*1 tortfeasor, carrier, only on notice to the UM/UIM required relitigate be those same issues an arbitration carrier, proceeding with the cannot be reconciled with UM/UIM prompted Legislature considerations that to man availability date coverage all insureds. Just UM/UIM Legislature’s purpose as the can be thwarted unreasonable Ciecka, restrictions on coverage, or exclusions from supra, 81 N.J. 427-28, legislative goal 409 A.2d so too is the obstructed delay unreasonably payment conditions that of the benefits provide. was intended to UM/UIM
IV judgment We reverse the Division. Justice, WILENTZ, For reversal —Chief and Justices HANDLER, POLLOCK, O’HERN, GARIBALDI, COLEMAN and STEIN —7.
Opposed one.—-N GREEN, PLAINTIFF-APPELLANT,
ROBERT v. SELECTIVE (SELECTED INSURANCE COMPANY OF AMERICA RISKS COMPANY), INSURANCE DEFENDANT-RESPONDENT. Argued January 1996—Decided June 1996. *2 Gary Wodlinger D. argued appellant (Lipman, cause Antonelli, Bait, Gilson, Dunlap, Wodlinger attorneys; Don- brief). Taylor, na M. on the (Tucker, argued
Edward J. Tucker respondents the cause for Munyon, attorneys). Latterman & *3 opinion by of the Court was delivered O’HERN, J. (1) appeal presents
This two issues: whether the statute of (UIM) limitations on a claim for underinsured motorist benefits to run on begins the date of an accident or on the breach of the contract; insurance and whether this has forfeited a claimant by failing give prompt collect underinsurance benefits company notice to the insurance having prejudiced or otherwise company’s subrogation rights. the insurance
I Green, plaintiff, injured On October Robert was in a car, by three-car automobile accident. Tingle, One driven Johnnie with Mary collided a car driven Galex. The two then' collided Tingle $15,000 with liability Green’s car. The car had a insurance $250,000 (These policy, and policy.. the Galex car had a were the limits.) $100,000 per person Green had of UIM with (Selective). defendant Company Selective Risks Insurance An oversimplified graphic of insight the accident scene lends into the statute of limitations issue. reasonably per-
Green
believed that to recover for his serious
injuries,
sonal
he would have to mahe a claim under his UIM
$82,000.
policy. Green valued his claim at over
Selective had
early
general
injuries.
notice of
paid
extent of Green’s
It
him
(PIP)
personal
injury
policy. During
benefits under the
treatment,
pay
course of Green’s
Selective refused to continue to
being
medical bills that were
incurred. Green had to sue Selective
provide
ultimately
the PIP benefits. That case was
settled
parties.
Tingle.
August
June
Green sued
Galex
$15,000
Tingle’s
paid
insurance carrier
its
limits into court.
proceed
Green refused to settle for that amount and wished to
*4
litigation.
Inadvertently,
with the
the file was closed without
parties during
pendency
notice to the
the
the lawsuit. On
26, 1992,
case,
August
reopened
years
the court
the
five
after the
interim,
original complaint
Tingle
was filed.
the
had died.
1,
February
The court held a settlement conference on
1993.
company
responsible
Galex’s insurance
denied that Galex was
for
accident,
$2,500
any
against
the
but offered
to settle
claims
her.
Tingle’s testimony,
Green believed
without
he would be
Therefore,
prove
unable to
that Galex was hable for the accident.
Selective, by telephone
company,
he contacted his own insurance
rights
preserve
under
writing,
his underinsurance
and later
Houten,
involved in an accident and undertakes during If, the insurer that action. the pendency insured must notify insurance insufficient satisfy the tortfeasor’s claim, proves again damages, of that the insured should the UIM insurer notify insured’s then fact. (1995).] [Rutgers Vassas, Ins. Co. v. 139 N.J. A.2d Casualty it its file representative told Green considered Selective’s time, passage of and that' he should exercise his closed due to the judgment accept to whether or not to the offer. Green own as accept decided to the settlement. accident, February seven after the Green over
sought of his claim Selective for UIM benefits. arbitration of limitations barred Green’s asserted that the statute Selective claim, any duty company to arbitrate. In March and the denied brought declaratory judgment compel action Green summary moved for to submit to arbitration. Selective Selective argument, trial judgment September on 1993. After oral granted complaint, motion and dismissed court Selective’s Green’s of limitations. It holding that the claim was barred the statute 2A:1<H, six-year statute of limitations ruled that N.J.S.A. claims, applicable begun to run on the date of the to contract had accident, expired on the claim more and that time had therefore year brought than a before Green suit Selective. appeal, Appellate Division affirmed the trial court’s On limitations. dismissal but not on the basis of the statute of Instead, Rutgers Casualty. it on our recent decision in relied certification, asserting complied petitioned for that he had Green processing guidelines with the Vassas of UIM claims. We (1995). granted petition. 142 We now his N.J. judgment Division and reinstate reverse the complaint against Selective. Green’s
349
II
“plumb
This is not the case which to
the intricacies” of the
v.
