Metropolitan Property and Casualty Insurance Company v. Estate of Eric E. Benson ( 2015 )

MAINE SUPREME JUDICIAL COURT Reporter of Decisions
Decision: 2015 ME 155
Docket: Cum-14-492
Argued: September 18, 2015
Decided: December 1, 2015
Panel: ALEXANDER, MEAD, GORMAN, JABAR, HJELM, and HUMPHREY, JJ.
METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY
v.
ESTATE OF ERIC E. BENSON et al.
MEAD, J.
[¶1] The Estate of Eric E. Benson appeals from a summary judgment
entered by the Superior Court (Cumberland County, Warren, J.) in favor of
Metropolitan Property and Casualty Insurance Company on Metropolitan’s
complaint seeking a declaratory judgment. On appeal, the Estate contends that the
Superior Court erred in concluding that an intentional loss exclusion in a
homeowner’s insurance policy precluded coverage for William Googins’s
intentional assault of Eric Benson, which resulted in Benson’s death. We affirm
the judgment.
I. BACKGROUND
[¶2] On May 23, 2010, in Monument Square in Portland, a verbal
altercation arose between William Googins and Eric Benson after Googins made a
comment about Benson’s female companion. Googins then struck Benson in the
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face. Benson fell backwards as a result of the single punch, hit his head on the
pavement, and died. Googins pleaded guilty to aggravated assault and served
approximately two years of a ten-year prison sentence.
[¶3] The Estate sued Googins in tort based upon the 2010 incident. In
exchange for the Estate’s promise that it would not seek to execute a judgment
against Googins personally, Googins admitted that his negligence caused Benson’s
death. Googins consented to a judgment in favor of the Estate in the amount of
$400,000 and assigned to the Estate all the rights he may have had against
Metropolitan. Metropolitan’s potential liability stemmed from a homeowner’s
policy it issued to Googins’s grandmother that was active at the time of the
May 2010 incident.1 On September 23, 2013, the Superior Court entered a
judgment against Googins in the amount of $400,000 pursuant to the agreement
between Googins and the Estate. Based on this judgment, the Estate filed a
reach-and-apply action against Metropolitan.
[¶4] On March 5, 2013, Metropolitan filed a complaint for declaratory
judgment seeking a determination as to its obligation to indemnify Googins. On
June 11, 2014, Metropolitan moved for summary judgment on the ground that even
if Googins was insured under his grandmother’s policy, which it did not concede,
1
Although Googins is not a named insured on his grandmother’s policy, the Estate contends that he
falls within the definition of “insured” under the policy because he resided with his grandmother.
3
the claim was nonetheless precluded by an intentional loss exclusion because
Googins intentionally punched Benson in the face.2 The Estate then filed what the
Superior Court treated as a cross-motion for summary judgment. On
November 3, 2014, the court granted Metropolitan’s motion for summary
judgment, declaring that it had no contractual obligation to indemnify Googins
because the homeowner’s policy’s intentional loss exclusion barred coverage.
[¶5] Metropolitan’s homeowner’s policy provides coverage for “all sums
for bodily injury and property damage to others for which the law holds you
responsible because of an occurrence to which this coverage applies.”3 The policy
defines “occurrence” as “an accident,” and “you” and “your” to mean:
1. the person or persons named in the Declarations and if a resident of the
same household:
A. the spouse of such person or persons;
B. the relatives of either; or
C. any other person under the age of twenty-one in the care of any of the
above . . . .
This broad coverage is limited by an exclusion for bodily injury or property
damage resulting from an “intentional loss,” which we discuss infra.
2
Metropolitan offered alternative theories in its motion for summary judgment, but the Superior
Court based its decision on only the intentional loss exclusion, and Metropolitan argues only that issue.
The other issues are deemed waived as a result of Metropolitan’s failure to address them. See Holland v.
Sebunya, 2000 ME 160, ¶ 9 n.6, 759 A.2d 205 (“The failure to mention an issue in the brief or at
argument is construed as either an abandonment or a failure to preserve that issue.”).
