Kobsic v. Erie Insurance

7 Pa. D. & C.5th 48
CourtPennsylvania Court of Common Pleas, Mercer County
DecidedMarch 13, 2009
Docketno. 2008-3323
StatusPublished

This text of 7 Pa. D. & C.5th 48 (Kobsic v. Erie Insurance) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, Mercer County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kobsic v. Erie Insurance, 7 Pa. D. & C.5th 48 (Pa. Super. Ct. 2009).

Opinion

ST. JOHN, J.,

Like most married couples, plaintiffs purchased a home and a standard homeowner’s insurance policy protecting them from fire and other common hazards. Both plaintiffs were named as people insured by the policy. Unfortunately, involuntary plaintiff (plaintiff Wife) became insane and intentionally set fire to their house and watched it burn from the driveway. She was not prosecuted for this act.

Plaintiff Husband, as an innocent party, sought to recover damages from the couple’s homeowner insurance [49]*49policy. Defendant denied his request on the basis of several exclusionary clauses in the policy, including one for intentional acts of any insured. Plaintiff Husband is now suing his insurance company for breach of contract and bad faith denial of coverage. Defendant filed preliminary objections in the nature of a demurrer, seeking dismissal of the complaint based upon the exclusions in the policy. The primary issue is whether the homeowner’s policy expressly excludes coverage to an innocent insured for the apparent intentional acts of a co-insured who was allegedly incapable of forming intent. Defendant’s preliminary objections in the nature of a demurrer will be denied for the reasons set forth below.

On September 3, 2007, plaintiff Wife was home alone. Complaint, 3,12a. She apparently believed that the house was haunted, “full of conflict,” and it was her prison and curse. Id. at 12h, 12f, 12a. It is further alleged that she injected herself with a large quantity of insulin and began consuming large amounts of prescription drugs. Id. at 12c-12d. Afterwards, she set fire to her house and sat in a lawn chair in the driveway to watch it burn. Id. at 12e.

Plaintiff Wife, who has allegedly suffered from severe depression and bipolar disorder for over 20 years, set fire to the house “in the midst of a psychotic episode,” and was insane at the time. Complaint 4,14; 2, 8; 4, 13. After the incident, she was apparently hospitalized in a psychiatric ward for three weeks. Id. at 4, 17. After her release, she was transferred to a “personal care home facility,” where she remains today. Id. at 4, 18.

Plaintiff Husband filed a claim with defendant asserting atotal loss of $402,125. Complaint, 2,10. Defendant [50]*50conducted an investigation of the incident, and concluded that plaintiff Wife had acted intentionally to bum the home. Id. at 4, 19. Thus, plaintiff was sent a written notice that his claim had been denied, which led plaintiff Husband to file the present suit.

Preliminary objections, the end result of which would be dismissal of a cause of action, should be sustained only in cases that are clear and free from doubt. Bower v. Bower, 531 Pa. 54, 57, 611 A.2d 181, 182 (1992). “The test is whether it is clear from all of the facts pleaded that the pleader will be unable to prove facts legally sufficient to establish his or her right to relief.” League of Women Voters of Pa. v. Commonwealth, 692 A.2d 263, 267 (Pa. Commw. 1997). “In ruling on preliminary objections, all well-pleaded facts in the petition for review and all inferences reasonably deducible therefrom must be accepted as true.” Id.

Plaintiffs’ homeowner’s policy includes several exclusionary clauses that defendant argues preclude recovery. Notably, the policy contains no specific exclusion for acts of insane insureds. The policy does excludes coverage as follows:

“for loss resulting directly or indirectly from any of the following, even if other events or happenings contributed concurrently, or in sequence, to the loss:
“(8) by neglect of anyone we protect to use all reasonable means to protect covered property at and after the time of loss or when property is threatened by a peril covered under Perils We Insure Against.
“(9) by intentional loss, meaning any loss arising from an act committed by, or at the direction of, anyone we [51]*51protect with the intent to cause a loss.” Complaint, exhibit 1, Erie insurance policy, 10.

Additionally, later in the policy under the heading “Rights and Duties-Conditions” an increase of hazard clause provides that: “[u]nless we agree beforehand, coverage is suspended if the hazard is substantially increased by any means within the control or knowledge of anyone we protect.” Id. at 14.

