Separated from Spouse, Separated from Coverage: Illinois Court Finds Phrase “Resides Primarily” in Spouse Definition Unambiguous and Enforceable

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In Gaudina v. State Farm Mutual Auto. Ins. Co., 2014 Il. App. (1st) 131264 (March 28, 2014), an Illinois appellate court found that State Farm properly denied coverage to a motorist seeking coverage under his estranged wife’s policy because he did not reside primarily with her. 

In Gaudina, a motorist was injured in an automobile accident.  He filed an underinsured motorist claim under his wife’s automobile policy, issued by State Farm.  The policy defined spouse to mean “your husband or wife who resides primarily with you.”  State Farm denied coverage because, at the time of the accident, the motorist did not primarily reside with his wife.  The motorist filed a declaratory judgment action against State Farm, and the trial court determined that State Farm properly denied coverage. 

On appeal, the motorist argued that the policy’s “spouse” definition was ambiguous because: (1) the definition differed from who a reasonable person might consider to be a spouse based on dictionary definitions; (2) the phrase “resides primarily” was not defined in the policy; and (3) the policy did not specify when the spouse had to be residing primarily with the named insured.  The appellate court rejected these arguments and found the definition to be unambiguous.  The court determined there was no need to consult dictionaries to define “spouse” because that term was defined in the policy.  Additionally, the court noted that courts in Wisconsin and Ohio found the phrase “resides primarily” to be unambiguous and enforceable.  Lastly, the court ruled that it was clear, for a spouse to be covered by the policy, a husband or wife must fall within the definition of spouse at the time of the accident. 

After finding the definition to be unambiguous, the court next examined the evidence to determine if the motorist qualified as a “spouse” who “reside[d] primarily” with the named insured at the time of the accident, as required by the policy.  The court concluded that he did not because he was separated from his wife and rented a townhouse where he stayed five to six times a week.  In addition, the motorist already had been out of the marital home since before his wife’s policy incepted through the date of the accident.  As such, the motorist was not entitled to coverage, and judgment in State Farm’s favor was proper.

 

 

Topics:  Auto Insurance, Bodily Injury, Car Accident

Published In: Civil Procedure Updates, General Business Updates, Insurance Updates, Personal Injury Updates

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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