3
This decision omits the boldface type that Metropolitan employs for certain words and phrases in its
policy.
4
II. DISCUSSION
[¶6] The Estate argues that the court erred by entering a summary judgment
in favor of Metropolitan after determining that Googins’s conduct was within the
scope of the intentional loss exclusion.
[¶7] “We review the grant of a motion for summary judgment de novo,
viewing the evidence in the light most favorable to the party against whom the
summary judgment has been granted in order to determine if there is a genuine
issue of material fact.” Brady v. Cumberland Cty., 2015 ME 143,
¶ 10, --- A.3d --- (quotation marks omitted). “A fact is material if it has the
potential to affect the outcome of the suit, and a genuine issue of material fact
exists when a fact-finder must choose between competing versions of the truth.”
Angell v. Hallee, 2014 ME 72, ¶ 17, 92 A.3d 1154 (quotation marks omitted).
[¶8] The interpretation of an insurance policy is reviewed de novo. Cox v.
Commonwealth Land Title Ins. Co., 2013 ME 8, ¶ 8, 59 A.3d 1280. An insurance
contract is ambiguous if it is “reasonably susceptible of different interpretations.”
Apgar v. Commercial Union Ins. Co., 683 A.2d 497, 498 (Me. 1996) (quotation
marks omitted). If there is an ambiguity, “a liability insurance policy must be
construed so as to resolve all ambiguities in favor of coverage.” Mass. Bay Ins.
Co. v. Ferraiolo Constr. Co., 584 A.2d 608, 609 (Me. 1990). On the other hand,
“[u]nambiguous language in an insurance contract must be interpreted according to
5
its plain and commonly accepted meaning.” Cookson v. Liberty Mut. Fire Ins. Co.,
2012 ME 7, ¶ 8, 34 A.3d 1156 (quotation marks omitted).
[¶9] According to the terms of the homeowner’s policy, for Googins’s
actions to fall within the scope of coverage (1) he must have been a resident of the
same household as his grandmother, the policyholder; (2) the injury must have
arisen from an “occurrence”; and (3) the injury sustained by Benson cannot be the
result of an “intentional loss.” Googins must satisfy all three elements before his
actions may be considered within the terms of the policy, and Metropolitan can
appropriately deny coverage if any element is not satisfied.
[¶10] In its motion, Metropolitan argued that even if Googins is an
insured—that is, assuming he is a resident of the insured’s household and the
injury arose from an “occurrence”—his actions are nonetheless excluded from
coverage because of the intentional loss exclusion. Because Metropolitan assumes
arguendo that Googins was a resident of his grandmother’s household and that the
injury arose out of an “occurrence,” we do not address these predicates for
coverage. Metropolitan’s intentional loss exclusion provides:
1. Intentional Loss. We do not cover bodily injury or property
damage which is reasonably expected or intended by you or which is
the result of your intentional and criminal acts or omissions. This
exclusion is applicable even if:
A. you lack the mental capacity to govern your conduct;
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B. such bodily injury or property damage is of a different kind
or degree than reasonably expected or intended by you; or
C. such bodily injury or property damage is sustained by a
different person than expected or intended by you.
[¶11] The disjunctive policy language in the first sentence makes clear that
the intentional loss provision in Metropolitan’s homeowner’s policy includes two
different exclusions. The first exclusion is for “bodily injury or property damage
which is reasonably expected or intended by you.” The second exclusion is for
“bodily injury or property damage . . . which is the result of your intentional and
criminal acts or omissions.”
[¶12] We have previously addressed insurance provisions similar to the first
exclusion. In Patrons-Oxford Mutual Insurance Co. v. Dodge, we interpreted a
policy that excluded coverage for “bodily injury or property damage which is
either expected or intended from the standpoint of the Insured.” 426 A.2d 888, 889
(Me. 1981). Similarly, in Royal Insurance Co. v. Pinette, we interpreted a policy
that excluded “bodily injury or property damage . . . which is expected or intended
by the insured.” 2000 ME 155, ¶ 2 n.2, 756 A.2d 520 (alterations in original).