The policy defines “anyone we protect,” as “you and the following residents of your household: (1) residents and wards; (2) other persons in the care of anyone we protect.” Complaint exhibit 1, Erie insurance policy, 4. You is defined as “the subscriber and others named on the declarations under named insured.” Id. at 5. Both plaintiff Husband and Plaintiff Wife are identified in the policy as named insureds. Complaint exhibit 1, duplicate declarations.

Since both plaintiff Husband and plaintiff Wife are named insureds, the exclusionary clauses in their insurance policy would operate to exclude coverage if either one of them violated one or more of the exclusionary clauses. The mere fact that plaintiff Husband is innocent of any wrongdoing is irrelevant to the consideration of whether he may recover. Rather, this court must honor the language of the policy. Under McAllister v. Millville Mutual Insurance Company, 433 Pa. Super. 330, 342, 640 A.2d 1283, 1289 (1994), use of the terms “an” or “any” insured is a clear indication that co-insured obligations are joint and wrongful action by one, prohibits recovery by the other. The present policy uses the term “anyone we protect,” which is a similarly clear indication [52]*52that an innocent co-insured may not recover after the wrongful actions of the other.

Thus, this court accepts defendant’s proposition that the exclusionary clauses in the policy can prohibit an innocent co-insured from the recovery for the wrongful acts of another insured. The question then becomes whether a clearly written exclusion prohibits recovery here at the preliminary objection stage.

Defendant argues that under one or more of the policy exclusions, plaintiff Husband may not recover, since plaintiff Wife acted wrongfully in setting fire to their home, and then doing nothing to prevent the fire from spreading. However, this court must accept the well-pled facts from plaintiffs’ complaint as true. Consequently, this court must accept as true that plaintiff Wife was insane at the time she set fire to the home and was therefore not capable of forming intent under the general purview of the law.

The Superior Court held in Donegal Mutual Insurance Co. v. Baumhammers that when interpreting the language of an insurance policy: “our goal is to ascertain the intent of the parties as manifested by the language of the written instrument. Madison Construction Co. v. Harleysville Mutual Insurance Co., 557 Pa. 595, 735 A.2d 100 (1999).

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Donegal Mutual Insurance v. Insurance Department
719 A.2d 825 (Commonwealth Court of Pennsylvania, 1998)
McAllister v. Millville Mutual Insurance
640 A.2d 1283 (Superior Court of Pennsylvania, 1994)
Madison Construction Co. v. Harleysville Mutual Insurance
735 A.2d 100 (Supreme Court of Pennsylvania, 1999)
United Services Automobile Ass'n v. Elitzky
517 A.2d 982 (Supreme Court of Pennsylvania, 1986)
Standard Venetian Blind Co. v. American Empire Insurance
469 A.2d 563 (Supreme Court of Pennsylvania, 1983)
Germantown Insurance v. Martin
595 A.2d 1172 (Superior Court of Pennsylvania, 1991)
Commonwealth v. Sirianni
428 A.2d 629 (Superior Court of Pennsylvania, 1981)
Stidham v. Millvale Sportsmen's Club
618 A.2d 945 (Superior Court of Pennsylvania, 1992)
Donegal Mutual Insurance Co. v. Baumhammers
893 A.2d 797 (Superior Court of Pennsylvania, 2006)
Bower v. Bower
611 A.2d 181 (Supreme Court of Pennsylvania, 1992)
Nationwide Mutual Insurance v. Hassinger
473 A.2d 171 (Supreme Court of Pennsylvania, 1984)
Allstate Insurance v. Lombardi
142 F. App'x 549 (Third Circuit, 2005)
Hazleton Area School District v. Bosak
671 A.2d 277 (Commonwealth Court of Pennsylvania, 1996)
League of Women Voters v. Commonwealth
692 A.2d 263 (Commonwealth Court of Pennsylvania, 1997)
Showalter v. Mutual Fire Insurance
3 Pa. Super. 448 (Superior Court of Pennsylvania, 1897)
Karow v. Continental Insurance
15 N.W. 27 (Wisconsin Supreme Court, 1883)
Hahn v. Atlantic Richfield Co.
625 F.2d 1095 (Third Circuit, 1980)

Cite This Page — Counsel Stack

Bluebook (online)
7 Pa. D. & C.5th 48, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kobsic-v-erie-insurance-pactcomplmercer-2009.