Case Title: Dorchester Mutual Insurance Co. v. Krusell

Citation: 

Docket Number: SJC-12856

State: massachusetts

Court: Massachusetts Supreme Court

Date: 2020-08-13T00:00:00Z

Document:
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SJC-12856 
 
DORCHESTER MUTUAL INSURANCE COMPANY  vs.  TIMOTHY KRUSELL 
& others.1 
 
 
 
Norfolk.     April 6, 2020. - August 13, 2020. 
 
Present:  Gants, C.J., Lenk, Lowy, Budd, Cypher, & Kafker, JJ. 
 
 
Insurance, Homeowner's insurance, Construction of policy, 
Insurer's obligation to defend, Coverage, Settlement of 
claim.  Consumer Protection Act, Unfair act or practice, 
Insurance, Offer of settlement.  Words, "Physical abuse." 
 
 
 
 
Civil action commenced in the Superior Court Department on 
November 12, 2015. 
 
 
The case was heard by Thomas A. Connors, J., on motions for 
summary judgment. 
 
 
The Supreme Judicial Court on its own initiative 
transferred the case from the Appeals Court. 
 
 
Charles S. Beal for the defendants. 
Kevin M. Truland for the plaintiff. 
Kathy Jo Cook, Thomas R. Murphy, Kevin J. Powers, J. 
Michael Conley, & John T. Ford, for Massachusetts Academy of 
Trial Attorneys, amicus curiae, submitted a brief. 
 
 
                     
 
1 Michele K. Krusell and Peter W. Krusell. 
2 
 
 
 
LENK, J.  At issue in this case is whether a homeowners' 
insurance policy issued by Dorchester Mutual Insurance Company 
(Dorchester Mutual) to the parents2 of Timothy Krusell requires 
Dorchester Mutual to indemnify the Krusells in a personal injury 
suit.  The principal question we must resolve is the scope of an 
exclusion in that policy precluding coverage for "[b]odily 
injury . . . arising out of sexual molestation, corporal 
punishment or physical or mental abuse," and whether it applies 
where, as here, Krusell pushed Robert Christian Haufler during a 
conversation on a public sidewalk, causing him to fall and 
sustain serious injuries. 
 
Haufler commenced a personal injury action in the Superior 
Court against the Krusells.  Arguing that Krusell's conduct was 
a form of "physical abuse" for which coverage was unavailable, 
Dorchester Mutual sought a declaratory judgment that it had no 
duty to indemnify the Krusells for Haufler's personal injury 
claims.  The Krusells responded that because the term "physical 
abuse" is ambiguous, the "abuse and molestation" exclusion did 
not preclude coverage.  They maintained as well that Dorchester 
Mutual's refusal to engage in settlement talks constituted an 
unfair settlement practice in violation of G. L. c. 93A and 
                     
 
2 Because the defendants share a last name, we refer to 
Timothy Krusell's parents individually by their first names, and 
to the defendants collectively as "the Krusells." 
3 
 
 
G. L. c. 176D.  A Superior Court judge concluded that the 
exclusion precluded coverage and granted Dorchester Mutual's 
motion for summary judgment.  The judge also determined that 
Dorchester Mutual's refusal to enter into settlement discussions 
did not violate G. L. c. 93A and G. L. c. 176D. 
 
We conclude that the term "physical abuse," as used in the 
policy, is ambiguous, but that a reasonable insured would 
interpret the term as not precluding coverage for Haufler's 
claim.  Accordingly, the order granting summary judgment in 
favor of Dorchester Mutual with respect to its duty to indemnify 
the Krusells was error and must be reversed.  We discern no 
error, however, in the allowance of summary judgment on so much 
of the Krusells' cross claim as asserted violations of G. L. 
c. 93A and G. L. c. 176D.3 
 
1.  Facts.  We recite the facts in the light most favorable 
to the Krusells as the nonmoving party.  See Premier Capital, 
LLC v. KMZ, Inc., 464 Mass. 467, 474-475 (2013). 
 
a.  The incident.  At approximately 12:30 A.M on September 
13, 2014, Krusell, then twenty-three years old, and a college 
friend were walking in downtown Newport, Rhode Island.  They 
struck up a conversation with Haufler, then sixty-two, and his 
companion; Haufler's companion and Krusell's friend were 
                     
 
3 We acknowledge the amicus brief of the Massachusetts 
Academy of Trial Attorneys. 
4 
 
 
acquaintances, but Krusell and Haufler had never met.  Krusell 
and Haufler were discussing a record-breaking swordfish Haufler 
said he had caught, about which Krusell expressed some 
skepticism.  While the events immediately preceding the push are 
disputed, it is uncontested that, at some point, Krusell pushed 
Haufler, causing him to lose his balance and fall onto a parked 
automobile before striking the pavement.4  Krusell ran from the 
scene after Haufler hit the vehicle, purportedly to avoid 
getting into a fight, and did not see Haufler fall to the 
ground.  Haufler suffered broken bones and other injuries 
requiring hospitalization, which ultimately resulted in 
permanent damage to his right arm. 
 
