Mello v. Hingham Mutual Fire Insurance

421 Mass. 333
CourtMassachusetts Supreme Judicial Court
DecidedNovember 10, 1995
StatusPublished
Cited by55 cases

This text of 421 Mass. 333 (Mello v. Hingham Mutual Fire Insurance) is published on Counsel Stack Legal Research, covering Massachusetts Supreme Judicial Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Mello v. Hingham Mutual Fire Insurance, 421 Mass. 333 (Mass. 1995).

Opinion

Fried, J.

The plaintiffs, Americo and Maria Mello, commenced this action against Hingham Mutual Fire Insurance Company (Hingham) in the Superior Court on April 26, 1994, to recover policy proceeds for fire loss. Hingham moved for summary judgment alleging that Americo Mello’s failure to submit to an examination under oath, as required both by the policy and G. L. c. 175, § 99, Twelfth (1994 ed.), constituted a material breach of the fire insurance policy, thus barring recovery under the policy. The plaintiff asserted that his refusal to submit to the examination was justified because he had become the subject of a criminal investigation for arson in connection with this fire. The plaintiff contends that the privilege against self-incrimination as protected by art. 12 of the Declaration of Rights of the Massachusetts Constitution and the Fifth Amendment to the United States Constitution justifies his refusal to submit to such an examination.

On October 27, 1994, a Superior Court judge granted Hingham’s motion for summary judgment. The plaintiffs have appealed. We granted their application for direct appellate review.

I.

The record on which the Superior Court judge granted summary judgment reveals the following facts. Hingham issued a policy to the plaintiffs effective September 4, 1992, insuring their residence. On September 25, 1992, a fire of undetermined origin broke out in the plaintiffs’ residence. On that day, Hingham received oral notice of loss and commenced an investigation. In addition, the Danvers police and the Massachusetts State police began investigations into what they deemed a suspicious fire. The law enforcement authorities immediately informed Hingham that the plaintiff was a suspect in their respective investigations. Four days later, Hingham sent the plaintiffs notice of the cancellation of their policy, effective October 9, 1992.2

[335]*335Pursuant to its investigation, on November 10, 1992, Hingham requested that plaintiff submit to an examination under oath, as required by the policy.* *3 He initially agreed to an examination. The plaintiff, however, postponed the examination on two occasions: the first to accommodate his attorney and the second to allow him the opportunity to retain a criminal attorney. On February 23, 1993, Hingham requested that the plaintiff submit to an examination within thirty days. His attorney responded by asking why such an examination was necessary. Hingham, by letter, explained that it required the sworn statement to complete its investigation and determine whether to pay the claim. The plaintiffs attorney responded on March 22, 1993, by asserting the plaintiffs constitutional privilege against self-incrimiriation.

On March 29, 1993, Hingham demanded that the examination take place before April 30, 1993. The plaintiff declined. On May 3, 1993, Hingham denied coverage for the fire loss.

II.

The plaintiffs raise two issues on appeal. First, the plaintiffs contend that, because the plaintiff was a subject of an on-going criminal investigation concerning the fire, his privilege against self-incrimination, as guaranteed by art. 12 and the Fifth Amendment, excused him from providing a statement under oath to Hingham as required by the insurance policy concerning the circumstances surrounding the fire. [336]*336Second, the plaintiffs suggest that prior to the refusal to submit to the statement under oath, Hingham had materially breached the policy by improperly cancelling it.

A.

General Laws c. 175, § 99 (1994 ed.), prescribes a statutory form for fire insurance policies. The statute sets out the insured’s duty to cooperate in two sentences reprinted in the margin.4 Prior to our decision in Johnson Controls, Inc. v. Bowes, 381 Mass. 278 (1980), the satisfaction of the insured’s duties embodied in this cooperation clause was a condition precedent to the insurer’s liability under the policy. Thus, the insured’s failure to provide notice of loss or a sworn statement of loss within the time period allotted in the policy released the insurer from its obligations under the contract. See, e.g., Romanos v. Home Ins. Co., 355 Mass. 499, 501-502 (1969); Rose v. Regan, 344 Mass. 223, 226 (1962).

In 1980, our decision in Johnson Controls, Inc. v. Bowes, supra, “modified the common law in this area by adding prejudice requirements in the contexts of notice provisions.” Darcy v. Hartford Ins. Co., 407 Mass. 481, 489 (1990). We reasoned that the notice provision of insurance policies should no longer be strictly construed as a condition precedent to the insurer’s liability. Johnson Controls, Inc. v. Bowes, supra at 282. Instead, the insurer must establish “both that the notice provision was in fact breached and that the breach resulted in prejudice to its position,” for its obli[337]*337gations to be discharged. Id. See Darcy v. Hartford Ins. Co., supra at 490-491.

Our decision in Johnson Controls, however, affected only the notice provisions of the G. L. c. 175, § 99 duty to cooperate. The second sentence of the statutory provision addresses the insured’s responsibilities during the investigation: “as often as may be reasonably required” by the insurer, the “insured . . . shall . . . submit to examinations under oath.” The statute contemplates that the insurer, when it determines that an examination is reasonable, may require that the insured submit to such an examination under oath.

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. See 13A G. Couch, Insurance § 49A:361 (2d ed. 1982 & Supp. 1994); 5A J.A. Appleman & J. Appleman, Insurance Law and Practice § 3549 (1970 & Supp. 1994). See also Pervis v. State Farm Fire & Casualty Co., 901 F.2d 944, 946-947 (11th Cir.), cert. denied, 498 U.S. 899 (1990); Allstate Ins. Co. v. Longwell, 735 F. Supp. 1187, 1193-1195 (S.D.N.Y. 1990); Standard Mut. Ins. Co. v. Boyd, 452 N.E.2d 1074, 1077 (Ind. Ct. App. 1983), and cases cited. This court agrees with these authorities.5 In this case, Hingham’s request was reasonable, and refusal to submit to an examination may have significantly hampered its ability to investigate the fire and assure itself that the plaintiff had not set the fire. The notification from the Danvers and State police that the plaintiff was being investigated on suspicion of arson understandably raised that concern for Hingham. Therefore, unless the privilege against self-incrimination excuses the plaintiff’s failure to comply with Hingham’s request, by refusing to submit to its reasonable request for an examination under oath, the plaintiff materially breached the insurance contract, releasing Hingham from its obligations.

[338]*338The plaintiff, though, asserts that the privilege against self-incrimination excuses his compliance with the statement under oath clause. The privilege is contained in art. 12 and the Fifth Amendment. Article 12 provides that “[n]o subject shall...

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Bluebook (online)
421 Mass. 333, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mello-v-hingham-mutual-fire-insurance-mass-1995.