By David W. White
A pair
of automobile insurance decisions by the Supreme Judicial Court in December
1998 promises to reshape bodily injury cases in a number of ways. In Lazaris
v. Metropolitan Property & Casualty Insurance Company, 428 Mass. 502
(1998), and Premier Insurance Company of Massachusetts v. Furtado,
428 Mass. 507 (1998), the Supreme Judicial Court completely dispatched the
principles set forth in Thaler v. The American Ins. Co., 34 Mass.
App. Ct. 639 (1993), and assured automobile insurers that they may, indeed,
terminate their legal defense of their insureds after tendering the policy
limits.
A
little history helps put these current events in perspective. In 1992 and
1993, the Appeals Court took up the mirror issues. The first of the two
cases considered by that court was Aetna Casualty & Surety v.
Sullivan, 33 Mass. App. Ct. 154 (1992). The central issue in the case
was whether the insurer's duty to defend its insured was terminated by the
tendering of the policy limits to the third party claimant. The insurer
wisely sought a declaratory judgment on the questions, but received
disheartening news from the court: Under the Fifth Edition policy then in
existence, the duty to defend did not end with the payment of the policy
limits. Indeed, the court ruled that the duty to defend under the policy
continued until the matter had been settled or a judgment had been rendered,
and after the policy limits had been paid to satisfy some or all of those
obligations.
In the
following year, the Thaler case was considered. In Thaler the
Appeals Court concluded that, if liability were undisputed, and the
claimant's damages clearly exceeded the policy limits, it would be a
violation of G.L. c. 93A for the insurer to insist upon a release before
tendering the policy limits. The reasoning of the court was twofold: The
court noted the duty imposed upon insurers by G.L. c. 176D, § 3(9)(f),
which requires insurers to "effectuate prompt, fair and equitable
settlements of claims" when liability is reasonably clear. Id. at 642.
In addition, the court reasoned, under the Sullivan case, the duty to defend
the insured did not end with the tender of the policy; the insured would
still be entitled to continuing representation. Id.
The Thaler
court was apparently unmindful of the fact that between Sullivan and Thaler
the insurance policy had been changed. Under the Sixth Edition policy
approved by the Insurance Commissioner in January 1993, the language
regarding the termination of legal representation after tender of the policy
limits was amended. The new policy more clearly articulated the intent of
the automobile insurers, to wit: The duty to defend ends with the tender of
the policy limits.
Thaler
rather quickly made its mark. In many cases where the liability was
undisputed, and the damages clearly exceeded the policy limits, the policy
limits were paid out. Thaler was utilized in contexts outside of the
automobile insurance arena, and was applied to other liability policies as
well. A few insurers, however, chose to lay the groundwork for the reversal
of Thaler. Choosing their cases carefully, the insurers denied Thaler
payments. Cases which were "groomed" for appeals included those
where there was some contest over liability or damages, as well as those in
which liability was perfectly clear, and the damages did exceed the policy
limits. Avoided, however, were the cases which had astronomical damages,
which might expose the insurer to significant bad faith damages should the
courts not reverse Thaler. Interestingly, at the same time, most
insurers were not gambling on the Sixth Edition amendments. Instead, they
continued to defend their insureds, even if they made policy limits payments
under Thaler.
A
number of trial court decisions applied the Thaler principles. A
common refrain in many of these cases was the argument by the insurance
companies that Sullivan had provided the underpinning for Thaler, and
that support had been removed by the insurance policy amendments in 1993.
This argument was not persuasive. There were clarifications to the Thaler
doctrine, but these focused, for example, on interpretations of the phrase
"uncontested liability."
Indeed, the vitality of Thaler seemed strong as a few cases rose to
the appellate courts on G.L. c. 93A issues. In Clegg v. Butler, 424
Mass. 413 (1997), the Supreme Judicial Court cited Thaler with
approval when it discussed the duty of insurers to effectuate settlements
pursuant to G.L. c. 176D, § 3(9)(f). Clegg at 419. The Supreme
Judicial Court also appeared to affirm the rule of Thaler when it
affirmed the award of G.L. c. 93A damages against an insurer which had
demanded a release before tendering policy limits under circumstances when
liability was undisputed and damages greatly exceeded the policy limits. Kapp
v. Arbella Mutual Insurance Company, 426 Mass. 683 (1998).
Ten
months later, the Supreme Judicial Court reversed this apparent tide. The
first of its two cases was Lazaris, which involved a disputed
liability situation. In brief, the plaintiff was a pedestrian who was hit by
Metropolitan's insured while crossing a street. The trial judge allowed
summary judgment for the insurer, ruling that liability was not even
reasonably clear, and that a good faith basis existed for disputing
liability. The Supreme Judicial Court agreed with the judge's conclusion,
and that affirmation could easily have provided a fitting end to the appeal.
Nevertheless, the court, mindful of similar issues pending on the
interpretation of G.L. c. 176D, § 3(9)(f), seized the opportunity to
overrule Thaler.
The key word
in the court's analysis was "settlement." The court reasoned that
a case could not be "settled" without a release. The court
expressed its concern that, "On one side, the company may be sued for
unfair settlement practices by a claimant disgruntled by the company's
failure to pay, and, on the other side, the company may be sued by an
insured disgruntled by the company's payment of the policy limit without
obtaining a release. We do not construe G.L. c. 176D, § 3(9)(f), to place
insurers in such a position." Hence, the end of the Thaler
doctrine.
