JENEVIEVE CASINELLI, PLAINTIFF-RESPONDENT, v. WILFREDO MANGLAPUS, DEFENDANT-APPELLANT.
Supreme Court of New Jersey
Argued January 5, 2004—Decided September 22, 2004.
181 N.J. 354 | 858 A.2d 1113
John N. Giorgi argued the cause for respondent (Peter M. Rozano, attorney).
Justice LONG delivered the opinion of the Court.
The question presented on this appeal is whether a plaintiff, who belatedly files a physician certification under the New Jersey Automobile Insurance Cost Reduction Act (AICRA),
I.
On December 27, 1999, a pickup truck, in which Jenevieve Casinelli was a passenger, was struck in the rear by an automobile owned and operated by Wilfredo S. Manglapus. Casinelli was injured in the accident. She was examined by Dr. James Garabo, a chiropractor, who sent her to the emergency room at Rahway Hospital where she was prescribed a cervical collar and over-the-counter pain medication, and advised to see a neurologist. The cervical x-ray taken at the hospital disclosed “[l]oss of normal lordosis1 with mild kyphosis2 [backward curvature of the spine] centered on C4-5.”
On December 29, 1999, Casinelli was examined by Dr. Nazar H. Haidri, a neurologist, who diagnosed post-concussion syndrome; post-traumatic headaches; acute cervical, dorsal and lumbar sprain; and symptoms consistent with bilateral lumbar radiculopathy.3 Dr. Haidri also observed a limited range of motion in both the cervical and lumbar areas of Casinelli‘s spine and spasms “over both cervical para-vertebral muscles.” Dr. Haidri noted that Casinelli had been involved in a prior motor vehicle accident
Based upon his examination, Dr. Haidri ordered several Magnetic Resonance Imagery (MRI) studies that were read by Dr. Howard Kessler, a radiologist. Dr. Kessler issued two reports on February 16, 2000, in which he concluded that the cervical MRI disclosed “[r]eversed cervical lordosis consistent with muscular spasm . . . [d]isc herniation at C5-[ ]6, central and left paracentral with sac indentation.” As a result, Dr. Haidri referred Casinelli to Dr. Steven L. Nehmer, an orthopedic surgeon, who examined her on May 11, 2000.
In a report dated May 16, 2000, Dr. Nehmer recommended that Casinelli undergo either a cervical epidural injection or physical therapy. In a subsequent report dated September 29, 2000, Dr. Nehmer diagnosed Casinelli as suffering from a cervical disc herniation at C5-6 along with lumbar strain. Because a cervical MRI taken after Casinelli‘s 1998 injury had not revealed any disc herniation, Dr. Nehmer opined that Casinelli‘s injuries were causally related to the accident with Manglapus. Overall, Dr. Nehmer viewed Casinelli‘s prognosis as “guarded.”
On July 17, 2000, Dr. Charles G. Kalko, a neurosurgeon, examined Casinelli and issued a report diagnosing her as having suffered cervical radiculopathy and cervical deformity at C5-6, as a result of the accident. He recommended that Casinelli “start physical therapy and consider obtaining a cervical CT myelogram and then consider surgical intervention.” Dr. Kalko also concluded that Casinelli‘s injuries were causally related to the accident, and declared her prognosis “guarded pending further diagnostic testing and surgery.”
On July 25, 2000, Casinelli was referred to Dr. Paul K. Ratzker, a neurosurgeon, for treatment. In a report dated July 25, 2000, Dr. Ratzker diagnosed Casinelli as suffering from “left sided C6 cervical radiculopathy secondary to the disc herniation at the C 5-
After Casinelli completed a three-week course of physical therapy, Dr. Ratzker reevaluated her and reported she was feeling better, but still experiencing “occasional spurts of pain.” He recommended that she either try a cervical epidural steroid injection or continue with the physical therapy and pain medication. Casinelli elected to continue with the physical therapy and returned for an examination by Dr. Ratzker on September 14, 2000, at which point she reported that she was feeling better, but had begun experiencing numbness in a small area in her forearm. Overall, Dr. Ratzker found Casinelli had experienced improvement with physical therapy and recommended a continued course of therapy twice a week for six more weeks and a reevaluation thereafter. He assessed her prognosis as “fair.”
