Haines v. Taft
| Decision Date | 01 June 2017 |
| Citation | 450 N.J.Super. 295,162 A.3d 296 |
| Parties | Joshua HAINES, Plaintiff–Appellant, v. Jacob W. TAFT, Bonnie L. Taft, jointly, severally and/or in the alternative, Defendants–Respondents, and John McHenry, Defendant. Tuwona Little, Plaintiff–Appellant, v. Jayne Nishimura, Defendant–Respondent. |
| Court | New Jersey Superior Court — Appellate Division |
Vincent A. Campo argued the cause for appellant Joshua Haines in A–5503–14 (Mr. Campo, on the brief).
Michael J. Marone argued the cause for respondents Jacob W. Taft and Bonnie L. Taft in A–5503–14 (McElroy, Deutsch, Mulvaney & Carpenter, L.L.P., attorneys; Mr. Marone, of counsel and on the brief; Eric G. Siegel, on the brief).
Susan Stryker argued the cause for amicus curiae Insurance Council of New Jersey and The Property Casualty Insurers Association of America (Bressler, Amery & Ross, P.C., attorneys, Ms. Stryker, of counsel and on the brief).
Stephen J. Foley, Jr., argued the cause for amicus curiae, The New Jersey Defense Association (Campbell, Foley, Delano & Adams, LLC, attorneys, Mr. Foley, on the brief).
Petrillo & Goldberg, PC, attorneys for appellant Tuwona Little in A–0727–15 (Jeffrey M. Thiel, on the brief).
McElroy, Deutsch, Mulvaney & Carpenter, L.L.P., attorneys for respondent Jayne Nishimura in A–0727–15 (Michael J. Marone, of counsel and on the brief; Eric G. Siegel, on the brief).
Bressler, Amery & Ross, P.C., attorneys for amicus curiae Insurance Council of New Jersey and The Property Casualty Insurers Association of America (Susan Stryker, of counsel and on the brief).
Campbell, Foley, Delano & Adams LLC, attorneys for amicus curiae, New Jersey Defense Association (Stephen J. Foley, Jr., on the brief).
Before Judges Lihotz, O'Connor and Mawla.
The opinion of the court was delivered by
O'CONNOR, J.A.D.
These back-to-back automobile negligence actions are addressed in a single opinion because they share a common legal question. In their respective actions, plaintiff Joshua L. Haines and plaintiff Tuwona Little sought to recover medical expenses that exceeded the $15,000 personal injury protection (PIP) limits provided in each plaintiff's automobile insurance policy. The judges reviewing these matters each entered an order barring the admission of these expenses; Haines and Little now appeal from those respective orders.
The Insurance Council of New Jersey, the Property Casualty Insurers Association of America, and the New Jersey Defense Association were granted amicus curiae status and filed briefs advocating the position presented by defendants, urging an insured may not recover such expenses from a tortfeasor. Therefore, the question presented is whether N.J.S.A. 39:6A–12 precludes the recovery of medical expenses above those collectible or paid under an insured's PIP provision in a standard automobile insurance policy, including medical expenses exceeding any elected PIP option allowed in a standard policy pursuant to N.J.S.A. 39:6A–4.3(e).
For the reasons that follow, we conclude it does not and reverse both orders.
In his complaint, Haines sought damages for the injuries he sustained in an automobile accident he claims was caused by the negligence of defendants Jacob W. Taft and John McHenry.1
Defendant Bonnie L. Taft owned the car Taft was driving.2 At the time of the accident, Haines lived in his father's household and was covered under his father's standard automobile insurance policy. That policy was subject to the limitation on lawsuit threshold, seeN.J.S.A. 39:6A–8(a) and 8.1(a), and provided PIP coverage of $15,000, with a $2500 deductible.
Although Haines' father, the named insured, designated his health insurance provider as the primary payer of PIP benefits, seeN.J.S.A. 39:6A–4.3(d), Haines did not have health insurance at the time of the accident. Under the terms of the policy, Haines' lack of health insurance mandated he pay a penalty of $750 in addition to the $2500 deductible. The policy further provided he was responsible for a twenty percent copayment for each medical bill incurred above the deductible and penalty, which when aggregated was $3250, and the sum of $5000.
