Family member?

[MMandM]

In a Dissenting opinion, a 9th Circuit Judge Raps Cohabiting Couple.

 

The case stemmed from a 2001 accident in which a man, I'll call Jim dove from a boat owned by his live in Girlfriend I'll call Mary, into shallow water, causing him to become a quadriplegic, according to the court decision.

 

The couple had lived together for 20 months prior to the accident in "an intimate relationship," the decision said.

 

The legal trouble arose when "Jim" sought to claim the maximum benefit, $100,000, from "Mary's"' insurer, Continental. Citing a clause that barred members of the same household from receiving the maximum, Continental instead offered $25,000, saying a provision limited any claim by a "family member" to that amount. The policy contained language defining "family member" as "any member of the same household."

 

When Jim refused that offer, Continental asked the U.S. District Court to declare that Jim was entitled only to $25,000. But a federal judge ruled that the term "household" was ambiguous both by California case-law precedent, and as defined in standard and legal dictionaries.

 

Since precedent required "ambiguous" insurance contracts be interpreted in favor of the insured, the judge ruled against Continental, which appealed to the 9th Circuit.

 

The Senior Judge launched a vigorous dissent.

 

"It appears that "Jim" and "Mary have successfully attached more importance to a single piece of paper, a marriage license, than they have ever before," wrote the Judge. "For quite some time, they have dwelt under the same roof. They have bedded down together in the same bed. The couple apparently felt that they did not need this single piece of paper to enjoy all the bliss of conjugal life. Nevertheless, they earnestly maintain that a marriage license vel non is of great importance to the Continental Insurance Company."

 

Noting that "Jim" had sued "Mary" and that Mary's' counsel had advised her to "confess judgment" in that action, in their efforts to extract money from the insurer, The Judge quoted Holt v. Holt, 77 F2d 538, a 1935 appellate decision from the District of Columbia.

 

"In essence," he wrote, "they undertake to 'litigate by day and copulate by night.'"

 

I wonder if this Judge would have condemned the decision if this case involved a co-habituating homosexual couple rather than a co-habituating heterosexual couple.

Edited May 25, 2007 by MarkInAlisoViejo

[Graeme]

As I understand it, co-habiting heterosexual couples in Australia are deemed to be in a defacto relationship (ie. a common law marriage) after 12 months. Defacto relationships do not convey the full benefits of marriage, but they convey many of them -- which is why I would be happy if same-sex couples in Australia were recognised as defacto couples. This case wouldn't occur in Australia.

 

Interesting, the Australian Bureau of Statistics advised same-sex couples to put down their relationship as "defacto" on the latest census (last year), but that fact was not well advertised, and some couples publicly refused to do so, say their relationship was not recognised as a "defacto" relationship.

 

EDIT:

 

I found the following document. It appears that my statement above wasn't quite right, but there are strong guidelines on what constitutes a defacto relationship. The main problem is that they are largely derived from State laws, not Federal:

 

Document submitted to the Human Rights commission regarding the recognition of same-sex relationships and defacto heterosexual relationships

[MMandM]

Excellent Graeme , as always, and as we have seen of late, they will try to have things both ways. A Family member is any member of the same household unless it would cost the insurance company more money than it's just the way we see it this time.

[colinian]

Mark,

 

It seems to me that it's possible that the Federal Judge established a judicial precedence that common-law marriage is effectively the law in California when it has not been legislated to be the law in California. Am I right or way off base?

 

Colin

[Graeme]

Colin, my read of the article is that the senior judge was presenting a dissenting opinion -- which means that the case was resolved the other way. In other words, the majority of judges decided that they were NOT a household and that "Jim" could claim the $100,000, with the senior judge quoted disagreeing.

[MMandM]

Most insurance contracts are contracts of adhesion, and policyholders "adhere" to wording chosen and punctuated by insurers. To keep insurers from abusing their monopolistic word usage authority, regulators typically require plain language contracts. Underlying this public policy is an almost na