Justia Massachusetts Supreme Court Opinion Summaries

When a fire caused by NSTAR Electric and Gas Company employees damaged a building owned by the Massachusetts Institute of Technology (MIT), two insurers paid the claims of the building’s tenants. The insurers then brought this complaint against NSTAR Electric Company and NSTAR Electric & Gas Company (collectively, NSTAR) seeking to recover for the claims paid. NSTAR moved for partial summary judgment, contending that, to the extent to which the insurers sought recovery for business interruption losses, the claims were barred by Massachusetts Department of Telecommunications and Energy Tariff No. 200A, filed with and approved by the Department of Public Utilities, and in effect when the explosion occurred. The tariff contained a limitation of liability clause that limited NSTAR from liability to nonresidential customers for special, indirect, or consequential damages resulting from the utility’s gross negligence. A judge of the superior court allowed NSTAR’s motion for partial summary judgment, concluding that a tariff filed with and approved by a regulatory agency may limit a public utility’s liability. The Supreme Judicial Court affirmed, holding that the limitation of liability clause in the tariff precluded Plaintiffs’ claims to recover for business interruption and other consequential or economic damages. View "Maryland Cas. Co. v. NSTAR Elec. Co." on Justia Law

The personal injury protection (PIP) statute provides that an injured person claiming PIP benefits shall submit to physical examinations by “physicians” selected by the insurer as required to assist in determining amounts due. Plaintiff was injured in an accident while riding in a vehicle insured by Progressive Insurance Company (Progressive). Progressive engaged Examworks, Inc. to arrange an independent medical examination (IME) of Plaintiff. A licensed physical therapist, but not a licensed medical doctor under the Commonwealth’s physician statute, examined Plaintiff. Plaintiff filed this action against Examworks on behalf of himself and similarly situated persons, alleging invasion of privacy and unfair or deceptive practices. The district judge dismissed the complaint. The Supreme Court affirmed, holding (1) the word “physicians” in the PIP statute refers to both licensed medical doctors and also other appropriate licensed or registered health care practitioners; (2) the invasions of privacy associated with the examination in this case were justified; and (3) Defendant’s claim that Examworks engaged in deception by leading him to believe that the physical therapist was a licensed medical doctor as the PIP statute required failed because the PIP statute does not require an IME to be performed by a licensed medical doctor. View "Ortiz v. Examworks, Inc." on Justia Law

Plaintiff sued its Insurer, alleging breach of contract and seeking declaratory relief, after the Insurer refused to defend or indemnify Plaintiff in connection with an environmental dispute. A superior court allowed Plaintiff’s motion for partial summary judgment on the Insurer’s duty to defend. Plaintiff then amended its complaint to assert a claim under Mass. Gen. Laws ch. 93A, 11 arising out of the Insurer’s duty to defend. Thereafter, Plaintiff subsequently accepted reimbursement from the Insurer for its expenses in litigating and resolving the environmental matter. Insurer then sought summary judgment on the chapter 93A claim, arguing that its reimbursement of Plaintiff’s expenses precluded a finding that Plaintiff had suffered a loss of money or property, as required to establish a violation of chapter 93A section 11. The trial court denied summary judgment on the chapter 93A claim. The Supreme Judicial Court affirmed, holding (1) chapter 93A does not require a showing of uncompensated loss or a prior judgment establishing the amount of damages as a prerequisite to recovery; and (2) therefore, neither Plaintiff’s acceptance of full reimbursement of its expenses nor the absence of a judgment establishing contract damages precluded Plaintiff from pursuing a claim under chapter 93A. View "Auto Flat Car Crushers, Inc. v. Hanover Ins. Co." on Justia Law

At issue in this case was whether an unpaid party who has brought an action for breach of contract against an automobile insurer and thereafter refused the insurer’s tender of personal injury protection (PIP) benefits due and payable, made prior to the entry of judgment, may proceed with the suit and obtain a judgment for those amounts, as well as its costs and attorney’s fees. Plaintiff here provided chiropractic services to a patient, who was injured while driving a vehicle insured by Defendant. Plaintiff sought payment from Defendant for its treatment of the patient, but Defendant determined it was liable for only a portion of Plaintiff’s submitted fees. Plaintiff then filed a complaint seeking, among other things, payment of the disputed amount plus costs and attorney’s fees pursuant to Mass. Gen. Laws ch. 90, 34M. Before trial, Defendant sent Plaintiff a check for the disputed amount, but Plaintiff rejected the offer. The district court granted summary judgment for Defendant, and the appellate division affirmed. The Supreme Judicial Court vacated the judgment in part, holding that an insurer’s late tender of PIP benefits, made after a claimant has filed suit and which the claimant denies to accept, does not entitle an insurer to summary judgment. View "Barron Chiropractic & Rehab., P.C. v. Norfolk & Dedham Group" on Justia Law

After being billed by NEPT for medically necessary chiropractic services provided to the passenger of its insured, Liberty Mutual, claimed that the cost was unreasonably high and thus refused to pay the full amount invoiced. At trial, Liberty Mutual sought to introduce statistical evidence from a commercial database to show that NEPT's charges exceeded the 80th percentile of reported charges for the same procedures, pursuant to G.L. c. 233, 79B, which creates a limited exception to the hearsay rule for factual statements contained in commercial publications. The trial judge denied the motion, finding that the database was unreliable, based on a prior decision from the appellate court with respect to the database. The Massachusetts Supreme Court affirmed. Based on the explicit language of section 79B, and the gatekeeper role of a trial judge, it is within a judge's discretion to consider the reliability of evidence offered pursuant to section 79B. View "N.E. Physical Therapy Plus, Inc. v. Liberty Mut. Ins. Co." on Justia Law

