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Sigel v. New Jersey Manufacturers Insurance Co.

February 24, 2000


Before Judges Pressler, Ciancia and Arnold.

The opinion of the court was delivered by: Ciancia, J.A.D.


Argued February 1, 2000

On appeal from the Superior Court of New Jersey, Law Division, Bergen County.

The question presented by this appeal is whether stepbrothers are "related by marriage" as that language is used in an automobile insurance policy for the purpose of defining coverage.

Plaintiff Michael Sigel was struck by an automobile as he attempted to walk across a street. The driver did not stop and has never been identified. At the time of the accident plaintiff lived with his mother, his stepfather and his stepfather's son, Anthony. Plaintiff had no automobile insurance but his mother and stepfather had a policy issued to them as named insureds by defendant New Jersey Manufacturers Insurance Company, and Anthony was the named insured on a policy issued to him by defendant Allstate Insurance Company. Plaintiff sought uninsured motorist coverage under both those policies. The matter went to arbitration and subsequently to litigation. A trial date had been set when Allstate moved for summary judgment on the theory that plaintiff was not entitled to coverage because he was neither a family member nor a relative of its insured. The motion judge was persuaded to the merits of Allstate's position and entered summary judgment in its favor. We denied a motion for leave to appeal that interlocutory judgment. The remainder of the litigation was settled, and New Jersey Manufacturers, which has never disputed the coverage of its policy, specifically reserved its right to pursue the present appeal against Allstate. We now reverse the entry of summary judgment in favor of Allstate.

The Allstate policy provided coverage to Anthony as the named insured and to his family members or relatives. The policy defined "family member" as, "a person related to you by blood, marriage or adoption who is a resident of your household. This includes a ward or foster child." Similarly, "relative" was defined as, "a person related to the named insured by blood, marriage or adoption (including a ward or foster child) who is a resident of the same household of the named insured."

Allstate successfully argued that plaintiff and his stepbrother, although living together in the same household, were not related by marriage. Although there is not a great deal of law addressing this question, the most analogous cases run counter to Allstate's position. Moreover, logic, common sense and the reasonable expectations of the average policyholder militate in favor of stepbrothers being considered related through marriage.

The rules for interpreting insurance contracts are well known and have been recently reiterated by our Supreme Court in Gibson v. Callaghan, 158 N.J. 662 (1999):

Insurance policies are contracts of adhesion and, as such, are subject to special rules of interpretation. As this Court noted in Allen v. Metropolitan Life Insurance Co., 44 N.J. 294, 305, 208 A.2d 638 (1965), an insurance company is "expert in its field and its varied and complex instruments are prepared by it unilaterally whereas the assured or prospective assured is a layman unversed in insurance provisions and practices." Therefore, when called on to interpret insurance policies, we "assume a particularly vigilant role in ensuring their conformity to public policy and principles of fairness."

. . . Generally, the words of an insurance policy are to be given their plain, ordinary meaning. In the absence of any ambiguity, courts "should not write for the insured a better policy of insurance than the one purchased."

However, that ambiguities in an insurance policy are to be interpreted in favor of the insured is fundamental. When obligated to construe an ambiguous clause in an insurance policy, courts should consider whether more precise language by the insurer, had such language been included in the policy, "would have put the matter beyond reasonable question."

Further, insurance policies must be construed to comport with the reasonable expectations of the insured. . . .

Concerning exclusion clauses that proscribe or limit coverage, we have observed that "[i]n general, insurance policy exclusions must be narrowly construed; the burden is on the insurer to bring the case within the exclusion." Conversely, ...

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