Ralston v. Phoenix Insurance

10 Mass. L. Rptr. 165
CourtMassachusetts Superior Court
DecidedApril 29, 1999
DocketNo. 9602508
StatusPublished

This text of 10 Mass. L. Rptr. 165 (Ralston v. Phoenix 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
Ralston v. Phoenix Insurance, 10 Mass. L. Rptr. 165 (Mass. Ct. App. 1999).

Opinion

Fecteau, J.

This is an action wherein the plaintiff alleges detrimental reliance on a statement by the defendant’s claim representative that “underinsured motorist” coverage was available to her in connection with the facts of the underlying personal injury accident, later learning that such was not the case. This information, she contends, led her to give a release to her tortfeasor, thus foreclosing her rights to enforce the liability of and seek a judgment in excess of the tortfeasor’s liability insurance. The defendant contends that any reliance upon this erroneous statement of coverage confirmation was not reasonable and, even if it were, the plaintiff suffered no actual harm. Additionally, the plaintiff alleges a G.L.c. 93A violation in these facts which the defendant says does not apply, as the substantive law of the State of Connecticut applies and does not allow for such a cause of action.

The matter came on for trial before me, sitting without jury, as the parties waived their rights thereto, on March 31, 1999. Upon consideration of the credible evidence, I make the following findings of fact and rulings of law.

FINDINGS OF FACT

1. On September 29, 1995, the plaintiff was injured in a motor vehicle accident in the Bondsville section of Palmer, Massachusetts, under circumstances that would result in a finding that the other driver, Mavis Sedlak, was at fault in the accident. Sedlak had a policy of automobile liability insurance with Arbella Mutual Insurance Company with bodily injury limits of $20,000.00 per claimant.

2. On said date, the plaintiff owned, in addition to the motorcycle which she was operating at the time of the accident, which was “garaged” in Massachusetts and insured under a Massachusetts automobile insurance policy with the Progressive Insurance Company, a jeep that was garaged in Connecticut and insured under a Connecticut automobile insurance policy with the defendant. Both of her policies had underinsured motorist benefits; the policy covering the motorcycle had underinsured limits of $20,000.00 per claimant and that for the jeep had $100,000.00 in underinsured motorist coverage limits per claimant.

3. The plaintiff retained counsel to represent her in connection with her personal injury claim. On October 19, 1995, he sent a letter of representation to the defendant that included a notice of her intent to make a claim on her underinsured motorist coverage.

4. On November 6th and 28th, 1995, he wrote to the defendant’s claim representative, experienced in the handling of bodily injury claims including under-insured claims, requesting confirmation that the un-derinsured coverage that the plaintiff had with her policy of insurance with the defendant applied to the facts of this accident claim.

5. Plaintiffs counsel was experienced in the handling of personal injury claims and had represented many claimants in pursuing claims against underin-sured motorist insurance coverage, although not many, if any, on a Connecticut insurance policy. At all times relevant to the facts herein, he neither had in his possession a copy of the policy, received from his client a copy of any part of her policy other than the coverage selection page nor requested a copy of the policy from the defendant.

6. The policy issued by the defendant contained the following “other insurance” clause:

If there is other applicable similar coverage available under one or more policies or provisions of coverage: with respect to “bodily injury” to an “insured”: 1. While “occupying” a vehicle owned by that “insured,” only the uninsured /underinsured motorist coverage applicable to that vehicle will apply and no other policies or provisions of coverage will apply . . .

7. On December 7, 1995, the claim representative of the defendant insurer, in response to the request from the plaintiffs counsel, confirmed the plaintiffs eligibility for underinsured motorist benefits under the policy with the defendant, notwithstanding the policy language and their knowledge of the existence of other coverage with Progressive for the occupied vehicle.

8. Upon receipt of this confirmation, and as a result, plaintiffs counsel proceeded to close out the plaintiffs liability claim against the tortfeasor.1 He promptly sought and received permission from the defendant to settle with Arbella Mutual Insurance Company, the liability insurer of Mavis Sedlak, the at-fault operator who caused the injury to the plaintiff. A full release of claim was signed by the plaintiff on or about February 13, 1996, and provided to the tortfeasor.

9. In response to the request of the defendant, on May 14, 1996, a “medical package” and settlement demand was provided by the plaintiff through counsel in support of her underinsured motorist claim. On May 31, 1996, the claim representative of the defendant wrote to plaintiffs counsel disclaiming coverage for the claim made by the plaintiff.

10. At the point in time when the plaintiff settled her claim against Sedlak, she had not performed any investigation into the financial assets or capability of the tortfeasor to satisfy any judgment which might be entered in excess of her liability insurance limit of $20,000.00. At the time of the settlement, Mavis Sedlak, a divorced mother of one child, was living in Massachusetts in a rented apartment, was employed full time by a supermarket chain earning less than ten dollars per hour and had insignificant financial assets.

11. At that time, the plaintiffs personal injury claim had a value in excess of the tortfeasor’s bodily injury limits. Her injuries included two fractures of the fibula of the right leg and a bone of the foot,2 together with associated pain and suffering and continuing partial disability. Special damages alleged include approximately $1820.00 in medical expenses and approximately $8000.00 in lost earning capacity from her [167]*167prior occupation. At the time of her settlement with Sedlak’s insurer, the value of her personal injury claim was between $50,000.00, and $75,000.00. Had suit been initiated against the tortfeasor and brought to a conclusion, the plaintiff, in all probability, would have obtained a judgment and execution for at least $50,000.00, together with interest and costs of suit.

12. At the time of her obtaining the policy with the defendant, Ralston was using her mother’s home in Glastonbury, Connecticut, as her mailing address. She was an “over-the-road” truck driver for eighteen years prior to 1995, and, for most of that period of time, she had no permanent residence of her own. She began to live in an apartment in Massachusetts in 1992, but would still regularly stay overnight with her mother and continued to use her mother’s address as her mailing address even after moving to Massachusetts. When she acquired the 1994 Jeep, she listed her address for purpose of the policy with the defendant as that of her mother. She obtained this policy through a Connecticut insurance agent. Indeed, even when she signed the release of her claim against Mavis Sedlak, she gave her address as Glastonbury, Connecticut.

RULINGS OF LAW

The plaintiff contends that she is entitled to recover for damages sustained as a result of the negligent misrepresentation by the defendant that she was eligible for underinsured motorist benefits, for her detrimental reliance upon those misrepresentations in that she relinquished a right to bring a cause of action against a tortfeasor and for a violation of G.L.c. 93A.

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Cite This Page — Counsel Stack

Bluebook (online)
10 Mass. L. Rptr. 165, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ralston-v-phoenix-insurance-masssuperct-1999.