NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-
CHRISTINE PRIEST, Administratrix
Ad Prosequendum and General
Administratrix of the Estate of
Chentele Stenger, CHRISTINE PRIEST,
Individually, DONALD STENGER,
Administrator Ad Prosequendum, and
DONALD STENGER, Individually,
Plaintiffs-Respondents,
v.
MATTHEW RONCONE,
Defendant/Third-Party Plaintiff-
Respondent,
v.
THE SELECTIVE INSURANCE COMPANY OF AMERICA,
Third-Party Defendant-Appellant.
___________________________________________
Argued May 17, 2004 - Decided July 6, 2004
Before Judges Petrella, Collester and Fuentes.
On appeal from Superior Court of New Jersey,
Law Division, Gloucester County, Docket No.
L-1061-95.
Gary S. Kull argued the cause for appellant
Selective Insurance Company of America
(Carroll, McNulty & Kull, attorneys; Mr. Kull,
and Janice F. Dolan, of counsel and on the brief).
David E. Poplar argued the cause for respondents
Christine Priest, Administratrix Ad Prosequendum
and General Administratrix of the Estate of
Chentele Stenger, Christine Priest, Individually, Donald Stenger, Administrator Ad Prosequendum, and
Donald Stenger, Individually (Carl D. Poplar, attorneys; Mr. David Poplar, on the brief).
J. Michael Farrell, attorney for respondent
Matthew Roncone, relies on respondents' brief.
The opinion of the court was delivered by
FUENTES, J.A.D.
This is a declaratory judgment action brought by Matthew Roncone against Selective Insurance
Company (Selective). The trial court granted summary judgment in favor of Roncone, holding
that Selective was legally obligated to provide him coverage under his homeowners' policy,
in connection with a survival and wrongful death action brought against him by
the parents of decedent Chentele Stenger, in their individual capacities and as administrators
ad prosequendum.
See footnote 1
This appeal requires us to address two principal legal questions: (1) whether decedent
was an "insured" within the meaning of the Selective policy, and thus excluded
from the class of potential claimants; and (2) whether coverage for the independent
wrongful death claim brought by decedent's parents is barred by the policy's intentional
wrongs exclusion. The trial court answered "no" to both of these questions. We
disagree as to question (1) and reverse. As to question (2), we remand
for an evidentiary hearing for the trial court to determine whether Roncone's criminal
act triggers the policy's intentional wrongs exclusion.
The core facts necessary to address the intra-family exclusion issue are not in
dispute.
I
Roncone and Christine Priest began a two-year relationship that culminated in the birth
of their daughter Lauren in April 1993. The couple had an apparent committed
and monogamous relationship, at times representing themselves as "married." After Lauren's birth, Priest
moved from her parents' home to Roncone's newly-built home in Sewell, with Chentele,
her four-year-old daughter from an earlier relationship with Donald Stenger.
Chentele had her own bedroom in Roncone's house. Priest described the relationship between
Roncone and Chentele as "affectionate," with Roncone acting like a "father figure." He
cared for both Chentele and Lauren on the evenings and weekends while Priest
worked.
Priest worked the morning of Saturday, December 11, 1993, leaving Chentele and Lauren
in Roncone's care. At approximately 10:45 a.m., Priest received a call from Roncone
requesting her to come home because Chentele had fallen down the stairs and
was immobile. Roncone explained that he instructed Chentele to go downstairs while he
fed the baby. He subsequently heard a noise and found Chentele lying at
the bottom of the steps. Roncone adamantly denied causing Chentele's injuries, but admitted
to shaking her in an attempt to wake her from her stupor.
Chentele was removed from life support on Monday, December 13, 1993. An autopsy
indicated that she died from brain injuries. Roncone was indicted for murder,
N.J.S.A.
2C:11-3. After a jury trial, he was convicted of second-degree manslaughter.
N.J.S.A. 2C:11-4b(1).
Under Roncone's homeowners' policy, the term "insured" is defined as "you and residents
of your household who are: (a) your relatives; or (b)
other persons under
the age of 21 and in the care of any person named above."
