“Family Member” In Auto Policy

If you live in Mansfield, Arlington, Dallas, Fort Worth, Grand Prairie, Hurst, Euless, Bedford, Grapevine, Keller, Colleyville, or anywhere else in Texas, how is “family member” defined in a Texas Insurance Policy?
The answer would seem to be simple on its face, but it is not. If you are having to decide this based on the definition in an automobile insurance policy, here is a “standard” definition in most auto policies:
Family member means a person who is a resident of your household and related to you by blood, marriage or adoption. This definition includes a ward or foster child who is a resident of your household, and also includes your spouse even when not a resident of your household during a period of separation in contemplation of divorce.
There is a case that was decided in 1977 which does a good job of helping to understand how the courts look at this issue. The case was decided by the Court of Appeals, Waco, and is styled, “Southern Farm Bureau Casualty Insurance Company v. Kenneth C. Kimbell et al.
Kenneth C. Kimbell is the named insured in a family automobile policy issued by Southern Farm Bureau Casualty Insurance Company (Farm Bureau). Kenneth’s wife, Connie, was killed in an automobile accident with an uninsured motorist when the policy was in force. At the time of her death, she and Kenneth were separated, living in separate residences, and a divorce action filed by her was pending. Farm Bureau brought suit seeking a declaration by the court that its responsibilities under the policy for uninsured protection benefits, personal injury protection benefits, and death indemnity benefits did not apply in this situation because Connie did not meet the definition of “family member.”
This case was tried to a jury and the jury had to answer one question, “Do you find from a prepoderance of the evidence that at the time of the accident in question, Connie Kay Kimball was a resident of the same household as Kenneth Kimball?” The jury was instructed that “by the term ‘resident of the same household’ is meant: (A) by the term ‘resident’ (is meant) a member of the same family; and (B) by the term ‘household’ is meant persons who dwell together as a family.” The jury answered the question, “She was a resident of the same household.”
The court stated, “The controlling test of whether persons are residents of the same household at a particular time, within the meaning of the policy in question, is not solely whether they are then residing together under the same roof. The real test is whether the absence of the party of interest from the household of the alleged insured is intended to be permanent or only temporary i.e., where there is physical absence coupled with an intent not to return.”
The insurance company was argueing that because divorce papers had been filed and Connie had moved out, that she was no longer a member of the household. However, evidence at trial showed that the two had reached a reconciliation a week prior to the accident and thus there was evidence that Connie had intent to return.
An experienced Insurance Law Attorney would know how to sift thru the facts of the case and the surrounding circumstances and be able to provide good advice as to a probable outcome under similar circumstances. Each of these cases need to be looked at carefully to understand the reasoning and the fact scenarios that play into a possible final outcome.