Riccio
Prudential
coverage.
law of
underinsured motorist
Co.,
Property
Casualty
&
Ins.
108 N.J.
This is the first time that we have addressed
begins
to run on a UIM claim.
when the statute of limitations
until
argues
Plaintiff
the cause of action did not arise
*6
underlying automobile case had been terminated and the insur
coverage.
company
ance
denied
A number of cases have so held.
See,
Altman,
e.g.,
200
491
Allstate Ins. Co. v.
(Ch.Div.1984) (explaining
analogous
that
A.2d 59
the
cause of
breach).
policy
a
does not
until
A
action under
UM
accrue
majority
jurisdictions
relationship
has held that the contractual
between the insured and the insurer underlies an action for UIM
benefits,
relationship
not the
to the tortfeasor. These courts have
period
begins
that
the limitations
for a
concluded
company
policy,
run when the insurance
makes a breach of the
not
Co.,
Liberty
when
accident
Blutreich v.
the
occurs.
Mut. Ins.
170
(1991) (statute
541,
1167, 1169
2
Ariz.
826 P.2d
n.
of limitations on
begins
insured’s UIM claim
to run when insurer breaches insur
contract); Metropolitan Property
Liability
ance
&
Ins. Co. v.
Walker,
1020,
594,
(same); Upte
136 N.H.
620
1022
A.2d
(Okla.1983) (“The
Co.,
681,
graft v. Home Ins.
662 P.2d
685
recovery
ultimately upon
of the insured is based
the
without
liability
imposed upon
which no
could be
the insurer for the tort of
another.”);
Barcom,
575,
Ins. Co. v.
112
773
Wash.2d
P.2d
Safeco
(1989) (statute
begins
against
60
of limitations
to run
insured
insurer).
on date of
breach UIM contract
Selective contends that
the statute
limitations for UIM claims
begin
jurisdictions
should
to run on the date of the accident. The
approach
that favor this
that
reason
the
of action
the
plaintiffs right
UIM carrier stems from the
of action
the
tortfeasor,
period begins
and thus the limitations
at the same time
for both the insurance and
tort
the
actions. State Farm Mut.
Kilbreath,
(Fla.1982);
Auto. Ins.
419
Co.
So.2d
O’Neill
Co.,
(Minn.1986);
v. Illinois Farmers Ins.
381 N.W.2d
see
(Fla.Dist.Ct.
Co.,
also Fladd v. Fortune Ins.
530 So.2d
390-91
App.1988) (applying same rationale to claim for PIP benefits and
accident).
concluding that cause of action arises at time of
disagree
reasoning
with
(although
We
the
of those cases
we
result)
disagree
not
repeatedly
with the
because our cases have
emphasized that
conceptually
the nature of a UIM claim is
differ-
Riccio,
recovery
from the
in tort.
108 N.J.
ent
(noting
although
claimant
is remitted to
A .2d 717
principles
liability of uninsured and
common-law tort
to establish
damages,
rights
claimant’s
under UM
nature and extent of
carrier).
governed
endorsement are
contract with UM
Although
respect
reasoning
we
of the cases that have held
until
the claim does not arise
there is
breach
contract,
holding
insurance
we believe that such a
runs counter to
require
policies
prompted
Legislature
that have
coverage
availability
and the
inclusion of uninsured motorist
every
insurance
underinsured motorist
automobile
policy.
legislative policy
“provid[e]
That
seeks to
maximum and
*7
financially
expeditious protection to the innocent victims of
irre
sponsible
Longworth, supra,
N.J.Super.
at
motorists.”
