Massachusetts Appellate Decision Outlines Limits of an Insurance Company’s Duty to Indemnify

If an accident occurs, both parties will likely look to insurance policies for coverage of a claim. The at-fault party, in particular, expects his or her insurance company to step in and defend the claim for them, shielding them from full personal liability. This is known as indemnification. The Appeals Court of Massachusetts recently looked at whether or not an insurance company providing a homeowner’s policy was obliged to defend or indemnify the policyholder’s son in a Massachusetts personal injury lawsuit filed by someone who was punched in the face by the son while in the homeowner’s home. The injured person filed suit against the son, alleging the insured’s son struck his face, causing serious and permanent injuries.

The father was insured under a personal umbrella liability policy in addition to his homeowner’s policy. The insurance company, after notice of the incident and lawsuit, moved for a declaratory judgment by the trial court to establish it had no duty to defend or indemnify the son. The trial court granted the motion, and the homeowner appealed. The appellate court reviewed the findings for clear error and for a ruling on the questions of law.

The Appeals Court first assessed the testimony of three witnesses who were present during the altercation. Their testimony resulted in finding the son hit the personal injury plaintiff three times in the face with a closed fist. This knocked him unconscious and led to further injuries after he hit his head on the pavement as he fell. The plaintiff sustained fractures in his face, jaw, and skull, developing a seizure disorder. In its assessment of whether or not this type of incident was something covered under the homeowner’s policy, the trial court determined the incident was not an act of self-defense nor an accident. The court found the son acted intentionally with the purpose of causing the other man injury.

The policy language offers coverage to an insured for bodily injuries stemming from an “occurrence.” An occurrence, as defined by the policy, includes an accident that results in a bodily injury, but it specifically excludes a bodily injury arising out of physical abuse. It also excludes a bodily injury arising out of criminal acts or any act intended or expected by an insured to cause bodily injuries. The insured argued the son was not intentionally causing harm when the injured person hit his head on the pavement. They also claimed the fall was not substantially certain to have occurred after the other party was hit in the face.

The appellate court was unpersuaded by this argument. The court looked at a prior Supreme Judicial Court case (Worcester Ins. Co. v. Fells Acres Day Sch., Inc., 408 Mass. 393 (1990)), which held that intended harm can be inferred from the very nature of the act. An insured does not have to intend a specific result for a policy exclusion to apply when the intent to harm is evident. If the act is inherently harmful, the subjective intent regarding the degree of injury is irrelevant. The Appeals Court found there was no error in the trial court’s finding the son intended to strike the plaintiff and the finding that the plaintiff’s injuries resulted from the attack. The court affirmed the lower court’s ruling there was no duty to indemnify, and it affirmed the judgment against the homeowner.

The pursuit of damages in a Massachusetts personal injury case can take strange turns. The experienced counsel at the Law Office of James K. Meehan can help you navigate the civil court system to maximize the damages you need and deserve. For a free, confidential consultation, contact our office at 508-822-6600.

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