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Smart Summary

Factual and Procedural Background

Lyndon Matthews, a co-owner and occupant of a dwelling insured by Lafayette Insurance Company, intentionally shot plaintiff during a confrontation over a personal debt on the insured premises. The dwelling was originally purchased by Charles Matthews, who procured insurance and paid premiums through his mortgage payments. After Charles Matthews died, Lyndon Matthews and his siblings were recognized as owners of the property. Lafayette issued a dwelling insurance policy naming "Matthews Charles Est." as the insured, a non-entity, while Lyndon Matthews paid premiums and lived in the dwelling.

Plaintiff filed suit against Matthews and Lafayette, seeking coverage under the landlord premises liability endorsement of the dwelling insurance policy. Lafayette denied coverage, arguing that Matthews was not an insured under the policy and that the injury did not arise from the condition or use of the premises. The trial court granted summary judgment in favor of Lafayette, which was affirmed by the court of appeal on the basis that the injury resulted from a personal dispute unrelated to the premises. The Louisiana Supreme Court granted certiorari to review the lower courts' decisions.

Legal Issues Presented

  1. Whether Lyndon Matthews qualifies as an "insured" under the landlord premises liability endorsement of the Lafayette dwelling insurance policy, despite the named insured being listed as "Matthews Charles Est."
  2. Whether the landlord premises liability endorsement provides coverage for injuries caused by intentional acts of an insured occurring on the insured premises, specifically whether coverage is limited to injuries arising out of a defect, condition, or use of the insured premises or if it extends to other injuries related to the premises.

Arguments of the Parties

Applicant (Plaintiff's) Arguments

  • The policy did not restrict liability coverage to bodily injury arising out of a defect or hazardous condition of the premises or the insured's use of the premises.
  • The phrase "only with respect to the insured premises" can reasonably be interpreted to include injury-causing acts of the insured occurring on or connected with the insured premises.
  • The insurance contract should be interpreted in favor of coverage when ambiguous.
  • Lyndon Matthews was effectively a named insured despite the policy listing a non-entity as the named insured, and the policy should be reformed to reflect the parties' clear intent.

Respondent (Lafayette Insurance Company) Arguments

  • Lyndon Matthews was not an insured under the premises liability coverage because the named insured was "Matthews Charles Est."
  • The liability coverage is limited to injuries causally related to the premises, such as those resulting from defects or negligent maintenance, and does not cover intentional acts unrelated to the premises' condition or use.
  • The injury did not arise out of the condition or use of the insured premises, but from a personal dispute, thus falling outside the scope of coverage.

Table of Precedents Cited

Precedent Rule or Principle Cited For Application by the Court
Central Louisiana Electric Co. v. Westinghouse, 579 So.2d 981 (La. 1991) Clear and unambiguous insurance policy language must be enforced as written. The court applied ordinary contract principles to interpret the insurance policy.
Breland v. Schilling, 550 So.2d 609 (La. 1989) Ambiguous provisions in insurance contracts are construed in favor of coverage to the insured. The court construed ambiguous policy language in favor of coverage.
State of Louisiana, Department of Transportation and Development v. Estate of Davis, 572 So.2d 39 (La. 1990) Named insured designation and its effect on coverage. Used to support the conclusion that Matthews was effectively a named insured despite the non-entity designation.
Richard v. United States Fidelity Guaranty Co., 247 La. 943, 175 So.2d 277 (1965) Reformation of insurance policies to reflect the parties' true intent. The court reformed the policy to recognize Matthews as a named insured.
Lawhorn v. State Farm Insurance Cos., 560 So.2d 619 (La. 4th Cir. 1990) Policy reformation and interpretation consistent with parties' intent. Supported the reformation of the policy to include Matthews as a named insured.
Taylor v. Audubon Insurance Co., 357 So.2d 912 (La.App. 4th Cir. 1978) Policy interpretation and insured status. Used as precedent for recognizing insured status despite nominal policy language.
Diaz v. Cherokee Insurance Co., 275 So.2d 922 (La.App. 4th Cir. 1973) Insurance contract interpretation and insured designation. Supported the court’s approach to insured status and policy interpretation.
Jackson v. Lajaunie, 270 So.2d 859 (La. 1973) Interpretation of similar policy language "in connection with" and coverage exclusions. The court distinguished this exclusion case from the present coverage case, analyzing the phrase "with respect to" in the policy.

