Miles v. Great Northern Insurance

671 F. Supp. 2d 231, 2009 U.S. Dist. LEXIS 112561
District Court, D. Massachusetts·Decided November 30, 2009·No. Civil Action 07-11722-NMG·Published·Cited by 2 cases

Opinion

MEMORANDUM OF DECISION

GORTON, District Judge.

This case involves a dispute between an insurance company, Great Northern Insurance Company, and two of its insured, James and Theresa Miles, that arose after a fire substantially destroyed the Miles’ residence in Rehoboth, Massachusetts. The Miles eventually filed a claim for the loss which Great Northern denied. The Miles then brought suit against Great Northern for breach of contract to which Great Northern responded "with counterclaims for breach of contract and unjust enrichment.

This Court, sitting without a jury, presided over a three-day trial of this case in late September, 2009. The Court now announces its findings of fact and conclusions of law.

I.Findings of Fact

Parties

1. Plaintiffs James F. Miles and Theresa B. Miles (collectively, “the Miles”), husband and wife, are natural persons who reside in Rehoboth, Massachusetts.

2. Defendant Great Northern Insurance Company (“Great Northern”) is a corporation licensed to sell fire insurance policies in the Commonwealth of Massachusetts. Great Northern, which has its principal place of business in Boston, Massachusetts, is a member of the Chubb Group of insurance companies.

3. Theresa and James Miles are the named insured under an insurance policy issued by Great Northern, Policy Number 11240825-01 (“the policy”).

The Fire and the Insurance Policy

4. In the early morning hours of October 17, 2004, a fire (“the fire”) occurred at the insured premises located at 1 Running Stream Road, Rehoboth, MA (“the Premises”).

5. Theresa Miles held title to the Premises which was a single-family home and the residence of Theresa and James Miles.

*234 6. The Premises were secured by a fire and alarm service provided by Protection One Alarm Monitoring, Inc.

7. Theresa Miles owned most of the contents of the house destroyed in the fire, with the exception of a small amount of business property that belonged to James Miles.

8. At the time of the fire, there were two mortgages on the Premises. The first mortgage, held by Webster Bank, was in the amount of approximately $183,000 and the second mortgage, held by Simon Belli, Theresa Miles’ father, as well as Jason Long and Joseph Mindick, was in the amount of approximately $611,000.

9. The policy insured the premises for the period from October 9, 2004 to October 9, 2005 with a Deluxe House Coverage limit of $1,080,000 and a Deluxe Contents coverage limit of $540,000.

10. The policy contains the following clause with respect to the duties of the insureds after a loss:

If you have a loss this policy may cover, you must perform these duties:
Notification. You must immediately notify us or your agent. In case of theft or accident, you must also notify the police or similar competent authority ...
Prepare an Inventory. You must prepare an inventory of damaged personal property, describing the property in full. It should show in detail the amount insured under this policy and actual amount of the loss. Attach bills, receipts, and other documents to support your inventory ...
Examination under Oath. We have the right to examine under oath, as often as we reasonably require, you, family members, and other members of your household. We also ask you to give a signed description of the circumstances surrounding a loss and your interest in it, and to produce all records and documents we request and permit us to make copies.
Proof of loss. You must submit to us, within 60 days after we request, your signed sworn proof of loss which documents, to the best of your knowledge and belief:
-the time and cause of loss;
-interest of the insured and all others in the property involved and all liens, claims and obligations on the property;
-specifications of any damaged building and detailed estimates for any repair of the damage;
-an inventory of damaged personal property;
-receipts for additional living expenses incurred and records supporting the fair rental value loss ...

11. The Policy also includes the following “Subrogation Clause”:

If we pay the mortgagee or loss payee for any loss and deny payment to you [the insured], then our rights are subrogated to all rights of the mortgagee or loss payee granted under the mortgage on the property.

12. Coverage under the Policy is rendered void for all insureds if “any covered person has intentionally concealed or misrepresented any material fact relating to this policy.”

The Investigation

13. The Miles reported the claim to Great Northern on October 18, 2004, the day after the fire occurred. Claims adjuster James Tagliente (“Tagliente”) was assigned to the Miles’ claim.

14. The initial investigation by local authorities indicated that the fire had been intentionally set. Accelerants were found *235 in the house and there was no sign of forced entry.

15. After learning of the local authorities’ initial findings, Great Northern assigned Charles McIntyre (“McIntyre”), a member of its Special Investigative Unit, to investigate the claim.

16. The policy provides coverage for a fire loss, even an arson loss, so long as the insured did not intentionally cause or participate in the cause of the fire.

17. McIntyre’s role, as special investigator, was to determine whether the Miles had any involvement in the cause of the fire and, accordingly, whether the loss should be paid or not.

18. Tagliente made several attempts to contact the Miles in the days and weeks following the fire but every attempt was unsuccessful. For over two weeks after the fire, Tagliente was able to contact the insured only through James Lehrberg, an attorney who was purported to represent the Miles at the time.

19. On October 22, 2004, McIntyre spoke with Jim Coyle, a representative of Protection One. Coyle told McIntyre that on the evening of the fire, the security alarm on the Premises had been armed and disarmed several times between 6:19 and 6:33 p.m. and that there was no subsequent recorded activity prior to the fire alarm activation at 12:28 a.m. (early the following morning).

20. McIntyre later determined that entry into the house was gained in a zone as to which the intrusion alarm had not been armed (Zone Four).

21. McIntyre also learned that one of the Miles’ neighbors, Katherine Antonio, heard voices outside her bedroom window shortly after Midnight on the night of the fire, which led McIntyre to conclude that the person(s) who set the fire were not attempting to remain quiet as they entered the house.

Recorded Interviews and Examinations Under Oath

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Miles v. Great Northern Insurance, 671 F. Supp. 2d 231, 2009 U.S. Dist. LEXIS 112561 (D. Mass. 2009).

671 F. Supp. 2d 231 (Miles v. Great Northern Insurance) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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