SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
A-1682-96T2
ALBERT KOR,
Plaintiff-Appellant,
v.
NATIONAL CONSUMERS INSURANCE
COMPANY,
Defendant-Respondent.
Argued: October 22, 1997 - Decided: March 5,
1998
Before Judges Muir, Jr., Cuff and Steinberg.
On appeal from the Superior Court of New
Jersey, Law Division, Hudson County.
Gregg A. Wisotsky argued the cause for
appellant (Feinman & Chapman, attorneys;
Laura M. Le Winn, on the brief).
Jerald J. Howarth argued the cause for
respondent (Hahn & Howarth, attorneys;
Mr. Howarth, on the brief).
The opinion of the court was delivered by
STEINBERG, J.S.C. (temporarily assigned).
This appeal requires us to consider the holding in Longworth
v. Van Houten,
223 N.J. Super. 174 (App. Div. 1988), in
circumstances where the underinsured motorist (UIM) insurer and the
tortfeasor's liability insurer are the same carrier. Plaintiff
settled his personal injury claim against the tortfeasor.
Defendant then denied plaintiff's UIM arbitration claim on grounds
plaintiff failed to protect its subrogation rights against the
tortfeasor. Plaintiff filed this action against defendant seeking
UIM benefits, personal injury protection benefits, and other
ancillary relief.
When plaintiff filed a motion for summary judgment, the motion
judge concluded plaintiff's noncompliance with the requisites of
Longworth required denial of plaintiff's motion. The judge held
plaintiff's failure to give timely notice that the statute of
limitations was about to expire, coupled with the failure to either
file an action against the tortfeasor or to advise defendant a suit
had not been filed, prejudiced defendant in its ability to pursue
a subrogation claim against the tortfeasor. The judge did so even
though plaintiff, prior to submission of a "Longworth" letter, had
negotiated a settlement of his claim against the tortfeasor with a
liability claims adjuster of defendant. Subsequent to the denial
of the summary judgment, the parties consented to a dismissal of
the complaint. Plaintiff appeals the denial of summary judgment.
We reverse.
On March 10, 1994, plaintiff sustained injuries when the
automobile he was driving was struck by the vehicle driven by the
tortfeasor. Defendant provided automobile liability insurance to
both plaintiff and the tortfeasor.
Plaintiff did not file suit against the tortfeasor prior to
commencing negotiations with the adjuster. On or about
February 28, 1996, twelve days before expiration of the statute of
limitations, the parties settled the claim against the tortfeasor
for the tortfeasor's policy limits subject to a "Longworth" letter.
Plaintiff then sent the letter. Defendant rejected plaintiff's UIM
claim on grounds it had been prejudiced by the failure of the
plaintiff to protect defendant's subrogation claim against the
tortfeasor due to plaintiff's failure to file suit against the
tortfeasor prior to the running of the statute of limitations.
Plaintiff then filed this action.
In support of his motion for summary judgment, plaintiff
furnished a certification of Kenneth Lucianin, a legal assistant
employed by plaintiff's attorney. According to Mr. Lucianin, he
sent a letter to defendant's liability adjuster, Eunice Wynn, on
February 23, 1996, advising her of plaintiff's claim, enclosing
plaintiff's "medical package", and calling to her attention a
February 16, 1996, telephone conversation. During this
conversation, Mr. Lucianin advised Ms. Wynn that the statute of
limitations was running and that plaintiff wanted to settle as
quickly as possible, especially since plaintiff's injuries were in
excess of the tortfeasor's policy limits. At this time, Ms. Wynn
agreed that the case would likely settle and said that plaintiff
should not file suit.
The February 23, 1996 letter, also stated, in bold print, that
the statute of limitations "will be running on March 10, 1994."
Obviously this was a misprint, as the caption of the letter
correctly set forth the accident date as March 10, 1994. Finally,
Mr. Lucianin asked that defendant set up an underinsured motorist
claim file. Mr. Lucianin contended that he sent the February 23,
1996 letter to defendant through Lawyers Service. He attached a
receipt to his affidavit indicating that the letter was received by
defendant on February 26, 1996.
Subsequently, Mr. Lucianin had a telephone conversation with
Ms. Wynn on February 28, 1996, during which she offered the
tortfeasor's policy limits of $15,000 and asked that plaintiff not
file suit against the tortfeasor. She also asked that Mr. Lucianin
send a "Longworth" letter to the attention of Tanya McKinny, the
personal injury protection benefits adjuster handling plaintiff's
claim. Mr. Lucianin sent this letter.
