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New Case Law: Who is Considered a "Household Member" for Insurance Coverage?

Many personal insurance injury policies provide for coverage to “household members” of the policyholder. But just who qualifies as a “household member”? The Massachusetts Appeals Court considered this question in a recent case.

In the case, Oliveira v. Commerce Insurance Company, the plaintiff filed a claim against an insurer to obtain coverage as a "household member" under an insurance policy that was held by the mother and stepfather of his long-term partner, with whom he had a child. In order to resolve the matter, the Court had to review what the term “household member” meant, and more specifically, whether the term “related by blood” included two persons with no blood relationship with each other whatsoever, but who each have a blood relationship with a third person.

The plaintiff in the case was involved in a serious car accident with as a passenger in the vehicle of a third party driver. The plaintiff suffered severe injuries, requiring hospitalization, long-term disability, and resulting in significant damages. The plaintiff accepted a settlement with the third party driver’s insurance company, but also sought to obtain additional damages under the insurance policy held by his partner’s mother and stepfather. The plaintiff lived with his long-term partner in a single-family unit with her mother and stepfather. The plaintiff was not married to his partner, but they had a minor son together

The policy in question provided coverage for the two vehicles used by the residents of the plaintiff's home for "damages for bodily injury to people injured or killed as a result of certain accidents caused by someone who does not have enough insurance." The policy also included a definition of the term “household member,” which was “anyone living in your household who is related to you by blood, marriage or adoption. This includes wards, step-children or foster children." The insurer denied the plaintiff’s claim, stating that he did not meet the definition of “household member” under the policy.

The plaintiff filed a claim in Superior Court, alleging breach of contract and seeking declaratory relief that would hold the plaintiff to be a “household member.” The judge granted the insurer’s motion for Summary Judgment, finding that the plaintiff was not related by blood to either policyholder, and thus he was not a "household member" and not entitled to coverage under the policy. The plaintiff appealed.

The Appeals Court affirmed the trial judgment, siding with the defendant. “In its usual and ordinary sense, the phrase ‘related by blood’ denotes a genetic relationship between the two persons asserted to be related,” the Court explained. “Here, there is no genetic relationship between the plaintiff and the policyholders; rather the plaintiff relies on the fact that both the plaintiff and one of the policyholders have a genetic relationship with the plaintiff's child…the plaintiff requests an expansive definition of ‘related by blood.’ The policy language, however, by specifically adding ‘wards, step-children or foster children’ to the persons included in ‘household member,’ makes evident that the meaning of ‘related . . . by blood, marriage or adoption’ is not suited to further expansion beyond its usual and ordinary meaning. Otherwise, there would be no need to add those persons to the definition of ‘household member.’”

The Court also differentiated this case from two previous cases, in which the definition of “household member” was broadened to include people who were similarly situated to the plaintiff—however, those cases involved restraining orders, where the intent of the Legislature was to make that definition broad, the Court stated. “Here, we are not interpreting legislative language in an attempt to best effectuate the intent of the Legislature. Instead, we are bound to apply the usual and ordinary meaning of the words ‘related by blood.’ Those words denote a genetic relationship, and it is undisputed that the plaintiff has none with either of the policyholders,” the Court explained. “Because the Superior Court judge correctly concluded, based on the undisputed facts, that the plaintiff was not ‘related by blood’ to the policyholders in the usual and ordinary sense of those words, the judge properly granted summary judgment to the insurer.”

If you have any questions about issues involving tort law, car accidents, or other injuries, you should contact a competent attorney licensed to practice law in Massachusetts. Our experienced professionals may be able to work on your behalf. Please contact our offices at your earliest convenience by phone at 978-225-9030 or complete a contact form on our website, and we will respond to you as early as possible.

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