Court's Reasoning and Analysis

The court began by interpreting the insurance policy under ordinary contract principles, enforcing clear and unambiguous language as written but construing ambiguities in favor of coverage. The court found that although the named insured was designated as "Matthews Charles Est.," a non-entity, the parties clearly intended Lyndon Matthews, the co-owner and occupant who paid premiums, to be the insured. Therefore, the policy was reformed to recognize Matthews as a named insured.

The court then analyzed the phrase "only with respect to the insured premises" in the landlord premises liability endorsement. Lafayette argued this phrase limited coverage to injuries causally related to defects or conditions of the premises, while plaintiff argued it limited coverage to acts occurring on or connected with the insured premises. The court noted that "with respect to" generally means "relating to" or "pertaining to," requiring some connection to the insured premises but not necessarily causation by a defect or use of the premises.

The court distinguished the present case from Jackson v. Lajaunie, which involved an exclusion clause interpreted narrowly against exclusion, whereas the present case involved a coverage provision interpreted liberally in favor of coverage. The court found no policy language restricting coverage to injuries arising from defects or use of the premises.

Because the injury occurred on the insured premises, with both parties present there, and the gun used was kept on the premises, the court concluded that the injury was broadly related to the premises. Thus, the coverage applied "with respect to" the insured premises, and the denial of coverage was improper.

Holding and Implications

The court reversed the judgments of the lower courts, denied the motion for summary judgment by Lafayette, and remanded the case for further proceedings.

Holding: Lyndon Matthews is a named insured under the dwelling insurance policy, and the landlord premises liability endorsement provides coverage for injuries caused by him "with respect to" the insured premises, including the intentional shooting incident at issue.

Implications: The decision directly affects the parties by reinstating coverage under the policy for Matthews’ liability. No new precedent was established beyond the interpretation of the specific policy language and the reformation of the named insured designation to reflect the parties’ intent.

FREDERICK SMITH, JR. v. LYNDON S. MATTHEWS, ET AL.

LEMMON, Justice.

The issue in this case is whether the landlord premises liability endorsement in the dwelling insurance policy issued by Lafayette Insurance Company provides coverage for the liability of Lyndon Matthews, a co-owner and an inhabitant of the insured dwelling who intentionally shot plaintiff in a confrontation over a personal debt.

Lyndon Matthews' father, Charles Matthews, bought the pertinent dwelling in 1978 and procured dwelling insurance in accordance with the requirements of the mortgagee. Charles Matthews paid to the mortgagee the monthly mortgage payments which included a prorated insurance premium, and the mortgagee paid the annual premium to the insurer.

Charles Matthews died in 1984, and Lyndon Matthews was appointed as executor of the estate. The judgment of possession, rendered in 1984, recognized Lyndon Matthews and his two siblings as the owners of the pertinent immovable property, the father having been judicially separated at the time of his acquisition of the property.

On September 27, 1986, Lafayette issued a dwelling policy, at the request of Lyndon Matthews, insuring the pertinent property and listing the named insured as "Matthews Charles Est." This policy replaced the policy obtained by Charles Matthews which expired on the same date. Lyndon Matthews, who lived in the dwelling on the property, paid the monthly mortgage payments which included the insurance premium. Lafayette renewed the policy in 1987 with "Matthews Charles Est." again listed as the named insured.

The Landlord Premises Liability Endorsement in the Lafayette policy provided premises liability coverage which obligated Lafayette to pay, up to its limits of liability, the damages for which the insured is legally liable when "a claim is made or a suit is brought against any insured for damages because of bodily injury or property damage to which this coverage applies." (emphasis added.) The endorsement defined "insured" as:

The liability coverage language in Lafayette's policy is virtually identical to that in a standard homeowner's policy. See 1 George J. Couch, Cyclopedia of Insurance Law § 1:61 (2d ed. 1984). However, the Lafayette policy did not contain an intentional act exclusion which is usually found in homeowner's policies. Moreover, the restricted definition of "insured" sets off Lafayette's policy from a typical homeowner's policy.

a. An individual shown in the declarations as a named insured or the husband or wife of such an insured, but only with respect to the insured premises.

b. A member of a partnership or joint venture which is a named insured; but you are an insured only with respect to your liability as such and only with respect to the insured premises.

c. An executive officer, director or stockholder of an organization that is a named insured; but you are an insured only with respect to your duties as such and only with respect to the insured premises.

d. A person (other than an employee of the named insured) or organization while acting as a real estate manager for a named insured. (emphasis added.)