In October of 2014, Haufler filed a civil complaint against 
Krusell asserting negligence, reckless indifference, intentional 
infliction of emotional distress, and assault and battery.  
Krusell's parents were joined in their capacity as cotrustees of 
                     
 
4 Krusell asserted that he was surprised when Haufler, who 
was standing two feet away, raised his cellular telephone to 
Krusell's face to show him a photograph of the fish, and that 
Krusell instinctively pushed the device away from his face, 
causing Haufler to lose his balance.  Haufler, in contrast, 
reported that Krusell had been sitting on a wall approximately 
five to six feet away from Haufler and the other men when 
Krusell overheard Haufler's account of setting a State record 
for catching swordfish.  Krusell said, "That's not your fish," 
stood up, walked slowly, and then ran at Haufler, body slamming 
him with both fists out, causing Haufler to fly through the air. 
5 
 
 
a real estate trust in which Krusell held a beneficiary interest 
(the family home).5 
 
b.  Claim settlement.  Dorchester Mutual agreed to defend 
the claim under a reservation of rights, citing a coverage 
exclusion in the Krusells' policy for intentional acts 
(intentional acts exclusion).6  The Krusells sought to settle the 
claim with Haufler, and repeatedly urged Dorchester Mutual to 
participate in settlement negotiations.  Dorchester Mutual 
declined to do so, on the ground that it had insufficient 
information to reach a final determination whether the claim 
would be covered.7  It was unable to obtain a statement of the 
events from Krusell because he faced criminal charges in 
connection with the incident; on advice of counsel, he declined 
                     
 
5 At the time of the incident, Krusell was living in his 
parents' house and thus was covered under their homeowners' 
insurance policy. 
 
 
6 The intentional acts exclusion in the Krusells' policy 
precludes coverage for "'[b]odily injury' . . . which is 
expected or intended by an 'insured' even if the resulting 
'bodily injury' . . . (a) is of a different kind, quality or 
degree than initially expected or intended; or (b) is sustained 
by a different person . . . than initially expected or 
intended."  Dorchester Mutual believed this exclusion applied 
because Haufler's claim alleged intentional conduct. 
 
 
7 Dorchester Mutual declined to enter into settlement 
discussions on numerous occasions; it demurred first to a demand 
letter from Haufler seeking $800,000 or, if less, the maximum 
allowed under the Krusells' policy.  The Krusells sought to 
offer $400,000, and later indicated their intent to offer a sum 
in excess of the $500,000 limit under their policy. 
6 
 
 
to provide a statement while those charges were pending.8  As a 
result, Dorchester Mutual had only the information in Haufler's 
complaint, a copy of the police report, and a brief account from 
Krusell's attorney. 
 
After Dorchester Mutual declined to participate in 
settlement negotiations, the Krusells eventually settled the 
claim for $750,000; they believed that $500,000 would be covered 
under their insurance policy.  Dorchester Mutual, however, 
informed the Krusells that due to the "pending coverage, 
liability and damage issues," it remained unable to consider 
payment. 
 
2.  Prior proceedings.  Dorchester Mutual commenced an 
action in the Superior Court seeking a judgment declaring that 
it had no duty to indemnify the Krusells under the terms of 
their homeowners' insurance policy.  The Krusells 
counterclaimed; they argued that Dorchester Mutual's refusal to 
indemnify, and its refusal to participate in settlement 
discussions, constituted a breach of contract, a breach of the 
                     
 
8 Krusell was charged in Rhode Island with assault on a 
person sixty years of age or older causing serious bodily 
injury, in violation of R.I. Gen. Laws § 11-5-10.1.  As 
discussed, see note 25, infra, the judge ultimately reduced the 
charge to simple assault and placed it on file for one year; the 
charge was to be expunged so long as Krusell did not commit any 
crimes during that period. 
7 
 
 
implied covenant of good fair and fair dealing, and a violation 
of G. L. c. 93A and G. L. c. 176D. 
 
Dorchester Mutual argued -- for the first time in its 
motion for summary judgment -- that even if Krusell did not 
intend to injure Haufler and the intentional acts exclusion was 
thus inapplicable, a different exclusion precluded coverage.  
This exclusion, known as the "abuse and molestation exclusion,"9 
precluded coverage for "'[bodily injury' or 'property damage' 
arising out of sexual molestation, corporal punishment or 
physical or mental abuse."  Dorchester Mutual argued that the 
phrase "physical abuse" unambiguously described Krusell's 
conduct, and that the exclusion thereby precluded coverage. 
 
The judge agreed that Krusell's conduct constituted 
physical abuse, and thus that the abuse and molestation 
exclusion precluded coverage.  Accordingly, the judge granted 
Dorchester Mutual's motion for summary judgment on both the 
question of indemnification and the G. L. c. 93A and G. L. 
c. 176D claims.  The Krusells filed an appeal in the Appeals 
Court, and we transferred the case to this court on our own 
motion. 
                     
 
9 See, e.g., 2 New Appleman Law of Liability Insurance 
§ 13.06[12] (2019), citing Fire, Casualty, & Surety Bulletins, 
at Hpe-7 (describing this type of exclusion as "abuse and 
molestation exclusion"). 
8 
 
 
 
3.  Discussion.  The Krusells assert error in the judge's 
conclusion that the abuse and molestation exclusion precludes 
coverage of Haufler's claim.  They also argue that Dorchester 
Mutual waived its right to raise the exclusion, or is estopped 
from doing so, because Dorchester Mutual did not mention the 
exclusion when reserving its right to deny coverage, instead 
relying on the intentional acts exclusion.10  In addition, the 
Krusells contend that the judge erred in granting Dorchester 
Mutual's motion for summary judgment on the G. L. c. 93A and 
G. L. c. 176D claims. 
 
a.  Standard of review.  "The standard of review of a grant 
of summary judgment is whether, viewing the evidence in the 
light most favorable to the nonmoving party, all material facts 
have been established and the moving party is entitled to 
judgment as a matter of law."  Augat, Inc. v. Liberty Mut. Ins. 
Co., 410 Mass. 117, 120 (1991).  We review decisions allowing 
                     
