A Tennessee woman whose terminally-ill husband burned down his house in an attempted suicide is not entitled to collect under policies for the house and autos destroyed in the fire.
The Tennessee Court of Appeals has upheld a lower court in agreeing that Tennessee Farmers Mutual Insurance Co. (TFMI) was right in denying the claims of Gladys Tuturea, who maintained that her husband, George, was insane when he set the fire and that she was neither a member of his household nor an insured under his policy at the time.
But the courts rejected psychiatric testimony that her husband was insane and concluded that she was effectively a resident and insured even though she sometimes lived in a separate residence.
George and Gladys Tuturea were a married couple who at times lived in separate houses located about one mile apart. Tennessee Farmers Mutual insured both homes as well as a Lincoln Town Car and a Dodge Ram.
Mrs. Tuturea had sought to recover under the three TFMI insurance policies for the loss of the residence, two vehicles, and personal property destroyed in the fire. After she was denied, she sought damages in excess of $300,000 as well as costs and attorney’s fees.
TFMI contended that Mr. Tuturea’s act was intentional and thus she should not recover for the loss. Mrs. Tuturea argued that the intentional acts exclusions of the policies did not apply because the fire was an accident.
Mrs. Tuturea alternatively argued that TFMI should be required to compensate her under the innocent coinsured doctrine. TFMI said that the innocent co-insured doctrine did not apply because the insurance policies clearly preclude recovery for the intentional acts of another insured.
In September 2004, Mr. Tuturea, who was suffering from terminal cancer, set fire to his house in an unsuccessful attempt to commit suicide. The home, personal property, and the two automobiles covered by the TFMI policies were destroyed.
The couple had a history of marital problems that led them to live in separate residences. However, at the time of the fire, Mrs. Tuturea had moved into Mr. Tuturea’s home to care for him in his illness. Mr. Tuturea subsequently died in December 2004.
TFMI denied insurance coverage for the loss of Mr. Tuturea’s house and the two automobiles on the grounds that the policies did not cover the losses because Mr. and Mrs. Tuturea were members of the same household and because the fire set by Mr. Tuturea was not “accidental” but intentionally set.
Mrs. Tuturea and a psychiatrist alleged that the fire set by Mr. Tuturea was accidental because he “suffered an insane attack prior to the fire and . . . his mental state remained that way for a period of time after the fire” and because he “was not in control of his actions due to his mental state.”.
TFMI also asserted there was no coverage under the policies because, at the time of the fire, Mr. Tuturea and Mrs. Tuturea were lawfully married residents of the same household and Mrs. Tuturea was an insured by definition under each policy.
Tuturea countered that she and Mr. Tuturea were not members of the same household where “[s]ometimes they would stay in the same house and at other times they would reside apart.”
She further claimed that the issue of whether she was an “insured” under the policy had “no bearing on whether or not there is coverage under the policies for the house. . . .” She claimed that the issue involved a determination of under which homeowner’s policy she was entitled to pursue her claim. She also claimed she was entitled to recover under the automobile policy, which excluded loss caused by the intentional act of a covered person because this policy also stated, “however the interest of the loss payee shown in the declarations shall not be invalidated by such act or omission by a covered person.”
TFMI argued that the innocent co-insured doctrine did not apply because the insurance policies unambiguously preclude recovery for the intentional acts of another insured.
In 2006, the trial court concluded that Mr. Tuturea intentionally burned the home and motor vehicles, that Mrs. Tuturea was a resident and an insured, and that the policies clearly showed that innocent coinsured doctrine did not apply.
On June 29, the Court of Appeals affirmed the trial court’s ruling in favor of TFMI in an opinion delivered by Justice David R. Farmer.
Was She a Resident?
The court said that evidence showed: (1) Mrs. Tuturea’s subjective or declared intent was to remain in the household for an indefinite period of time; (2) she was in a formal, married relationship with Mr. Tuturea; (3) she lived in the same residence as Mr. Tuturea at the time of the fire; (4) she made a voluntary choice to reside at that residence in order to care for her husband. Although Mrs. Tuturea maintained another place of lodging that she visited on occasion, the agreed with the trial court’s conclusion that Mrs. Tuturea was “without question” a resident of Mr. Tuturea’s household.
