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Case Law Alerts

Court Denies UIM Coverage to Woman, Claiming ‘Family Member’ Status Through Daughter

Miller v. USAA General Indemnity Company, No. 23-1934 (3d Cir. Jan. 7, 2025)

April 1, 2025

by Christopher W. Woodward

The plaintiff, who resided with her daughter in the home of her daughter’s paternal grandmother, sought UIM benefits under an auto insurance policy issued to the grandmother. The policy limited UIM coverage to the named insured or “family members,” defined as those related by blood, marriage, or adoption and residing in the same household. Arguing that her daughter’s designation as an “operator” effectively made the daughter a named insured, the plaintiff claimed she qualified as a family member. Both the district court and the Third Circuit rejected this argument, holding that the plaintiff did not meet the policy’s definition of a covered person and was, therefore, ineligible for UIM benefits.

Melanie Miller lived with her daughter, Kayleigh, in the home of Kayleigh’s grandmother (her father’s mother). The grandmother was a named insured on a policy of auto insurance issued by USAA General Indemnity Company while Kayleigh (Miller’s daughter) was listed on the declarations page of that auto policy as an “operator.” The named insured, Kayleigh’s grandmother, and Miller were, by Miller’s own admission, not related by blood, marriage, or adoption. 

After suffering injuries in a motor vehicle accident, Miller sought UIM benefits under the policy issued to the named insured, the grandmother. The policy limited UIM coverage to the named insured or “family member[s]” of the named insured, defining “family member” as a person related to the named insured by blood, marriage, or adoption and primarily residing in the same household as the named insured. 

Before the District Court, and again before the Third Circuit, Miller argued that she qualified as a family member because the policy identified her daughter, Kayleigh, as an “operator” on the declarations page which, she claimed, is tantamount to Kayleigh qualifying as a named insured on the policy. As such, Miller claimed, she qualified as a “family member” since she is related by blood to Kayleigh and lived in the same household. The Third Circuit agreed with the District Court that Kayleigh’s designation as an “operator” did not elevate her status to that of a named insured. Thus, since there was no evidence that Miller was related to the named insured, Kayleigh’s grandmother, by blood, marriage, or adoption, Miller did not qualify for UIM coverage under the policy.

Miller also argued that the limitations in the policy as to who qualifies for UIM coverage conflicts with the MVFRL’s provisions and acts as a disguised waiver of UIM stacking requirements. The Third Circuit disregarded this argument by noting that the issue was not whether the named insured waived UIM benefits, expressly or otherwise, but whether Miller qualifies as a covered person—which she did not.

The Third Circuit also affirmed the district court’s dismissal of Miller’s claim for statutory bad faith on the basis that, since Miller does not qualify as an insured under the terms of the policy, there was no duty of good faith owed to her by USAA General Indemnity Company. 


 

Case Law Alerts, 2nd Quarter, April 2025 is prepared by Marshall Dennehey to provide information on recent developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. Copyright © 2024 Marshall Dennehey, all rights reserved. This article may not be reprinted without the express written permission of our firm.

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Appellate Division Affirms Dismissal of Legal Malpractice Counterclaim Against Martin Law Firm

In Martin v. Loury, 2026 N.J. Super. Unpub. LEXIS 1617 (App. Div. July 15, 2026), Martin Law Firm represented Kirk Loury in an employment matter Mr. Loury filed against his former employer, Concord Equity Group Advisors LLC (“Concord”). The allegations included, among other things, that Loury was not fairly compensated for his employment with Concord. After a bench trial finding in Loury’s favor, the Appellate Division remanded this matter in February 2016 for a second trial. During the second trial, Concord CEO, Lee Argush, testified to lower compensation estimate than first trial. On remand, the second trial judge awarded Mr. Loury the same damages as the first judge, finding Mr. Argush not credible. After the findings during the second trial, Martin Law Firm filed an action against Mr. Loury to recover legal fees and costs of representing Mr. Loury in a second bench trial and Mr. Loury filed a counterclaim against Martin Law Firm for legal malpractice, alleging he should have received an even higher award in the second bench trial. In this allegation, Mr. Loury, through his expert, claimed that Martin Law Firm should have recalled Mr. Loury to the stand to rebut Mr. Argush’s testimony to allege an alternative theory of damages. Mr. Loury’s expert admitted that the second judge already rejected Mr. Argush's theory and accepted Loury's damages theory. The trial court barred Mr. Loury’s expert and dismissed Loury's counterclaim with prejudice before convening the collection trial, and the jury ruled in Martin Law Firm’s favor. Mr. Loury appealed the trial court's pretrial rulings barring his liability expert from testifying in support of his legal malpractice counterclaim, denying his motion for summary judgment on that counterclaim, and denying his motion to amend his counterclaim by adding attorney Joseph A. Martin as a codefendant. In affirming the trial court’s decision, the Appellate Division held that the trial court properly excluded Loury’s expert testimony in the counterclaim against Martin Law Firm because the expert could not explain how calling Loury as a rebuttal witness would have increased damages when the second judge already rejected Mr. Argush's testimony and accepted Loury's damages theory, making the expert’s causation opinion speculative. The Appellate Division also held that the trial court properly denied Mr. Loury's summary judgment motion on his malpractice counterclaim because reasonable minds could differ on whether Mr. Martin's alleged failures would have changed the second judge's damages award, given the judge already found Mr. Argush not credible, creating genuine factual disputes precluding summary judgment. Also, the Appellate Division held that the trial court properly denied Loury's May 2023 motion to add Joseph Martin individually because the statute of limitations expired in February 2022, six years after the 2016 appellate remand when Mr. Loury incurred new legal costs, and relation back did not apply because Mr. Loury knew Mr. Martin's identity throughout and strategically chose to sue only Martin Law Firm in his 2019 counterclaim.