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City of Fall River vs. Ætna Insurance Company

Massachusetts Supreme Judicial Court1914-12-29
219 Mass. 454

Summary

Holding. The exceptions are sustained and the case is remanded for a new trial, as the trial judge's general finding failed to indicate which of the plaintiff's requested instructions were refused, making it unclear whether the judge based the decision on the occupancy defense or another theory.

Fall River sought recovery under a fire insurance policy issued by Ætna for a building that operated as a contagious hospital. The insurer argued the policy never became effective because it described the building as "occupied as a contagious hospital," while the building was actually unoccupied at the time of the policy, though fully furnished and ready for patients. The court rejected this argument, finding that the insurer had failed to show the unoccupied building presented a materially greater risk than an occupied one. The prior cases establishing the rule that policies fail when the actual risk differs substantially from the described risk (such as a building used partly as a store versus purely residential) did not apply here.

The trial judge issued a general finding for the insurer without specifying which of the plaintiff's sixteen requested jury instructions were refused or allowed. The court held this was reversible error because it was unclear whether the judge rejected the instructions based on the occupancy issue or another defense. The court also addressed the insurer's secondary argument that any loss amount required arbitration or waiver thereof. The court noted that when an insurer denies liability after proof of loss without seeking arbitration, the jury may find arbitration has been waived, and the insurer's explicit denial of liability in this case supported such a finding.

Summary generated by law.co from the public-domain opinion. The opinion text itself is public domain.

Key issues

  • Whether a building's description as 'occupied' in an insurance policy creates a material variance when the building is unoccupied but fully equipped and ready for immediate use
  • Whether the trial court's failure to specify which jury instructions were refused or allowed constitutes reversible error
  • Whether an insurance company's denial of liability after proof of loss waives the requirement for arbitration to determine the amount due

Procedural posture

The case was tried in the lower court with the insurer prevailing; the plaintiff appealed the general finding in favor of the defendant, arguing that certain jury instructions should have been granted.

Authorities cited

No cited authorities resolved to law.co cases yet.

Opinion

majority opinion

Loring, J.

The defendant, at the trial, contended “thatthe plaintiff could not recover because the policy in question never took effect as a contract, and because if it did take effect as a contract, the amount of loss had not been determined by agreement or arbitration, and such arbitration had not been waived.” “The defendant makes no claim that the building in question became vacant by the removal of the owner or occupant.”

The ground on which the defendant has contended that the policy did not take effect as a contract is that it has brought this case within the rule laid down in Goddard v. Monitor Mutual Fire Ins. Co. 108 Mass. 56 and subsequently applied in Thomas v. Commercial Union Assurance Co., Limited, 162 Mass. 29, and Bowditch v. Norwich Union Fire Ins. Co. 193 Mass. 565.

That rule is that, if the property owned by the plaintiff is not that described in the policy, the minds of the parties never met, and for that reason the policy never attached.

The defendant’s contention in this case is that the thing described in the policy is a building “occupied as a contagious hospi tal,” and that the building owned by the plaintiff, though a contagious hospital, was unoccupied at the date of the policy. It appeared that at the date of the policy and for four years before that date no patient had been in the hospital and no one, not even a caretaker, had been in occupation, although it did appear that the building was fully furnished as a hospital and ready to receive patients at a moment’s notice.

The rule laid down in Goddard v. Monitor Mutual Fire Ins. Co., ubi supra, (and subsequently applied in Thomas v. Commercial Union Assurance Co., Limited, and Bowditch v. Norwich Union Fire Ins. Co., ubi supra), is based upon the fact that the risk upon the building described in the policy was a less hazardous risk than that upon the building owned by the plaintiff. In Bowditch v. Norwich Union Fire Ins. Co., at page 568, the following statement of that rule was made: “If the question here had been the question of the identification of the building insured, the fact that it was described as a dwelling house would not have been material, although there was a shoe store in the basement and a dry goods store on the first floor. But the question here was not a question of identification. A building used in part as a dwelling house and in part as a store for the purposes of insurance is not a dwelling house but a different kind of building. It costs half as much again to insure it. The defendant agreed to insure the building as a dwelling house. For the purpose of insurance the building in question was not a dwelling house. No contract ever was made insuring this building as it was,—part dwelling and part store.” The fact that the risk upon the building owned by the plaintiff was a more hazardous risk than that upon the building described in the policy was also put in evidence in the earlier cases of Goddard v. Monitor Mutual Fire Ins. Co. and Thomas v. Commercial Union Assurance Co., Limited, ubi supra.

