LOUIS DIMARZO vs. AMERICAN MUTUAL INSURANCE COMPANY.
Supreme Judicial Court of Massachusetts
May 4, 1983
389 Mass. 85
Plymouth. October 7, 1982. — May 4, 1983.
Present: HENNESSEY, C.J., WILKINS, LIACOS, ABRAMS, NOLAN, LYNCH, & O‘CONNOR, JJ.
In an action against a motor vehicle liability insurer brought under
Entry of judgment in a tort action against an insured, in an amount exceeding the limits of his motor vehicle liability insurance policy, following his insurer‘s refusal to settle the claim within the policy limits constituted a “loss [to the insured] of money or property” sufficient to satisfy the requirements of
Refusal by a motor vehicle liability insurer to settle a claim within the limits of an insurance policy in the circumstances deprived the insured of his contractual right to payments so as to constitute a “loss of money or property” within the contemplation of
In an action under
Evidence at the trial of an action under
Evidence at the trial of an action under
Evidence at the trial of an action under
A judge‘s finding that a motor vehicle liability insurer‘s failure to settle a claim within the policy limits resulted in exposure of the insured to liability exceeding the policy amount was not clearly erroneous, in light of the claimant‘s testimony that he would have accepted an offer of a settlement in the amount of the policy. [100-101]
In an action under
In an action against an insurer, the amount recoverable on a count to reach and apply the amount payable under a policy of insurance should not have been included as part of the damages recoverable on counts under
Where a tender of settlement under
The judge in a civil action did not abuse his discretion in refusing to place before the jury the text of a statutory amendment, where it appeared that the text would be unhelpful to them. [102-103]
At the trial of an action under
In an action under
CIVIL ACTION commenced in the Superior Court Department on January 17, 1979.
The case was tried before Prince, J.
The Supreme Judicial Court granted a request for direct appellate review.
Phillip M. Davis (Stephen J. Andrick & D. Alice Olsen with him) for the defendant.
Michael E. Mone (Patricia L. Kelly with him) for the plaintiff.
LIACOS, J. The defendant, American Mutual Insurance Company (American Mutual), appeals from a judgment for damages, attorneys’ fees, and costs. Following a jury trial, a judge of the Superior Court found that American Mutual had committed unfair or deceptive acts or practices by refusing to settle the tort claim of the plaintiff Louis DiMarzo for the limits of its motor vehicle liability insurance policy. DiMarzo had claimed that American Mutual‘s insured, William J. MacDonald, was liable for DiMarzo‘s injuries. The judge awarded double damages and attorneys’ fees to MacDonald‘s assignee, Louis DiMarzo, under
The facts giving rise to this appeal are as follows. On June 25, 1971, DiMarzo sustained serious injuries as a result of an automobile accident caused by MacDonald. As a result of the accident, DiMarzo incurred substantial medical expenses. DiMarzo received $2,000 in Personal Injury Protection (P.I.P.) benefits from his own insurance company, Provi-
At the time of the accident, MacDonald was insured by a policy issued by American Mutual. This policy provided bodily injury coverage in the amount of $20,000 a person. The policy contained the usual provisions obligating American Mutual to defend MacDonald against any claims arising out of his operation of the insured automobile, and required MacDonald to cooperate with American Mutual in defending any such claim.
American Mutual investigated the accident. It determined that MacDonald was liable to DiMarzo, and that DiMarzo‘s damages exceeded the policy limits. It recognized that it had an obligation to offer the policy limits in settlement of DiMarzo‘s claim so as to avoid exposing MacDonald to liability in excess of those limits. American Mutual took the position, however, that only $18,000 coverage remained on the policy because of the $2,000 payment made to Providence Washington to reimburse Providence Washington for the P.I.P. payments it made to DiMarzo. American Mutual therefore made an offer of settlement for $18,000 in April, 1973.1 This offer was rejected.