The
rationale for Lazaris was in some measure belied, however, by the Furtado
decision, which was the next opinion of the court. Furtado concerned
a demand by an insurer for releases of both of its insureds. The underlying
accident was caused by the wife, who was operating the car owned by her
husband, the insured. She was clearly at fault, having been intoxicated, and
having pled guilty to two counts of motor vehicle homicide. The policy was
for only $40,000, which was paid into court. The insurer denied liability
under Thaler, but sought declaratory judgment that it could abandon
the defense of the case after paying its policy limits. The trial court
found a violation of G.L. c. 93A, § 2, but found no bad faith, and awarded
the interest on the funds held in escrow, the actual damages, or the nominal
damages under c. 93A
The
insurer had not challenged the Thaler rule in the Superior Court, and
though the Supreme Judicial Court declined to "accept" the belated
challenge, it nevertheless discussed the application of Thaler to the
facts of the case. The court resolved generally that an insurer can avoid
liability under G.L. c. 93A if it (1) "has a reasonable and good faith
belief that it is not obliged to make a payment to a claimant" who is
asserting a G.L. c. 93A violation; (2) asserts that point; and (3) offers to
take active steps to resolve that dispute. Under these circumstances, the
company will be relieved of bad faith liability, even if its interpretation
of the law proves incorrect. Id. at 510, citing Boston Symphony
Orchestra, Inc. v. Commercial Union Ins. Co., 406 Mass. 7, 14-15 (1987),
and Gulezian v. Lincoln Ins. Co., 399 Mass. 606, 613 (1987). These
cases should be compared to the case of DiMarzo v. American Mutual
Insurance Company, 389 Mass. 85 (1983), in which the company's
misinterpretation of the policy was found to be unreasonable and in bad
faith. In DiMarzo, the insurer did not seek a declaratory judgment on
its policy interpretation, and it ignored opinions from the Department of
Insurance that were contrary to its position on the policy language.
More
important, however, the Furtado court affirmed the trial court's
ruling that Premier had no continuing duty to defend its insured, after it
paid its policy limits into court. This confirmation of the Sixth Edition
policy language received, remarkably, not one word of discussion, though it
potentially opens the flood gates for abandonment of the defense of insureds
at the reasonable discretion of the insurer.
The
combined effect of these two decisions is greatly harmful to the interests
of claimants and insureds. Injured third party claimants have lost access to
prompt payments of insurance policy limits even when liability is undisputed
and the damages exceed the policy limits. Insureds have lost the right to
compel the insurance company to continue its defense of a claim. All of the
options have been shifted to the insurance companies, which have been
awarded wide discretion as to when to tender policy limits. In a manner, Thaler
payments will still be made, but only when the insurance companies decide to
do so. Neither the interests of the claimants nor of the insureds will
govern the timing of the payments.
What
will the likely fallout be in terms of G.L. c. 93A and the duty to defend
under the Sixth Edition policy? While a third party claimant can no longer
demand policy limits without a release, other theories of damages for bad
faith litigation practices are left in place. In those cases in which the
insurer causes a judgment to be entered against its insured as a result of
bad faith settlement practices, and the judgment exceeds the policy limits,
the insurer will still face the prospect of multiple damages claims pursuant
to the well-established principles set forth in DiMarzo. In addition,
when a judgment has been entered against an insured, and the judgment
resulted from the bad faith settlement practices (for example, a low-ball
offer), the measure of damages will be the amount of the judgment itself,
without regard to the limits of the insurance policy, pursuant to G.L. c.
93A, § 9, as amended by St. 1989, c. 580. Absent a judgment, an insurance
company will be liable for actual damages, typically the loss of the use of
money, which was caused by any of its bad faith settlement practices.
One
can reasonably expect the next wave of first party G.L. c. 93A litigation to
focus on the question of whether policy limits were tendered in good faith
when an insurer decides it no longer wishes to defend a case. Although the
Sixth Edition policy language would seem to offer a green light to insurers
who wish to avoid defense obligations in cases where the cost of litigation
might easily exceed the policy limits, there is not yet a definitive
guideline that they may do so. A duty to an insured may still exist. This
duty was described in Thaler as follows:
While the policy in this case
did not expressly provide that American [Insurance Co.] require a release
from a claimant before payment of the policy limits, implicit in every
contract between an insurer and the insured is a covenant of good faith
and fair dealing. Murach v. Massachusetts Bonding & Ins. Co.
339 Mass. 184, 186-189 (1959). DiMarzo v. American Mut. Ins. Co.,
389 Mass. 85, 97 (1983). In determining the scope of this obligation, the
understanding or expectations of an objectively reasonable insured can be
considered. Hazen Paper Co. v. Unitied States Fid. Guar. Co., 407
Mass. 689, 700 (1990). Aetna Cas. & Sur. Co. v. Sullivan, 33
Mass. App. Ct. at 156. Ordinarily, because the payment of policy limits to
a claimant removes a potential incentive for a claimant to settle with an
insured, an insured arguably might expect that an insurer's covenant of
good faith and fair dealing would require the insurer to obtain a release
before paying out the limits of the coverage purchased. See Murach v.
Massachusetts Bonding & Ins. Co., 339 Mass. at 187 (good faith
requires an insurer in deciding whether to settle or try a case to act as
if no policy limits were applicable to the claim).
The history of G.L. c. 93A
cases has shown that the Massachusetts courts are reluctant to expand
remedies against insurance companies in favor of third party claimants or
even first party insureds. The Lazaris and Furtado cases certainly fit well
within that historical framework. The unfortunate losers are Massachusetts
consumers.