Mfrs. Ins. Gp. v. Holger Trucking
9 A.3d 1095
N.J. Super. Ct. App. Div.2011Background
- Lange was injured in an automobile accident on December 1, 2006, and his insurer NJM opened a PIP file for him the same day.
- NJM sent a PIP application to Lange; Lange began treatment by a chiropractor on December 4, 2006.
- Dr. Palluzzi submitted bills and a letter of medical necessity; NJM authorized treatment on December 11, 2006.
- NJM received continued bills and treatment notices through December 2006, and Lange submitted a completed PIP application on December 20–26, 2006.
- NJM filed a complaint for reimbursement on December 24, 2008, seeking $53,323.29 in PIP benefits.
- Dispute centers on whether the two-year limit in N.J.S.A. 39:6A-9.1 runs from the first claim or from the insurer-requested PIP claim form submission.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| What triggers the two-year limitations period | NJM argues the claim is filed on the insured's first claim for PIP benefits. | Holger/ARI contend the trigger is earlier or later depending on which event is deemed 'the claim'. | The claim is triggered by the submission of the PIP claim form requested by the insurer. |
Key Cases Cited
- Burlington Cnty. Abstract Co. v. QMA Assocs., 167 N.J. Super. 398 (App.Div. 1979) (broad definition of 'claim' but contextual limits used in no-fault statutes)
- Germann v. Matriss, 55 N.J. 193 (Supreme Court of New Jersey 1970) (statutory interpretation principles)
- Lesniak v. Budzash, 133 N.J. 1 (Supreme Court of New Jersey 1993) (legislative policy and interpretive approach)
- Price v. N.J. Mfrs. Ins. Co., 182 N.J. 519 (Supreme Court of New Jersey 2005) (statutory limitations and interpretation principles)
- W.V. Pangborne & Co. v. N.J. Dep't of Transp., 116 N.J. 543 (Supreme Court of New Jersey 1989) (statutory interpretation and limitations period logic)
- David v. Gov't Emp. Ins. Co., 360 N.J. Super. 127 (App.Div. 2003) (broad-to-narrow approach; no-fault statutory goals)
- Fernandez v. Nationwide Mut. Fire Ins. Co., 199 N.J. 591 (Supreme Court of New Jersey 2009) (no-fault cost reduction and liberal construction)
- Washington v. Mkt. Transition Facility, 295 N.J. Super. 368 (App.Div. 1996) (liberal construction of no-fault provisions)
- LaFage v. Jani, 166 N.J. 412 (Supreme Court of New Jersey 2001) (statutory interpretation and legislative intent)