As a result of the injuries he sustained, Haines incurred $43,000 in medical bills, leaving $28,000 in unreimbursed medical expenses after the $15,000 in PIP benefits was exhausted. Before trial, Haines dismissed his claim for non-economic damages, but sought to recover from Taft the $28,000 in uncompensated medical expenses. Thereafter, the court granted defendant Taft's motion to bar Haines from introducing into evidence the $28,000 in medical bills not covered by PIP benefits. While not entirely clear from the record, it appears when the court granted Taft's motion, no other issues remained and the complaint was dismissed.
In her complaint, Little alleged she suffered injuries in a car accident she claimed was caused by defendant Jayne Nishimura's negligence. At the time of the accident, Little was also covered under a standard automobile insurance policy. She had selected the limitation on lawsuit option and a $15,000 limit of her PIP benefits, with a $500 deductible. The policy also provided she pay twenty percent of those bills between the deductible amount and $5000.
By the time of trial, Little had incurred $25,488 in medical expenses, and sought to recover from Nishimura the $10,488 in medical bills not satisfied by PIP benefits. Before trial, the court granted Nishimura's motion to bar the admission of any bill that exceeded the PIP limits in Little's policy.
The jury found Little did not vault the limitation on lawsuit threshold, and a judgment was entered dismissing her complaint.3 Although the jury found Little was not entitled to non-economic damages, were it not for the trial court's ruling, Little would have pursued her claim for those medical bills exceeding the $15,000 limit of her PIP benefits.
On appeal, Haines and Little contend the trial courts in their respective actions erred by barring the introduction of medical bills that exceeded the $15,000 limit in PIP benefits provided in each plaintiff's policy. The issue is one of statutory construction, which we review de novo. State ex rel. K.O. , 217 N.J. 83, 91, 85 A. 3d 938 (2014).
There is no dispute the relevant language in the first paragraph of Section 12 makes inadmissible evidence of the amounts collectible or paid under a provision for PIP benefits in a standard policy. If these amounts are not admissible, they are not recoverable. Defendants' specific contention is the first paragraph makes inadmissible evidence of the first $250,000 in medical expenses an insured incurs, because $250,000 is the PIP limit provided in a standard policy, unless otherwise requested by the named insured. Plaintiffs, on the other hand, claim this paragraph makes inadmissible only evidence of those medical expenses that have been or are eligible to be paid under an insured's PIP coverage provision. Given the controversy, we review the subject language of Section 12.
The first paragraph in Section 12 refers to "amounts collectible or paid under a standard automobile insurance policy pursuant to ... [N.J.S.A. 39:6A–4 ]." A standard automobile insurance policy is defined as a "policy with at least the coverage required pursuant to ... [N.J.S.A. 39:6A–4 ]." SeeN.J.S.A. 39:6A–2(n). N.J.S.A. 39:6A–4 states, in relevant part, that every standard automobile policy shall provide PIP benefits for the named insured and members of his family residing in his household in an amount not to exceed $250,000 per person per accident. However, benefits payable under N.J.S.A. 39:6A–4 are "subject to any option elected by the policyholder pursuant to ... [N.J.S.A. 39:6A–4.3 ]."
N.J.S.A. 39:6A–4.3 requires automobile insurers to provide the options for PIP coverage set forth in this statute. These include "[m]edical expense benefits in amounts of $150,000, $75,000, $50,000 or $15,000 per person per accident." N.J.S.A. 39:6A–4.3(e).
Additionally, N.J.S.A. 39:6A–4.3 provides if none of these four medical expense benefits options is chosen, the policy shall provide $250,000 in medical expense benefits coverage. Ibid.
Here, the named insureds on the policies providing coverage to plaintiffs chose the $15,000 medical expense benefit option. Plaintiffs do not contend defendants are responsible for the first $15,000 in medical bills they incurred, as these amounts have been satisfied by plaintiffs' respective PIP benefits and are undeniably inadmissible under Section 12. Plaintiffs do argue if they prove defendants are responsible for their medical expenses, defendants must compensate them for those medical expenses exceeding the $15,000 PIP limit, up...
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