ESTATE OF JOAN STURGILL, ET AL., Appellants, v. UNITED SERVICES AUTOMOBILE ASSOCIATION.
[1] Insurance - Construction of Policy - Question of Law or Fact - In General. The interpretation of an insurance contract is a question of law.
[2] Insurance - Construction of Policy - Summary Judgment. An action turning on the interpretation of an insurance policy may be decided by summary judgment unless the terms of the policy are ambiguous and contradictory evidence is introduced to resolve the ambiguity.
[3] Insurance - Construction of Policy - "Resident of House-hold" - Case-Specific Inquiry. The phrase "resident of the same household" in an insurance policy does not have a precise meaning; its meaning varies according to the circumstances of the particular case.
[4] Insurance - Construction of Policy - "Resident of House-hold" - Independent Household Under Same Roof - Factors. A common roof is not necessarily the controlling factor in determining who the "residents of the same household" are for purposes of an insurance policy that excludes coverage for injuries sustained by residents of the same household as the insured; an insured's relatives who live separately and independently from the insured may not be "residents of the same household" even
878 ESTATE OF STURGILL v. USAA Feb. 1997
84 Wn. App. 877, 930 P.2d 945
though they live under a common roof. The critical inquiry is whether separate domestic establishments are maintained. Indicia of a separate domestic establishment include: segregated living quarters, segregated kitchen and dining facilities, physical partitions, payment of rent, separate utility services, and separate leisure time activities.
[5] Judgment - Review - Judgment Granted on Review. An appellate court may grant a judgment as a matter of law if there are no disputed facts.
[6] Insurance - Expenses of Insured - Insured's Action To Obtain Benefit of Policy - In General. An insured who is compelled by an insurer to assume the burden of legal action to obtain the benefit of the insurance contract is entitled to an award of attorney fees from the insurer, regardless of whether the insurer's duty to defend is at issue.
Nature of Action: The estate of a decedent who had died in an automobile driven by her daughter sought to recover underinsured motorist benefits from the decedent's husband's insurer. The decedent's husband's underinsured motorist policy contained an exclusion for injuries sustained by any person who operates or occupies a motor vehicle not insured under the policy that is owned by or available for the regular use of a family member, and defining "family member" as a person who is related by blood, marriage, or adoption and is a resident of the same household as the insured.
Superior Court: The Superior Court for Spokane County, No. 92-2-03541-8, Robert D. Austin, J., on February 28, 1995, entered a summary judgment in favor of the insurer.
Court of Appeals: Holding that the daughter, who maintained separate living quarters in her father's house, was not a "resident of the same household" as her father, the court reverses the judgment and grants judgment in favor of the estate.
Lloyd A. Herman and Lloyd A. Herman & Associates, P.S., for appellants.
G. Ward McAuliffe III and Chase, Hayes & Kalamon, P.S., for respondent.
Feb. 1997 ESTATE OF STURGILL v. USAA 879
84 Wn. App. 877, 930 P.2d 945
THOMPSON, J. - Joan Sturgill was a passenger in an automobile owned and operated by her daughter, Ramona Sturgill. They were involved in an accident with an uninsured motorist, resulting in injuries to Joan Sturgill that caused her death. Ramona Sturgill's automobile was insured by Allstate Insurance Company, which paid uninsured motorist (UIM) and other benefits to Joan Sturgill's estate. Joan Sturgill's own insurance carrier, Farmers Insurance Company, also paid UIM benefits. Joan Sturgill's husband, Stanley Sturgill, was insured by United Services Automobile Association (USAA), which paid some of Mrs. Sturgill's medical bills. However, the Estate's claim for UIM benefits under Stanley Sturgill's USAA policy was denied.
The Estate filed this action seeking uninsured motorist benefits under the USAA policy. The trial court denied the Estate's motion for summary judgment, but granted USAA's motion, finding that at all material times Ramona Sturgill was a resident of her father's household, which precluded coverage. The Estate appeals.
The UIM coverage provision in Mr. Sturgill's policy provides USAA will pay compensatory damages which Stanley or any family member is entitled to recover from the owner or operator of an uninsured or underinsured motor vehicle because of bodily injury caused by an accident. The policy also contains an exclusion which provides:
A. We do not provide UIM Coverage for PD or BI sustained by any person:
1. While operating, or occupying, any motor vehicle owned by or available for the regular use of you
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84 Wn. App. 877, 930 P.2d 945
or any family member which is not insured for Liability Coverage under this policy.
The policy defines "family member" as a "person related to you by blood, marriage, or adoption who is a resident of your household." (Emphasis added.)
