The Florida First District Court of Appeal recently issued an opinion regarding the coverage in an auto insurance policy for a woman severely injured in a motorcycle accident. The woman’s mother had purchased “two-parent family” auto insurance coverage for herself, her spouse, and her children. “Dependent children” were defined in the mother’s policy as natural children who are unmarried, under 25, and qualify as legal dependents for tax exemption purposes under the US Tax code.
The injured woman filed suit and the matter eventually went to a jury trial. Both witness and expert medical testimony were offered, providing conflicting accounts to the fact-finder. The insurer claimed the injured woman was not in a coma long enough to qualify for coverage. The appellate court found there was competent substantial evidence supporting the trial court’s findings of the injury. The trial court agreed the type of injuries suffered were covered within the auto policy for the coma and third degree burns. The court, however, did not agree the injured woman was a “dependent child” under the policy. The court determined she was ultimately not covered and the insurer was not obligated to pay benefits for her injury. The family appealed.
Case law directs courts to favor the plain language of an insurance contract. The appellate court found the policy language to be extremely clear about the definition of a dependent. The parties agreed the IRS definition for a dependent was based on Internal Revenue Code (I.R.C.) section 152 which allows a qualifying child to be anyone who bears a relationship to the taxpayer, shares the same principal place of abode as the taxpayer, meets the age requirements (under 19 by the end of the calendar year, or under 24 and a student); and has not provided more than half of the individual’s own support. The insurer argued the policy’s definition contradicted itself with the phrase “under age 25”, which differs from the age requirements in Internal Revenue Code (I.R.C.) section 152. When she was injured, the plaintiff was over the age of 19 and not a student nor disabled.