In February, 1976, a master‘s hearing was scheduled on the tort action by DiMarzo against MacDonald. American Mutual‘s counsel, Thomas F. Quinn, mailed a certified letter concerning the hearing to MacDonald at 430 Warren Avenue in Brockton. Mr. Quinn had sent two previous letters to MacDonald at the same address. The first letter, asking MacDonald to appear at a deposition, had been sent by certified mail. The return was signed by a person other than the insured. MacDonald did not appear for the deposition. The second letter, sent to the same address two weeks later, was returned unclaimed. The third letter,
The tort case subsequently was scheduled for a jury trial. Throughout this period, the parties discussed the possibility of a settlement. DiMarzo indicated that he would be willing to settle for $20,000, the face amount of the policy. American Mutual insisted that only $17,800 coverage remained on the policy and refused to offer more. On March 7, 1977, American Mutual filed a complaint for a declaratory judgment concerning the amount of coverage available under the policy. While this complaint was scheduled for hearing, it apparently never was heard.
The tort case went to trial on September 19 and 20, 1977. During that trial, Mr. Quinn stated for the first time that American Mutual was proceeding under a reservation of rights.2 The attorneys for the parties discussed the possibility of a settlement. No agreement was reached. While the jury were deliberating, Mr. Quinn withdrew American Mutual‘s offer to settle for $17,800. The jury returned a verdict in the amount of approximately $104,000, which, with interest and costs, resulted in a judgment and execution for $149,068.78. The execution was sent to Mr. Quinn.
On December 12, 1977, Mr. Quinn sent a letter to American Mutual stating that American Mutual should not pay the execution. He stated that American Mutual now was liable only for the minimum $5,000 statutory coverage. He recommended that an offer of $2,800 be made (the minimum statutory coverage, minus the P.I.P. payment). A district claim manager agreed and recommended offering the minimum statutory coverage, less the P.I.P. payment,
In December, 1978, DiMarzo hired a private investigator to locate MacDonald. The investigator was instructed to tell MacDonald that if he executed an assignment of his rights and claims against American Mutual, DiMarzo would release him from all liability. After a week-long search, the investigator located MacDonald, and MacDonald executed the assignment.
DiMarzo then brought the present action against American Mutual individually and as MacDonald‘s assignee. Pursuant to
As finally amended, DiMarzo‘s complaint contained seven counts. Under count one, DiMarzo sought to reach and apply the full proceeds of the policy issued by American Mutual to MacDonald. Under count two, he sought damages as MacDonald‘s assignee for breach of contract. Under count three, he sought damages, as MacDonald‘s assignee, for failure to settle in good faith the tort claim against MacDonald. Under count four, he sought damages, as MacDonald‘s assignee, for failure to settle DiMarzo‘s claim with due care. Under count five, he sought multiple damages individually for violations of
The judge then conducted a hearing on counts one, five, and six. He filed his findings, rulings, and orders for judgment on August 24, 1981.6 The judge adopted the answers to the special questions and made findings of fact consistent with the jury‘s answers. He found first that each failure to settle DiMarzo‘s claim for the policy limits after American Mutual had determined that MacDonald‘s liability extended
On October 28, 1981, judgment was entered consistent with the trial judge‘s findings. A ruling by the judge provided that any execution which issued in the case “shall not exceed the actual damage doubled, plus counsel fees awarded, and interest and costs.” American Mutual filed a notice of appeal. We granted DiMarzo‘s application for direct
I. Recovery Under the Prior Version of
We consider first whether DiMarzo can recover under
A. The validity of the assignment. American Mutual argues that the assignment is void because MacDonald did not understand the nature of the instrument which he signed.8 The difficulties with American Mutual‘s position are many. First, there is authority that, in the absence of fraud, an instrument is not void merely because the party signing it did not understand fully the consequences of his signature. Cohen v. Santoianni, 330 Mass. 187, 193 (1953). Second, to
More importantly, both the judge and the jury found the assignment to be valid. Their finding is supported by the record. There was evidence which indicated that the investigator who procured the assignment explained fully the consequences of the release. While MacDonald‘s testimony indicated that he may not have understood completely the nature of the assignment, his testimony was not altogether consistent and indicated that he did not have a clear recollection of the evening when he executed the assignment. He did not testify to any facts which require a finding that his signature was procured by fraud or duress. MacDonald testified at trial that he would be willing to sign the assignment again. The jury‘s finding that the assignment was valid is amply supported by the evidence.
