Justices to Decide If Injured Motorists Can Recoup Benefits Beyond PIP Limits
The New Jersey Supreme Court has taken up a case that requires it to consider whether motorists who opt for the $15,000 minimum in personal-injury-protection benefits in their insurance policies can recover medical expenses exceeding that amount.
November 15, 2017 at 05:05 PM
10 minute read
The New Jersey Supreme Court has taken up a case that requires it to consider whether motorists who opt for the $15,000 minimum in personal-injury-protection benefits in their insurance policies can recover medical expenses exceeding that amount.
The court on Tuesday granted a petition for certification agreeing to hear the two consolidated cases: Haines v. Taft and Little v. Nishimura.
The court will likely hold oral arguments in the cases next year.
In June, a three-judge Appellate Division panel, in a reported decision, said plaintiffs in automobile accident cases that choose the PIP minimum may recover medical expenses that exceed $15,000. Judge Amy O'Connor, joined by Judges Hany Mawla and Marie Lihotz, said statutes limiting PIP recovery apply only to co-payments and deductibles.
“We are satisfied the language references the litigation of minor medical expenses, such as co-payments and deductibles … not all medical expenses,” O'Connor said.
In the ruling, the appeals court overturned decisions by two Camden County Superior Court judges to bar the admission of evidence from two injured motorists, Joshua Haines and Tuwona Little, who were covered by policies that included the $15,000 PIP limit, but whose medical expenses were greater. Both plaintiffs appealed the trial court rulings.
The Insurance Council of New Jersey and the New Jersey Defense Association contested the appeals as amici, arguing that the Legislature, in various statutes enacted over recent years, sought to limit plaintiffs' recovery for medical expenses based on the PIP options they chose in their policies.
“We decline to adopt this inferential determination,” O'Connor wrote in June.
Haines and Little were injured in separate automobile accidents, according to the decision.
Haines, after his PIP benefits were exhausted and after paying his co-payment and deductible, still had $28,000 in uncovered medical expenses. Little, after her benefits were exhausted, had $10,488 in unpaid medical expenses, the court said.
O'Connor said the relevant PIP and automobile insurance statutes permit them to seek recovery for those unpaid medical expenses—co-pays and deductibles, she added, are different from other medical expenses.
O'Connor noted that the Legislature permitted drivers to choose PIP limits of $15,000, $50,000, $75,000 or $150,000 in order to limit premiums. The Legislature did not, however, include language that limited recovery for medical expenses that exceeded co-payments and deductibles, she said.
“Having the right to recover a claim against a tortfeasor for medical expenses not covered by PIP does not result in a windfall for those who, in exchange for reduced PIP benefits, paid lower premiums,” O'Connor said.
O'Connor quoted a 2011 Law Division ruling in Wise v. Marienski: “Plaintiffs are not having their cake and eating it, too. Their medical expenses are not immediately recoverable. Instead, they must file suit, go through the discovery process, and run the gauntlet of proving defendant's liability. That process typically takes years.”
The NJDA's attorney, Stephen Foley Jr., said it was “appropriate” that the Supreme Court take up the question.
“This is a question the court needs to answer,” said Foley, of Campbell, Foley, Delano & Adams in Asbury Park.
The defendants, Jacob Taft and Jayne Nishimura, are represented by Michael Marone of Morristown's McElroy, Deutsch, Mulvaney & Carpenter. Susan Stryker of Bressler, Amery & Ross in Florham Park represents the ICNJ. The plaintiffs are represented by Vincent Campo of Malamut & Associates in Cherry Hill.
None returned calls about the court's certification grant.
The New Jersey Supreme Court has taken up a case that requires it to consider whether motorists who opt for the $15,000 minimum in personal-injury-protection benefits in their insurance policies can recover medical expenses exceeding that amount.
The court on Tuesday granted a petition for certification agreeing to hear the two consolidated cases: Haines v. Taft and Little v. Nishimura.
The court will likely hold oral arguments in the cases next year.
In June, a three-judge Appellate Division panel, in a reported decision, said plaintiffs in automobile accident cases that choose the PIP minimum may recover medical expenses that exceed $15,000. Judge
“We are satisfied the language references the litigation of minor medical expenses, such as co-payments and deductibles … not all medical expenses,” O'Connor said.
In the ruling, the appeals court overturned decisions by two Camden County Superior Court judges to bar the admission of evidence from two injured motorists, Joshua Haines and Tuwona Little, who were covered by policies that included the $15,000 PIP limit, but whose medical expenses were greater. Both plaintiffs appealed the trial court rulings.
The Insurance Council of New Jersey and the New Jersey Defense Association contested the appeals as amici, arguing that the Legislature, in various statutes enacted over recent years, sought to limit plaintiffs' recovery for medical expenses based on the PIP options they chose in their policies.
“We decline to adopt this inferential determination,” O'Connor wrote in June.
Haines and Little were injured in separate automobile accidents, according to the decision.
Haines, after his PIP benefits were exhausted and after paying his co-payment and deductible, still had $28,000 in uncovered medical expenses. Little, after her benefits were exhausted, had $10,488 in unpaid medical expenses, the court said.
O'Connor said the relevant PIP and automobile insurance statutes permit them to seek recovery for those unpaid medical expenses—co-pays and deductibles, she added, are different from other medical expenses.
O'Connor noted that the Legislature permitted drivers to choose PIP limits of $15,000, $50,000, $75,000 or $150,000 in order to limit premiums. The Legislature did not, however, include language that limited recovery for medical expenses that exceeded co-payments and deductibles, she said.
“Having the right to recover a claim against a tortfeasor for medical expenses not covered by PIP does not result in a windfall for those who, in exchange for reduced PIP benefits, paid lower premiums,” O'Connor said.
O'Connor quoted a 2011 Law Division ruling in Wise v. Marienski: “Plaintiffs are not having their cake and eating it, too. Their medical expenses are not immediately recoverable. Instead, they must file suit, go through the discovery process, and run the gauntlet of proving defendant's liability. That process typically takes years.”
The NJDA's attorney, Stephen Foley Jr., said it was “appropriate” that the Supreme Court take up the question.
“This is a question the court needs to answer,” said Foley, of Campbell, Foley, Delano & Adams in Asbury Park.
The defendants, Jacob Taft and Jayne Nishimura, are represented by Michael Marone of Morristown's
None returned calls about the court's certification grant.
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