 
10 The Krusells maintain that, by not mentioning the 
physical abuse exclusion in its letter reserving its rights, 
Dorchester Mutual waived the right to rely on the exclusion as a 
defense or should be estopped from doing so.  These claims are 
unavailing.  Express policy coverage limits are not subject to 
waiver.  See Merrimack Mut. Fire. Ins. Co. v. Nonaka, 414 Mass. 
187, 191 (1993).  Estoppel requires a showing that "one has been 
induced by the conduct of another to do something different from 
what otherwise would have been done and that harm has resulted."  
Lumbermens Mut. Cas. Co. v. Offices Unlimited, Inc. 419 Mass. 
462, 468 (1995).  We discern no evidence that Dorchester Mutual 
engaged in any conduct on which the Krusells reasonably could 
have relied. 
9 
 
 
summary judgment de novo.  See Federal Nat'l Mtge. Ass'n v. 
Hendricks, 463 Mass. 635, 637 (2012).  "An order granting or 
denying summary judgment will be upheld if the trial judge ruled 
on undisputed material facts and his [or her] ruling was correct 
as a matter of law" (citation omitted).  Allmerica Fin. Corp. v. 
Certain Underwriters at Lloyd's, London, 449 Mass. 621, 628 
(2007). 
 
b.  Whether the abuse and molestation exclusion precludes 
coverage.  The crux of the parties' dispute is whether, in the 
context of a homeowners' insurance policy, the term "physical 
abuse" in the abuse and molestation exclusion precludes coverage 
for Krusell's conduct.  The Krusells contend that the term 
"physical abuse" is ambiguous and should be read to require 
intentional conduct, or should be limited to conduct involving a 
sexual element, neither of which would preclude coverage here.  
Construing the term much more broadly, Dorchester Mutual 
maintains that the phrase "physical abuse" in the exclusion 
provision encompasses any form of physically harmful treatment, 
and that the abuse and molestation exclusion precludes 
coverage.11 
                     
 
11 In its brief, Dorchester Mutual also argues that the 
intentional acts exclusion -- which precludes coverage for 
"'[b]odily injury' . . . which is expected or intended by an 
insured" -- provides a separate ground on which to affirm the 
allowance of summary judgment.  We do not agree.  As discussed, 
10 
 
 
 
For the reasons discussed infra, we conclude that the term 
"physical abuse" in the exclusion provision is ambiguous.  We 
therefore consider what an objectively reasonable insured would 
expect to be covered, and conclude that a reasonable insured 
would interpret the term "physical abuse" as not precluding 
coverage for the conduct at issue here. 
 
i.  Policy provisions.  The Krusells' homeowners' policy 
provides "personal liability" coverage for a claim or lawsuit 
"brought against an 'insured' because of 'bodily injury' or 
'property damage' caused by an 'occurrence' to which this 
coverage applies."  An "occurrence" is defined as "an accident, 
including continuous or repeated exposure to substantially the 
same general harmful conditions, which results, during the 
policy period, in:  a. 'Bodily injury'; or b. 'Property 
damage.'" 
 
Personal liability coverage under the policy is excluded 
for a number of enumerated reasons.  As relevant here, one such 
exclusion, entitled "Sexual Molestation, Corporal Punishment Or 
Physical Or Mental Abuse," excludes coverage for "'[b]odily 
injury' or 'property damage' arising out of sexual molestation, 
                     
see note 4, supra, it remains disputed whether Krusell 
"expected" or "intended" to injure Haufler.  Because a material 
fact pertaining to the application of the intentional acts 
exclusion remains in dispute, summary judgment on this ground is 
unwarranted.  See Augat, Inc. v. Liberty Mut. Ins. Co., 410 
Mass. 117, 120 (1991). 
11 
 
 
corporal punishment or physical or mental abuse."  While the 
policy defines "personal injury" and "property damage," it does 
not define "sexual molestation," "corporal punishment," 
"physical abuse," or "mental abuse." 
 
ii.  Interpretation of insurance contracts.  "The proper 
interpretation of an insurance policy is a matter of law to be 
decided by a court . . . ."  Boazova v. Safety Ins. Co., 462 
Mass. 346, 350 (2012).  "[L]anguage in an insurance contract 'is 
no different from . . . [language in] any other contract, and we 
must construe the words of the policy in their usual and 
ordinary sense."  Metropolitan Life Ins. Co. v. Cotter, 464 
Mass. 623, 634-635 (2013), quoting Metropolitan Prop. & Cas. 
Ins. Co. v. Morrison, 460 Mass. 352, 362 (2011).  We assume that 
every word in an insurance contract serves a purpose, and "must 
be given meaning and effect whenever practicable" (citation 
omitted).  Metropolitan Life Ins. Co., supra at 635. 
 
Where unambiguous, the terms of an exclusion "should be 
construed 'in their usual and ordinary sense'" (citation 
omitted).  See Bagley v. Monticello Ins. Co., 430 Mass. 454, 457 
(1999).  "Any ambiguities in the language of an insurance 
contract," however, "are interpreted against the insurer who 
used them and in favor of the insured."  Allmerica Fin. Corp., 
449 Mass. at 628.  This rule "applies with particular force to 
exclusionary provisions," Hakim v. Massachusetts Insurers' 
12 
 
 
Insolvency Fund, 424 Mass. 275, 282 (1997), and an insurer bears 
the burden of proving that a particular exclusion is applicable, 
see Allmerica Fin. Corp., supra.  When in doubt as to the proper 
meaning of a term in an insurance policy, we "consider what an 
objectively reasonable insured, reading the relevant policy 
language, would expect to be covered" (citation omitted).  See 
Metropolitan Prop. & Cas. Ins. Co., 460 Mass. at 362.  See also 
James B. Nutter & Co. v. Estate of Murphy, 478 Mass. 664, 670 
(2018), quoting Golchin v. Liberty Mut. Ins. Co., 466 Mass. 156, 
159-160 (2013) ("standard insurance policies must be interpreted 
in light of 'what an objectively reasonable insured . . . would 
expect to be covered'"). 
 