B. Loss of money or property. American Mutual contends that MacDonald had no rights to assign under
Additionally, MacDonald suffered a loss of property as well as money. By refusing to settle the case for $20,000, American Mutual effectively reduced the value of the policy by $2,200. The purchaser of an insurance policy acquires a contractual right to payment, a form of personal property. Dodd v. Commercial Union Ins. Co., 373 Mass. 72, 81 (1977). In the circumstances of this case, MacDonald suffered a loss of property by American Mutual‘s refusal to recognize the full extent of MacDonald‘s property interest. Cf. Wolfberg v. Hunter, 385 Mass. 390, 398 (1982) (interference with contractual right to the use of property constituted a loss of property).
C. Unfair or deceptive acts. American Mutual determined, soon after the accident between DiMarzo and MacDonald, that MacDonald was potentially liable for damages far in excess of the policy limits of $20,000. American Mutual concedes that it had an obligation to offer DiMarzo whatever coverage existed under the policy. It argues, however, that the evidence requires a finding that it believed in good faith that the coverage under the policy had been reduced by the payment of P.I.P. benefits and, later, by MacDonald‘s failure to cooperate. American Mutual claims that since the terms of the applicable statute,
American Mutual‘s claim of an exemption under
We also reject American Mutual‘s claim that the terms of its policy authorized it to deduct the amount of the P.I.P. benefits. Again, American Mutual advances one possible interpretation of the standard form policy, which was rejected by the insurance industry.12 To the extent that American Mutual relies on common law principles of subrogation, the language of Schubach v. Household Fin. Corp., supra, explicitly states that common law principles are not conclusive on the issue of unfairness. In these circumstances, the terms of the policy are not conclusive, but are merely factors which the trier of fact was entitled to consider on the issue of bad faith. See Penney v. First Nat‘l Bank, 385 Mass. 715, 721 (1982); Fortune v. National Cash Register Co., 373 Mass. 96, 104-105 (1977).
We turn now to consider whether the findings as to bad faith were warranted. American Mutual does not challenge that the breach of an insurer‘s duty to act in good faith to settle a claim brought against an insured within the policy limits, see Murach v. Massachusetts Bonding & Ins. Co., 339 Mass. 184, 186-187 (1959), provides a sufficient basis for recovery under
First, there was ample evidence from which the judge could have concluded that American Mutual acted in bad faith by reducing the coverage available under the policy by the amount of P.I.P. benefits. DiMarzo introduced in evi-
There was also evidence that American Mutual stood alone in reducing the policy coverage by the amount of the P.I.P. benefits. There was expert testimony that (1) American Mutual violated sound claims practice by not obtaining an early return of the P.I.P. reimbursement from Providence Washington and by not resolving a matter of coverage in favor of its insured, and (2) other insurance companies were offering the limits of the policy. Moreover, there was evidence that the Insurance Commissioner‘s office believed that it was the practice of the insurance industry
The judge also found that American Mutual acted in bad faith again by offering $2,800 to DiMarzo after the execution in the underlying action had been secured. We conclude that the evidence warranted such a finding. There was evidence that American Mutual made that offer, knowing that it had waived the defense of noncooperation and had failed to exercise a valid reservation of its right to disclaim liability.
Beginning with MacDonald‘s failure to attend his deposition in November, 1972, American Mutual had sufficient notice of the fact that MacDonald might not cooperate in his defense. Despite the opportunity to do so, American Mutual made no effort to reserve its rights.15 Instead, American Mutual chose to proceed to a master‘s hearing without MacDonald. This hearing resulted in a finding against MacDonald in the amount of $75,000. Such a finding was admissible at the subsequent jury trial and constituted prima facie evidence of liability.
American Mutual seeks to overcome its failure to take timely steps to disclaim liability or reserve its rights by arguing that MacDonald‘s disappearance obviated any requirement that it formally notify MacDonald before proceeding to trial. Our decisions place the insurer under a duty to take affirmative steps to secure the cooperation of a vanished policyholder. Allen v. Atlantic Nat‘l Ins. Co., supra. See Imperiali v. Pica, 338 Mass. 494, 498-499 (1959). American Mutual‘s efforts primarily consisted of repeated attempts to locate MacDonald at an address where he obviously no longer resided.16 These efforts were not sufficient to discharge its duty. Contrast Airway Underwriters v. Perry, 362 Mass. 164 (1972).
