Caron v. Horace Mann Ins. Co.

• Decision Date: 09 August 2013
• Docket Number: SJC–11273.
• Citation: 466 Mass. 218,993 N.E.2d 708
• Court: United States State Supreme Judicial Court of Massachusetts Supreme Court
• Parties: Scott CARON & another v. HORACE MANN INSURANCE COMPANY.

466 Mass. 218

993 N.E.2d 708

Scott CARON & another ¹

v.HORACE MANN INSURANCE COMPANY.

SJC–11273.

Supreme Judicial Court of Massachusetts,

Essex.

Submitted April 4, 2013.

Decided Aug. 9, 2013.

Owen Gallagher (Kara Larzelere with him), Malden, for the defendant.

Eric J. Parker, Boston (Susan M. Bourque, Boston, & Lisa M. Scalisi with him) for the plaintiffs.

Paul M. Moretti, Boston, for Property Casualty Insurers Association of America, amicus curiae, submitted a brief.

Present: IRELAND, C.J., SPINA, CORDY, BOTSFORD, GANTS, DUFFLY, & LENK, JJ.

LENK, J.

The written homeowner's insurance policy at issue here had an over-all coverage limit of $500,000, but also contained an “animal liability” endorsement that limited coverage to $25,000 per occurrence for claims arising from animal bites. The question before us is whether, on the ground of mutual mistake, the policy should be reformed by striking that endorsement. It is undisputed that both the insurance company's agent and the homeowner mistakenly believed that the policy did not contain such a limitation of liability, but that neither conveyed her mistaken belief to the other. We conclude that, absent full, clear, and decisive proof of some prior agreement between the parties as to coverage for animal bites different than that contained in the policy, there was no mutual mistake warranting reformation of the policy. We accordingly reverse the entry of partial summary judgment in the insured's favor ordering such reformation, and order the entry of separate and final judgment for the insurer on the reformation claim.

1. Background.² In March, 2006, Alan and Katherine Fowler purchased a homeowner's insurance policy from the Horace Mann Insurance Company (Horace Mann). The policy was to replace a previous policy the Fowlers had purchased through the Massachusetts Property Insurance Underwriting Association's assigned risk pool (“FAIR plan”).³ The FAIR plan was considerablymore expensive than commercial homeowner's insurance policies, and the Fowlers sought a more affordable option.

On March 10, 2006, Katherine ⁴ met with Barbara Bode,⁵ Horace Mann's agent, at Bode's office to prepare an application for homeowner's insurance through Horace Mann. Bode requested a copy of the declarations page for the Fowlers' FAIR plan policy; the declarations page indicated that the personal liability limit was $500,000. Bode asked Katherine if she owned certain specific breeds of dog, and Katherine answered, “[N]o.” Katherine added that she owned an American Bull Dog (which was not among the breeds Bode had named). Katherine did not express any concern as to the potential risk for the American Bull Dog breed, nor did she ask any questions about coverage for dog-related claims.

Bode printed Katherine's completed application form and they both signed the form. Katherine gave Bode a check for $310, representing forty per cent of the total premium cost. The policy was substantially less expensive than Katherine's then-existing FAIR plan policy. Bode provided Katherine a “Verification of Coverage” sheet, showing personal liability limits of $500,000, and informed Katherine that a full policy would be mailed to her.

When Katherine received the full policy, she “skimmed” through it. The policy contained an “Animal Liability Endorsement” (endorsement) ⁶ which limited coverage to $25,000 for claims arising from animal bites, and precluded any coverage for bites by certain listed breeds of dog; the Fowlers' American Bull Dog was not among the excluded breeds. According to Katherine's affidavit, when she purchased the policy after meeting with Bode, she mistakenly assumed that the policy provided the full $500,000 in liability coverage for claims involving animal bites. Bode states in her affidavit that she, too, mistakenly believed that the policy would provide full liability coverage for dog bite claims if the dog was not one of the listed excluded breeds, although she never conveyed this belief to Katherine. Indeed, during their meeting, Bode and Katherine did not discuss coverage for animal bite claims.

On June 17, 2006, plaintiff Scott Caron was bitten in the face and severely injured by the Fowlers' dog. He and his wife Caryn brought an action against the Fowlers in the Superior Court. A jury found for the Carons and awarded them $250,559.96, including prejudgment interest. Horace Mann paid $25,000 of this judgment, maintaining that, due to the endorsement, such was the extent of its liability. The Carons reached a settlement with the Fowlers regarding the balance of the judgment, and became assignees of the Fowlers' claims against Horace Mann.