The trial court, in granting summary judgment, held that the undisputed facts establish: Ramona Sturgill was a resident of Stanley Sturgill's household; the vehicle in which Joan Sturgill was injured belonged to Ramona; and Ramona's vehicle was not insured for liability coverage under the USAA policy.«1»
On appeal, the Estate contends the USAA policy exclusion did not apply because, contrary to the trial court's ruling, the undisputed evidence established (1) Stanley and Ramona shared a roof, but maintained separate, independent households; (2) Ramona's vehicle was not available for either of her parents' regular use; and (3) the exclusionary clause is ambiguous and must be construed in favor of the Estate. We conclude the dispositive issue is whether Ramona Sturgill was a resident of Stanley Sturgill's household and therefore a "family member." If she was a "family member," as the term is used in the policy exclusion, it is immaterial whether her car was available for her mother's regular use.
[1-3] The interpretation of an insurance contract is a question of law, properly decided on summary judgment unless terms of the contract are ambiguous and contradictory evidence is introduced to clarify the ambiguity. National Gen. Ins. Co. v. Sherouse, 76 Wn. App. 159, 162, 882 P.2d 1207 (1994), review denied, 126 Wn.2d 1009 (1995). Who is a "resident" of a "household" for insurance purposes must be determined on the specific facts of each individual case; the terms themselves have no precise meaning. Id. at 163.
«1» Joan Sturgill was divorced from Stanley Sturgill until shortly before the accident. But she had remarried him and was living in his home on the day the fatal accident occurred.
Feb. 1997 ESTATE OF STURGILL v. USAA 881
84 Wn. App. 877, 930 P.2d 945
[4] No Washington decisions expressly hold there can be multiple, separate and independent households among relatives living under a common roof, but common sense and cases from other jurisdictions indicate this is so. See, e.g., State Farm Mut. Auto. Ins. Co. v. Snyder, 122 Ga. App. 584, 178 S.E.2d 215, 217 (1970). In the Snyder case, the insured's mother-in-law maintained a separate, domestic establishment even though she lived in the same house as the insured. A common roof is not the controlling element; the critical distinction is whether separate, domestic establishments are maintained. 12 GEORGE J. COUCH, COUCH ON INSURANCE 2D §§ 45:520, 45:521 (Mark S. Rhodes rev. ed. 1981).
The problem in this case is not defining "residence" or "household," it is applying the definitions to the facts. The undisputed evidence before the court established Stanley Sturgill and Ramona Sturgill maintained separate domestic units under a common roof, and neither was a resident of the other's household. Ramona Sturgill moved with her teenaged daughter into her father's home as an upstairs tenant after being on her own for 14 years. Her father lived downstairs in the family room, dining room and kitchen. He either ate out or fixed and ate his own meals downstairs. He used a toilet in the basement, and only came upstairs to bathe in the single, full bathroom and to change clothes in the bedroom he used solely for storage.
Ramona Sturgill and her daughter lived upstairs on the second floor. They occupied two bedrooms and the hall/ landing where Ramona had set up a dining table, chairs and a kitchenette. Ramona installed heavy curtains across the stairwell for privacy, and put locks on the bedroom doors, for which she and her daughter alone had the keys. Ramona paid rent and her share of the utilities and telephone bills. She bought all household goods and groceries for herself and her daughter which she kept in their own refrigerator upstairs. They either ate out, or prepared and ate their meals upstairs. They watched television in their rooms and entertained guests there. Stanley Sturgill
882 ERVIN v. COLUMBIA DISTRIB., INC. Feb. 1997
84 Wn. App. 882, 930 P.2d 947
and Ramona Sturgill each went his or her own way without regard to any social or family obligations, one to the other. In other words, they did not compose a family; though they were father and daughter by blood, they were not father and daughter in their living arrangement. Their households operated just as separately as if they occupied adjoining apartments in an apartment building, but shared a common area.
We conclude the court erred in granting USAA's motion for summary judgment.
[5] This issue can be determined by this court as a matter of law. Sherouse, 76 Wn. App. at 162. We reverse and grant the Estate's motion on summary judgment.
[6] The Estate requested attorney fees and costs for having to bring a court action to obtain the benefit of Stanley's insurance policy with USAA. The Estate is entitled to reasonable fees in an amount to be determined by a court commissioner pursuant to RAP 18.1. McGreevy v. Oregon Mut. Ins. Co., 128 Wn.2d 26, 40, 904 P.2d 731 (1995); Olympic S.S. Co. v. Centennial Ins. Co., 117 Wn.2d 37, 53, 811 P.2d 673 (1991).
SWEENEY, C.J., and MUNSON, J. Pro Tem., concur.
Reconsideration denied March 19, 1997.