Given American Mutual‘s apparent unconcern with MacDonald‘s presence, the judge was free to conclude that American Mutual‘s feeble and untimely attempt to reserve its right to disclaim liability was taken in bad faith.
D. Causation. American Mutual challenges the judge‘s finding that its offer of $2,800 after the jury verdict in the first trial was the cause of exposing MacDonald to liability in excess of the policy limits. This argument is not persuasive. The fact remains that American Mutual‘s refusal to settle the case for $20,000 caused DiMarzo to litigate his
E. Damages. American Mutual claims that recovery under
We do think, however, that the judge erred in one respect. The policy coverage of $20,000 is available to DiMarzo under his count to reach and apply. This amount should not be included under the
F. Reasonableness of relief tendered by American Mutual. Under
II. Evidentiary Rulings.
A. Exclusion of
American Mutual relies on cases where courts have employed the canon of statutory construction that an amendment to a statute presumably intends a change in the law. See, e.g., Marshfield v. Springfield, 337 Mass. 633, 637-638
In the present case, the language of the statute does not indicate that the Legislature believed it was changing, rather than clarifying, existing law.19 DiMarzo also introduced persuasive evidence demonstrating that the amendment merely ratified existing practice in the insurance industry. Thus, the amendment provides little insight into the state of the law prior to its enactment. The judge did not abuse his discretion.
B. Custom and usage. American Mutual argues that the testimony concerning the custom and usage of the insurance industry should have been excluded since it was given in the form of an opinion. We have stated that the existence of a custom and usage is a question of fact and may not be proven by opinion. Barrie v. Quinby, 206 Mass. 259, 265 (1910). This rule, however, excludes testimony where the witness seeks to give his opinion as to the legal effect of the custom or usage. Haskins v. Warren, 115 Mass. 514, 535-536 (1874). The mere assertion that custom and usage exists does not call for an opinion and is therefore admissible. See 7 J. Wigmore, Evidence § 1954 (Chadbourn rev.
American Mutual also argues that DiMarzo failed to lay a proper foundation for the introduction of evidence concerning a custom and usage by showing that the usage had “become notorious by the long and uniform practice of those engaged in the trade.” Caggiano v. Marchegiano, 327 Mass. 574, 579-580 (1951), quoting Barrie v. Quinby, supra. The cases on which American Mutual relies are cases in which evidence of custom and usage was offered to explain or supplement the terms of a contract. Arguably, where the usage is not “notorious” by long and uniform practice, it would be unjust to say that the parties contracted with reference to it.20 But where the usage is merely being established to determine whether a party acted in good faith or committed an unfair or deceptive act or practice, the rationale for requiring that the usage be “notorious” by long and uniform practice loses much of its force.
The issue here is more akin to the admissibility of evidence of custom and usage to establish a standard of unreasonable dangerousness, Back v. Wickes Corp., 375 Mass. 633, 641-643 (1978), or of due care, Stewart v. Roy Bros., 358 Mass. 446, 451-452 (1970). The admission of evidence of usage in such cases has long been left to the discretion of the trial judge. Dolan v. Boott Cotton Mills, 185 Mass. 576, 579-581 (1904). In the present case, evidence of custom and usage was admissible subject to the sound discretion of the trial judge. The evidence was properly admitted.
American Mutual also argues that the expert witnesses called by DiMarzo were incompetent to testify as to custom and usage within the insurance industry. We disagree. The issue whether a witness possesses sufficient knowledge to
C. Business records. American Mutual‘s next claim of error is that certain records taken from the files of Mr. Quinn and American Mutual should have been admitted in evidence as business records under
Under
D. Closing argument. American Mutual contends that the closing argument of counsel for DiMarzo contained statements of a highly prejudicial nature. We see little in these statements that was improper. To the extent that counsel might have exceeded the proper bounds of argument, the judge delivered a limiting instruction. See Luz v. Stop & Shop, Inc., 348 Mass. 198, 207-208 (1964). There was no prejudice.
