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  • Writer's pictureWise Men Insurance Services, Inc.

What Other Family Members Should Be Covered?

Notice that insured status does not depend on being listed in the application or in the policy’s declarations.

An insured, as used in the PAP’s liability section, includes not only the named insured (and their resident spouse) but also any resident family members.

Who Is a Family Member?

As defined in the Insurance Services Office, Inc. (ISO), PAP, a family member is a person related to the named insured by blood, marriage (e.g., brother-in-law), or adoption who resides in the household. A ward or foster child who may be living at the residence temporarily is considered a family member. A “ward” is “a person, usually a minor, who is under a guardian’s charge or protection.” A “foster child” is “a child whose care and upbringing are entrusted to an adult other than the child’s natural or adoptive

parents.” (Both definitions from Black’s Law Dictionary, 9th edition.)

The concept of family members is an area that has involved numerous court cases, particularly with children in transition to independence. Confusion can result for a child who lives elsewhere most of the time, such as a college student. Most courts rule that a college student who is supported by the family, who has the majority of their possessions in the home, or who has retained the home as a legal residence is still considered a family member. However, a college student who is older, is self-supporting, has most of their possessions in an apartment near the campus and has their legal and official address at the off-campus apartment is not considered a family member.

This same logic applies to a child in the military. A child who enlists in the military with the intent of establishing a permanent career and who has no plans of returning to the parents’ household is not considered a family member after they have moved out of the home.

An adult son who pays rent to his parents, is self-sufficient, and retains his bedroom in the home is considered a family member since he is a blood relative and lives in the same residence. However, an adult son who lives down the street in his own apartment on a permanent basis but still relies on financial support from his parents is not considered a family member.

Questions of “family member” and “residency” sometimes arise regarding children who move between the homes of divorced parents. Courts often recognize that a child has a “dual residency” in both households. This “dual residency” approach brings the children under the insurance policies of both parents, regardless of where the child happens to be residing when an accident occurs. Other courts follow a litmus test and will bring the child within insurance coverage of a particular parent only if the child is staying in the home at the time of an accident. Under this second test, if a child who

usually lives with their mother is visiting their father and is involved in an auto accident during that visit, the child is considered a resident of only the father’s household for insurance purposes.

The issue of what constitutes a household often arises when unmarried couples live together. The definition makes it clear that a family member must be related by blood, marriage, or adoption and be a resident of the named insured’s household. However, the term “household” is not defined. In Firemen’s Ins. Co. v. Viktora, 318 N.W.2d 704 (Minn. 1982), the court quoted the following three circumstances that were indicative of residency in a household.

 Living under the same roof

 A close, intimate, and informal relationship

 An intended duration likely to be substantial in which it is reasonable to conclude that the parties would consider the relationship in contracting about matters such as insurance.

The US Court of Appeals ruled that if there were more than one reasonable interpretation of the word “household” resulting in a coverage dispute, the ambiguity should be ruled against the drafter of the policy.

Courts have generally made it clear that the term “household” does not include roommate situations or landlord-tenant relationships.

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