On July 17, 2001, Casinelli filed a complaint against Manglapus alleging that she was injured as a result of his automobile negligence. Manglapus filed an answer on October 12, 2001, and on February 25, 2002, moved for summary judgment seeking dismissal of Casinelli‘s complaint, with prejudice, on the ground that she had failed to produce a physician certification establishing that she met the verbal threshold requirement contained in
On March 20, 2002, in opposition to the summary judgment motion, Casinelli filed the requisite physician certifications. Two medical experts (Drs. Haidri and Ratzker) certified that Casinelli sustained a “permanent and significant injury” as a result of the
By leave granted, Manglapus challenged the trial court‘s order. On appeal, he argued that Casinelli‘s complaint required dismissal with prejudice for failure to comply with
The Appellate Division rejected Manglapus’ argument that a dismissal with prejudice is compelled and held instead that a dismissal without prejudice is the proper remedy for late filing. Casinelli v. Manglapus, 357 N.J. Super. 398, 401 (App. Div. 2003). However, recognizing the “harsh consequences” that would flow from the dismissal without prejudice remedy where the statute of limitations had expired, the court held, the doctrines of substantial compliance and equitable estoppel could be invoked by Casinelli. Id. at 416-17. Accordingly, it affirmed the denial of summary judgment and remanded the case for proceedings consistent with its opinion. Ibid. We granted Manglapus’ petition for certification. 177 N.J. 491 (2003). We now affirm in part and reverse in part.
II.
On appeal, the parties essentially stake out the same ground as they did below. Manglapus contends that dismissal with prejudice is the proper remedy under AICRA and that even if dismissal
Casinelli counters that nothing in AICRA requires dismissal for a late-filed physician certification and that the court has available a broad set of less draconian remedies to address that issue.
III.
AICRA is, as its name implies, a cost-containment initiative enacted as a refinement to the no-fault automobile insurance system that originally became law in this State in 1972. See Caviglia v. Royal Tours of Am., 178 N.J. 460, 466-71 (2004) (detailing history and amendments to no-fault system). The legislative findings and declarations underlying AICRA are unequivocal; cost containment, fraud avoidance and a fair rate of return to insurers. See
To achieve those goals, AICRA follows the template of its predecessor, the 1988 Verbal Threshold Act (
AICRA, effective on March 22, 1999, continued the two option model, allowing purchasers of automobile insurance to choose between a “basic policy” that provides “for a revised lawsuit
Under AICRA, the limited lawsuit option only allows recovery for non-economic losses if the plaintiff
has sustained a bodily injury which results in death; dismemberment; significant disfigurement or significant scarring; displaced fractures; loss of a fetus; or a permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement. An injury shall be considered permanent when the body part or organ, or both has not healed to function normally and will not heal to function normally with further medical treatment.
[
N.J.S.A. 39:6A-8(a) .]
As is evident from that language, the main difference between the AICRA threshold and prior law is that AICRA tightened the categories of injury that would justify non-economic damages. See Sponsor‘s Statement to Senate Bill No. 3, at 59 (Apr. 2, 1998) (“[i]n order to further limit the number of lawsuits filed and thereby reduce premiums for bodily injury coverage, the bill completely eliminates the existing verbal threshold and substitutes a new verbal threshold which is intended to eliminate some of the lawsuits for minor injuries, including soft tissue injuries, which are neither serious nor permanent“); see also Cynthia M. Craig & Daniel J. Pomeroy, New Jersey Auto Insurance Law § 15:4-1a at 255 (2004) (commenting on legislative intent to address through AICRA “the failure of prior law to stem the tide of lawsuits related to soft-tissue injuries“).
AICRA also requires the filing of a physician certification:
In order to satisfy the tort option provisions of this subsection, the plaintiff shall, within 60 days following the date of the answer to the complaint by the defendant, provide the defendant with a certification from the licensed treating physician or a board-certified licensed physician to whom the plaintiff was referred by the treating physician. The certification shall state, under penalty of perjury, that the plaintiff has sustained an injury described above. The certification shall be based on and refer to objective clinical evidence, which may include medical testing, except that any such testing shall be performed in accordance with medical protocols pursuant to subsection a. of section 4 of P.L.1972, c. 70 (C.39:6A-4) and the use of valid diagnostic tests administered in accordance with section 12 of P.L.1998, c. 21 (C.39:6A-4.7). Such testing may not be experimental in nature or
dependent entirely upon subjective patient response. The court may grant no more than one additional period not to exceed 60 days to file the certification pursuant to this subsection upon a finding of good cause. A person is guilty of a crime of the fourth degree if that person purposefully or knowingly makes, or causes to be made, a false, fictitious, fraudulent, or misleading statement of material fact in, or omits a material fact from, or causes a material fact to be omitted from, any certification filed pursuant to this subsection. Notwithstanding the provisions of subsection e. of
N.J.S.A. 2C:44-1 , the court shall deal with a person who has been convicted of a violation of this subsection by imposing a sentence of imprisonment unless, having regard to the character and condition of the person, the court is of the opinion that imprisonment would be a serious injustice which overrides the need to deter such conduct by others. If the court imposes a noncustodial or probationary sentence, such sentence shall not become final for 10 days in order to permit the appeal of such sentence by the prosecution. Nothing in this subsection a. shall preclude an indictment and conviction for any other offense defined by the laws of this State. In addition, any professional license held by the person shall be forfeited according to the procedures established by section 4 of P.L.1997, c. 353 (C.2C:51-5).[
N.J.S.A. 39:6A-8(a) .]
