2018 ME 125
Me.2018Background
- In Oct. 2011, high-school student Joshua Francoeur ambushed and punched classmate Jonathan Ben‑Ami multiple times in the face, causing serious injury (broken jaw).
- Francoeur’s father held a Vermont Mutual homeowner’s policy; Vermont Mutual defended Francoeur provisionally and then sought a declaratory judgment that the policy’s "expected or intended" exclusion barred coverage.
- A consent judgment awarded Ben‑Ami $150,000 against Francoeur, with execution deferred pending the declaratory action and a reach-and-apply action against Vermont Mutual.
- At bench trial, the superior court found Francoeur intended to hit Ben‑Ami multiple times but credited Francoeur’s testimony that he did not subjectively intend or consider the extent of the serious injury inflicted.
- The superior court concluded the policy exclusion did not apply; Vermont Mutual appealed. The Supreme Judicial Court reviewed whether the exclusion for bodily injury "expected or intended" by the insured barred coverage.
Issues
| Issue | Ben‑Ami's Argument | Vermont Mutual's Argument | Held |
|---|---|---|---|
| Whether injuries fell within the policy exclusion for bodily injury "expected or intended" by the insured | Exclusion requires subjective intent; court found Francoeur did not subjectively intend the extent of injury, so coverage applies | Given premeditation, ambush, and multiple closed‑fist blows, Francoeur must have subjectively foreseen injury; exclusion applies | Court of Errands: Evidence compelled finding Francoeur subjectively expected bodily injury; exclusion applies and judgment for insurer required |
| Whether an assault that causes a broken jaw is categorically excluded as inherently injurious (i.e., as matter of law) | Coverage should be fact‑specific; unexpected severity may preserve coverage | Insurer urged broader rule that intentional assaults of this type are excluded as inherently injurious | Court declined to adopt a categorical rule but held facts here compelled finding of subjective expectation, so exclusion applies |
Key Cases Cited
- Patrons-Oxford Mut. Ins. Co. v. Dodge, 426 A.2d 888 (Me. 1981) (interpreting "expected or intended" exclusion to require subjective intent or subjective foresight of harm)
- Landry v. Leonard, 720 A.2d 907 (Me. 1998) (recognizing certain inherently injurious criminal acts may be excluded as a matter of law)
- Mut. Fire Ins. Co. v. Hancock, 634 A.2d 1312 (Me. 1993) (holding violent criminal conduct excluded from coverage)
- Perreault v. Me. Bonding & Cas. Co., 568 A.2d 1100 (Me. 1990) (sexual abuse held inherently injurious for exclusion purposes)
- Worcester Ins. Co. v. Fells Acres Day Sch., Inc., 558 N.E.2d 958 (Mass. 1990) (observing that deliberately striking another in the face is inherently likely to cause harm)