Accordingly, to resolve the question here, we first must 
determine whether the term "physical abuse" is ambiguous; if it 
is, we proceed to consider how an objectively reasonable insured 
would interpret the term, in other words, whether a reasonable 
insured would expect the exclusion to preclude coverage in this 
case. 
 
iii.  Whether the term "physical abuse" is ambiguous.  A 
term is not rendered ambiguous merely by virtue of the fact that 
the parties disagree as to its meaning.  See Sullivan v. 
Southland Life Ins. Co., 67 Mass. App. Ct. 439, 443 (2006).  
Rather, a term is ambiguous where "it is susceptible of more 
than one meaning and reasonably intelligent persons would differ 
13 
 
 
as to which meaning is the proper one."  Citation Ins. Co. v. 
Gomez, 426 Mass. 379, 381 (1998). 
 
When deciding whether a term is ambiguous, we initially do 
not consider any extrinsic evidence of the intended meaning.  
See Bank v. Thermo Elemental Inc., 451 Mass. 638, 648 (2008).  
Instead, we look "both to the contested language and to the text 
of the [insurance policy] as a whole" (citation omitted).  See 
James B. Nutter & Co., 478 Mass. at 670.  In attempting to 
ascertain possible relevant meanings, we consider dictionary 
definitions; we also look to case law to determine whether 
courts have adopted a consistent interpretation.  Cf. Suffolk 
Constr. Co. v. Illinois Union Ins. Co., 80 Mass. App. Ct. 90, 94 
(2011), citing BloomSouth Flooring Corp., v. Boys' & Girls' Club 
of Taunton Inc., 440 Mass. 618, 622-623 (2003). 
 
To begin, we note that the term "physical," in context, is 
not ambiguous; it reasonably is understood to mean "of or 
pertaining to the body."  Webster's New Universal Unabridged 
Dictionary 1461 (2003).  The question remains, however, whether 
"abuse" is an ambiguous term. 
 
Dictionary definitions indicate at least two plausible 
strands of interpretation.  One -- advanced by Dorchester 
Mutual -- interprets the term broadly to include any form of 
physically harmful treatment.  See, e.g., Webster's New 
Universal Unabridged Dictionary, supra at 9 (ninth definition of 
14 
 
 
"abuse" is "bad or improper treatment"); Webster's Ninth New 
Collegiate Dictionary 47 (1991) (fifth definition of "abuse" is 
"physical maltreatment").  The second strand recognizes that the 
term "abuse" contemplates conduct that is more circumscribed 
than simply any form of physically harmful treatment, such that 
"abuse" implies a qualitative aspect to the treatment beyond the 
fact that it causes harm.  See, e.g., Black's Law Dictionary 12 
(11th ed. 2019) (defining "abuse" as "[c]ruel or violent 
treatment of someone; [specifically] physical or mental 
maltreatment, often resulting in mental, emotional, sexual, or 
physical injury" [emphasis supplied]).  Cruelty, in turn, 
implies a disposition to inflict pain or suffering on the part 
of the abuser.  See Webster's New Universal Unabridged 
Dictionary, supra at 483 ("cruel" means "willfully or knowingly 
causing pain or distress to others"; Webster's Ninth New 
Collegiate Dictionary, supra at 311 (defining "cruel" as 
"disposed to inflict pain or suffering:  devoid of humane 
feelings"). 
 
Those courts that explicitly have interpreted the term 
"abuse" in the context of abuse and molestation exclusions have 
relied upon one or other of these divergent approaches.12  Some 
                     
 
12 In many other cases considering whether an exclusion 
provision is applicable, the terms "abuse" or "physical abuse" 
are not specifically addressed, generally because the conduct at 
15 
 
 
courts, as did the judge here, have adopted the broad 
interpretation that physical abuse includes any harmful physical 
treatment.  See, e.g., Miglino v. Universal Prop. & Cas. Ins. 
Co., 174 So. 3d 479, 481 (Fla. Dist. Ct. App. 2015) (defining 
"abuse" as "physical . . . maltreatment" and holding that 
physical abuse exclusion barred coverage for shooting where 
insured loaned firearm to sister); American Family Mut. Ins. Co. 
v. Chiczewski, 298 Ill. App. 3d 1092, 1095 (1998) (construing 
word "abuse" in provision excluding coverage for "physical abuse 
of a minor" as "physically harmful treatment").13  Numerous 
others have concluded that physically abusive conduct is a 
subset of physically harmful treatment.  See, e.g., Riley v. 
Maison Orleans II, Inc., 829 So. 2d 479, 491 (La. Ct. App. 2002) 
("Physical abuse, as opposed to simple assault, is generally the 
act of a person in control, dominance, or authority who misuses 
                     
issue unquestionably falls within the more narrow definition and 
the issue is not raised.  In cases challenging application of an 
exclusion, the dispute more frequently involves whether the term 
"physical abuse" in an abuse and molestation exclusion requires 
intent.  See, e.g., Merrimack Mut. Fire Ins. Co. v. Ramsey, 117 
Conn. App. 769, 772–773 (2009) (where abuse and molestation 
provision used same language as at issue in this case, parties 
disputed whether "physical abuse" required insured's intent; 
court concluded that it did not, by reading this provision in 
conjunction with provision excluding coverage for intentional 
acts). 
 
 
13 See also Smyth vs. Scherer, Mass. Super. Ct., No. 
ESCV2016189 (Essex County May 02, 2017). 
16 
 
 
his [or her] position to harm or mistreat a person over whom he 
[or she] exercises such control" [emphasis supplied]).14 
 
In sum, as evinced by the several dictionary definitions 
and the varying interpretations in different courts, there 
appears to be no judicial consensus as to whether abuse -- here 
"physical abuse" -- connotes any conduct whatsoever that causes 
physical harm, or, instead, a subset of physically harmful 
conduct characterized by an "abusive" quality, such as an 
imbalance of power.  In light of these diverging 
interpretations, we conclude that the term "abuse" is 
susceptible of more than one meaning and reasonably intelligent 
persons could differ as to which meaning is the proper one.  
Hence, the term is ambiguous.  See Citation Ins. Co., 426 Mass. 
at 381. 
 