The policy defines an "occurrence" as "an accident, including exposure to conditions, which
results, during the policy period, in: (a) bodily injury; or (b) property damage."
The Personal Liability provision extends coverage in connection with a claim or suit
brought "against an insured for damages because of bodily injury or property damage
caused by an occurrence." The policy excludes from coverage (1) bodily injury "which
is expected or intended by the insured;" and (2) bodily injury to an
"insured."
With respect to decedent's survival claim under
N.J.S.A. 2A:15-3, Selective disclaimed liability because
Chentele was (1) a resident in the Roncone household; (2) under the age
of twenty-one; and (3) in his care at the time of her death.
The first two definitional elements are not in contention.
See footnote 2 Chentele was a four-year-old
child residing in Roncone's house with her mother.
In its decision directing Selective to provide coverage, the trial court focused on
the phrase "in the care of." The court found this phrase to be
reasonably susceptible to different meanings. To resolve this alleged ambiguity, the court inserted
the word "primary" into the phrase "in the care of," thus creating the
phrase "in the
primary care of." Armed with this judicially-crafted language, the court
concluded that decedent was not in Roncone's "primary" care at the time he
recklessly caused her death.
We are unable to find any factual or legal support for this material
alteration of the policy.
II
We will start our analysis by reaffirming certain basic principles of insurance law.
As contracts of adhesion, insurance policies are subject to special rules of interpretation.
Araya v. Farm Family Cas. Ins. Co.,
353 N.J. Super. 203, 206 (App.
Div.),
certif. denied,
175 N.J. 77 (2002). Insurance policies must be construed liberally
and in favor of the insured's reasonable expectations of coverage.
Gibson v. Callaghan,
158 N.J. 662, 671 (1999);
United Servs. Auto. Ass'n v. Turck,
156 N.J. 480, 492-93 (1998).
However, in interpreting a policy of insurance, words should be given their ordinary
meaning.
Zacarias v. Allstate Ins. Co.,
168 N.J. 590, 595 (2001). "In the
absence of any ambiguity, courts 'should not write for the insured a better
policy of insurance than the one purchased.'"
Gibson v. Callaghan,
supra, 158
N.J.
at 670 (citation omitted). If the express language of the policy is clear
and unambiguous, "'the court is bound to enforce the policy as it is
written.'"
Royal Ins. Co. v. Rutgers Cas. Ins. Co.,
271 N.J. Super. 409,
416 (App. Div. 1994) (citation omitted).
A word or phrase is not automatically rendered ambiguous simply because the policy
fails to define it.
See Boddy v. Cigna Prop. & Cas. Cos.,
334 N.J. Super. 649, 656-57 (App. Div. 2000). Where, as here, the policy fails
to define a term or phrase, "the words must be interpreted in accordance
with their ordinary, plain and usual meaning."
Daus v. Marble,
270 N.J. Super. 241, 251 (App. Div. 1994).
In construing the phrase "in the care of," we will utilize an approach
rooted in common sense and based on the words' ordinary meaning, without inserting
legalisms in an attempt to obfuscate their meaning, thereby creating a judicially-contrived ambiguity
where none exists. There is nothing ambiguous about the phrase "in the care
of." We expect a reasonable insured reading this phrase to give it a
plain, ordinary meaning.
Webster's II New College Dictionary 168 (2001), defines "care" as
"the function of watching, guarding or overseeing." The word "care" is typically associated
with the supervision of children and other physically vulnerable or dependent individuals such
as the elderly or infirm.
We are satisfied that the phrase "in the care of" does not require
the existence of a formal, judicially-sanctioned custodial or guardianship relationship. It is sufficient
for the individual to temporarily assume the responsibility for the supervision, well-being and
safety of a child. Our conclusion is bolstered by similar conclusions reached in
other jurisdictions that have examined this issue.
In
Henderson v. State Farm Fire & Cas. Co.,
596 N.W.2d 190 (1999),
the Michigan Supreme Court addressed this precise issue. There, the eighteen-year-old girlfriend of
the homeowners son was temporarily residing with the homeowners when an altercation occurred,
resulting in the injury of plaintiff. Plaintiff sued the girlfriend for negligence and
the insurer disputed coverage.