The physician certification provision has two purposes: to supply evidence that a plaintiff has, in fact, sustained an injury that qualifies for recovery of non-economic damages under the new verbal threshold and, to provide a legal foundation for a charge of perjury, should false swearing later be shown. See Watts v. Camaligan, 344 N.J. Super. 453 (App. Div. 2001). That is the backdrop for our inquiry.
IV.
In Alan J. Cornblatt, P.A. v. Barow, 153 N.J. 218 (1998), we addressed the late filing of an Affidavit of Merit under
In Watts, supra, the Appellate Division was faced with the question of “what sanction or remedy lies for failing to file a timely [AICRA] physician certification.” 344 N.J. Super. at 461,
The court in Watts concluded that it was that specific language that generated the outcome in Cornblatt and that its absence in AICRA required a different analysis. Id. at 464. Thus, it determined that AICRA is not governed by the dismissal with prejudice—extraordinary circumstances template of Cornblatt. See also Konopka v. Foster, 356 N.J. Super. 223 (App. Div. 2002) (rejecting dismissal with prejudice remedy as appropriate sanction for belatedly filed physician certification). The courts in Watts and Konopka went on to hold that because the physician certification is a statutory requirement, without which the “plaintiff is precluded from continuing to prosecute an action,” Watts, 344 N.J. Super. at 466-67, it is analogous to a pleading, and thus subject to dismissal without prejudice under Rule 4:6-2. See Printing Mart-Morristown v. Sharp Elecs. Corp., 116 N.J. 739 (1989) (dismissal without prejudice should ordinarily be granted in response to a successful motion for failure to state a claim); Konopka, supra, 356 N.J. Super. at 228. In so ruling, the Appellate Division was only partially correct.
We fully subscribe to the Appellate Division‘s conclusion here, echoing Watts and Konopka, that the physician certification is not a fundamental element of the AICRA cause of action and that therefore the Cornblatt template of dismissal with prejudice except in extraordinary circumstances is inapplicable. Unlike the
It is as to the remedy that we part company from Watts, Konopka and the Appellate Division in this case. In our view, the perceived analogy between the AICRA physician certification and a pleading, which is the underpinning of the dismissal without prejudice remedy, does not withstand scrutiny.
Pleadings are a unique aspect of our jurisprudence. They serve to identify the claims and defenses that are being advanced by the parties and to narrow the issues in dispute.5 See James Hazard, Civil Procedure, 127-84 (3d ed. 1985). If a pleading does not state a claim that, if proven, would entitle the pleader to relief, it is facially defective and thus subject to dismissal under Rule 4:6-2(e). An example would be a complaint seeking damages for breach of a contract to marry. Because New Jersey does not recognize such a cause of action,
In embracing the dismissal without prejudice remedy in Watts and Konopka, the Appellate Division characterized the physician certification as statutorily essential to the continuance of the litigation and thus denominated its absence as structurally parallel to a pleading. Although superficially seductive, that analogy only
However, in the vast majority of cases in which an attorney has simply slipped up and missed the filing date for an otherwise acceptable physician certification, the analogy to a pleading breaks down. In such cases, there is no statutory bar to the continuation of the lawsuit. Rather, the physician certification is belatedly produced evidence supporting the otherwise cognizable claims advanced in the complaint. In such circumstances, we can see no warrant for adopting as mandatory the dismissal without prejudice remedy recognized by the court in Printing Mart, supra, as appropriate for pleadings that, on their face, fail to state a claim on which relief can be granted.
On the contrary, we view the tardy presentation of a physician certification as falling under the broad umbrella of failure to make discovery, thus subject to the arsenal of remedies provided in our rules for such procedural errors. Put another way, the court has available to it, along with dismissal, where warranted, discovery-type sanctions such as orders to compel, the award of reasonable expenses incurred in obtaining the certification, and counsel fees. See Rule 4:23-1 to 5. In each case, the court should assess the facts, including the willfulness of the violation, the ability of plaintiff to produce the certification, the proximity of trial, and prejudice to the adversary, and apply the appropriate remedy. That methodology provides judges with discretion to choose a response that is proportionate to the procedural stimulus; saves for trial the meritorious claims of truly injured victims; and allows dismissal of cases in which a plaintiff cannot or will not supply a certification or in which a plaintiff‘s conduct has irremediably prejudiced the defendant.