iv.  A reasonable insured's expectations as to coverage.  
As we have concluded that the term "physical abuse" is 
ambiguous, we turn to consider "what an objectively reasonable 
insured, reading the relevant policy language, would expect to 
be covered."  See Metropolitan Life Ins. Co., 464 Mass. at 635, 
quoting Hazen Paper Co. v. United States Fid. & Guar. Co., 407 
                     
 
14 See also Lexington Ins. Co. vs. New Mexico Ass'n of 
Counties, U.S. Dist. Ct., No. 07-464 RB/LAM (D.N.M. June 28, 
2010) (rejecting definition of "abuse" that included all forms 
of "mistreat[ment]"); Quincy Mut. Fire Ins. Co. vs. Kim, Mass. 
Super. Ct., No. 1483CV00847 (Plymouth County July 28, 2015). 
17 
 
 
Mass. 689, 700 (1990).  If a reasonable insured in the Krusells' 
position would construe the phrase "physical abuse" as not 
encompassing the conduct at issue, the exclusion does not 
preclude coverage. 
 
When read in the context of the abuse and molestation 
exclusion and the policy as a whole, the broad definition of 
"physical abuse" as including any conduct that causes physical 
harm proves unworkable.15  Words are, at least in part, defined 
by the company they keep, and such a broad reading, among other 
things, would render superfluous the exclusion's references to 
"sexual molestation" and "corporal punishment," because both are 
forms of physically harmful treatment.  See Metropolitan Life 
Ins. Co., 464 Mass. at 634-635. 
 
In addition, interpreting the term to apply to any form of 
physically harmful conduct arguably would preclude coverage for 
physical injuries resulting from an accident.  Imagine, for 
example, that a homeowner injured a guest by accidentally 
spilling coffee on the guest's arm.  If any physically harmful 
treatment constituted physical abuse, the exclusion almost 
certainly would preclude coverage for such an accident.  Where, 
                     
 
15 Because the abuse and molestation exclusion in the policy 
explicitly includes not only "sexual molestation," but also 
nonsexual forms of "corporal punishment" and "physical or mental 
abuse," we also reject any interpretation of physical abuse as 
limited exclusively to sexual conduct. 
18 
 
 
as here, an insurance policy is designed to provide coverage for 
"occurrences," which are defined in part as "accidents," such a 
broad interpretation of "physical abuse" would undermine the 
basic purpose of a homeowner purchasing such a policy.16  Cf. 
Quincy Mut. Fire Ins. Co. v. Abernathy, 393 Mass. 81, 84-85 
(1984) ("Equating the word 'expected' [in policy exclusion for 
expected injuries] with negligent conduct would result in a 
severe and inequitable curtailment of such insurance 
coverage . . ."). 
 
Moreover, the history of the adoption of abuse and 
molestation exclusions confirms that their terms were not 
intended to be read as broadly as Dorchester Mutual suggests.  
An abuse and molestation exclusion originally was added to 
liability insurance policies to "reinforce" the intentional acts 
exclusion.  See, e.g., 2 New Appleman Law of Liability Insurance 
§ 13.06[12] (2019), citing Fire, Casualty, & Surety Bulletins, 
at Hpe-7.  Broadly speaking, the exclusion shields insurers in 
two situations where the intentional acts exclusion proves 
inadequate. 
                     
 
16 Indeed, judges in other cases have rejected overly broad 
definitions of abuse exclusions for this very reason.  See, 
e.g., Quincy Mut. Fire Ins. Co., Mass. Super. Ct., No. 
1483CV00847, supra (defining "physical abuse" as physically 
harmful treatment renders exclusion "meaningless because it 
invites all harmful conduct to fit into the exclusion's 
definition"). 
19 
 
 
 
The first is where a victim of abuse seeks to recover for 
an insured party's negligent supervision of a third-party 
assailant.  The abuse and molestation exclusion originated in 
the 1980s in response to an increasing number of far-reaching 
sexual abuse claims against organizations that alleged harm to 
children arising from negligent hiring or supervision, rather 
than from the abuse itself.  See Bartley, The Liability 
Insurance Regulation of Religious Institutions After the 
Catholic Church Sexual Abuse Scandal, 16 Conn. Ins. L.J. 505, 
517-518, 530 (2010).17  Because the basis for such claims was the 
negligent conduct of a third party, rather than the intentional 
conduct of the alleged abuser, existing policy exclusions for 
intentional acts were insufficient to shield insurers from 
coverage obligations.  See id.18 
                     
 
17 See also Nonprofits Insurance Alliance, Improper Sexual 
Conduct and Physical Abuse Liability, https://insurancefor 
nonprofits.org/coverages/nonprofits-own/improper-sexual-conduct 
[https://perma.cc/4X76-N5TP] ("Any organization that provides 
services to youth, developmentally disabled individuals of any 
age, or senior citizens should consider this type of insurance.  
The intent of this coverage is to respond to allegations of 
sexual abuse"). 
 
 
18 Although such negligent supervision claims generally are 
associated with organizations such as the Boy Scouts and certain 
religious entities, the theory also has been applied, for 
example, in domestic settings such as supervision of family 
members and child care providers, as well as against 
administrators in school settings.  Thus, from its roots in 
liability insurance for organizations, abuse and molestation 
exclusions took root in homeowners' insurance policies as well 
20 
 
 
 
