When seeking damages through a personal injury lawsuit, the goal is to become “whole,” or as you were prior to the injury. Some of the damages are to help cover the costs during this period like lost wages. Others are to help pay for the medical care received after the injury and for future medical expenses required to continue healing. An experienced personal injury attorney will seek damages from any and all entities deemed responsible for the payment of damages. Many times, this will be an insurance company that issued an auto, homeowner, or commercial policy that is designed to provide quick, accessible payments. While insurers exist to provide funds in times of emergency, insurance companies often decline to pay the benefits found in a policy. These types of challenges present additional obstacles for the injured person to overcome.
A recent Massachusetts case (No. 15-P-1706) was a case in which an insurer was ultimately required by the appellate court to provide coverage. The plaintiff was injured by a dog while she was walking her own dogs. The injured person tried to protect her dogs during the attack, suffering a broken arm, a laceration to her face, and scrapes on her knees, elbows, and ankles. The aggressive dog had a history of biting other dogs. The owner of the dog had a homeowner’s insurance policy and attempted to file a claim to help pay for the injuries sustained by the injured person. The insurer refused to provide coverage, pointing to the application submitted by the owner that left out the prior bites. The trial court, despite protests from the dog owner and the injured woman, granted the insurance company’s motion to dismiss the claims against it seeking payment of benefits. Both the owner and the injured person appealed.
The dog owner acknowledged he owned a dog on his initial application for homeowner’s insurance. Under a section asking him to “Note breed and bite history”, he wrote, “American bull dog — no biting incidents.” The dog owner signed and verified that his answers were ‘true, complete and correct to the best of my knowledge and belief.” After the injury in this case, the insurance company investigated the claim and found that the offending dog had previously bitten two other dogs before the owner’s application was turned in. In its motion to dismiss, the insurer argued the answers were a material misrepresentation that voided the policy and its benefits.
The appellate court looked at Massachusetts case law that provides guidance on interpreting policy language. Prior cases state that insurers are supposed to be as clear and explicit as possible. If there are two interpretations, the policy is read in favor of the insured. During trial, the dog owner testified that he thought the questions were asking whether the animal had a history of biting humans, which is why he responded in the negative. One agent from the insurance company said her custom and practice was to ask if the animal was aggressive or had a biting incident when she asked the question. Another underwriter from the insurance company interpreted the term to mean “bodily injury or property damage to someone else’s pet.” The appellate court noted the trial judge adopted a broad meaning that was not offered by any witness at trial, taking the phrase to ask if the dog had a history of biting “anything or anybody.”
The appellate court agreed with the trial judge that the language at issue could be read to mean anything that was ever bitten, but it felt that the view was not reasonable in the context of the language and dogs’ propensity to chew things. While they knew the judge meant any living thing, they felt that the presence of multiple reasonable interpretations meant the policy language should be read in favor of the dog owner. The trial court’s decision was reversed, and the insurance company was directed to honor its contractual obligation to provide coverage.
The Massachusetts personal injury attorneys at Karsner & Meehan can help you with your injury or accident claim. Call today for a free, confidential consultation at 508.822.6600.
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