The bedrock of our conclusion is the legislative purpose behind the physician certification requirement of AICRA. As we have
The same cannot be said of the mandatory dismissal with prejudice remedy. Given the number of complaints filed on the eve of the expiration of the statute of limitations, that remedy does nothing but guarantee the random elimination of meritorious cases. If AICRA‘s purpose simply were to thin the herd of cases at any cost, that outcome might be appropriate. But AICRA‘s intention was quite different: to cull out those non-meritorious matters in which the new threshold cannot be met and to counter fraud. Dismissing legitimate cases involving late physician certifications advances neither of those goals; treating the late filing of a physician certification as a discovery violation, subject to remedies ranging from penalties to dismissal, depending on the facts, does.
It goes without saying that, unless the late filing is entirely faultless on the attorney‘s part, some sanction should be imposed. As we have said, although AICRA did not intend the random dismissal of meritorious cases, neither was its purpose to allow non-meritorious cases to remain on the docket indefinitely due to attorney inattention. Abiding by the physician certification time requirements thus serves the fundamental purpose of disposing of non-meritorious cases expeditiously. Accordingly, attorney delay should not go unsanctioned even though dismissal will not be warranted in most cases.
V.
Insofar as the judgment of the Appellate Division affirmed the denial of Manglapus’ motion to dismiss Casinelli‘s complaint with prejudice, it is affirmed. The Court‘s concomitant conclusion that a dismissal without prejudice is required is reversed. Our disposition obviates the need to reach the issues of substantial compliance and equitable estoppel. The case is remanded to the trial court for further proceedings consistent with its original disposition of the case.
Justice LaVECCHIA, dissenting.
I have a different view of the legislative intent animating the provisions of the New Jersey Automobile Insurance Cost Reduction Act (AICRA), L. 1998, c. 21 and c. 22 generally, and the physician certification requirement specifically. AICRA added that requirement to the other conditions that an accident victim must satisfy to pursue a tort recovery under the limitation on lawsuit provisions set forth in
I.
There is no need to duplicate the majority‘s succinct history of New Jersey‘s system of no-fault automobile insurance. Suffice it to say, in 1998 AICRA tightened the limitations on the injuries that are considered serious enough to allow for a tort recovery, notwithstanding an insured‘s selection of the limitation on lawsuit option in an insurance policy (the “verbal threshold“).
Thus, a person injured in an automobile accident may maintain a lawsuit for economic damages only if the injury falls into one of the following categories: (1) death; (2) dismemberment; (3) significant disfigurement or significant scarring; (4) a displaced fracture; (5) loss of a fetus; or (6) a permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement.
[i]n order to satisfy the tort option provisions of this subsection, the plaintiff shall, within 60 days following the date of the answer to the complaint by the defendant, provide the defendant with a certification from the licensed treating physician or a board-certified licensed physician to whom the plaintiff was referred by the treating physician. The certification shall state, under penalty of perjury, that the plaintiff has sustained an injury described above. The certification shall be based on and refer to objective clinical evidence, which may include medical testing . . . . The court may grant no more than one additional period not to exceed 60 days to file the certification pursuant to this subsection upon a finding of good cause.
The making of a false or misleading certification constitutes a crime, and provides grounds for forfeiture of the professional license held by the person so certifying. Ibid. Thus, while the heightened verbal threshold effectuates “the statute‘s clear purpose to limit standing for recovery for pain and suffering,” Watts, supra, 344 N.J. Super. at 465 (citing Governor‘s Recommendations for Reconsideration Statement to Senate Bill No. 3, at 4 (Apr. 27, 1998) (L. 1998, c. 21)), the corollary physician certification requirement is plainly designed to deter fraudulent claims, to punish physicians who collude in the presentation of those claims, and to facilitate early and easy elimination of faulty suits from court dockets.
