Pennsylvania Court: No Coverage for Mother’s Distress Over Son’s Overdose Death
The Pennsylvania Supreme Court has ruled that Nationwide Property and Casualty is not obligated to defend its homeowner insureds against a wrongful death claim for emotional and mental distress brought by a mother whose son died from a drug overdose in their home.
The high court reversed a lower court because the Nationwide insurance policy only covers bodily injury and the policy explicitly excludes emotional distress from the definition of bodily injury.
The mother sought damages for emotional and mental distress under Pennsylvania’s Wrongful Death Act. She also sought damages in a survival action for her son’s pain and suffering prior to his death. Nationwide denied the claims, noting the mother did not suffer a bodily injury and also that the policy contained a controlled substance exclusion.
According to the facts of the case, one night in 2018, the mother’s son stayed over at the home of Nationwide’s insureds with their son, while his parents were away. The next day, first responders discovered her son dead in the home. The coroner determined that his cause of death was the use of heroin, fentanyl, and benzodiazepines.
The mother’s lawsuit asserted that the insureds breached a duty of care owed to all invitees by entrusting their son with their home when they knew or should have known that he used and distributed narcotics. She alleged that the insureds’ son permitted access to and use of controlled substances and that but for their grant of access to the controlled substances her son would not have died. She also maintained that the harm was foreseeable.
The trial court sided with the homeowners over Nationwide, finding that the allegations brought by the mother involve negligence for entrusting the insureds home to their son and alleged breach of duty of care to an invitee, allegations that the court said are distinct from injuries “resulting from” the use or delivery of controlled substances. The trial court concluded that the negligence claims were not excluded and fell within the policy’s coverage and thus Nationwide must provide a defense.
Nationwide appealed the trial court’s refusal to apply the controlled substances exclusion to the Superior Court. The Superior Court panel also sided with the homeowners, albeit on different grounds.
The Superior Court recognized that Nationwide’s single ground for appeal emanated from the trial court’s refusal to apply the controlled substances exclusion since the decedent was alleged to have died solely from the use of the drugs. However, in framing its analysis, the Superior Court broadly stated the “substantive issue” was whether Nationwide had a duty to defend the parents in the underlying action.
Regarding the controlled substances liability exclusion, the Superior Court stated that the policy excludes personal liability coverage for bodily injury resulting from the use of controlled substances. The court noted that the policy defines “bodily injury” as “bodily harm, including resulting care, sickness or disease, loss of service or death.” It said that Nationwide “would have no obligation to pay out for such damages if … the parents are ultimately found liable for them. Correspondingly, Nationwide would then have no duty to defend with respect to those damages under the survival action.
However, when it came to the wrongful death claim, the Superior Court said the policy was not limited to bodily injury and that there was potentially a claim for other types of damages rooted in “’emotional distress, mental distress or injury, or any similar injury,” none of which would be the direct result of bodily harm. Because these types of damages do not fall under the policy’s bodily injury definition, the Superior Court panel determined that the policy’s controlled substance exclusion, which excludes coverage for bodily injury resulting from the use of controlled substances, did not apply to those damages.
The Superior Court went on to hold that the controlled substances exclusion applied to the survival action in its entirety and it also excluded the wrongful death action except to damages for emotional and mental distress. For those damages, Nationwide still had a duty to its insureds. Nationwide again appealed.
The Pennsylvania Supreme Court, Middle District, took the appeal on whether the Superior Court incorrectly ruled that emotional distress damages are covered under an insurance policy providing liability coverage only for bodily injury, where the policy explicitly excludes emotional distress from the definition of bodily injury.
The Supreme Court reversed the Superior Court and sided with Nationwide.
The Superior Court had based its conclusion that Nationwide had a duty to defend on the wrongful death claim for emotional and mental distress it found embedded in the wrongful death action. According to the Supreme Court, the Superior Court erred in its determination that Nationwide was potentially required to pay out for the mother’s emotional and mental distress damages in the wrongful death action even though it recognized that she did not suffer a bodily injury. That conclusion by the Superior Court was “contrary to the unambiguous provisions of the policy and erroneous as a matter of law” because emotional and mental distress is not a bodily injury. The court noted that the insurance policy explicitly excludes emotional distress from the definition of bodily injury.
“”A bodily injury, by definition under the policy, does not include emotional distress or similar injury unless the direct result of bodily harm,” the high court declared.
The high court said the Superior Court’s “erroneous theory” was contingent upon its preliminary holding that the controlled substances exclusion applied to the damages sought for the son’s overdose death.
Attorney John Ewell, with Cozen O’Connor, wrote recently that some jurisdictions consider the Insurance Services Office (ISO)-form definition of bodily injury to be ambiguous and this has prompted many insurers to expressly require a physical component.
The Pennsylvania Supreme Court accepted solely for the limited purposes of its analysis that damages for emotional and mental injuries are recoverable in a wrongful death action. However, the Supreme Court noted that it has never addressed whether mental and emotional distress injuries to surviving family members are compensable under the state’s current wrongful death act and it did not going do so in this ruling.