This determination that Mrs. Tuturea was a resident of Mr. Tuturea’s household produced the conclusion that Mrs. Tuturea was an insured under Mr. Tuturea’s homeowner’s policy at the time of the fire.
Was the Fire Intentional?
Mrs. Turturea would be entitled to recover fully if Mr. Tuturea did not intentionally burn the residence. However if Mr. Tuturea did intentionally burn the residence, the question of recovery would then turn on the application of the innocent co-insured doctrine.
Determining whether Mr. Tuturea intentionally set fire to his residence rested on whether he formed a conscious desire or objective to bring about the fire as a foreseen result of his actions. Mrs. Tuturea argued that Mr. Tuturea did not form a conscious desire or objective to bring about the fire because he was insane, had an acute break with reality, and was not in control of his actions when he set the fire. Expert testimony from Dr. J. Gerard Monette, suggested Mr. Tuturea may have been unable to form a conscious objective or desire to bring about a planned result.
But the courts rejected the psychiatrist’s testimony and noted that Mrs. Tuturea herself suggested that Mr. Tuturea had formed a conscious desire and objective to burn the house down prior to the fire when he threatened to do so in September, 2004, when he forced her to flee the house. Mrs. Tuturea rushed to neighbor’s home for help and exclaimed that “George [is] threatening to set fire to the house.” The court said that this statement showed that “burning of the house was not, as Mrs. Tuturea submits, unforeseen.” The Tutureas’ also neighbor testified that Mr. Tuturea specifically threatened to burn down the house in the month preceding the fire. Additionally, the court said the even the expert offered testimony that suggested Mr. Tuturea was mentally alert and oriented at the time of the fire.
Thus the court agreed with the conclusion that Mr. Tuturea intentionally burned the residence and found that TFMI was correct to apply the intentional acts exclusions of each policy in this case.
In her final plea, Mrs. Tuturea argued that she was entitled to recover under the “innocent co-insured” or “innocent spouse” doctrine. The innocent co-insured doctrine permits recovery for losses caused by the intentional acts of another insured if the policy, as the result of an ambiguity, does not inform the reasonable person purchasing insurance that an innocent co-insured will be held jointly responsible. The innocent co-insured doctrine has no application where an insurance agreement clearly and unambiguously excludes coverage for property loss resulting from the intentional acts of a co-insured, the court noted.
The appeals court agreed with the trial court’s conclusion that the innocent co-insured doctrine does not apply under the facts because the TFMI policies were unambiguous:
“The relevant provisions of the homeowner’s policies limit coverage to accidents that are neither expected nor intended by “an insured,” exclude any act other than accidental committed by or at the direction of “any insured,” exclude coverage “for anyone” regardless of the cause of the excluded event, and void coverage as to “all insureds” if “any insured” commits fraud, conceals material facts, et cetera. The automobile policy similarly limits coverage to accidental loss and excludes “any” loss caused by the intentional act or omission of, or at the direction of, a covered person.”
According to the court, “The policies clearly and unambiguously create joint responsibility between the insureds and exclude recovery by an innocent co-insured for intentional acts committed by another insured.”
Thus the language governing Mrs. Tuturea’s rights as an innocent co-insured was not ambiguous and she was not entitled to recover.
In his conclusion, Justice Farmer acknowledged some concern over this clause, however.
“We recognize that insurance companies have written policies in response to the proliferation of the innocent co-insured doctrine that often expressly exclude recovery by an innocent co-insured or, at the very least, more clearly impose joint responsibility on the coinsureds. An argument exists that these carefully written provisions return the relationship between insureds and the insurer to the former status quo previously deemed unacceptable, but it is not the duty of the judiciary to impose liability where none exists,” he wrote
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