On December 21, 1987, plaintiff went to the insured dwelling to collect a personal debt owed by Lyndon Matthews. As a result of the ensuing confrontation, Matthews shot plaintiff several times.

Plaintiff filed this action against Matthews and Lafayette, seeking to hold Lafayette liable for Matthews' tort under the premises liability endorsement in the dwelling policy. Lafayette denied coverage for the shooting incident on the basis (1) that Lyndon Matthews was not an insured under the premises liability coverage and (2) that the incident did not relate to the condition or use of the building.

The trial court granted Lafayette's motion for summary judgment, dismissing plaintiff's action as to Lafayette. The court of appeal affirmed, holding that the injury "did not grow out of a defect, condition or use of the insured premises," but resulted from a personal dispute unrelated to the premises. 592 So.2d 427, 428. Concluding that the policy was intended to provide coverage for liability for injuries arising out of a condition, defect or use of the insured premises, the court observed that "[t]he only connection with the premises is that the act occurred on the insured property." Id.

This court granted certiorari to review the decision of the lower courts. 599 So.2d 318.

An insurance policy is an agreement between the parties and should be interpreted by using ordinary contract principles. If the language in an insurance contract is clear and unambiguous, the agreement must be enforced as written. Central Louisiana Electric Co. v. Westinghouse, 579 So.2d 981 (La. 1991). However, any ambiguous provisions in an insurance contract must be construed in favor of coverage to the insured and against the insurer who issued the policy. Breland v. Schilling, 550 So.2d 609 (La. 1989).

The Dwelling Policy in this case provided coverage to the insured for loss resulting from property damage caused by fire, lightning and other perils. The Landlord Premises Liability Endorsement provided additional coverage for premises liability to "any insured" who was legally liable for a claim for damages because of bodily injury "to which this coverage applies." The policy, as plaintiff correctly argues, did not by its terms restrict the applicability of the liability coverage to bodily injury which arises out of a defect or hazardous condition on the premises or out of the insured's use of the premises. However, the policy did restrict liability coverage to an "insured," as defined under that coverage in the policy, and further provided that liability coverage to such an insured was "only with respect to the insured premises."

Lyndon Matthews was effectively a named insured under the policy. There was no entity listed as the named insured, inasmuch as "Matthews Charles Est." was a non-entity. Compare State of Louisiana, Department of Transportation and Development v. Estate of Davis, 572 So.2d 39 (La. 1990). Lyndon Matthews purchased this insurance for his own benefit (and perhaps for the benefit of his siblings), and he paid the premiums. Lafayette's agent knew that Lyndon Matthews was the co-owner of the insured premises who was to benefit from the policy coverages. Indeed, Lafayette's agent knew that Charles Matthews was dead, that his estate was not the proper named insured and that someone other than the designated "named insured" was to be the covered person. If Lyndon Matthews, the co-owner and occupant, had been designated as the named insured instead of a non-entity, that designation apparently would have made no difference to Lafayette as to premiums or policy terms and conditions. Under such circumstances the insurer may not invoke the designation of the estate (rather than the succession representative/heir) as the named insured to defeat the heir's rights under the policy. See 5A John A. Appleman Jean Appleman, Insurance Law and Practice § 3338 (1970). The parties clearly intended for Lyndon Matthews to be the named insured (or one of the named insureds), and the policy must be reformed to conform with the clear intent of the parties. Richard v. United States Fidelity Guaranty Co., 247 La. 943, 175 So.2d 277 (1965); Lawhorn v. State Farm Insurance Cos., 560 So.2d 619 (La. 4th Cir. 1990); Taylor v. Audubon Insurance Co., 357 So.2d 912 (La.App. 4th Cir. 1978); Diaz v. Cherokee Insurance Co., 275 So.2d 922 (La.App. 4th Cir. 1973); 15 William S. McKenzie H. Alston Johnson, Louisiana Civil Law Treatise, Insurance Law and Practice § 5 (1986). Unless Matthews is recognized as the named insured, the policy had no named insured. Such a result is untenable, especially in view of the clear intent of the parties in entering into the insurance contract. We therefore conclude that Lyndon Matthews was a named insured under the policy.

The agent admittedly knew Matthews for six years and also knew his occupation and marital status.