A second set of circumstances is where a claim generally 
would be brought directly against an abuser, but the abuser is 
deemed incapable of intentional conduct by virtue of a mental 
disease or defect.  Even though, ordinarily, abuse is 
intentional conduct, in such a situation the abuser's inability 
to act with intent renders the intentional acts exclusion 
inapplicable.  See, e.g., Merrimack Mut. Fire Ins. Co. v. 
Ramsey, 117 Conn. App. 769, 770, 772-773 (2009) (abuse and 
molestation exclusion precluded coverage where insured sexually 
assaulted romantic partner but insurer could not rely upon 
exclusion for intentional acts because insured suffered from 
psychiatric disorder and could not act with intent).  See also 
                     
as in liability insurance in other industries.  See, e.g., 
Hingham Mut. Fire Ins. Co. v. Smith, 69 Mass. App. Ct. 1, 6 
(2007) (abuse and molestation exclusion precluded coverage of 
claim for negligent supervision of insureds' son, who sexually 
assaulted plaintiffs' children).  See also, e.g., General Ins. 
Co. of Am. v. Okeke, 182 Conn. App. 83, 99, 101-102 (2018) 
(Okeke) (abuse and molestation exclusion precluded coverage of 
claim based on negligent supervision of child who beat and 
stabbed neighbor); Miglino v. Universal Prop. & Cas. Ins. Co., 
174 So. 3d 479, 480-481 (Fla. Dist. Ct. App. 2015) (abuse and 
molestation exclusion precluded coverage of negligent 
supervision claim where insured lent firearm to sister, who used 
it to shoot her son-in-law); American Commerce Ins. Co. v. 
Porto, 811 A.2d 1185, 1189, 1201-1202 (R.I. 2002) (abuse and 
molestation exclusion precluded coverage of claim for negligent 
supervision of Boy Scout troop leader who abused child); S.C. 
Farm Bureau Mut. Ins. Co. v. Oates, 356 S.C. 378, 380, 383 (Ct. 
App. 2003) (abuse and molestation exclusion precluded coverage 
of negligent supervision claim brought against employer of child 
care worker claimed to have shaken child). 
21 
 
 
Frey, Allstate Ins. Co. v. Troelstrup:  Application of the 
Intentional Acts Exclusion Under Homeowner's Insurance Policies 
to Acts of Child Molestation, 68 Den. U. L. Rev. 429, 433-434 
(1991); 2 New Appleman Law of Liability Insurance § 13.06[12] 
(2019), citing Fire, Casualty, & Surety Bulletins, at Hpe-7.19 
 
Because they often are not based directly on acts of the 
abuser, these claims also resulted in the now-common language 
for injuries "arising out of" an act of abuse or molestation.  
An abuse and molestation exclusion shields insurers from 
liability in such situations by precluding coverage for any 
claim "arising out of" abuse or molestation, as opposed to 
claims seeking recovery on the basis of intentional conduct.  
See Bartley, supra at 530. 
 
The contexts in which abuse and molestation exclusions 
arose are instructive here.  First, that the rationale for 
including such exclusions was to enforce the intentional acts 
exclusion in particular factual circumstances confirms that an 
                     
 
19 A third rationale for the exclusion is that, in some 
insurance policies -- such as the policy at issue here -- the 
intentional acts exclusion applies only to "bodily injury," 
thereby allowing abuse victims to recover for emotional injuries 
resulting from intentional abuse.  See 9 S. Plitt, D. Maldonado, 
J.D. Rogers, & J.R. Plitt, Couch on Insurance 3d § 127:25 
(2019), citing Hartford Roman Catholic Diocesan, Corp. v. 
Interstate Fire & Cas. Co., 199 F. Supp. 3d 559 (D. Conn. 2016) 
(sexual abuse by priests was deemed "occurrence" under insurance 
policy of archdiocese that had placed priests in environments 
where they had opportunity to abuse children). 
22 
 
 
ordinary understanding of the term "physical abuse" remains 
limited to deliberately harmful treatment.  Insurers did not 
adopt the abuse and molestation exclusion to expand the scope of 
conduct for which coverage was precluded so as to include any 
physically harmful treatment.  Rather, the rationale was to 
shield themselves from liability for abuse or molestation claims 
where they unexpectedly could not rely upon the intentional acts 
exclusion to preclude coverage.  In addition, the fact that one 
of the contexts in which such provisions first arose involved 
the physical or sexual abuse of parishioners by priests 
reaffirms that the term "abuse" implies a qualitative aspect, 
such as an imbalance of power, to the harmful conduct. 
 
v.  Analysis.  To determine whether a reasonable insured 
would interpret the term "physical abuse" to preclude coverage 
in this case, we consider cases where insurers successfully have 
relied upon the abuse and molestation exclusion to preclude 
coverage for claims of physical abuse, as well as instances 
where they have not been successful.  We look also to examples 
of physically harmful conduct that are characterized as "abuse" 
in our statutes and regulations.  It is apparent from these 
sources that the characteristics that would render conduct 
"abusive" in the eyes of a reasonable insured are absent in the 
present case. 
23 
 
 
 
A.  Prior cases.  Cases where insurers successfully have 
relied upon the abuse and molestation exclusion to preclude 
coverage for claims arising from "physical abuse" generally 
involve more than mere physical harm.  The conduct at issue in 
these cases yields differing characterizations of what renders 
physically harmful conduct "abusive."  One frequent trait, 
however, is conduct that involves an imbalance of power. 
 
The abuse and molestation exclusion has been used, for 
example, to preclude coverage for allegations of physical abuse 
arising in connection with claims of domestic violence (a type 
of physically harmful conduct that commonly is recognized as 
abuse),20 and which, as with some other forms of abuse, often 
involves an imbalance of power.21  See, e.g., Merrimack Mut. Fire 
Ins. Co., 117 Conn. App. at 772-773 (abuse and molestation 
exclusion precluded coverage where individual stabbed romantic 
partner twenty-four times); Miglino, 174 So. 3d at 480-482 
                     
 
20 See Black's Law Dictionary 1801 (10th ed. 2014) (domestic 
violence, also termed domestic abuse, includes violence between 
members of household, usually spouses; assault or violent act 
committed by one member of household against another; infliction 
of physical injury or creation of reasonable fear that physical 
injury will be inflicted, by parent or member or former member 
of child's household, against child or another member of 
household). 
 
