634 F.3d 61
1st Cir.2011Background
- James and Theresa Miles held a comprehensive home policy from Great Northern Insurance covering a fire loss at their Rehoboth, MA home; Theresa alone owned title but both were insured under the policy; the policy required cooperation, examinations under oath, and proof of loss within sixty days; the policy included concealment or fraud and per-person coverage provisions; the fire occurred October 17, 2004, with accelerants found and no forced entry; both Mileses resisted Great Northern's investigations and Theresa, under her husband’s instruction, refused to answer questions; Great Northern denied coverage after conclusion of non-cooperation and advanced living expenses were discontinued; the Mileses filed breach of contract and unfair insurance practices claims in state court, which were removed to district court; the district court later granted summary judgment to Great Northern on unfair practices claims and found that both Mileses breached their duty to cooperate, with the court imputing James Miles’s conduct to Theresa for purposes of breach; the district court proceeded to trial on the remaining breach of contract and unjust enrichment claims and entered judgment for Great Northern.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Theresa Miles independently breached the contract. | Miles argued no independent breach by Theresa. | Great Northern argued Theresa’s conduct could be a material breach. | Yes, Theresa independently breached and is barred from recovery. |
| Whether a willful, unexcused failure to submit to an examination under oath constitutes a material breach under Massachusetts law. | Miles contends no prejudice shown; husband’s conduct matters. | Noncooperation can be a material breach without prejudice showing. | Willful, unexcused refusal constitutes a material breach. |
| Whether the appellate court should remand or decide on independent state-law grounds. | Ask for remand to resolve state-law question. | Alternative grounds are available to affirm. | Addressed on independent state-law ground; affirmed. |
| Whether the district court’s findings support independent breach by Theresa. | Findings do not show prejudice; relies on imputation. | Findings show independent willful noncooperation. | District findings support Theresa’s independent breach. |
Key Cases Cited
- Lorenzo-Martinez v. Safety Ins. Co., 58 Mass.App.Ct. 359 (Mass. App. Ct. 2003) (willful refusal to submit to examination discharges insurer's liability)
- Mello v. Hingham Mut. Fire Ins. Co., 421 Mass. 333 (Mass. 1995) (willful, unexcused failure to comply as material breach)
- Hanover Ins. Co. v. Cape Cod Custom Home Theater, Inc., 72 Mass.App.Ct. 331 (Mass. App. Ct. 2008) (willful obstructionism at examinations constitutes material breach)
- Rymsha v. Trust Ins. Co., 51 Mass.App.Ct. 414 (Mass. App. Ct. 2001) (duty to produce documents relevant to claim parallels duty to submit to examination)