Barbosa v. Metropolitan Property & Casualty Insurance

9 Mass. L. Rptr. 315
CourtMassachusetts Superior Court
DecidedNovember 16, 1998
DocketNo. 98-02021-E
StatusPublished
Cited by3 cases

This text of 9 Mass. L. Rptr. 315 (Barbosa v. Metropolitan Property & Casualty Insurance) is published on Counsel Stack Legal Research, covering Massachusetts Superior Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Barbosa v. Metropolitan Property & Casualty Insurance, 9 Mass. L. Rptr. 315 (Mass. Ct. App. 1998).

Opinion

Garsh, J.

Pursuant to G.L.c. 90, §34M, the plaintiff, Antonio Barbosa (“Barbosa”), brings this action to recover personal injury protection (“PIP”) benefits for injuries arising out of an automobile accident alleged to have occurred on September 3, 1993. According to the plaintiff, a stolen vehicle struck a car in which he was a passenger. The defendant, Commerce Insurance Company (“Commerce”), the insurer of the car in which the plaintiff was riding, now moves for summary judgment on the grounds that Barbosa is precluded from recovering because he refused to submit to an examination under oath. For the reasons stated below, Commerce Insurance Company’s motion for summary judgment is ALLOWED.

BACKGROUND

The following facts are undisputed:

Barbosa claims that he was injured on September 3, 1993 when a stolen vehicle struck a car in which he was a passenger. Commerce insured the car in which the plaintiff was riding. Following notice of the incident, Commerce commenced an investigation to evaluate the existence of a covered loss and the nature and extent of Barbosa’s claimed damages.

As part of its investigation and pursuant to the standard Massachusetts Automobile Insurance Policy (6th ed.) (“Policy”), Commerce sought an examination under oath from Barbosa. The Policy provides that when there is an accident or loss, the insurer may “require you and any person seeking payment under any part of this policy to submit to an examination under oath at a place designated by us, within a reasonable time after we are notified of the claim.” The Policy also provides that “failure to cooperate with [the insurer] may result in the denial of your claim.”

[316]*316On March 25, 1994, Commerce advised Barbosa, through his counsel, that his examination under oath had been scheduled for April 12, 1994. The notice advised that if the date was not convenient for Barbosa or his attorney or should Barbosa need more time to assemble the requested documents, Commerce would be amenable to rescheduling the examination. On March 28, 1994, Barbosa, through counsel, notified Commerce that Barbosa would not submit to the examination under oath. The sole reason given for his unwillingness to appear was his attorney’s position that an individual who is neither a policyholder nor a householder member of a policyholder cannot be compelled to submit to an examination under oath. A second examination under oath was scheduled for April 25, 1994. Commerce brought the language in the Policy giving it the right to require “any person” seeking payment under any part of the Policy to submit to an examination under oath to the attention of Barbosa’s counsel. But once again, Barbosa refused to submit to such an examination.

On May 1, 1996, Barbosa’s counsel advised Commerce that the law firm had closed its file on Barbosa’s claim and was taking no further action. Approximately two years later, on or about April 28, 1998, Barbosa served Commerce with the instant complaint. At no time prior to the filing of this action did Barbosa appear for an examination under oath or repudiate his previous refusals to submit to such an examination.

DISCUSSION

This court grants summary judgment where there are no genuine issues of material fact and where the moving party is entitled to judgment as a matter of law. Cassesso v. Comm’r Correction, 390 Mass. 419, 422 (1983); Community National Bank v. Dawes, 369 Mass. 550, 553 (1976); Mass.R.Civ.P. 56(c). The moving party bears the burden of affirmatively demonstrating the absence of a triable issue and that the summary judgment record entitles the moving party to judgment as a matter of law. Pederson v. Time, Inc., 404 Mass. 14, 16-17 (1989). All evidence in the record is construed in favor of the party opposing the motion. Parent v. Stone & Webster Engineering Corp., 408 Mass. 108, 112-13 (1990).

Submission to an examination under oath when one has been demanded by the insurer is a condition precedent to recovery under an insurance policy and failure to submit to such an examination constitutes a material breach of the insurance contract. Mello v. Hingham Mutual Fire Insurance Co., 421 Mass. 333, 337 (1995) (affirming grant of summary judgment to insurer which denied fire coverage under a homeowners policy because insured invoked privilege against self-incrimination and failed to submit to an examination under oath). See also Cohen v. Commercial Casualty Insurance Co., 277 Mass. 460, 462 (1931) (insured’s failure to submit to an examination in New York where the loss occurred and where employees were familiar with the claim violated essential condition of the insurance policy justifying denial of coverage). Massachusetts law conforms with the general principle that submission to an examination under oath, so long as the request is reasonable, is strictly construed as a condition precedent to the insurer’s liability. “It is the law in most jurisdictions that the submission to an examination, if the request is reasonable, is strictly construed as a condition precedent to the insurer’s liability . . . This court agrees with these authorities.” Mello, 421 Mass, at 337 (citations omitted). See also 13A Ronald A. Anderson, Couch’s Cyclopedia of Insurance Law §49A:361 (2d rev. ed. 1982 & Supp. 1998) (Basically, the failure to submit to an examination under oath is a material breach of the policy which will relieve the insurer of its liability to pay); 5A John Alan Appleman & Jean Appleman, Insurance Law and Practice §3549 (1970 & Supp. 1998).

Barbosa argues that he is not bound by any condition precedent in the policy because, as a passenger, there is no privity between him and the insurer. Privily is not required. Barbosa brings this action pursuant to G.L.c. 90, §34M. That statute requires every motor vehicle liability policy issued in the Commonwealth to provide PIP benefits in lieu of damages otherwise recoverable by the injured person in tort as a result of an accident occurring within the Commonwealth. A policy’s PIP provisions provide for payment — without regard to negligence or fault of any kind — to the named insured, members of the insured’s household, any authorized operator or passenger of the insured’s, or any pedestrian struck by the insured’s motor vehicle of reasonable expenses incurred within two years from the date of the accident for necessary medical services, lost wages or salary, expenses incurred by virtue of engaging others to do work that the injured would had done were it not for the injury, and loss by reason of diminution of earning power with respect to a person not employed at the time of the accident, to the amount or limit of at least eight thousand dollars on account of injury to any one person. G.L.c. 90, §34A. Every owner or operator of a motor vehicle to which PIP benefits apply who would otherwise be liable in tort is made exempt from tort liability to the extent that the injured party is entitled to recover PIP benefits. G.L.c. 90, §34M. If a person claiming or entitled to PIP benefits brings an action in tort against the owner or person responsible for the operation of such a vehicle, PIP benefits are not due and payable until a settlement is reached or judgment rendered in the action, whereupon the benefits then due are reduced to the extent that they have been included in the judgment or settlement. Id. A claim for PIP benefits must be presented to the insurer as soon as practicable after an accident. Id.

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Cite This Page — Counsel Stack

Bluebook (online)
9 Mass. L. Rptr. 315, Counsel Stack Legal Research, https://law.counselstack.com/opinion/barbosa-v-metropolitan-property-casualty-insurance-masssuperct-1998.