The liability coverage provided to Matthews as a named insured under the premises liability endorsement was expressly applicable "only with respect to the insured premises." This case therefore turns on the interpretation of the quoted phrase. Lafayette contends that the phrase limits liability coverage to injuries causally related to the premises, such as injuries resulting from a defect in the steps or a negligently maintained floor covering. On the other hand, plaintiff contends that the phrase limits liability coverage to injury-causing acts of the insured occurring on or connected with the insured premises, as contrasted to other places. Plaintiff argues that the limitation at least can be reasonably interpreted in that manner and invokes the maxim that a coverage provision in an insurance policy which can be reasonably interpreted in two ways must be construed in the way most favorable to coverage.

The phrase "with respect to" generally means "with reference to", "relating to", or "pertaining to." 46 Words and Phrases, "With Respect to", 202 (1970). The policy therefore provided Matthews with liability coverage only for activities with reference to or relating or pertaining to the insured premises.

In Jackson v. Lajaunie, 270 So.2d 859 (La. 1973), this court considered a similar phrase, "in connection with," in the context of a homeowner's policy insuring payment of "damages because of bodily injury," but excluding applicability of coverage to "any act or omission in connection with premises, other than [the insured premises]," which are "owned, rented or controlled by any insured." The insured, a service station owner negligently shot a customer with a pistol in the course of a practical joke at the station. The customer sued the owner's homeowner's insurer. This court applied the quoted exclusion, reasoning that "in connection with" is broader terminology than "arising out of". The court declined to limit the exclusion to injuries caused by defects on the premises, noting that the policy language did not limit the exclusion to injury incurred because of the condition of the premises. The court observed that the injury-causing act was "linked to the station, associated with the station, related to the station and, in the absence of a new and restrictive definition of an old and well understood word, connected with the station." Id. at 864.

The Jackson case involved interpretation of an exclusion from coverage which generally is construed narrowly against exclusion. The present case involves interpretation of a coverage provision which generally is construed liberally in favor of coverage.

Nowhere in the Lafayette policy is the liability coverage restricted to injuries arising out of the insured premises or caused by a condition, defect or use of the insured premises. The broader terminology providing coverage "with respect to" the insured premises does not necessarily limit coverage to injuries caused by premises defects or arising out of the use of the premises, but only requires some connection with or relation to the insured premises as opposed to any other location.

The personal liability coverage of a typical homeowner's policy generally covers the insured's liability for injuries occurring on the insured premises, whether or not the injury arises out of the premises. See Breland v. Schilling, 550 So.2d 609 (La. 1989). However, such a policy typically excludes activities such as business pursuits, professional services and use of motor vehicles, and further excludes injuries arising out of any premises owned or rented by an insured which is not an insured location. See George J. Couch, supra, at 164. The latter exclusion, which is apparently designed to require an insured to cover specifically all owned or rented premises, is the type of language by which Lafayette might have accomplished the position for which it now argues.

In the present case the injury occurred on the insured premises. The tort victim was at the insured premises because the insured lived there, and both parties were present on the premises when the injury occurred. The gun which produced the injury was kept by the insured on the insured premises, apparently for the protection of the premises and of the insured while he was there. Although the injury did not arise out of the use of the premises and was not caused by a premises defect, the injury was broadly related to the premises. The coverage, therefore, can reasonably be construed under the circumstances as applicable "with respect to" the insured premises, as contrasted to acts of the insured occurring on or with respect to locations away from the insured premises.

Accordingly, the judgments of the lower courts are reversed, the motion for summary judgment is denied, and the case is remanded to the district court for further proceedings.

COLE, J., respectfully dissents and would affirm for reasons assigned by the Court of Appeal.

MARCUS, J., dissents and assigns reasons.

[26] MARCUS, Justice, dissenting.

I accept the majority's finding that defendant is a named insured under the policy. However, since the insured was covered "only with respect to the insured premises," I am unable to say that the shooting incident in which plaintiff was injured falls within this coverage. The clear intent behind this provision was to provide coverage for liability for injuries arising out of a condition, defect or use of the insured premises. By its very nature, such a provision excludes coverage for intentional acts by the insured which have no connection with the insured property other than simply occurring on the property. Accordingly, I would affirm the judgment of the trial court granting summary judgment in favor of the insurer.

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SMITH v. MATTHEWS
(Feb 18, 1993)