DEFINING "FAMILY MEMBER"

In Dissenting Opinion, 11th Circuit Judge Raps Cohabiting Couple

. . . The case stemmed from a 2001 accident in which Stephen Gimopoulos dove from a boat owned by Polly Roberts 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 [Stephen] Gimopoulos sought to claim the maximum benefit, $100,000, from [Polly] Roberts' 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 Gimopoulos refused that offer, Continental asked the U.S. District Court for the Middle District of Florida to declare that Gimopoulos was entitled only to $25,000. But a federal judge ruled that the term "household" was ambiguous both by Florida 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 11th Circuit.


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Senior Judge James C. Hill, named to the federal appellate bench by President Ford in 1976, launched a vigorous dissent.

"t appears that Mr. Gimopoulos and Ms. Roberts have successfully attached more importance to a single piece of paper -- a marriage license -- than they have ever before," wrote Hill. "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 Gimopoulos had sued Roberts -- and that Roberts' counsel had advised her to "confess judgment" in that action -- in their efforts to extract money from the insurer, Hill 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.'"