08 Aug Dog Bites – An Interesting Recent Court Decision
It appears that each year, insurance carriers are paying out increasing dollars on dog-related injury claims. In fact, according to the Insurance Information Institute (Triple-I) and State Farm, U.S. insurers paid out more than $1 billion in dog-related injury claims in 2022.
A July 12 Insurance Journal article (below) discussed a court decision involving how a dog bite affected a person’s homeowners coverage. This was a Connecticut court decision, so it is impossible to state how this scenario would be handled in other jurisdictions.
“A Connecticut homeowner who is being sued by a woman who alleges his dog bit her in the face is not entitled to insurance coverage because his home insurance application, which was completed by his insurance agent, indicated he did not have a dog.
Providence Mutual Fire Insurance Co. declined to defend Waterbury resident Antonio Laires against the dog bite lawsuit on the grounds that the policy was voided because the misrepresentation regarding the dog was material. Had it known he had a dog, the insurer said it would not have issued the policy.
Laires told the court that the application was completed by his insurance agent, and he was unaware that the application indicated that there were no animals at the premises when he electronically signed it. Because he was unaware that the application was inaccurate, he did not fail to disclose any material facts to plaintiff, Laires argued.
U.S. District Judge Kari A. Dooley in Connecticut last week granted Providence Mutual summary judgment, holding that the insurer has neither a duty to defend nor to indemnify because of the material misrepresentation. The judge also found that the homeowner had a responsibility to read the policy that his agent procured before signing it.
Dooley’s ruling does not suggest or offer any opinion as to whether Laire’s allegations implicate liability for the insurance agent with respect to his duties to Laire.
The policy incorporates “Special Provisions for Connecticut,” which include that Providence Mutual would not provide coverage to an insured who concealed or misrepresented any material fact or circumstance; engaged in fraudulent conduct; or made materially false statements relating to insurance. Under the policy, a material representation is one where, had the insurer known the truth, it would not have issued coverage.
In Connecticut, the judge noted, an insurer has a right to rescind coverage for a material misrepresentation in an insurance application if it is not an innocent misrepresentation, but one “known by the insured to be false when made.”
Providence Mutual said that when an insured indicates there is an animal or exotic pet kept on the premises, it sends the applicant a questionnaire seeking more information about the animal or pet. Whether to issue a policy and what premiums to charge depend on the answers received.
According to court documents, Laires acknowledged that he purchased his dog in January 2017 and that he kept the dog at his home through November 2019, when he submitted the home insurance application. The question on the application asked whether there were any animals or exotic pets kept on the premises, to which the application indicated, “N,” or “no.”
Laires told the court that he did not knowingly make such a misrepresentation because his insurance agent filled out the application and did not supply him with the entire document.
Judge Dooley was not persuaded by his story. “Under Connecticut law a person may not claim that a misrepresentation is innocent solely because the person failed to read the application before signing it. The law requires that the insured shall not only, in good faith, answer all the interrogatories correctly, but shall use reasonable diligence to see that the answers are correctly written,” she wrote, citing past cases.
Here, Laires signed the application, acknowledging that its contents were true and accurate. “Whether or not he personally reviewed the answers or checked for their accuracy is of no consequence,” the judge stated, adding that where a “person of mature years who can read and write, signs or accepts a formal written contract affecting his pecuniary interests, it is his duty to read it and notice of its contents will be imputed to him if he negligently fails to do so.”
Moreover, the judge found his argument that his broker is responsible for the inaccuracy to be without merit. “An insurance broker is the agent of the insured in obtaining an insurance policy. As such, the broker owes a duty of care to the principal,” she noted.
The insurance agent signed the application, attesting that he was Laire’s authorized representative, and that he made a reasonable inquiry to procure the answers to the questions. The essence of the agency relationship is the “manifestation of consent by one person to another that the other shall act on his behalf and subject to his control, and consent by the other to so act,” the opinion concludes.”
It might be worth discussing at your next staff meeting to see how your agency handles this type of issue.