Mr. Lucianin also spoke with Ms. McKinny on February 28, 1996,
and said that he would be sending her a "Longworth" letter by
facsimile transmission and Lawyers Service that day. He advised
her that time was of the essence. The Longworth letter correctly
set forth March 10, 1994, in the caption, as the date of the
accident, thereby formally advising Ms. McKinny that the statute of
limitations was about to expire. The Longworth letter also advised
Ms. McKinny that plaintiff intended to accept the $15,000 policy
limits in exchange for providing the tortfeasor with a general
release. Additionally, the letter asked Ms. McKinny, on behalf of
defendant, for guidance as to how to proceed. That is, plaintiff
inquired as to whether defendant would either instruct him not to
issue a general release and pay the tortfeasor's policy limits to
plaintiff in return for an assignment of plaintiff's claim, or
settle his UIM claim, or proceed to arbitration. In the
alternative, plaintiff asked that defendant permit settlement to
take place if defendant did not wish to pursue subrogation.
The February 29, 1996 letter asked Ms. McKinny to respond
within thirty days. The statute of limitations expired prior to
the end of the thirty-day time period Longworth recommended. Mr.
Lucianin telecopied the letter to Tanya McKinny on February 29,
1996, and attached to his certification a facsimile transmittal
sheet indicating transmission of the letter on that date. In
addition, he attached a receipt from Lawyers Service indicating
that the letter addressed to Tanya McKinny was received by
defendant on March 4, 1996, six days prior to the expiration of the
statute of limitations. Significantly, the letters to Ms. Wynn and
Ms. McKinny were both sent to the same office address.
In opposition to the motion, defendant furnished the
certification of Ms. Wynn who stated that when she received the
"medical specials" on behalf of plaintiff on February 29, 1996, she
extended authority to settle the claim against the tortfeasor,
"subject to a one (1) month notice period to enable plaintiff to
pursue UIM and the release would then come." Obviously, Ms. Wynn
was aware of the fact that a "one month notice" extended beyond the
statute of limitations.
Defendant also supplied a certification of Kerry Cecil, who
stated that she was the UIM adjuster and that her office received
a notice seeking UIM benefits from plaintiff on March 5, 1996.
This was five days prior to the running of the statute of
limitations. The carrier took no immediate action and waited until
March 18, 1996, to assign the file to Ms. Cecil. This was eight
days after the statute of limitations had run. On March 27, 1996,
she forwarded a letter to plaintiff's attorney denying UIM benefits
on the grounds previously noted.
The motion judge denied plaintiff's motion for summary
judgment because plaintiff prejudiced defendant's right of
subrogation in violation of the subrogation clause of the policy.
The judge based this decision upon the fact that neither the letter
of February 23, 1996, nor the letter of February 29, 1996, stated
that the statute of limitations was about to run and that suit had
not been filed. In addition, the judge was persuaded by the fact
that the most effective manner in which to preserve defendant's
subrogation rights would have been to file suit. Accordingly, the
motion for summary judgment was denied and the subsequent consent
order was entered nunc pro tunc, dismissing plaintiff's complaint.
The purpose of UIM protection is to provide "maximum and
expeditious protection to the innocent victims of financially
irresponsible motorists." Longworth, supra, 223 N.J. Super. at 184
(footnote omitted). A strict construction of the language of an
insurance policy may frustrate the intent of the Legislature in
authorizing UIM coverage. The policy may contain an exhaustion
clause that requires the insured to exhaust the policy limits of
the tortfeasor prior to asserting a UIM claim. This frustrates an
injured party, particularly one whose damages are in excess of the
policy limits, in seeking an expeditious resolution of the claim.
Longworth, supra, 223 N.J. Super. at 183. In addition, an
insurance carrier owes a duty to its own insured to provide the
protection of a general release as a condition of settlement.
Therefore, an injured party such as plaintiff will not be able to
settle with an underinsured tortfeasor unless he is also willing to
give a general release. A general release prejudices the UIM
carrier's right of subrogation. Id. at 183-84. As a result, the
injured party cannot settle his claim without jeopardizing his
right to recover under the UIM provisions of his policy. Ibid.
The dilemma confronting an injured party seeking to assert a
UIM claim in the ordinary circumstance where the UIM carrier and
the liability carrier are different was resolved in Longworth,
supra, and Rutgers Cas. Inc. Co. v. Vassas,
139 N.J. 163 (1995).
In Rutgers Casualty, the Court said:
Accordingly, when an insured under an
automobile insurance policy providing UIM
benefits is involved in an accident and
undertakes legal action against the
tortfeasor, the insured must notify the UIM
insurer of that action. If, during the
pendency of the claim, the tortfeasor's
insurance coverage proves insufficient to
satisfy the insured's damages, then the
insured should again notify the UIM insurer of
that fact.
