." ' "¿ (Berkley v. Dowds (2007) 152 Cal.App.4th 518, 525.)¿In applying these standards, the court liberally construes the complaint to determine whether a cause of action has been stated.¿(Picton v. Anderson Union High School Dist. (1996) 50 Cal.App.4th 726, 733.) "The court may, upon a motion made pursuant to Section 435, or at any time in its discretion, and upon terms it deems proper: (a) Strike out any irrelevant, false, or improper matter inserted in any pleading. (b) Strike out all or any part of any pleading not drawn or filed in conformity with the laws of this state, a court rule, or an order of the court."¿(Code Civ.

Proc., Sec. 436.) "Immaterial" or "irrelevant" matters include allegations not essential to the claim, allegations neither pertinent to nor supported by an otherwise sufficient claim or a demand for judgment requesting relief not supported by the allegations of the complaint. (Code Civ. Proc., Sec. 431.10, subds. (b)(1)-(3).) Request for Judicial Notice Plaintiff requests for the Court to take judicial notice of two court orders in the following cases: (1) Crawford v. Blue Cross of California (2023) (LASC No. 22STCV09453); and (2) Diaz v.

Blue Cross of California (2025) (LASC No. 23STCV18814). The Court grants Plaintiff's request for judicial notice pursuant to Evidence Code section 452, subdivision (d).

Analysis

Preliminary Issues "Except in a summary judgment or summary adjudication motion, no opening or responding memorandum may exceed 15 pages. In a summary judgment or summary adjudication motion, no opening or responding memorandum may exceed 20 pages. No reply or closing memorandum may exceed 10 pages." (Cal. Rules of Court, rule 3.1113(d).) Anthem filed a 19-page memorandum, which exceeds the length permitted by the California Rules of Court. Anthem did not provide the Court with any explanation as to why its memorandum exceeded 15 pages.

Nor has the Court granted Anthem permission to exceed the page limit. The Court is not required to accept the parties' papers that exceed the procedural page limit. Thus, the Court will not consider the demurrer after the first 15 pages. Meet and Confer Pursuant to Code of Civil Procedure section 430.41, "a demurring party is required to meet and confer in person, by telephone, or video conference with the party that filed the pleading. . . ." (Code Civ. Proc. Sec. 430.41, subd. (a).) A moving party in a motion to strike

must meet and confer before filing the motion. (Code Civ. Proc. Sec. 435.5, subd. (a).) Anthem contends that on July 1, 2026, the parties met and conferred over telephone. (Valluru Decl., P. 4.) Thus, the parties fulfilled their meet-and-confer obligations. Demurrer Anthem demurs to Plaintiff's first cause of action on the basis of uncertainty, for failure to allege sufficient facts, and for failure to allege an enforceable contract between the parties. Breach of Implied Covenant of Good Faith and Fair Dealing "It has long been recognized in California that "[t]here is an implied covenant of good faith and fair dealing in every contract that neither party will do anything which will injure the right of the other to receive the benefits of the agreement."" (Kransco v.

American Empire Surplus Lines Ins. Co. (2000) 23 Cal.4th 390, 399, as modified (July 26, 2000).) ""This covenant [of good faith and fair dealing] not only imposes upon each contracting party the duty to refrain from doing anything which would render performance of the contract impossible by any act of his own, but also the duty to do everything that the contract presupposes that he will do to accomplish its purpose."" (Pasadena Live v. City of Pasadena (2004) 114 Cal.App.4th 1089, 1093.) "'The implied covenant of good faith and fair dealing is limited to assuring compliance with the express terms of the contract, and cannot be extended to create obligations not contemplated by the contract.'" (Id. at p. 1094.)

Anthem argues that Plaintiff fails to allege a contract between the parties. "A written contract may be pleaded either by its terms--set out verbatim in the complaint or a copy of the contract attached to the complaint and incorporated therein by reference--or by its legal effect. [Citation.] In order to plead a contract by its legal effect, plaintiff must 'allege the substance of its relevant terms. This is more difficult, for it requires a careful analysis of the instrument, comprehensiveness in statement, and avoidance of legal conclusions.' [Citation.]"" (Heritage Pacific Financial, LLC v.

Monroy (2013) 215 Cal.App.4th 972, 993.) Here, Plaintiff has not provided the alleged contract between the parties. Nor has he alleged the contract's terms verbatim in relation to his cause of action. (FAC, P.P. 16-22.) In opposition Plaintiff contends that provided a link to the ""Medi-Cal Managed Care Boilerplate Contract" with the DHCS (DHCS Contract) to receive Medi-Cal managed care business." (Opp., 6:11-14; FAC, P. 25.) However, the link provided does not open, and also assuming it is regarding the DHCS contract, the contract is not a contract with Plaintiff.

Plaintiff has not provided any legal authority to support this position. Plaintiff also argues that evidence of coverage ("EOC") is a contract between him and Anthem. The Court is persuaded by Plaintiff's argument. "An evidence of coverage is a contract between a health plan and a subscriber that provides the terms of coverage, which generally include benefits, covered services, premiums, how much the

prescriber pays, conditions, and limitations. (Pacific Bay Recovery, Inc. v. California Physicians' Services, Inc. (2017) 12 Cal.App.5th 200, 205 fn. 2.) Both parties quote or summarize parts of the EOC, but the EOC is not before the Court, so the Court cannot make a finding of express terms. Alternatively, Plaintiff argues that his claim against Anthem is a bad-faith delay cause of action and does not require a breach of an express contract provision. "The law implies in every contract, including insurance policies, a covenant of good faith and fair dealing. "The implied promise requires each contracting party to refrain from doing anything to injure the right of the other to receive the agreement's benefits.

