Sentry Insurance v. Moda

14 Mass. L. Rptr. 33
CourtMassachusetts Superior Court
DecidedSeptember 26, 2001
DocketNo.9400502L2
StatusPublished

This text of 14 Mass. L. Rptr. 33 (Sentry Insurance v. Moda) 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
Sentry Insurance v. Moda, 14 Mass. L. Rptr. 33 (Mass. Ct. App. 2001).

Opinion

Smith, J.

This case at its heart involved allegations of insurance claim fraud. Specifically, Sentry Insurance Company’s (Sentry) claimed that defendant Antonio Moda (Moda) submitted an insurance claim for property damage on behalf of Locke Manufacturing Company1 in support of which he included two false invoices which were inflated in the amount of $38,142.48 to pay for work which was performed in the construction of his home. Sentry claims that it is entitled to recover from Moda as damages the $603,521.10 it paid to Locke Manufacturing Company on the insurance policy claim, resulting from the roof collapse because Moda’s fraud voided the insurance policy ab initio. Despite admissions Moda made in his guilty plea colloquy before the Federal District Court for the District of Massachusetts2 that he indeed persuaded a contractor3 to inflate an invoice submitted to Locke Manufacturing Company for repairs by some $9,647.00, Moda claims that he committed no fraud or if he had, the plaintiff suffered no damages or only damages amounting to $9,647.00, the amount of the overcharge of one4 of the two inflated invoices.

After a trial on Sentry’s claim for damages for fraud and intentional misrepresentation against defendant Moda, the Jury returned a verdict finding that Moda did not commit fraud in connection with the insurance claim of Locke Manufacturing Co. Additionally, the Jury returned an advisory G.L.c. 93A verdict in favor of the defendant. Specifically, the Jury found that defendant Moda did not commit any unfair and deceptive practices in his dealings with the plaintiff.

FACTS

At all times material hereto the Plaintiff provided a policy of insurance to Locke Manufacturing Company, Inc., covering the premises located at 44 Sixth Road, Woburn, Massachusetts. On or about January 30, 1987 the roof at Locke Manufacturing facility collapsed after a heavy snowfall. At the time of the roof collapse on January 30, 1987 defendant Moda was a Shareholder, Director, and President of Locke Manufacturing Company, Inc. Moda personally participated in the submission of the insurance claim to Sentry on behalf of Locke Manufacturing Company for damages arising out of the January 30, 1987 roof collapse and allegedly covered by the policy of insurance. In connection with its insurance claim, Locke Manufacturing Company submitted a Dowgiert Building & [34]*34Remodeling (Dowgiert) invoice dated April 4, 1987 in the amount of $13,647.58 in support of its building damage claim. The April 4, 1987 Dowgiert invoice was false and inflated by approximately $9,647.58.

Although Sentry advanced $136,000.00 to Locke Manufacturing Company on its insurance claim, the parties could not reach an agreement as to the value of the claim. Consequently, Locke Manufacturing Company and Sentiy submitted the matter to a reference pursuant to the terms of the policy. After several hearings conducted between September 14, 1989 and Februaiy 8, 1990, the referees, on March 6, 1991, returned an award of $460,997.09 to Locke Manufacturing Company, less the $136,000.00 advance and the $1,000.00 policy deductible. Of note, Moda testified at the hearings in support of Locke Manufacturing Company’s claims. The false Dowgiert invoice was offered in evidence and authenticated during Moda’s testimony as an invoice for work performed in connection with the insurance claim at that hearing.

On March 22, 1991, Moda executed and submitted to Sentiy a Subrogation Receipt and Assignment in the amount of $603,231.18, which represented the referees’ award with interest, less the policy deductible. Sentiy paid the award in full. Thus, Sentry made payments to Locke Manufacturing Company on its insurance claim totaling $603,231.18.

On or about April 9, 1987 Moda gave a Locke Manufacturing Company check, number 15289, in the amount of $9,647.58 to Dowgiert. On or about April 15, 1987 Dowgiert signed over the Locke Manufacturing Company check number 15289 in the amount of $9,647.58 to Moynahan North Reading Lumber, Inc. as payment for lumber used in the construction of Moda’s Boxford residence. (See Indictment at Paragraph H.) Moda knew or reasonably should have known that the Dowgiert invoice was false and inflated in the amount of approximately $9,647.58. In early Februaiy 1987, shortly after Dowgiert had erected two temporary walls, Ted Dowgiert, Dowgiert Building & Remodeling’s principal, visited Locke Manufacturing Company and met with Moda. Dowgiert had prepared a bill which was for under $5,000.00. Moda told Mr. Dowgiert to prepare a bill that included all the materials Dowgiert had used. Dowgiert then asked if he should include on the bill lumber supplied at Moda’s house in West Boxford. Moda responded, “Put everything on it.” (See Probation Memorandum, pages 10-11.)

In connection with its insurance claim, Locke Manufacturing Company also submitted to Sentiy Insurance Company an invoice from HB Electric dated April 10, 1987 in the amount of $80,032.03. (See Indictment Paragraph G.) The HB Electric invoice was inflated by an approximate amount of $28,495.00 by the inclusion of cost for labor and/or materials used in the construction of Moda’s residence in West Boxford. (See Indictment Paragraph 24 0, I, K, M, P, Q; See also Moda’s response to Request For Admissions.) Moda knew or reasonably should have known that the HB Electric invoice was false and inflated and included charges for labor or material used in the construction of his residence in West Boxford.

Moda engaged in a deliberate scheme to defraud Sentiy by submitting or causing to be submitted to Sentiy invoices which included charges for labor and/or materials utilized in the construction of his personal residence in West Boxford. Moda testified at his deposition in this action, which was read into evidence at trial, that he had read the Probation Memorandum prepared by his attorneys prior to its submission to the United States District Court in connection with his plea to criminal charges and was satisfied that the contents of the Memorandum were true and accurate to the best of his knowledge and ability.

This Court also finds that Moda was not acting within the scope of his employment when he had the repair invoices falsified. There is no evidence that Moda conspired with or even informed any other principal or executive at Locke Manufacturing Company about his scheme. There is no evidence that any other principal or agent of Locke Manufacturing Company knew about Moda’s scheme and winked at it or tacitly approved of it. If anything, Moda was stealing from Locke Manufacturing Company by taking advantage of its loss to make money for himself. Whatever claims Sentiy may have had against Locke Manufacturing Company for insurance fraud or violation of G.L.c. 93A, §11, those claims were resolved when Sentry paid Locke Manufacturing Company’s insurance claim after the March 6, 1991 referees’ award and when Locke Manufacturing Company (after it became LKM) subsequently settled Sentry’s legal action against it for $350,000. Finally, the Court finds that Locke Manufacturing Company did suffer damages from the 1987 roof collapse which fell within the insurance policy and which entitled Locke Manufacturing Company to payment on its claim from Sentiy. The uncontested final decision of the referees resolved in Locke Manufacturing Company’s favor the legitimacy of its insurance claim.

n. RULINGS OF LAW

General Laws chapter 93A Section 11 provides in pertinent part that:

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Bluebook (online)
14 Mass. L. Rptr. 33, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sentry-insurance-v-moda-masssuperct-2001.