After reviewing these provisions, among others, we held that an expected or
intended exclusion “applies only when the insured has acted with the intention or
expectation that another will be harmed by the insured’s intentional act.” Pinette,
2000 ME 155, ¶ 8, 756 A.2d 520.
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[¶13] The Superior Court denied summary judgment to Metropolitan after
concluding that Dodge and Pinette controlled the interpretation of the first
exclusion because the provisions at issue in those cases, and the first exclusion
here, all rely on the phrase “expected or intended.” However, unlike the provisions
in Dodge and Pinette, the Metropolitan policy also provides additional language in
subparts A, B, and C that may affect the applicability of Dodge and Pinette.
Because Metropolitan has not filed a cross-appeal on the denial of its motion for
summary judgment on the basis of the first exclusion, we need not address whether
the court’s application of Dodge and Pinette was correct.
[¶14] The issue on appeal is the second clause of the intentional loss
exclusion. The Estate argues that the court should not have entered summary
judgment for Metropolitan based on the second exclusion because the policy is
ambiguous with respect to the definition of “intentional” in the phrase “intentional
and criminal.” The Estate contends that Dodge controls the interpretation of the
second exclusion, thus requiring Googins to have intended to cause the death of
Benson for the exclusion to apply. The court rejected these arguments, concluding
that Dodge did not control the second exclusion because that exclusion does not
use the language “expected or intended by you.” Instead, the court construed the
second exclusion according to its unambiguous terms, requiring that an act be both
intentional and criminal for the exclusion to apply.
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[¶15] Although we have not previously addressed the language of the
second exclusion, persuasive authority has rejected the same arguments presented
by the Estate here. In Metropolitan Property and Casualty Insurance Co. v.
Morrison, the Massachusetts Supreme Judicial Court considered whether the word
“intentional” in the phrase “intentional and criminal” means the intent to commit
the conduct that caused injury or whether, as the Estate contends here, it also
requires the intent to cause the resulting harm. 951 N.E.2d 662, 664 (Mass. 2011).
Morrison held that the second exclusion is unambiguous and applies “where the
insured intended to commit the conduct that caused injury and where that conduct
was criminal.” Id. at 671. In rejecting the contention that “intentional” requires
the intent to cause the ultimate harm, the Massachusetts court noted that the
exclusion was distinct from previously construed exclusions because this exclusion
is predicated on both an intentional and criminal act. Id.
[¶16] We similarly conclude that the second clause of the intentional loss
exclusion is unambiguous and requires both an intentional and criminal act. The
exclusion applies where an insured commits a volitional act resulting in injury, and
where that act is also criminal. Although the Superior Court relied on the
explanatory language “[t]his exclusion is applicable even if[] . . . such bodily
injury or property damage is of a different kind or degree than reasonably expected
or intended by you,” we need not do so because the provision is unambiguous.
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[¶17] Our holding today is limited to the precise language “intentional and
criminal acts or omissions” and does not affect our previous decisions construing
the exclusions at issue in Dodge, Pinette, and the trespass cases referenced in
Pinette, all of which involved policy language with no limiting principle, distinct
from the case here.4 If, in those cases, we had held that an act is “intentional” if it
is merely volitional, then all losses that resulted from an insured’s conscious
actions would not be covered. Such an interpretation would have been sweeping
and effectively negated coverage in nearly all cases.