goals,
Longworth court
We respect congruent affording intended to the insured a contractual was be basically against his own insurer to at least in for the tortfeasor’s insurance compensate part at all or underinsurance has that is no insurance Whether inadequacy. inadequacy legislative no under the the insured victim’s since, scheme, consequence conceptual coverage contractual is in both cases limited to the amount of the recovery in the case of no from his own carrier. The difference is that only purchased obligated coverage to to the limit. the carrier is its own insurance, pay up obligated In to its insured underinsurance, the case of the carrier is pay up coverage Everything coverage limit the tortfeasor’s limit. else is the same. less being it is to that the most efficient and the so, That dear us procedure procedure comporting legislative most with the intent would be to the insured nearly permit coverage his under the without first at his to UIM victim, pursue remedy option, having against If arbitration to conclude his claim the tortfeasor. the consequent damages finding and an in excess resulted in a of the tortfeasor’s award liability coverage, from the tortfeasor’s the insured victim would be entitled to recover damages in the amount of his actual or daim, the UIM carrier on the UIM namely, coverage At is the tortfeasor’s limits. less, the UIM whichever reduced limit, received an offer from the that whether or not the insured had yet point, - it the UIM carrier could determine whether wished tortfeasor, preserve subrogation right If it it could also its insured the did, the tortfeasor. pay limit and itself the claim the tortfeasor. tortfeasor’s prosecute policy (footnote omitted).] [Id at 538A.2d 414 unreported decision of attention has been called to a recent Our Appellate disagreed with the conclusion that the Division six-year period provided began N.J.S.A 2A:14-1 to run for a suggested claim UIM on the date of the accident. The court required because N.J.S.A. 17:28-l.le the exhaustion of all avail- coverage, might able automobile insurance a claim not arise on the date of the accident. however, believe,
We that once an automobile accident “target victim knows or has reason to know that a defendant” is underinsured, permits the contract the accident victim to make a A policy. under the cause of action accrues because Moise, capable present “there exists a claim enforcement.” Les Co., Rossignol Inc. v. Ski 122 Wis.2d 361 N.W.2d omitted). (quotation Our eases hold that the arbitrator of fully UM qualified benefits under the automobile liability coverage resolve issues and thus to determine policies whether other auto insurance are available. Gold Co., Casualty Aetna & Ins. Life (App.Div.1989), explained court that when N.J.S.A 17:28-l.le speaks coverage, plainly of “available” insurance it refers to
that of actual who are tortfeasors and not that of those persons responsible who being have been “involved” in the accident without liable under the law. To rule otherwise would lead to the result that underinsured would be eliminated whenever blameless involved in an accident entirely persons happen be insured. heavily
[Id. 854.] A.2d 276, 558 Longworth, Division held that “UIM *8 choose, may, they if carriers honor demands from their insureds to proceed prior disposition to arbitration of the UIM claim of the Longworth, supra, N.J.Super. the tortfeasor.” 223 195, at 538A.2d 414.
Thus,
case,
perhaps entirely
in this
the fact that the
blameless
heavily
but
in
Galex was involved
the accident should not
deprive
“practical
Green of his UIM benefits. This is the
common
understanding
sense
of the term
in
‘available’ as used N.J.S.A
17:28-l.le____”
Co.,
Indemnity
Dickenson v.
N.J.Super.
Ins.
276
72,
(Law Div.1994).
79,
circumstances,
354 Ins., Zirger 144 N.J. 676 A .2d v. General Accident (1996), today, future also decided we set forth as notice, damages in
subject proper a contested trial of to underlying tort suit will establish the value of the UIM claim. As more familiar with the different avenues for the bar becomes recovery, process reparations be the entire of automobile expedited. keeping philosophy, with that we believe that the run from the statute of limitations on claims should date UM/UIM otherwise, last, might it automobile cases as of an accident. Were (two here, years years injury eight personal or more for the limitations and six for the statute of statute of UM/UIM limitations). That makes little There should be more than sense. years. enough to resolve all the issues within six The more time question ruling given be difficult is whether our should retroactive effect.
Ill
retroactivity
primary
resolving questions
focus in
“[T]he
justice,
with ‘considerations of fairness and
related
reasonable
surprise
prejudice
to those affected.’” Green v. Auerbach
591, 600-01,
Corp., 127 N.J.
Because we are
for the first time the date on which
run,
begins
the statute of limitations on
claims
to
it is
UM/UIM
justice”
apply
holding prospec
the interest of “fairness and
to
this
Auerbach,
tively.
supra, 127
See
N.J.
