Continental Insurance Co. v. Polly Roberts

410 F.3d 1331, 2005 A.M.C. 1853, 2005 U.S. App. LEXIS 10177, 2005 WL 1313692
CourtCourt of Appeals for the Eleventh Circuit
DecidedJune 3, 2005
Docket04-12566
StatusPublished
Cited by6 cases

This text of 410 F.3d 1331 (Continental Insurance Co. v. Polly Roberts) is published on Counsel Stack Legal Research, covering Court of Appeals for the Eleventh Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Continental Insurance Co. v. Polly Roberts, 410 F.3d 1331, 2005 A.M.C. 1853, 2005 U.S. App. LEXIS 10177, 2005 WL 1313692 (11th Cir. 2005).

Opinions

CARNES, Circuit Judge:

This appeal arises out of a disagreement about the meaning of a term in an insurance contract. As always in this type of case, “the pivotal issue is whether a policy term is ambiguous and therefore to be interpreted against the insurer, meaning that there is coverage, or is plain, meaning that there is no coverage.” Am. Cas. Co. of Reading, Pa. v. Etowah Bank, 288 F.3d 1282, 1284 (11th Cir.2002). The term in question is “household,” as used to define “family member” in a limitation clause contained in an insurance policy on a boat.

In July of 2001 Stephen Gimopoulos suffered severe spinal injuries causing him to become quadriplegic after he dove headfirst off Polly Roberts’ boat into shallow water. Following the accident, Gimopoulos filed a claim seeking to recover under Roberts’ insurance policy, which had been issued by Continental Insurance Company. The policy had a liability provision, which provided $100,000.00 in coverage for bodily injuries arising out of operation of the boat. That coverage was limited, however, by another provision in the policy, which specified that “[bloating liability coverage for any claim ... by any family member(s) shall be limited to $25,000.00 per accident.” The policy defined the term “family member” as “any member of the named insured’s household.” It did not define the term “household.”

When Continental investigated Gimopoulos’ claim, it discovered that for a period of twenty months leading up to the accident Gimopoulos and Roberts had been living together in an intimate relationship. Continental also found that they had shared meals and expenses, and that Roberts had allowed Gimopoulos to carry a cellular telephone and credit card in her name. Based on that information, Continental believed that Gimopoulos was a member of Roberts’ household, which would mean that he was subject to the family member limitation clause of the insurance policy. Acting on its belief, Continental offered Gimopoulos $25,000.00. Believing differently, Gimopoulos did not accept Continental’s offer.

In June of 2003 Continental filed the present lawsuit against Gimopoulos and Roberts in federal district court. Among other things, Continental sought a declaration that Gimopoulos was entitled to only $25,000.00 under the policy because he had been a member of Roberts’ household at the time of the accident. Continental contended that the word “household,” as used in the policy, included all people living together in one dwelling regardless of whether they were related by blood, marriage, or adoption. Because it was undisputed that Gimopoulos and Roberts lived together, Continental argued that Gimopoulos was a member of Roberts’ household.

Gimopoulos and Roberts responded that the word “household,” as used in the insurance contract, was limited to people shar[1333]*1333ing a dwelling who were also related by blood, marriage, or adoption. They argued that because Gimopoulos was not related to Roberts in any of those ways, he was not a member of her household and was, therefore, entitled to the full $100,000.00 coverage.

The parties presented their differences to the district court in cross-motions for summary judgment. The district court granted Gimopoulos and Roberts’ motion and denied Continental’s. The court explained that it did so because both interpretations of “household” were reasonable in light of the way dictionaries defined the term, because of what Florida case law said about the term, and because of the context in which the term was used in the insurance policy. There being two reasonable interpretations, the court concluded that the contract term was ambiguous and as a result had to be construed against Continental. On that basis, the court ruled that Gimopoulos was not a member of Roberts’ household and thus was not her family member for purposes of the limitation clause. Following entry of final judgment, Continental filed this appeal challenging the district court’s ruling on the cross-motions for summary judgment.