The Carons then commenced an action in the Superior Court against Horace Mann alleging, among other claims,⁷ that the Fowlers and Horace Mann were mutually mistaken as to the application of the endorsement, and thus that the policy should be reformed by striking the endorsement. A Superior Court judge granted partial summary judgment in favor of the Carons on this claim, and denied Horace Mann's cross motion for summary judgment on all counts. The judge allowed the Carons' motion for entry of separate and final judgment on the reformation claim, pursuant to Mass. R. Civ. P. 54(b), 365 Mass. 820 (1974).

Horace Mann moved to correct the judgment, Mass. R. Civ. P. 60(a), 365 Mass. 828 (1974), and the judge issued an amended final judgment against Horace Mann, totaling $225,559.96, with interest in the amount of $77,197.80. Horace Mann appealed, and we granted its application for direct appellate review.

2. Discussion. a. Standard of review. “The standard of review of a grant of summary judgment is whether, viewing the evidence in the light most favorable to the nonmoving party, all material facts have been established and the moving party is entitled to a judgment as a matter of law.” Augat, Inc.v. Liberty Mut. Ins. Co., 410 Mass. 117, 120, 571 N.E.2d 357 (1991). “Because our review is de novo, we accord no deference to the decision of the motion judge.” DeWolfe v. Hingham Ctr., Ltd., 464 Mass. 795, 799, 985 N.E.2d 1187 (2013). In order to prevail on a motion for summary judgment on a claim for reformation due to mutual mistake, the moving party must establish “that the undisputed material facts fully, clearly, and decisively show[ ] a mutual mistake.” Polaroid Corp. v. Travelers Indem. Co., 414 Mass. 747, 756, 610 N.E.2d 912 (1993) (Polaroid ).

b. Mutual mistake. i. Plaintiffs' motion for summary judgment. Insurance policies may be reformed under the same principles as any other contract. See Polaroid, supra at 756, 610 N.E.2d 912. The “doctrine of reformation is driven by respect for the parties' intent and ‘gives effect to the terms mutually agreed upon by the parties.’ ” Berezin v. Regency Sav. Bank, 234 F.3d 68, 72 (1st Cir.2000), quoting Southeastern Ins. Agency, Inc. v. Lumbermens Mut. Ins. Co., 38 Mass.App.Ct. 642, 646, 650 N.E.2d 1285 (1995), S.C.,423 Mass. 1008, 668 N.E.2d 347 (1996) ( Southeastern Ins. Agency ). “If the language of a written instrument does not reflect the true intent of both parties, the mutual mistake is reformable.” Polaroid, supra. See 2 G. Couch, Insurance § 27:1 (3d. rev. ed. 2010) (“Equity will reform a contract which, by reason of mutual mistake, does not express the real agreement between the parties”). “The mistake must either be mutual ... or be made by one party and known to the other party” (citations omitted), Polaroid, supra, and “must relate to an essential element of the agreement.” LaFleur v. C.C. Pierce Co., 398 Mass. 254, 257–258, 496 N.E.2d 827 (1986).

Here, there is no dispute that, under the policy as written, coverage for claims arising from a bite by the Fowlers' dog was limited to $25,000. It is also undisputed that Horace Mann fully intended the endorsement to be included in the policy and to limit the Fowlers' coverage for animal bite claims. Indeed, the endorsement was mandatory in all Horace Mann policies.

The summary judgment record indicates, however, that Katherine mistakenly believed that the policy provided up to $500,000 in personal liability coverage for “any incident at all,” including claims resulting from a dog bite. Nonetheless, nothing in the record suggests that Katherine expressed this understanding to Bode, Horace Mann's agent, and Katherine undisputedly did not ask Bode any questions regarding the extent of coverage for animal bite claims. Bode, in turn, testified at her deposition that she also mistakenly believed that the policy would provide coverage up to the $500,000 personal liability limit for a dog bite claim, but that she neither conveyed this understanding to Katherine nor even discussed coverage for dog bite liability with her.

The question before us, then, is whether Bode's misunderstandingof the endorsement, which was never expressed to Katherine, but which tracks Katherine's own misunderstanding, provides a basis by which the Carons may claim mutual mistake. See Simon v. National Union Fire Ins. Co. of Pittsburgh, 57 Mass.App.Ct. 350, 354, 782 N.E.2d 1125 (2003) (“the pertinent intent [for analyzing mutual mistake] ... must be the intent of the agent ... who participated in negotiating the contract, not the intent of the principal ... who did not”). The rationale underlying the mutual mistake doctrine compels us to answer in the negative.

The mutual mistake doctrine exists to effectuate the agreement intended by the parties to a contract where the contract language fails to capture that agreement. Central to this doctrine is the fundamental underpinning that the parties had reached an agreement on a point which they intended to enshrine in the written contract but which, for some reason, was mistakenly omitted from that written contract. See Sancta Maria Hosp.v. Cambridge, 369 Mass. 586, 595–596, 341 N.E.2d 674 (1976) (“this court will not decree a reformation unless we are convinced that the parties expressed agreement and an intention to be...