Delgado v. Costello

580 P.2d 500, 91 N.M. 732
CourtNew Mexico Court of Appeals
DecidedJune 6, 1978
Docket3463
StatusPublished
Cited by12 cases

This text of 580 P.2d 500 (Delgado v. Costello) is published on Counsel Stack Legal Research, covering New Mexico Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Delgado v. Costello, 580 P.2d 500, 91 N.M. 732 (N.M. Ct. App. 1978).

Opinion

OPINION

WOOD, Chief Judge.

Plaintiff’s appeal involves the sufficiency of the amended complaint. The trial court granted defendants’ motions to dismiss on the ground the amended complaint “fails to state a claim upon which relief can be granted as a matter of law”. There are four claims—fraud, constructive fraud, negligent misrepresentation, and reformation of an insurance policy. All claims involve the coinsurance clause of a fire insurance policy. We discuss: (1) allegation of fraud; (2)duty of disclosure; and (3) pleading a claim under the doctrine of reasonable expectations. Dismissal was under Rule of Civ.Proc. 12(b)(6). Dismissal under this rule is proper only if it appears that plaintiff cannot recover under any state of facts provable under the claims made. - Villegas v. American Smelting & Refining Co., 89 N.M. 387, 552 P.2d 1235 (Ct.App.1976) and cases therein cited.

The amended complaint alleges: 1) that Costello was acting within the scope of his employment with The Insurance Center, Inc. and that The Insurance Center, Inc. was acting within the scope of its agency for Security Insurance Company; 2) on or about January 1, 1974 plaintiff obtained a standard fire insurance policy through Costello and The Insurance Center, Inc., and that the policy was written by Security Insurance Company; 3) that the policy was issued in the amount of $25,000 for a commercial building and contained an 80 percent coinsurance clause; 4) that a fire loss occurred in January, 1977 resulting in damages of approximately $16,000; 5) that only $7,643.07 was paid because of the coinsurance provision, and plaintiff has been damaged in the amount of $10,000.

There is some argument that the policy provisions are ambiguous, but this argument is without merit. The 80 percent coinsurance is identified on the face of the policy. The policy recites:

[I]t is expressly stipulated and made a condition of this contract that the Insured shall at all times maintain contributing insurance on each item of property covered by this policy to the extent of at least the percentage specified on the first page of this policy or endorsed hereon of the actual cash value at the time of the loss, and that failing to do so, the Insured shall to the extent of such deficit bear his, her or their proportions of any loss.

This explanation was not “hidden” in the policy; it does not involve a series of negatives or exceptions, . See Pribble v. Aetna Life Insurance Company, 84 N.M. 211, 501 P.2d 255 (1972). This explanation cannot be held ambiguous as a matter of law. See Wiseman v. Arrow Freightways, Inc., 89 N.M. 392, 552 P.2d 1240 (Ct.App.1976).

Plaintiff’s claims are based on the allegation that she “did not know or understand the nature of the coinsurance clause and would not have purchased the policy as written had she understood the nature of the clause, but would have purchased additional insurance in order to be fully protected under the coinsurance clause.”

Allegation of Fraud

Claiming fraud, plaintiff alleged that Costello “knew the relevance of the 80% coinsurance clause, but in order to effect the sale [of the fire insurance policy], knowingly and willfully failed to disclose the meaning of said provision to the plaintiff. The plaintiff relied upon the advice of . Costello, in the purchase of said insurance”.

One of the elements of fraud is that the representation made “was made with intent to deceive and for the purpose of inducing the other party to act upon it”. Sauter v. St. Michael’s College, 70 N.M. 380, 374 P.2d 134 (1962). Defendants assert the claim of fraud is insufficient “[b]ecause of the omission of the crucial allegation of fraudulent inducement”.

Rule of Civ.Proc. 9(b) requires allegations of fraud to be stated with particularity. A pleading of fraud is sufficient if the facts alleged are facts from which fraud will necessarily be implied; in addition, the allegations should leave no doubt in defendants’ minds as to the claim asserted. Steadman v. Turner, 84 N.M. 738, 507 P.2d 799 (Ct.App.1973). The allegation that Costello knowingly failed to disclose the meaning of the coinsurance clause “in order to effect the sale” was a sufficient allegation of the inducement element of fraud; it left no doubt as to the basis for the fraud claim.

Duty of Disclosure

A duty of disclosure is implicit in the fraud claim and specifically pleaded in the claims of constructive fraud and negligent misrepresentation. This asserted duty is the duty “to disclose the nature of the coinsurance clause to the plaintiff”. Defendants assert that dismissal of the fraud, constructive fraud and negligent misrepresentation claims was proper because of absence of law to support them. See C & H Constr. & Pav. Inc. v. Foundation Reserve Ins. Co., 85 N.M. 374, 512 P.2d 947 (1973). The contention is that Costello had no duty to disclose the nature of the coinsurance clause to plaintiff. In support of this contention, defendants argue that the existence of such a duty was a question of law to be determined by the trial court.

We agree that these claims depend on a duty on the part of defendants. As to “duty” in the fraud claims, see Krupiak v. Payton, 90 N.M. 252, 561 P.2d 1345 (1977) and Snell v. Cornehl, 81 N.M. 248, 466 P.2d 94 (1970). As to “duty” in the claim of negligent misrepresentation, “negligence” encompasses the duty to use ordinary care. See Latimer v. City of Clovis, 83 N.M. 610, 495 P.2d 788 (Ct.App.1972). Plaintiff is relying on a duty of disclosure; if no such duty exists, the claims were properly dismissed.

We also agree that the trial court is to determine whether such a duty exists. See Southern Union Gas Co. v. Briner Rust Proofing Co., 65 N.M. 32, 331 P.2d 531 (1958).

We do not agree, however, that the trial court could determine the absence of a duty to disclose on the basis of the amended complaint. Thompson v. Occidental Life Ins. Co. of Cal., 90 N.M. 620, 567 P.2d 62 (1977) held that the selling agent had no duty to advise the purchaser of the policy concerning the refund of premiums. The holding in Thompson, supra, was based on the circumstances; the circumstances were a motion for summary judgment based on affidavits and answers to interrogatories. Southern Union Gas Co. v.

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Bluebook (online)
580 P.2d 500, 91 N.M. 732, Counsel Stack Legal Research, https://law.counselstack.com/opinion/delgado-v-costello-nmctapp-1978.