TV given The issue that remains is whether Selective was late policy. Rutgers Casualty notice under the Insurance Co. Vassas, supra, 139 N.J. 652A.2d the claimant’s insurance pending, company never knew that there was a tort case much injuries. personal that less a claim for Here Selective knew there injuries were extensive because there was a contest over PIP accident, paid as a result of the and benefits to Green Selective injuries. fully presume was aware of the extent his We must cursory investigation would have disclosed the limits of liability Tingle’s policy. Appellate
The Division affirmed the trial court’s dismissal on seven-year delay the basis that between date of the accident and Green’s claim Selective UIM benefits unfairly prejudiced subrogation rights. Selective’s result; however, reaching relied on this Vassas Division Vassas distinguishable. ease, Vassas, belatedly policyholder, sought In that provisions his enforce underinsured motorist contained within liability policy. automobile Vassas had been involved in an auto- Void, mobile accident with a vehicle driven Andre an underin- accident, Shortly Rut motorist. after the Vassas notified sured vehicle, Rutgers gers damage of collision to his but never informed personal injury personal claim. then filed a possible of a Vassas injury informing Rutgers. Following action without Void 4:21A-l(a)(l), non-binding under Rule Vassas was arbitration $15,000. awarded, accepted, policy limit of Void’s On Vassas’s award, motion, judgment gave on the and Vassas was entered judgment. a satisfaction of Id. at 652A.2d 162. Void later, asserted, time, first a claim Fifteen months Vassas for the against Rutgers by failing for UIM benefits. We held *11 accident, notify Rutgers years of this claim until three after the judgment, unfairly preju and fifteen months after the had Vassas Rutgers’s subrogation rights against diced the underinsured mo torist, contrary requirements policy. of Id. at the suit, By Rutgers of A.2d 162. the time Vassas notified the Rutgers precluded pursuing subrogation was from a Void, judgment given The released Void. satisfaction Vassas addition, responsible party, any liability. two-year the In the expired. which to statute limitations within sue Void had incurred, prejudice Rutgers Because of the was released of its obligation provisions policy. under the UIM of Vassas’s Ibid. case, Appellate this the Division concluded that because “delay of three from the date of the accident to assertion of prejudice a claim resulted in unfair UIM to the insurance carrier ], here, compelled we are to reach a [in Vassas similar conclusion policyholder delayed years.” the [where] more than seven How- ever, attempted Longworth/Vassas guidelines. Green to follow the In Vassas we said: If a the insured receives settlement offer or arbitration award that does not because the tortfeasor claim, underinsured, the UIM completely satisfy
insurer
then
offer to
has two
the insured the amount of the
options:
pay
tortfeasor’s settlement offer or the arbitration
the tortfeasor’s
award, usually
exchange
subrogation
rights against
in
limit,
for
of the insured’s
the tortfeasor; or,
allow the
to settle.
In either
insurer must further
case,
allow the
coverage.
insured the benefit of the UIM
162.]
[Vassas, 174-75, supra, accepted settlement, Green he contacted Selective before and judgment regard Selective told him to exercise own with his accepting it. could paid Selective have Green $2500 and taken subrogation rights fully over the case Galex. Its were short, intact. Although Vassas does not control this case. we asserted, specific no prejudice note that been has other than died, Tingle prejudice has whether Selective has suffered on must account late notice be determined the trial court aon Tingle’s testimony fuller assessment of the record. or his state preserved or ments have been be otherwise available Riccio, any comparative liability. assess See N.J. (explaining assessing of UM role arbitrator fault). comparative judgment Division is reversed and
matter is proceedings remanded to Law Division for further opinion. accordance with this WILENTZ,
For reversal and remandment —Chief Justice HANDLER, POLLOCK, O’HERN, GARIBALDI, and Justices STEIN COLEMAN —7.
Opposed—None.