Legislative expressions during passage of AICRA, as well as gubernatorial statements upon presentment of the bill, convey these themes. The statute was the product of legislative and executive compromise. The bill was the subject of a gubernatorial conditional veto, in which the Governor explained why the bill should be amended in order for it to receive her signature.1 The Governor discussed the principal provisions of AICRA in light of “the level of interest in and the certainty of judicial interpretation,” and reaffirmed the bill sponsors’ overall view that the statute was designed “to limit standing for recovery for pain and
Complementing the tightened lawsuit threshold in controlling premium costs are several measures designed to combat fraud. First, every complaint in a pain and suffering lawsuit brought under the lawsuit threshold must be accompanied by a certification from the treating physician attesting the seriousness of the plaintiff‘s condition. The certification is executed under penalty of perjury; fraudulent filing of a certification is grounds for imprisonment and revocation of one‘s professional license. The certification is intended as an anti-fraud measure to assure legitimacy; it is necessary to state a claim, not sufficient to establish one, and will be subject to challenge through the normal discovery and summary judgment processes.
[Id. at 4-5 (emphasis added).]
II.
Plaintiff did not submit the required certification within the sixty-day time period required under
In Watts, supra, the Appellate Division held that the failure to comply timely with the physician certification requirement of AICRA warranted dismissal without prejudice. 344 N.J. Super. at 468. The automobile accident in Watts occurred on February 8, 2000. A complaint was filed on March 17, 2000, and an answer followed on April 19, 2000. Id. at 458. On September 20, 2000, the defendant filed a motion to dismiss based on plaintiff‘s failure to supply a physician‘s certification within the time allotted under AICRA. The plaintiff thereupon filed the necessary certification on October 6, 2000, in response to the motion. Id. at 458. Significantly, in Watts “the two-year statute of limitations period set forth in
The Watts court compared the physician certification requirement of AICRA with the similarly worded Affidavit of Merit Statute,
Although recognizing that “[t]he physician certification requirement was intended as an anti-fraud measure to assure legitimacy,” the court likened the requirement to “the imposition of a condition for the continued maintenance of a lawsuit.” Id. at 466. The court explained that
[t]he requirement is procedural in nature related to the sufficiency of the pleadings, i.e. the statement of a claim. The required production is not intended to go to the
establishment of a cause of action. We conclude that the failure to comply with the physician certification requirement of AICRA was not intended by the Legislature to preclude future suits for legitimate injuries sustained as the result of another‘s negligence.
Our analysis is consistent with R. 4:6-2(e), Failure to State a Claim, and the holding in Printing Mart v. Sharp Electronics, 116 N.J. 739, 772, 563 A.2d 31 (1989), that, “barring any other impediment such as a statute of limitations,” a dismissal without prejudice should ordinarily be granted in response to a successful motion for failure to state a claim. Here, the impediment to future causes of action created by the Legislature was the revised verbal threshold, not the failure to file a physician certification.
[Id. at 467.]
The intersection of the statute of limitations for filing a tort action with the physician certification condition for bringing suit under the verbal threshold, was not present in Watts. It is squarely presented here. The statute of limitations on plaintiff‘s tort action had run at the time that plaintiff filed the physicians’ certifications and the trial court had to decide whether to dismiss the action with or without prejudice.
Konopka, supra, presented similar circumstances. 356 N.J. Super. 223. There, the plaintiff served on the defendant, within one month of the filing of the defendant‘s answer, a report by her treating chiropractor that established permanency, but failed to file the physician certification until sixteen months after the defendant‘s answer, when more than two years had elapsed from the date of the motor vehicle accident. Id. at 228. Citing Watts, the Konopka court stated that although plaintiff‘s claim should not have been dismissed with prejudice for failure to file timely the physician certification, “a transformation of the dismissal to one without prejudice offers plaintiff no particular benefit in this case because any reinstitution of suit is barred by the statute of limitations.” Ibid. I agree.
The remainder of the court‘s analysis considered whether the doctrine of substantial compliance could be applicable. Noting that the two-fold purpose of the physician certification requirement was to acquaint the defendant with the nature and severity of the plaintiff‘s alleged injuries and to prevent fraud, id. at 229, the court held that the service of a mere report, as
Thus, I am of like mind with the courts in Watts and Konopka to the extent that they concluded that the failure to comply with the strict temporal requirements of AICRA‘s physician certification obligation should be treated as the equivalent of a failure to state a claim, and that the presumptive disposition in such a case should be a dismissal without prejudice, barring any other “impediment” such as a statute of limitations. Where, as here, the statute permits a common-law negligence action to proceed subject to certain substantive (the severity of injury) and procedural (the physician certification) requirements, barring clear legislative intent to the contrary a plaintiff‘s failure to comply with the procedural requirement should be handled consistent with our involuntary dismissal practice under Rule 4:37-2(a), which provides that the involuntary dismissal of an action for failure to comply with a procedural rule should be presumptively without prejudice.3 That policy fits here.
Accordingly, I would conclude that when a plaintiff fails to comply with the physician certification requirement and the timelines for its submission contained in
For dissent—Justice LaVECCHIA—1.