Insureds purchased a homeowner's insurance policy from Insurer with a personal liability limit of $500,000. The policy contained an animal liability endorsement (endorsement) which limited coverage to $25,000 for claims arising from animal bites. Both Insurer's agent and Insureds mistakenly believed the policy did not contain the limitation of liability but neither conveyed their mistaken belief to the other. After Plaintiff was bitten by Insured's dog, he and his wife successfully brought an action against Insureds. Insurer paid only $25,000 of this judgment. Plaintiffs and Insureds reached a settlement regarding the balance of the judgment and Plaintiffs became assignees of Insureds' claims against Insurer. Plaintiffs sued Insurer, alleging that Insureds and Insurer were mutually mistaken as to the application of the endorsement, and therefore, the policy should be reformed by striking the endorsement. The superior court concluded Plaintiffs were entitled to summary judgment on the reformation claim. The Supreme Court vacated the judgment, holding 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. View "Caron v. Horace Mann Ins. Co." on Justia Law

Claimant sustained injuries in a car accident. The car was insured under a standard Massachusetts automobile insurance policy (auto policy) issued by Liberty Mutual that included optional "medical payments" coverage (MedPay). Claimant was also insured under a separate policy of health insurance issued by Blue Cross Blue Shield (Blue Cross). Liberty Mutual paid personal injury protection benefits to Claimant and Claimant's additional medical expenses. After Liberty Mutual declined to pay Claimant any MedPay benefits because Blue Cross had already submitted the expenses, Claimant commenced this action against Liberty Mutual on behalf of herself and a putative class of similarly situated individuals. On remand, the superior court granted Liberty Mutual's motion for judgment on the pleadings. The Supreme Court reversed, holding that Claimant was entitled to the MedPay benefits provided by her auto insurance policy, notwithstanding that her medical expenses were covered by and paid under a separate policy of health insurance. Remanded. View "Golchin v. Liberty Mut. Ins. Co." on Justia Law

Karla Brown brought a lawsuit against Deutsche Bank and others seeking rescission of a note and first mortgage securing that note, alleging that she was the victim of a predatory lending scheme. The mortgage was originated by Deutsche Bank's predecessor in interest in connection with the purchase of Brown's home. Deutsche Bank requested that First American Title Insurance Company defend Deutsche Bank's mortgage interest pursuant to the terms of its title insurance policy. First American refused coverage, claiming the lawsuit did not trigger its duty to defend because Brown was claiming she was misinformed as to the terms of the note rather than challenging that she granted the mortgage. Deutsche Bank subsequently brought this action seeking a judgment declaring First American had a duty to defend it in Brown's lawsuit. The superior court granted summary judgment in favor of First American. The Supreme Court affirmed, holding that the allegations in Brown's complaint did not trigger First American's duty to defend because the complaint's claims were not specifically envisioned by the terms of the title insurance policy. View "Deutsche Bank Nat'l Ass'n v. First Am. Title Ins. Co." on Justia Law

This case involved multiple litigations among three parties - Insurer, insured Mortgagee, and Homeowner - arising out of a defect in the title to Homeowner's home. Insurer brought suit in the land court on behalf of Mortgagee seeking to reform the deed to the property or to equitably subrogate Homeowner's interest in the property behind Mortgagee's mortgage. Homeowner initiated suit in the superior court against Mortgagee. Eventually, all claims in both actions became part of a federal court case, which settled. Thereafter, Mortgagee filed a complaint against Insurer in the U.S. district court seeking to recover from Insurer for the costs Mortgagee incurred in defending against Homeowner's claims. The judge determined Insurer had no obligation under its title insurance policy to pay Mortgagee's defense costs but certified two questions to the Massachusetts Supreme Court. The Court answered by holding that, under Massachusetts law (1) a title insurer does not have a duty to defend the insured in the entire lawsuit where one claim is within the scope of the title insurance coverage and other claims are not; and (2) a title insurer that initiates litigation similarly does not have a duty to defend the insured against all reasonably foreseeable counterclaims. View "GMAC Mortgage, LLC v. First Am. Title Ins. Co." on Justia Law

Defendant purchased an "own occupation" disability insurance policy from an affiliate of Plaintiff, Metropolitan Life Insurance Company (MetLife). After Defendant was diagnosed with cancer, Defendant's employment was terminated. Defendant filed a clam for disability benefits and began receiving disability payments. Defendant later began working at a lower stress job. MetLife concluded that Defendant was no longer eligible to receive disability benefits. Metlife reached this conclusion by interpreting a clause in Defendant's policy requiring Defendant to receive care by a physician that "is appropriate for the condition causing the disability" to mean that Defendant was required to pursue treatment aimed at returning him to his prior occupation. MetLife filed an action seeking a judgment declaring it had no continuing obligation to pay benefits to Defendant and reimbursement of benefits it had paid. The superior court declared MetLife was not required to continue paying Defendant benefits but that MetLife was not entitled to restitution of any benefits paid. The Supreme Court affirmed, holding (1) Defendant was not entitled to benefits under the policy since he was not receiving care designed to enable him to return to him prior occupation; and (2) MetLife was not entitled to reimbursement for benefits paid to Defendant. View "Metro. Life Ins. Co. v. Cotter" on Justia Law