 
21 See Opinion of the Justices, 427 Mass. 1201, 1208-1209 
(1998) (discussing how, in domestic violence context, "victims 
of abuse are generally . . . dependent on abusers and will often 
be threatened with custody litigation by abusers if they 
leave"). 
24 
 
 
(abuse and molestation exclusion precluded coverage where woman 
shot her son-in-law in midst of his divorce proceedings with her 
daughter). 
 
Cases where courts have declined to apply the abuse and 
molestation exclusion also illustrate that abuse reasonably can 
be interpreted to refer to a limited subset of physically 
harmful treatment, and not the simple assault at issue here.  In 
Riley, 829 So. 2d at 482, 490-491, for example, the court 
considered whether the abuse and molestation exclusion precluded 
coverage for a claim brought against a nursing home after one 
resident physically attacked another with a pipe.  The court 
concluded that the incident did not involve "physical abuse" 
because "[p]hysical abuse, as opposed to simple assault, is 
generally the act of a person in control, dominance, or 
authority who misuses his [or her] position to harm or mistreat 
a person over whom he [or she] exercises such control" (emphasis 
supplied).  See id. at 491. 
 
Simply put, where insurers successfully -- or 
unsuccessfully -- rely upon the term "physical abuse" in an 
abuse and molestation exclusion to preclude coverage, the mere 
fact that the conduct at issue was physically harmful does not 
suffice to render it "physical abuse."  While no single quality 
transforms physically harmful conduct into physically abusive 
25 
 
 
conduct,22 a reasonable insured could, and likely would, 
understand the "abusive" quality of physical abuse to apply to a 
limited subset of physically harmful treatment, often 
characterized by an imbalance of power.23 
                     
 
22 For example, some cases where insurers successfully 
relied upon an abuse and molestation exclusion involve conduct 
that implies that the abuser is cruel or inhumane, that is, 
disposed to inflict pain or suffering.  See, e.g., Auto-Owners 
Ins. Co. v. American Cent. Ins. Co., 739 So. 2d 1078, 1080-1082 
(Ala. 1999) (abuse and molestation exclusion precluded coverage 
of claim involving physical and mental abuse where, inter alia, 
leaders of fraternity forced fraternity pledge to jump into 
ditch filled with urine and feces, and where "hazing" was 
defined as any willful action that "recklessly or intentionally 
endangers the mental or physical health of any student"); Okeke, 
182 Conn. App. at 101-103 (abuse and molestation exclusion 
precluded coverage where fifteen year old male violently 
attacked, assaulted, and stabbed elderly female neighbor).  This 
interpretation is consistent with one of the common dictionary 
definitions of "abuse."  See Black's Law Dictionary 12 (11th ed. 
2019) (defining "abuse" as "[c]ruel or violent treatment"); 
Webster's New Universal Unabridged Dictionary 483 (2003) 
("cruel" means "willfully or knowingly causing pain or distress 
to others"); Webster's Ninth New Collegiate Dictionary 301 
(1991) (defining "cruel" as "disposed to inflict pain or 
suffering:  devoid of humane feelings"). 
 
 
23 Indeed, a number of the cases Dorchester Mutual cites in 
its brief as instances where insurers successfully relied upon 
the abuse and molestation exclusion to deny coverage involve 
physically harmful treatment commonly recognized as forms of 
abuse, e.g., domestic violence, sexual abuse, or child abuse.  
See Safeco Ins. Co. of Am. vs. Vecsey, U.S. Dist. Ct., No. 
3:08cv833 (JBA) (D. Conn. Sept. 30, 2010) (abuse and molestation 
exclusion precluded personal injury suit based on alleged 
incident of domestic violence); Covenant Ins. Co. vs. Sloat, 
Conn. Super. Ct., No. 385786 (May 23, 2003) (abuse and 
molestation exclusion precluded coverage of claim involving 
sexual abuse -- sodomy -- of mentally disabled student by his 
classmate); Smyth, Mass. Super. Ct., No. ESCV2016189, supra 
(abuse and molestation exclusion precluded coverage of claim 
26 
 
 
 
B.  Statutes and regulations.  Numerous statutes and 
regulations in the Commonwealth further illustrate that one 
hallmark of physically abusive -- as opposed to physically 
harmful -- conduct is an imbalance, or misuse, of power.  The 
term routinely has been applied to conduct causing harm to a 
vulnerable type of victim, where the alleged abuser may be 
responsible for the vulnerable individual's care.  Statutes 
enumerating crimes against a person, for example, reference 
"abuse" in connection with children and the elderly.  See G. L. 
c. 265, § 13K (a 1/2) (abuse of elder); G. L. c. 265, § 23 (rape 
and abuse of child).  See also Commonwealth v. Cruz, 88 Mass. 
App. Ct. 206, 208-210 (2015) (sufficient evidence of abuse and 
neglect where defendant caretaker wantonly and recklessly failed 
to provide adequate care to elderly mother, who died of sepsis 
after defendant failed to attend to mother's hygiene).  Other 
potential victims of abuse, as defined by Massachusetts statutes 
and regulations, include (1) persons with disabilities, see 118 
Code Mass. Regs. § 2.02 (2016); (2) inmates in a correctional 
facility, see 103 Code Mass. Regs. § 491.13 (2017); and 
(3) medical patients or residents in long-term care facilities, 
see 105 Code Mass. Regs. § 155.003 (2017). 
                     
involving domestic violence -- husband strangled wife); Saunders 
ex rel. Wright vs. Sperry, Wis. Ct. App., No. 98-2929 (May 6, 
1999) (abuse and molestation exclusion precluded coverage of 
claim involving child abuse -- homeowner shook child). 
27 
 
 
 
Massachusetts statutes characterize domestic violence, 
which also often involves a power imbalance or element of 
control, as a form of "abuse."  See G. L. c. 209A, § 1 (domestic 
abuse prevention statute defining "abuse" as acts between family 
or household members that cause, attempt to cause, or place 
another in fear of imminent serious physical harm). 
 