[¶18] Here, however, the Metropolitan policy uses “intentional” in the
context of the phrase “intentional and criminal.” By using “intentional” in
conjunction with “criminal,” the word “intentional” has a broader meaning because
it is coupled with the limiting principle of criminality. This same rationale led the
court in Morrison to conclude that “intentional” means a volitional act, without
being overreaching. See Morrison, 951 N.E.2d at 671 (“By limiting the exclusion
to acts that are both intentional and criminal, the Metropolitan policy poses no risk
that the exclusion may be interpreted so broadly as to effectively negate the
4
See Royal Ins. Co. v. Pinette, 2000 ME 155, ¶ 2 n.2, 756 A.2d 520 (“[B]odily injury or property
damage . . . which is expected or intended by the insured.”) (alterations in original); Patrons-Oxford Mut.
Ins. Co. v. Dodge, 426 A.2d 888, 889 (Me. 1981) (“[B]odily injury or property damage which is either
expected or intended from the standpoint of the Insured.”); Gibson v. Farm Family Mut. Ins. Co.,
673 A.2d 1350, 1353 (Me. 1996) (“The policy specifically excludes from coverage any damages resulting
from an intentional act by the insured.”); Mass. Bay Ins. Co. v. Ferraiolo Constr. Co., 584 A.2d 608, 610
(Me. 1990) (“An ‘occurrence’ is defined as an accident . . . which results in bodily injury or property
damage neither expected nor intended from the standpoint of the insured.”) (alterations in original).
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policy’s liability coverage for accidents.”). In this respect, the Metropolitan policy
aligns with the earlier guidance referenced in Morrison that insurers need to draft
exclusions predicated on narrower language, as opposed to the sweeping,
standalone concept of intentionality. Id. at 671-72.
[¶19] Because we determine that the second exclusion is satisfied when the
injury is caused by an act of an insured that is both intentional and criminal, the
next question is whether the summary judgment record established both elements.
[¶20] There is no genuine issue of material fact that Googins’s conduct was
intentional. Googins admitted to civil liability for Benson’s death by admitting to
all of the allegations contained in the Estate’s third amended complaint. The
complaint stated, “Googins’[s] contact with Benson and the resulting death were
caused by the negligence of Googins.” Despite denying intentional conduct in the
pleadings, Googins testified multiple times in his deposition that he intended to
strike Benson in the face.
[¶21] Googins’s deposition reveals a clear intent to strike Benson in the
face, which caused Benson to fall over, hit his head, and die. Googins’s testimony
that he did not intend or expect to hurt Benson by punching him is irrelevant to the
second exclusion because that exclusion operates based on whether the insured
intended to commit the act, not whether he or she intended the ultimate harm.
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Given that Googins unequivocally intended to strike Benson, the “intentional”
aspect of the second exclusion is satisfied.
[¶22] Likewise, no genuine issue of material fact exists as to whether
Googins’s conduct was criminal. Googins pleaded guilty to aggravated assault and
served over two years in prison as a result of punching and ultimately killing
Benson. The Estate correctly notes that Googins’s guilty plea to aggravated
assault, standing alone, does not conclusively prove intent as a matter of law
because assault can be committed recklessly. See 17-A M.R.S.
§§ 207(1)(A), 208(1) (2014); Dodge, 426 A.2d at 891-92. This is of no occasion,
though, because Googins’s deposition testimony demonstrated an unequivocal
intent to strike Benson in the face.
[¶23] Because no genuine issue of material fact exists as to the applicability
of the second exclusion, the Superior Court correctly entered a summary judgment
in favor of Metropolitan. No unresolved issues of material fact remain.
The entry is:
Judgment affirmed.
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On the briefs:
Robert H. Furbish, Esq., and Alicia F. Curtis, Esq., Berman &
Simmons, Lewiston, for appellant Estate of Eric E. Benson
Jeffrey T. Edwards, Esq., Preti, Flaherty, Beliveau & Pachios,
LLP, Portland for appellee Metropolitan Property & Casualty
Insurance Company
At oral argument:
Robert H. Furbish, Esq., for appellant Estate of Eric E. Benson
Jeffrey T. Edwards, Esq., for appellee Metropolitan Property &
Casualty Insurance Company
Cumberland County Superior Court docket number CV-2013-102
FOR CLERK REFERENCE ONLY