There is much about which the parties agree. They agree that Florida law governs the interpretation of the term “household” in this contract. See Wilburn Boat Co. v. Fireman’s Fund Ins. Co., 348 U.S. 310, 320-21, 75 S.Ct. 368, 374, 99 L.Ed. 337 (1955) (while maritime insurance contracts are within the admiralty jurisdiction of the federal courts, state law will control in the absence of an admiralty rule). They agree that if the term “household” is ambiguous, the policy is to be construed against Continental, the insurer. See State Farm Mut. Auto. Ins. Co. v. Pridgen, 498 So.2d 1245, 1248 (Fla.1986) (“[Exclusionary provisions which are ambiguous or otherwise susceptible to more than one meaning must be construed in favor of the insured, since it is the insurer who usually drafts the policy.”). They agree that the term “household” is ambiguous if it is subject to two reasonable interpretations. See Auto-Owners Ins. Co. v. Anderson, 756 So.2d 29, 34, (Fla.2000) (“If the relevant policy language is susceptible to more than one reasonable interpretation, one providing coverage and the another limiting coverage, the insurance policy is considered ambiguous.”); Cont’l Cas. Co. v. Wendt, 205 F.3d 1258, 1261 (11th Cir.2000) (“An, insurance contract is deemed ambiguous if it is susceptible to two or more reasonable interpretations that can fairly be made.” (quotation omitted)). And they agree that Continental’s proffered interpretation of “household,” which includes certain unrelated people who reside with the insured, is reasonable. Thus, the only question left for our review is whether the interpretation of “household” offered by Gimopoulos and Roberts is also reasonable. If so, they win; if not, they lose.

There are ample grounds for concluding that the interpretation of “household” offered by Gimopoulos and Roberts, which requires kinship by blood or marriage or adoption, is reasonable. The most important indication of the reasonableness of that interpretation is the dicta in five Florida, appellate court decisions stating that an essential characteristic of a household member is “close ties of kinship” — a relationship by blood, marriage, or adoption. Dwelle v. State Farm Mut. Auto. Ins. Co., 839 So.2d 897, 898-99 (Fla. 1st DCA 2003); Kepple v. Aetna Cas. & Sur. Co., 634 So.2d 220, 221-22 (Fla. 2d DCA 1994); Universal Underwriters Ins. Co. v. Evans, 565 So.2d 741, 742 (Fla. 5th DCA 1990); Row v. United Servs.. Auto. Ass’n, 474 So.2d 348, 349 (Fla. 1st DCA 1985); Gen. Guar. Ins. Co. v. Broxsie, 239 So.2d 595, 597 (Fla. 1st DCA 1970); see also Black’s Law Dictionary 393 (2d pocket ed.1996) (defin[1334]*1334ing kinship as a “[Relationship by blood, marriage, or adoption”). While dicta cannot establish decisional law, it can serve to show the reasonableness of an interpretation. Cf. McDonald’s Corp. v. Robertson, 147 F.3d 1301, 1314-15 (Carnes, J., concurring specially) (while “dicta in our opinions is not binding on anyone for any purpose,” it “can be used as a vehicle for offering to the bench and bar ... views on an issue”). Here it does exactly that.

Continental touts some other dicta' or, more accurately, the implication of some dicta that is contained in the Fifth District Court of Appeal’s Evans opinion.

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Continental Insurance Co. v. Polly Roberts
410 F.3d 1331 (Eleventh Circuit, 2005)

Cite This Page — Counsel Stack

Bluebook (online)
410 F.3d 1331, 2005 A.M.C. 1853, 2005 U.S. App. LEXIS 10177, 2005 WL 1313692, Counsel Stack Legal Research, https://law.counselstack.com/opinion/continental-insurance-co-v-polly-roberts-ca11-2005.