To fulfill its implied obligation, an insurer must give at least as much consideration to the interests of the insured as it gives to its own interests. When the insurer unreasonably and in bad faith withholds payment of the claim of its insured, it is subject to liability in tort." (Wilson v. 21st Century Ins. Co. (2007) 42 Cal.4th 713, 720 (emphasis added); Kotler v. PacifiCare of California (2005) 126 Cal.App.4th 950, 956 (Kotler); CACI No. 2331.) "In the insurance context the implied covenant requires the insurer to refrain from injuring its insured's right to receive the benefits of the insurance agreement." (Brehm v. 21st Century Ins.

Co. (2008) 166 Cal.App.4th 1225, 1235 (Brehm).) The Court is persuaded by Plaintiff's argument that a breach of an express contract term is not required. The court in Brehm addressed this very issue, relying on Schwartz v. State Farm Fire & Casualty Co. (2001) 88 Cal.App.4th 1329, 106 Cal.Rptr.2d 523, where the Court determined that: the principle that no breach of the covenant of good faith and fair dealing can occur if there is no coverage or potential for coverage under the policy is quite different from the argument that no breach of the implied covenant can occur if there is no breach of an express contractual provision: '[B]reach of a specific provision of the contract is not a necessary prerequisite to a claim for breach of the implied covenant of good faith and fair dealing.... [E]ven an insurer that pays the full limits of its policy may be liable for breach of the implied covenant if improper claims handling causes detriment to the insured.' (Brehm, supra, 166 Cal.App.4th at p. 1236.)

In reply, Anthem contends that Kotler and Brehm are not applicable because the existence of a contract is still required. While the EOC is a contract between the parties, the Court cannot determine whether the policy provided coverage to Plaintiff because the excerpts are insufficient. However, an ongoing issue in Plaintiff's pleading is the basis for his claim against Anthem. The Court previously raised an issue that Plaintiff interchanged between contractual duties and statutory duties. (May 6, 2026, Minute Order.)

Plaintiff is seeking relief based on an alleged contract between the parties, and concedes that the EOC is the basis of Anthem's alleged liability. Plaintiff's reliance on the statutes does not replace Plaintiff's requirement to allege or provide the contract between the parties. Defendant also argues that Plaintiff repeatedly

contends that the DHCS Contract is a basis for this claim, but Plaintiff has not alleged that he has standing to bring these claims. Plaintiff argues that Anthem issued him an EOC that describes the benefits it is agreeing to provide him pursuant to its DHCS Contract. However, neither agreement is before the Court, so the Court cannot address this issue. Anthem also argues that Plaintiff failed to allege bad faith with respect to a benefit allegedly due. However, the issue of unreasonable delay is a question of fact that cannot be resolved at the pleading stage. (Kotler, supra, 126 Cal.App.4th at p. 956.)

Furthermore, the FAC contains allegations that Plaintiff required urgent surgery and made repeated efforts to resolve the issue, but there was a delay. (FAC, P.P. 30, 32-35, 37, 40.) At this stage of the proceedings, these allegations are sufficient. The Court notes that Plaintiff relies on sanctions imposed on Anthem for its alleged "illegal practices"; however, these allegations do not support the allegation requirements for a viable cause of action. Anthem argues that Plaintiff did not allege that Anthem consciously and deliberately withheld a contractual benefit without proper cause. (Mot., 14:25-28.)

However, Plaintiff is not required to make such allegations for his bad faith delay cause of action. (Kotler, supra, 126 Cal.App.4th at p. 956.) Thus, Anthem's argument is inapplicable for purposes of demurrer. Therefore, the Court sustains Anthem's demurrer as to Plaintiff's first cause of action. Motion to Strike Anthem moves to strike paragraphs 49-58, 65, and the prayer for punitive damages from Plaintiff's FAC. Because the Court has sustained Anthem's demurrer to Plaintiff's FAC in its entirety, Anthem's motion to strike is rendered moot.

Thus, Anthem's motion to strike is rendered moot. Leave to Amend Leave to amend must be allowed where there is a reasonable possibility of successful amendment. (See Goodman v. Kennedy (1976) 18 Cal.3d 335, 349 [court shall not "sustain a demurrer without leave to amend if there is any reasonable possibility that the defect can be cured by amendment"]; Kong v. City of Hawaiian Gardens Redevelopment Agency (2002) 108 Cal.App.4th 1028, 1037 ["A demurrer should not be sustained without leave to amend if the complaint, liberally construed, can state a cause of action under any theory or if there is a reasonable possibility the defect can be cured by amendment."]; Vaccaro v.

Kaiman (1998) 63 Cal.App.4th 761, 768 ["When the defect which justifies striking a complaint is capable of cure, the court should allow leave to amend."].) The burden is on the complainant to show the Court that the pleading can be successfully amended. (Blank, supra, 39 Cal.3d at p. 318.) Plaintiff will be given the opportunity to amend to conform with the issues addressed in this ruling. The

Court grants leave to amend Plaintiff's first cause of action against Anthem.

Conclusion

Anthem's demurrer is sustained. Anthem's motion to strike is rendered moot. Plaintiff shall have leave to amend, and must file an amended pleading by September 25, 2026. | Home -->)" -->