POLLOCK, J., concurring. *12 Co., Zirger 327, 333, v. General Accident Ins. 144 N.J. 676 1065, (1996), today, A.2d recognizes 1068 also decided the Court that governs disputes contract law the resolution of about UM and coverage. Consequently, UIM a cause of action for UIM benefits contract, does the not accrue until carrier breaches the for exam Altman, ple, by denying the Allstate Ins. v. 200 benefits. Co. 269, 275, 491 N.J.Super. (App.Div.1984). A.2d 59 case, present a recognizing the the contractual nature of claim, majority recovery UIM the asserts that of UIM benefits is 333, recovery “conceptually from in tort.” Ante at 676 different Curiously, however, ignores majority A.2d at 1068. the con the determining claim in event tractual nature of the the that starts 358 Even running of limitations. N.J.S.A. 2A:14r-l.
the of the statute period curiously, majority that the limitations more the concludes accident, implicitly of the a conclusion that runs from the date Yet, majority sounding a as in tort. the recognizes claim UIM the rejects the that an insured’s action proposition the claim the tortfeasor. UIM carrier stems from tort Ibid. say so,
Although majority expressly does it solves the the not apparently that asserting Legislature that the intended riddle the to run the the statute of limitations on contract starts on Significantly, the Ante at A.2d at 1078. date of accident. 676 history statutory language support it cites no its assertion. or Instead, majority simply policy to legislative the refers “ expeditious innocent finan ‘provide protection to the victims of ” cially irresponsible at A.2d at 1078 motorists.’ Ante 676 Houten, (quoting Longworth N.J.Super. 223 538 v. Van (App.Div.1988)). opinion explana 414 Missing A.2d from is an majority protection by measuring furthers tion how accident, than right of to sue from date of the rather claimants from the date denial of benefits. UIM majority’s requirement bring a claimant an action must on a UIM claim within six from the accident date does not law, contrast, Existing protects protect accident victims. case by permitting victims those the assertion UIM claims before Rutgers Casualty tort Ins. Co. the determination of actions. See Vassas, 163, 171, 174, (adopting N.J. Longworth); Longworth, supra, may (stating A.2d 414 that an seek arbitration of UIM action). underlying tort similar benefits before resolution No salutary requiring prema from an effect follows insured to file ture claim benefits. majority opinion
Implicit is an awareness that an insured potential not on the date of the accident that a know at 1078. In tortfeasor underinsured. Ante at A.2d *13 case, hardly right such a it seems fair to the to measure insured’s sue from date. that an timely
Most claimants will have
economic incentive to file
claims
already obligated
for UIM benefits. UIM claimants are
to
notify
litigation. “If,
ensuing
during
carriers
accidents and of
claim,
pendency of
the
the
the tortfeasor’s insurance
proves
satisfy
to
damages,
insufficient
the insured’s
then the
again notify
the UIM
should
insurer
that fact.” Vas
sas,
Additionally,
My provide majority, further concern is that the it what claims, perceives practical procedure a more for be has unintentionally consistency practicality. sacrificed doctrinal supports Established contract law the result reached same as that majority, may pursue that Green suit his Selective. Thus, my majority difference with the not the is result but acceptance means it uses reach that result. Public decisions, judiciary depends only judicial not but on results of on Regrettably lacking means courts use to reach those results. majority opinion any from the reason for the result reached majority’s other than to reach result. desire majority I misplaces also believe its reliance on a text, leading Cynthia Craig automobile-insurance M. & Daniel J. Law, 23:3-l(b), Pomeroy, Jersey § New Auto Insurance *14 (1996). analogous majority, a According “[i]n somewhat raise context, Pomeroy claimants must Craig observe that UM & years accident.” of the for arbitration within six their demand however, majority opinion, Ante at A .2d at 1079. paragraph in the next any to the statement omits reference Pomeroy’s Craig treatise: & obligation contractual an insurer for breach of the It is that suit noteworthy brought six of the insurer’s a claim is when within timely to arbitrate UM begin regard, limitation does not In that the six-year period
refusal to arbitrate. rejects claimant’s arbitration demand. run until the insurer the UM 1(b), [Craig § 299.] at & Pomeroy, 23:3— encouraging Pomeroy recognize the benefit of Although Craig & benefits, they recognize that timely also file claims for insureds to that starts the claims is a breach of contract the denial of such N.J.S.A under running six-year statute of limitations 2A:14r-l. propose majority opinion be read to
To the extent that the claim for benefits underlying tort action and the that the ante proceeding, at 676 A .2d at adjudicated in one should be any stage proceedings parties, these no one —not Division, suggested that the Law or the Division—has minimum, parties to comment permit I would proposal. At writing That proposal it into the law of the State. on the before process provide practice parties include the in the would thinking. with the benefit of their Court sum, begin run six-year statute of limitations did not by denying claim for until breached its contract Green’s Selective Thus, February, 1993. That denial occurred UIM benefits. expire he instituted this limitations did not on Green’s before action. joins in this concurrence.
Justice STEIN