In addition, some regulations formalize the requirement 
that "abuse" necessitates an imbalance of power or misuse of 
control.  The Department of Developmental Services, for example, 
defines "abuse" as "an act or omission of a provider that 
results in serious [physical or emotional injury] to an 
individual."  See 115 Code Mass. Regs. § 9.02 (2017). 
 
We conclude that a reasonable insured would interpret 
"physical abuse" to apply only to a limited subset of physically 
harmful treatment, where the treatment is characterized by an 
"abusive" quality such as a misuse of power or, perhaps, conduct 
so extreme as to indicate an abuser's disposition towards 
inflicting pain and suffering.  As the conduct at issue in this 
case involves no such hallmarks of abuse, a reasonable insured 
would interpret the term "physical abuse" in the policy as not 
precluding coverage here.  Accordingly, Dorchester Mutual cannot 
rely upon the exclusion to deny liability for indemnification, 
and the allowance of summary judgment in its favor was error. 
28 
 
 
 
c.  Violations of G. L. c. 93A and G. L. c. 176D.  The 
Krusells contend that the judge erred in granting Dorchester 
Mutual's motion for summary judgment with regard to their claims 
for violations of G. L. c. 93A and G. L. c. 176D.  In the 
Krusells' view, Dorchester Mutual engaged in an unfair claim 
settlement practice by failing to effectuate settlement once 
liability had become reasonably clear.  We do not agree. 
 
Pursuant to G. L. c. 176D, § 3 (9) (f), an insurer engages 
in an unfair claim settlement practice by "[f]ailing to 
effectuate prompt, fair and equitable settlements of claims in 
which liability has become reasonably clear."  "An insurance 
company which in good faith denies a claim of coverage on the 
basis of a plausible interpretation of its insurance policy 
cannot ordinarily be said to have committed a violation of G. L. 
c. 93A."  Lumbermens Mut. Cas. Co. v. Offices Unlimited, Inc. 
419 Mass. 462, 468 (1995). 
 
From the outset of its investigation, Dorchester Mutual 
maintained that the asserted conduct fell within the intentional 
acts exclusion.  This exclusion precludes coverage for bodily 
injury that is "expected or intended by an insured."  For such 
an exclusion to apply, the injury, and not just the conduct, 
must have been intentional.  See Preferred Mut. Ins. Co. v. 
Gamache, 426 Mass. 93, 94 (1997). 
29 
 
 
 
The undisputed evidence in the record shows that, until 
just days before the settlement, the only full accounts of the 
incident available to Dorchester Mutual were Haufler's complaint 
and the police report; the police report indicated that Krusell 
had charged towards Haufler and had pushed him with sufficient 
force that he became airborne.  During the initial months of the 
investigation, the only additional pieces of information that 
the Krusells provided Dorchester Mutual were (1) an article 
discussing how the prevailing jurisprudence on the intentional 
acts exclusion was unfavorable to insurers, and (2) a brief 
summary of the incident relayed by Krusell's attorney. 
 
Just days before the Krusells agreed to settle with 
Haufler, they provided Dorchester Mutual with a report by a 
forensic psychiatrist who had been retained to evaluate Krusell 
in connection with the criminal proceeding.  This report 
contained a more detailed summary of Krusell's recollection of 
the incident, including his explanation that he had pushed 
Haufler in an instinctive reaction when Haufler abruptly raised 
his cellular telephone to Krusell's face.24 
                     
 
24 According to that report, Krusell maintained that he had 
pushed Haufler in an instinctive reaction to Haufler's abruptly 
raising his cellular telephone toward Krusell's face; Krusell 
had been "startled by the sudden movement," and denied any 
intent to harm Haufler.  Dorchester Mutual received this report 
sometime between September 19 and September 23, 2015. 
30 
 
 
 
Thus, until shortly before settlement, the information 
available to Dorchester Mutual indicated that Krusell 
intentionally had pushed Haufler, meaning that Haufler's claim 
would be excluded under the intentional acts exclusion in the 
Krusells' policy.25  Although the psychiatrist's report 
contradicted Haufler's initial narrative, it remained a second-
hand account of the incident.  Accordingly, at the time that the 
Krusells agreed to a settlement, Dorchester Mutual reasonably 
could have concluded that liability remained unclear.  Although 
we express no view as to whether the intentional acts exclusion 
in fact would preclude coverage in this case, we nonetheless 
discern no error in the decision to grant summary judgment to 
Dorchester Mutual on the G. L. c. 93A and G. L. c. 176D claims. 
 
4.  Conclusion.  So much of the order granting Dorchester 
Mutual's motion for summary judgment with respect to the duty to 
                     
 
25 The Krusells felt some urgency to settle the civil claim 
in part because the judge handling the criminal case had 
indicated that he would be inclined to reduce the criminal 
charges if a settlement were reached (thus likely allowing 
Krusell to avoid jail time).  As of the day that they agreed to 
settle Haufler's claim, the Krusells had been advised that the 
criminal case would proceed to trial "without any further 
notice, possibly within days."  The Krusells opted to settle 
before that could occur.  This strategy proved successful.  
After the settlement was reached, the judge handling Krusell's 
criminal case reduced the charges to simple assault, and then 
placed them on file for one year, meaning that Krusell's not 
guilty plea would stand and, if Krusell did not commit any 
crimes during that year, the case would be expunged, leaving him 
with no criminal record. 
31 
 
 
indemnify is reversed.  That part of the order granting summary 
judgment to Dorchester Mutual on the defendants' claims for 
violations of G. L. c. 93A and G. L. c. 176D is affirmed.  The 
matter is remanded to the Superior Court for further proceedings 
consistent with this opinion. 
 
 
 
 
 
 
 
So ordered.