In finding the phrase unambiguous, the
Henderson Court noted the lower courts [failure]
to recognize that this phrase is a colloquial or idiomatic phrase that is
peculiar to itself and readily understood as a phrase by speakers and readers
of our language.
Id. at 194. Courts in other jurisdictions have followed
Henderson
in finding the phrase "in the care of" unambiguous; the New Hampshire Supreme
Court in
Oliva v. Vermont Mut. Ins. Co.,
842 A.2d 92, 95 (2004),
and the Wisconsin Appellate Division in
Cierzan ex rel. Weis v. Kriegel,
655 N.W.2d 217, 221 (Wis. App. 2002),
review denied,
661 N.W.2d 102 (2003).
The
Henderson Court listed the following factors that a court may look to
in ascertaining whether a person is in the care of the insured. Those
factors include:
(1) is there a legal responsibility to care for the person;
(2) is there some form of dependency;
(3) is there a supervisory or disciplinary responsibility;
(4) is the person providing the care providing substantial essential financial support;
(5) is the living arrangement temporary or permanent, including how long it has
been in existence and is expected to continue;
(6) what is the age of the person alleged to be "in the
care of" another (generally, the younger a person the more likely they are
to be "in the care" of another);
(7) what is the physical or mental health status of the person alleged
to be "in the care of" another (a person with health problems is
more likely to be "in the care" of another); and
(8) is the person allegedly "in the care of" another gainfully employed (a
person so employed is less likely to be truly dependent on another)?
[Id. at 195-96.]
We agree with this commonsense approach and adopt the Henderson factors as analytical
tools for determining whether decedent here was in the care of Roncone at
the time of her death. These factors are not intended to provide an
exhaustive list of relevant considerations. They are meant only to provide a reviewing
court with an analytical starting point on the subject.
Applying the Henderson factors to the facts here, we note that factors (3),
(5) and (6) apply because: (a) Chentele was left in the physical care
of Roncone on the day of her death; (b) as the only adult
in the house Roncone was responsible for her supervision, nourishment and general well-being;
(c) the living arrangement was permanent and long-standing, with the child having her
own room in the house for a period of months before her death;
and (d) Chentele was four years old. Under these circumstances, Chentele was an
"insured" within the meaning of the Selective policy and excluded from the class
of individuals legally capable of bringing a claim thereunder.
III
Resolution of the intra-family exclusion issue does not end the discussion. As decedent's
parents, Priest and Stenger have a legally independent right to bring a wrongful
death action.
Gershon v. Regency Diving Ctr., Inc.,
368 N.J. Super. 237, 246
(App. Div. 2004). They are also clearly not "insureds" under the policy. Selective
contends, however, that their claim for coverage is barred by the section excluding
bodily injury "which is expected or intended by the insured." The record here
is insufficient to determine this issue.
We begin our analysis of this issue by emphasizing that exclusions based on
intentional wrongful acts are common, legally acceptable and consistent with public policy.
Figueroa
v. Hartford Ins. Co.,
241 N.J. Super. 578, 582 (App. Div. 1990). Although
a criminal conviction is not a mandatory precursor to coverage determinations,
Mroz v.
Smith,
261 N.J. Super. 133, 137 (App. Div. 1992), a criminal conviction can
bring the act within the exclusion.
Princeton Ins. Co. v. Chunmuang,
151 N.J. 80, 96 (1997).
Generally, a court must examine the actors subjective intent.
Harleysville Ins. Cos. v.
Garitta,
170 N.J. 223, 234 (2001). Where the actions are particularly reprehensible [however,]
an intent to injure can be presumed from the act without an inquiry
into the actors subjective intent.
