Appeals Court Affirms Summary Judgment / Insured’s Adult Son Not a Household Member

Attorney Matthew Lindberg obtained affirmation of summary judgment before the Massachusetts Appeals Court on behalf of an insurance company in a declaratory judgment action arising from a claim for underinsured motor vehicle coverage.

The subject action arose following an accident in which the insured’s son, traveling as a passenger in a friend’s vehicle, claims he sustained serious personal injuries as a result of a motor vehicle accident. Upon the exhaustion of the insurance policies of both drivers involved in the accident, the insured’s son sought Underinsured Motorist (UIM) benefits under the policy issued by the plaintiff insurer.  The insurer took the position that the son was not entitled to UIM benefits because he was not a household member at the time of the accident.

Attorney Lindberg filed a Declaratory Judgment action, arguing that although the insured’s son lived in the same building as the insured, he lived in a separate unit, with a separate entrance.  The defendant insured argued that her son should be deemed a household member because the back doors between the units were unlocked and the parties moved between the two units regularly, doing laundry and frequently eating dinner together.   The insurer referenced medical records, utility bills and the son’s driver’s license, all of which showed a different unit number for the son.  Additionally, through discovery, the insurer obtained a lease between the insured and her son for the unit that he occupied.

In its Answer to the declaratory judgment Complaint, the insured maintained that the insurer should be estopped from denying coverage based on a telephone call between the insured and a representative of the insurer.  The insured cited parts of the recorded conversation in which the insurer’s representative reassured the insured that her son would be covered.  Attorney Lindberg argued that the context of the passage was liability coverage, not UIM coverage.   Finally, the insured argued that the son was a third party beneficiary under the policy.  The lower court rejected the insured’s arguments and granted a Motion for Summary Judgment in favor of the insurance company.  The plaintiff appealed the lower court’s decision to the Massachusetts Appeals Court.   The Appeals Court affirmed summary judgment in favor of the insurance company.