If the insured receives a settlement offer or arbitration award that does not completely satisfy the claim, because the tortfeasor is underinsured, the UIM insurer then has two options: offer to pay the insured the amount of the tortfeasor's settlement offer or the arbitration award, usually the tortfeasor's policy limit, in exchange for subrogation of the insured's rights against the tortfeasor; or, allow the insured to settle. In either case, the UIM insurer must further allow the insured the
benefit of the UIM coverage. If the insurer
does not respond within the time allotted for
rejection of the award or settlement offer,
the insured victim may, consistent with
Longworth, supra, move for a declaratory
ruling on order to show cause concerning the
parties' rights and responsibilities. In this
manner, the insured victim is afforded the
protection and benefits of the tortfeasor's
insurance coverage in addition to the
insured's own UIM coverage. As well, the UIM
carrier is able to weigh the relative merits
of allowing its insured to settle and paying
the difference in UIM benefits compared with
paying its insured the settlement offer plus
UIM benefits and itself maintaining a
subrogation action against the tortfeasor.
The Longworth procedure balances the
interests of insureds and insurers, injured
victims and tortfeasors. It provides the
insured victim an opportunity both to assert
liability against the tortfeasor and to
determine the liability of the UIM insurer.
In addition, it apprises the UIM insurer of
pending litigation by one of its insureds,
which may obligate it to provide UIM coverage
under the insured's policy.
[139 N.J. at 174-75 (emphasis omitted).]
Defendant contends that plaintiff's belated Longworth letter
entitled it to deny the UIM claim. In doing so it essentially
argues the thirty-day time period prescribed by Longworth is
immutable. We rejected a similar contention in Breitenbach v.
Motor Club Ins. Co.,
295 N.J. Super. 328 (App. Div. 1996). There,
the UIM carrier failed to respond in writing within thirty days of
the insured's notice of intention to settle with the tortfeasor for
the policy limits. The notice also provided that unless the
insured was advised to the contrary within thirty days, he would
assume that there was no objection to the settlement. When the UIM
carrier failed to respond, the insured settled. We rejected the
carrier's contention that it was entitled to an irrebuttable
presumption of prejudice whenever the insured settles with a
tortfeasor, without the carrier's express written consent, if that
settlement occurs within thirty days of the notice.
We said:
Even accepting a settlement within the
thirty day period, in the absence of a
declaratory judgment action, however, does not
per se constitute prejudice to the UIM
carrier. By not waiting the thirty day
period, the insured takes a risk and must
demonstrate either consent or waiver by the
carrier or a lack of prejudice to the carrier
if the carrier, within that period, gives
notice of its election to pay the settlement
amount.
....
While plaintiff settled with the
tortfeasor within the thirty days, defendant
never delivered a response within that period,
either objecting to the settlement or offering
to pay the settlement proceeds. Having not
responded in writing within thirty days of
receipt of plaintiff's notice, the carrier's
right of subrogation cannot be deemed to have
been compromised. Thus, although he settled
with the tortfeasor, plaintiff can also pursue
his UIM claim against the carrier.
[Id. at 334-35 (citation omitted).]
Applying the Breitenbach reasoning to the unique facts here,
we conclude defendant must provide plaintiff with UIM arbitration.
The Longworth thirty-day time period is not applicable in this
instance.
Defendant's claim adjuster knew the statute of limitations
would run on March 10, 1996. Defendant cannot disavow that
knowledge and hide behind the thirty-day provision on the ground it
settled the tortfeasor claim conditioned upon a Longworth letter.
The knowledge of the tortfeasor adjuster has to be imputed to
defendant. That imputed knowledge combined with defendant's
delayed handling of the Longworth letter dictates against
defendant's entitlement to claim prejudice. A carrier may not deny
a claim for UIM coverage on grounds of prejudice where its own acts
caused or significantly contributed to the claimed prejudice.
Here, defendant's conduct and knowledge bar its right to reject
plaintiff's UIM arbitration claim.
Longworth was decided upon principles of fairness. We find no
fairness in defendant's claims given its dual rule and its
contribution to its lost opportunity to seek subrogation from the
tortfeasor, its own insured.See footnote 1
The order under appeal is reversed. The matter is remanded to
the trial court for entry of an order requiring defendant to submit
plaintiff's UIM claim to arbitration.
Reversed.
Footnote: 1We note that the Law Division recently held in Walsh v. State
Farm Ins. Co.,
301 N.J. Super. 619, 623 (Law Div. 1997), which is
factually inapposite, that where an insurer offers the liability
policy limits of its insured in exchange for a complete release
from the injured party, the injured party need not first obtain
written consent to accept the settlement offer from another
department of the same insurer in order to preserve a UIM claim
under another policy issued by that insurer.