III. Attorneys’ Fees and Costs.
We are left only to consider whether the judge properly awarded attorneys’ fees. American Mutual argues that the award of attorneys’ fees and costs under
We also reject the argument that the judge should have limited attorneys’ fees to the services devoted to the
American Mutual also contends that the award of attorneys’ fees under
The plaintiff is to have the costs of this appeal. The judge may, in his discretion, award reasonable attorneys’ fees for the appeal under
So ordered.
HENNESSEY, C.J. (concurring, with whom Nolan, J., joins). I concur in the result and reasoning of the court‘s opinion. Nevertheless, I am constrained to add a few comments.
The money damages here are, in the circumstances, extraordinarily large. A policy of insurance affording to the insured indemnity coverage of $20,000, undoubtedly at a cost to the insured commensurate with that amount of coverage, will result in a judgment (including interest as ultimately computed) of more than $500,000 against the insurer. An argument can be made that the Legislature which created
That argument is inapposite. The facts as found by the jury, and later by the judge, are warranted on the evidence. The law, step by step, was correctly applied. The crucial principles are either explicit in
O‘CONNOR, J. (concurring). The evidence did not warrant a conclusion that American Mutual waived the defense of noncooperation or that it was estopped to rely on it. Therefore, I do not agree with the court‘s statement that there was evidence that American Mutual made a $2,800 offer “knowing that it had waived the defense of noncooperation and had failed to exercise a valid reservation of its right to disclaim liability.” Supra at 99. The court‘s conclusion in this regard deviates substantially from established case law, and improperly restricts the right of an insurer to deny coverage to an insured who has disappeared.
The result reached by the court is correct. The jury found that MacDonald failed to cooperate, but did not spec-
While I agree with the result, I disagree with the court‘s holding that American Mutual forfeited the defense of noncooperation. In addition to the facts set forth in the main opinion, certain uncontroverted testimony of MacDonald is relevant to this issue. MacDonald testified that he lived at 430 Warren Avenue, Brockton, at the time the accident occurred. In June, 1972, he entered the Plymouth house of correction, where he remained a prisoner until 1973. After his release he resided in numerous places in Plymouth, in Quincy, on Cape Cod, in Rhode Island, and in Brockton. At no time did MacDonald notify the post office of his changes of address. After MacDonald left the house of correction he did not want to be found or bothered by anyone. Mac-
American Mutual should not be held to have forfeited its defense of noncooperation before the time of the jury trial. Until that time, it did not even have the defense. This court has never held that an insurer is precluded from disclaiming on account of the noncooperation of its insured because it did not disclaim, or reserve its right to do so, before the noncooperation occurred. To require disclaimer whenever the insurer is on notice that the insured might not cooperate in his defense, as the main opinion appears to require, places an unwarranted burden on insurers.
Furthermore, American Mutual did nothing after MacDonald‘s noncooperation was established which operated as a waiver of the noncooperation defense or estopped the company from relying on it.1 The general rule is that “[a] company knowing that it possesses sufficient grounds to disclaim cannot pursue the trial to a conclusion and then, an adverse result having been reached at the trial, disclaim liability.” Polito v. Galluzzo, 337 Mass. 360, 365 (1958). Salonen v. Paanenen, 320 Mass. 568, 572 (1947). Daly v. Employers Liab. Assurance Corp., 269 Mass. 1, 5 (1929). This rule is based on estoppel or waiver, Salonen v. Paanenen, supra at 572, Phillips v. Stone, 297 Mass. 341, 344 (1937), and is a rule of fairness. Salonen v. Paanenen, supra.
Fairness requires that an insurer that has continued to defend an insured after a material breach of a cooperation requirement, in circumstances reasonably leading the in-
Waiver is the intentional relinquishment of a known right. Rose v. Regan, supra at 229. Sheehan v. Commercial Travelers Mut. Accident Ass‘n, supra at 552. The company‘s conduct after MacDonald‘s noncooperation was established does not permit the inference that it intended to relinquish its right to disclaim. Id. at 552-553. With the
Notes
We do not rely on this analysis, however, because it was not presented below. Rather, DiMarzo predicated his case on a showing of subjective bad faith which both the judge and jury found.
Having successfully located MacDonald once through the use of an investigator, American Mutual might have been expected to hire an investigator again if it felt it needed MacDonald. DiMarzo‘s success in locating MacDonald by hiring an investigator suggests that MacDonald could have been located by American Mutual as well.