But in the case at bar there was no evidence that the risk upon a building fitted for use as a hospital and not in fact occupied at all was a greater risk than that on a building fitted for and occupied as a hospital, using the word “occupied” in the sense of some person or persons being in occupation. For this reason the case at bar was not brought within the rule of Goddard v. Monitor Mutual Fire Ins. Co.

Under these circumstances it is not necessary to consider the question whether the description of the building insured (“occupied as a contagious hospital”) is a statement that the building was occupied and not vacant, or was a statement that the building was appropriated to the uses of a contagious hospital. Upon that question we intimate no opinion.

At the trial the plaintiff asked for sixteen rulings set forth. The only exception taken by it is stated in these words in the bill of exceptions: “ The court in finding for the defendant did not specifically indicate which of these requests he refused or allowed except so far as the same are indicated by the finding, to all of which the plaintiff duly excepted.” We are of opinion that the only exception taken was to the refusal to make the rulings asked for.

The case was tried and has been argued on the basis that the facts shown in evidence by the plaintiff were true. Therefore the rule does not apply that ordinarily a finding in favor of the party who has the burden of proof cannot be directed as matter of law, as to which see Leary v. William G. Webber Co. 210 Mass. 68. Assuming the facts shown by the plaintiff to be true, the second ruling asked for by the plaintiff should have been given.

As we.have said, the judge made a general finding for the defendant without indicating which of the sixteen requests he refused or which he allowed, “except so far as the same are indicated by the finding.” For all that appears, therefore, the judge may have refused to give the second ruling asked for, and have found for the defendant because he thought that the defense stated above had been made out. Under these circumstances the exceptions must be sustained, even if the other defense relied upon by the defendant was made out and the requests in connection with it were refused properly. See in this connection Leverone v. Arancio, 179 Mass. 439; York v. Johnson, 116 Mass. 482; Kilberg v. Berry, 166 Mass. 488; Hagar v. Norton, 188 Mass. 47.

As the case must go back for a new trial, we consider the other question raised by the defense but not perhaps covered by the plaintiff’s requests for instructions, namely, that “the amount of loss had not been determined by agreement or arbitration, and such arbitration had not been waived.”

It is stated in the bill of exceptions that “the plaintiff properly rendered the defendant a statement in accordance with the requirement of the policy, wherein the plaintiff stated, among other things, that the building and contents were totally destroyed.” As we have said, the fire took place on April 22, 1907. In June, 1908, the defendant’s special agent wrote to the plaintiff’s attorney that the matter of this insurance had been “left entirely in the hands of our attorney, Mr. Brown.” On July 21, 1908, the defendant’s attorney, Mr. Brown, wrote to the plaintiff’s attorney: “My recollection of our conversation is quite clear that the company in terms declined to admit its liability to the city.” It is settled that if after proof of loss an insurance company denies its liability and does not seek to have the matter in dispute submitted to arbitration, the jury can find that fixing by arbitration the amount due has been waived, Lamson Consolidated Store Service Co. v. Prudential Fire Ins. Co. 171 Mass. 433, if, indeed, it is not waived under these circumstances as matter of law. See Willett v. Smith, 214 Mass. 494. In this connection see also Hayes v. Milford Mutual Fire Ins. Co. 170 Mass. 492.

Exceptions sustained.

The second ruling asked for was as follows: “The policy of insurance was in full force and effect on the date of the fire.”