Mroz v. Smith,
supra, 261
N.J. Super. at
138 (quoting
Voorhees v. Preferred Mut. Ins. Co.,
128 N.J. 165, 184 (1992)).
Thus, we have denied coverage in suits based on the insured's failure to
advise his sexual partner of his HIV-positive status,
F.S. v. L.D.,
362 N.J.
Super. 161 (App. Div. 2003); based on violations of the Domestic Violence Act,
Bittner v. Harleysville Ins. Co.,
338 N.J. Super. 447 (App. Div. 2001); to
individuals sued for spousal abuse,
Merrimack Mut. Fire Ins. Co. v. Coppola,
299 N.J. Super. 219 (App. Div. 1997); and in cases involving the sexual molestation
of children,
Atlantic Employers Ins. Co. v. Tots & Toddlers Pre-School Day Care
Ctr., Inc.,
239 N.J. Super. 276 (App. Div.),
certif. denied,
122 N.J. 147
(1990).
In all of these cases, the record permitted a rational inference that the
insured's actions were intentional or substantially likely to cause the resulting injury. Here,
the jury convicted Roncone of the crime of second-degree reckless manslaughter as a
lesser included offense of murder.
N.J.S.A. 2C:11-4 defines reckless manslaughter as a criminal
homicide that is committed "recklessly." Pursuant to
N.J.S.A. 2C:2-2b(3), a person acts recklessly,
with respect to a material element of an offense when he consciously disregards
a substantial and unjustifiable risk that the material element exists or will result
from his conduct. The risk must be of such a nature and degree
that, considering the nature and purpose of the actor's conduct and the circumstances
known to him, its disregard involves a gross deviation from the standard of
conduct that a reasonable person would observe in the actor's situation. "Recklessness," "with
recklessness" or equivalent terms have the same meaning.
In this civil action, the only version of how Chentele suffered the injuries
that caused her death come from Roncone himself. He claims that the child
accidentally fell down the stairs while he was attending eight-month-old Lauren. When he
rushed to investigate the noise caused by her fall, he found Chentele at
the bottom of the stairs in a semiconscious state. He shook the child
only as an attempt to bring her to consciousness. We conclude from the
guilty verdict that the criminal jury rejected this version of events. However, without
more, we cannot conclude that Roncone's actions fall within the policy's intentional wrongs
exclusion.
Although causing the death of a four-year-old child is inherently a "particularly reprehensible"
act, the jury's verdict does not provide a rational basis from which to
presume that Roncone acted in such a manner that Chentele's death was an
intended or expected consequence of his actions. Compare
Harleysville Ins. Cos. v. Garitta,
supra, 170
N.J. at 228, where the insured stabbed the victim twice in
the torso area, puncturing his heart and stomach. Under these circumstances, the Supreme
Court concluded that "[t]he insurer has demonstrated that the insured intended to cause
some injury, and that the actual injury that led to [the victim's] death
was an inherently probable consequence of the insured's actions."
Id. at 235.
Here, what is missing from the record before us is the State's version
of how this child died. We presume that, at the very least, the
State's evidence in the criminal trial consisted of the testimony and findings of
the medical examiner. This evidence should have included a forensic analysis of the
injuries and how they caused Chentele's death. This medical evidence may provide insight
into Roncone's state of mind. Depending on this and other evidence that may
be revealed in the course of an evidentiary hearing, the trial court may
be capable of inferring whether Roncone's actions fall within the scope of the
policy's intentional wrongs exclusion.
IV
Conclusion
We reverse the trial court's determination that decedent was not an "insured" under
the policy's intra-family exclusion. We remand for an evidentiary hearing to determine whether
the insured's actions fall within the intentional wrongs exclusion. We do not retain
jurisdiction.
Footnote: 1
The parties entered into a consent judgment against Roncone in the amount
of $300,000. By stipulation, they also agreed to limit Selective's liability to $100,000,
in the event we were to affirm the trial court's judgment.
Footnote: 2 In the course of arguing the summary judgment motion before the Law
Division, counsel for Roncone claimed that Priest held a New Jersey driver's license
indicating that she resided with her parents. Thus, by implication, Chentele's residence may
appear to be in dispute. There is no competent evidence in the record
before us to support this contention. All of the evidence indicates that Chentele
resided with her mother at Roncone's house up to the time of her
death.