Insurance – Vehicle – Inspection

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Where the defendant insurance company denied the plaintiff’s claim of property damage to his vehicle because it had suspended the plaintiff’s property damage coverage based on his failure to obtain a pre-insurance inspection of the car, the plaintiff’s motion for summary judgment must be allowed as to his breach of contract claim because the plaintiff was an existing customer of the insurer and therefore was not required to obtain a pre-insurance inspection.

“In Count I, [plaintiff Michael] Dziok alleges that [defendant] MetLife violated the comprehensive coverage section of Policy 3 by rejecting his claim of property damage to the BMW. …

“… [U]nder the applicable statutory and regulatory framework, an applicant for physical damage coverage in a vehicle liability insurance policy who is an existing customer of the insurer need not obtain a pre-insurance inspection. …

“… Because Dziok was not the named insured or the individual that applied as the named insured under Policy 1 (Dziok’s parents were), MetLife argues, he has not been insured for three years and cannot be an existing customer. MetLife incorrectly interprets the definition of ‘applicant.’

“It is clear from the plain meaning of the regulatory language that ‘applicant’ refers to the person currently seeking a vehicle insurance policy, who may be required to obtain a pre-insurance inspection under the regulations. …

“… ‘Applicant’ therefore does not serve to limit an ‘existing customer’ to one who was previously a named insured or one who applied as a named insured.

“MetLife also apparently argues that Policy 2 does not count toward the three-year continuous period because it was issued to Dziok in Connecticut for a different vehicle… and had a different policy number than Dziok’s policy at the time of the BMW’s damage… MetLife again interprets the definition of ‘existing customer’ too narrowly. The regulatory language does not require that the existing customer have been an insured under the same policy. Rather, it specifically provides that an existing customer is an applicant ‘who has been insured for three years or longer, without interruption, under a Motor Vehicle Liability Policy or Policies.‘ …

“Dziok was not required to obtain a pre-insurance inspection of the BMW, and MetLife therefore improperly suspended his physical damage coverage. By doing so and failing to accept and pay for Dziok’s claim on that basis, MetLife—not Dziok—breached Policy 3. Dziok is entitled to summary judgment on Count I of his complaint. …”

Dziok v. MetLife Auto and Home (Lawyers Weekly No. 12-035-12) (10 pages) (Tucker, J.) (Worcester Superior Court) (Civil Action No. 2008-2502) (Jan. 13, 2012).