Lazaris v. Metropolitan Property and Cas. Ins. Co.

• Decision Date: 15 December 1998
• Citation: 703 N.E.2d 205,428 Mass. 502
• Parties: Aristides A. LAZARIS v. METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY.
• Court: United States State Supreme Judicial Court of Massachusetts Supreme Court

Page 205

703 N.E.2d 205

428 Mass. 502

Aristides A. LAZARIS v. METROPOLITAN PROPERTY AND CASUALTY INSURANCE COMPANY.

Supreme Judicial Court of Massachusetts,

Middlesex.

Argued Oct. 9, 1998.

Decided Dec. 15, 1998.

Michael S. Lalikos, Danvers, for plaintiff.

Alice Olsen Mann, Auburndale (Karyn T. Hicks, Boston, with her), for defendant.

Before WILKINS, C.J., and ABRAMS, LYNCH, GREANEY, FRIED, MARSHALL and IRELAND, JJ.

WILKINS, Chief Justice.

It is an unfair settlement practice, and also an unfair or deceptive act or practice under G.L. c. 93A, § 9(1), if an insurance company fails "to effectuate prompt, fair and equitable settlements of claims in which liability has become reasonably clear." G.L. c. 176D, § 3(9) (f ). We are presented, for the first time, with the question whether an insurance company violates § 3(9) (f ) if it insists that a claimant against one of its insureds release all claims against its insured before it will pay a claim in which liability has become reasonably clear. ¹ We shall answer the question, setting forth a construction of G.L. c. 176D, § 3(9) (f ), that differs from the view of § 3(9)(f) taken by the Appeals Court in Thaler v. American Ins. Co., 34 Mass.App.Ct. 639, 614 N.E.2d 1021 (1993). We shall first, however, consider the appeal of the plaintiff from a judgment in favor of the defendant insurer that was based on principles set forth in the Thaler case. We affirm the judgment applying the principles of the Thaler case.

On November 18, 1992, the plaintiff was walking on Trapelo Road in Belmont when he was struck by a vehicle operated by Christopher J. Manni, who was insured by Metropolitan Property and Casualty Insurance Company (Metropolitan). Manni's parents owned the vehicle. The plaintiff sustained substantial injuries and incurred medical expenses well above Manni's bodily injury liability coverage of $100,000. The parties stipulated that "throughout the course of its investigation, Metropolitan had serious questions concerning Manni's liability for the accident." The night in question was dark, it was sleeting or hailing, and the road surface was wet. Lazaris was wearing dark clothes, and there was evidence that he was crossing the street outside of the crosswalk. The plaintiff disputed that he was not in the crosswalk but acknowledged that he began crossing Trapelo Road before the light for traffic turned red and despite having seen Manni's car approaching. Manni said the light was green in his direction as he drove through the crosswalk. An investigating police officer believed that the plaintiff was not in the crosswalk and that Manni had not been speeding. Outside counsel gave Metropolitan an opinion that Manni's liability was questionable and that payment of the policy limit should not be made without obtaining a release of the plaintiff's claims against Manni.

Metropolitan offered to pay the full amount of the policy in settlement of the plaintiff's claims against the insured. The plaintiff, however, declined to release his claim against Manni in exchange for payment of the policy limit.

This action followed in which the plaintiff alleged (a) a negligence claim against Manni (which has been settled) and (b) a violation of G.L. c. 176D and G.L. c. 93A by Metropolitan. ² On cross motions for summary judgment, a Superior Court judge granted summary judgment for Metropolitan. She concluded that Manni's liability was not reasonably clear, and hence Metropolitan did not violate § 3(9) (f ). Lazaris appealed, and we allowed Metropolitan's application for direct appellate review.

The motion judge determined that the extent of Manni's liability was disputed. The stipulated facts demonstrated that "a very valid issue [is] raised in this case concerning contributory negligence on the part of [the plaintiff]." There was, in the motion judge's view, "a good faith and factually supported disagreement concerning the insured's responsibility," or at least his degree of responsibility, for the accident. The judge concluded, and we agree, that Metropolitan's liability to the plaintiff was not "reasonably clear" in the words of § 3(9) (f ). Metropolitan did not commit an unfair settlement practice.

Because the plaintiff's appeal fails under the rule of the Thaler case, we need not decide the question whether to endorse the construction of § 3(9) (f ) prescribed in that case. We are aware, however, of other pending cases in which the construction of § 3(9) (f ) expressed in the Thaler case has been challenged. Moreover, the question of the rights of claimants and the obligations of insurance companies in similar and related situations, which will often arise, should be clarified. We, therefore, set forth the obligation of insurers based on our construction of § 3(9) (f ) in situations in which the liability is reasonably clear and the claimant's damages unquestionably exceed the coverage set forth in the insured's policy.

Section 3 (9) (f ) speaks of effectuating "settlements of claims," not the payment of claims. We conclude that a claim is settled within the meaning of § 3(9) (f ) only when it is fully disposed of, which means that the claimant has released all claims against the insured. In deciding as we do, we overrule the Thaler rule. That rule, which was made applicable prospectively, stated that an insurance company violates G.L. c. 176D § 3(9) (f ), if it insists on a release as a condition of payment of the policy limit where liability of the insured "is undisputed and damages clearly exceed the policy limits." Id. at 643, 614 N.E.2d 1021. Further appellate review was not sought in the Thaler case (the insurer prevailed under pre-Thaler principles), and until this case we have not confronted the question whether to accept the rule of the Thaler case. ³

There is a difference between making a payment on a claim and settling that claim. General Laws c. 176D, § 3(9), recognizes that difference. Clause (d ) concerns "[r]efusing to pay claims" without conducting a reasonable investigation. Clause (j ) refers to "making claims payments." On the other hand, clauses (f ), (h ), (i ), (k ), and (m ) refer to "settlements," "settle a claim," or the like. Clause (f ) concerns claims against an insured of the insurance company. An unfair settlement practice occurs under clause (f ) only if the company fails to make a settlement of claims in which liability is reasonably clear.

If a claimant with a claim in excess of the policy limit will not settle all claims against the insured that are covered by the policy, the company does not violate clause (f ) by refusing to pay the policy limit. A settlement typically involves the "release or termination of further claims against the tortfeasor." MacInnis v. Aetna Life & Cas. Co., 403 Mass. 220, 226, 526 N.E.2d 1255 (1988). See Clegg v. Butler, 424 Mass. 413, 421 n. 8, 676 N.E.2d 1134 (1997); id. at 427, 676 N.E.2d 1134 (O'Connor, J., dissenting) (no liability under clause [f ] for failure to offer policy limit until claims against insured are to be settled and insured released).

The typical claim against an insured is one that falls below the insured's policy limit. In such a case, § 3(9) (f ) works well. If liability has become reasonably clear, the...