Pennsylvania Supreme Court Upholds Homeowner's Insurance Carrier's Denial of Coverage in a Drug Overdose Case

In the case of Kramer v. Nationwide Insurance, No. 103 MAP 2022 (Pa. April 25, 2024) (Op. by Donohue, J., Dougherty, J., Concurring, Mundy, J., Concurring), the court addressed the scope of a controlled substance abuse exclusion found in a homeowner’s policy.

According to the Opinion, the dispute between the insureds and the homeowner’s carrier arose after a fatal drug overdose of the Plaintiff's decedent within the insured Defendant's home. The family of the decedent sued the homeowners and their son for wrongful death and survival action claims.

The homeowners sought coverage under their insurance policy with Nationwide.  Nationwide denied coverage based upon a controlled substance exclusion in the policy. The homeowners then filed this declaratory judgment action.

The Pennsylvania Supreme Court held that the finding of the Superior Court that the carrier was potentially required to pay out for emotional and mental distress damages was contrary to the unambiguous provisions of the policy and erroneous as a matter of law.

The Pennsylvania Supreme Court concluded that Nationwide had no duty to defend the underlying lawsuit because emotional and mental distress damages in the wrongful death claims were not "bodily injuries" as that term was considered under the policy language at issue.

Anyone wishing to review a copy of this decision may click this LINK.  Justice Dougherty's Concurring Opinion can be viewed HERE.  Justice Mundy's Concurring Opinion can be viewed HERE.

Source of image:  Photo by Tierra Mallorca on www.unsplash.com.

Court Addresses Motion To Dismiss Section 1983 Prison Case Regarding Medical Care Issues

In the case of Cyr v. Schuylkill County, No. 3:22-CV-00453 (M.D. Pa. Jan. 30, 2023 Saporito, M.J.), the court denied the Defendant nurse's and prison medical care company’s Motion to Dismiss a claim for an alleged §1983 denial of medical care and failure to intervene action after the Plaintiff's son died in prison of an alleged drug overdose.

The court found that the Plaintiff had adequately pled a denial of medical care and a failure to intervene in the Complaint. The court found that the allegations sufficiently pled a plausible claim against the medical company.

More specifically, after reviewing the Complaint, the court noted that the Plaintiff asserted in the Complaint that the son’s serious medical need was “so obvious” that a layperson could recognize it.

Magistrate Judge Joseph F. Saporito, Jr.
M.D. Pa.

The court additionally found that the Complaint sufficiently alleged deliberate indifference to substantiate a denial of medical care claim.

Judge Saporito also pointed to the fact that the Plaintiff had identified several policies, customs, or practices that the nurses and medical company allegedly violated which allegedly caused the deprivation of the son’s constitutional rights. Those alleged policies included alleged insufficient staffing, failing to train employees on diagnosing intoxicated or overdosing inmates, and not monitoring inmates in need or emergency care.

The court additionally found that the Plaintiff plausibly pled a failure to intervene claim.

Anyone wishing to review a copy of this decision may click this LINK.

Source: “Digest of Recent Opinions.” Pennsylvania Law Weekly (Feb. 14, 2023).

Court Recognizes Duty of a Drug and Alcohol Treatment Facility to Prevent Drug Overdose of its Patients

In the case of Ramsey v. Salvation Army, No. 21-557 (W.D. Pa. Jan. 14, 2022 Dodge, Mag. J.), a Western District Federal Magistrate judge denied a Motion to Dismiss and found that a Plaintiff had sufficiently stated a claim for negligence in the treatment of the decedent’s drug addiction, even though the decedent ultimately broke the Defendant treatment facilities’s rules against drug use.  The decedent had a fatal overdose.

According to the Opinion, the Plaintiff's decedent had left the facility with two other residents to take drugs.  When they came back to the facility, the Plaintiff's decedent was incoherent and was being assisted into the facility by his friends back to his room.  Along the way, the individuals encountered at least two of the treatment facilities workers who did not intervene.  The next morning, the Plaintiff's decedent was found unresponsive and died later that same day.  

The court found that the Plaintiff had stated a plausible claim that the Defendant drug and alcohol in-patient treatment facility owed a duty to prevent in-patient residents from overdosing.

Anyone wishing to review a copy of this decision may click this LINK.

I send thanks to Attorney James M. Beck from the Philadelphia office of the Reed Smith law firm for bringing this case to my attention.

Coverage Found Under a Homeowner's Policy For a Drug Overdose at a House Party

In the case of Kramer v. Nationwide Prop. & Cas. Ins. Co., No. 726 EDA 2021 (Pa. Super. Dec. 2, 2021 Lazarus, J., Dubow, J., and Pellegrini, J.), the Pennsylvania Superior Court addressed an insurance coverage action arising out of an incident during which the insured’s son hosted a house party at his parents’ home while they were out of town. Early in the morning thereafter, the decedent partygoer was found dead and a coroner later determined that the cause of death was a drug overdose.

The decedent’s mother filed a wrongful death and survival action against the homeowners and their son. The Plaintiffs asserted that the son who hosted the party was negligent in supplying the decedent with the drugs that caused his overdose. The Plaintiffs also allege in both the survival and wrongful death claims that the homeowners were negligent in allowing their son to use the home in such regard.

At the time of the incident, Nationwide was the insurance company for the parents at whose house the party was held. Nationwide denied coverage under the case presented.

According to the Opinion, the insurane policy at issue provided that Nationwide must “pay damages and insured is legally obligated to pay due to an occurrence resulting from negligent personal acts or negligence arising out of the ownership, maintenance, or use of real or personal property.”

In asserting that it did not have to provide a defense, Nationwide relied upon coverage exclusions in the policy which applied when certain damages arise from criminal conduct or the use of controlled substances.

The trial court had ruled that Nationwide had a duty to defend and the Pennsylvania Superior Court affirmed this decision.

Although the Pennsylvania Superior Court addressed the policy exclusion noted above, it ruled, in part, that the carrier was required to defend its insured in this suit arising from an alleged accidental drug overdose death because the damages under the Wrongful Death Act did not implicate the term “bodily injury” under the policy definitions.

Anyone wishing to review a copy of this decision may click this LINK.

I send thanks to Attorney Matthew D. Vodzak of the Philadelphia office of Fowler Hirtzel McNulty & Spaulding, LLP for bringing this case to my attention.