Legislature Should Clarify No-Fault Insurance Rules
The effect of PIP coverage limits in court is not a minor issue but one that goes to the very heart of the legislative scheme.
April 28, 2019 at 12:00 PM
3 minute read
In its decision in Haines v. Taft (A-13/14-17), the New Jersey Supreme Court again waded into the no-fault minefield in consolidated cases involving injured insureds who opted for $15,000 in PIP coverage and then sought to recover medical expenses in excess of the policy limits from the respective tortfeasors. In each case, the trial judge barred recovery of those losses. The Appellate Division reversed, essentially based on what the panel found was the clear language of N.J.S.A. 39:6A-12 and N.J.S.A. 39:6A-2(k).
In relevant part N.J.S.A. 39:6A-12 provides that amounts “collectible or paid” under a standard automobile insurance policy are inadmissible in a suit against the tortfeasor. The statute goes on to say that “nothing in this section shall be construed to limit the right of recovery, against the tortfeasor, of uncompensated economic loss sustained by the injured party.” N.J.S.A. 39:6A-2(k), in turn, defines “economic loss” as the “uncompensated loss of income or property, or other uncompensated expenses, including, but not limited to medical expenses”.
The Supreme Court granted certification and reversed the Appellate Division in a 3-2 decision in which the majority declared that N.J.S.A. 39:6A-12 proscribes fault-based suits solely for medical expenses in excess of the elected amount of PIP coverage.
The dissent concluded otherwise and rejected the argument that any loss up to the $250,000 PIP cap, which is the amount the insureds could have purchased, was therefore “collectible”. To the contrary, and based on plain language, the dissent held that N.J.S.A. 39:6A-12 has as its sole purpose the avoidance of double recovery at whatever level of coverage is purchased. The dissent concluded that the Legislature did not intend low income accident victims to surrender their right to sue the wrongdoer for their uncompensated medical costs simply because they could not afford a better policy.
What is interesting about the opinions is that the majority found the language of N.J.S.A. 39:6A-12 “ambiguous” while the dissent relied on its “absolute clarity” and that both sides used much of the same legislative history to reach dueling results.
We agree with both opinions insofar as they invite the Legislature to weigh in on the question presented. The majority stated: “Should the Legislature disagree with our restrained interpretation of its statutory scheme, we invite the Legislature to make its intention to introduce fault-based suits into the no-fault medical reimbursement scheme more explicit.” The dissent issued the same invitation: “The Legislature can make clear that today's decision is not what it meant or ever envisioned.” This is not a minor issue but one that goes to the very heart of the legislative scheme. We think Legislative clarification is warranted.
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