SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-1099-98T1
BENJAMIN ADEN and BEATRICE ADEN,
Plaintiffs-Respondents,
v.
ROBERT F. FORTSH,
Defendant-Appellant,
and
JOHL & COMPANY,
Defendant.
________________________________________
Submitted September 23, 1999 - Decided January
19, 2000
Before Judges Baime and Eichen.
On appeal from the Superior Court of New
Jersey, Law Division, Bergen County.
Methfessel & Werbel, attorneys for appellant
(John Methfessel, Jr., on the brief).
LeBoeuf, Lamb, Greene & MacRae, attorneys for
respondents (Louis Smith, on the brief).
No brief was submitted on behalf of Johl &
Company.
The opinion of the court was delivered by
EICHEN, J.A.D.
In this action for negligent failure to procure adequate
insurance coverage for the interior structure of a condominium unit
owned by plaintiffs, the principal issue presented on appeal is
whether the trial court erred in refusing to instruct the jury
concerning plaintiffs' comparative fault.
These are the relevant facts. In September 1994, after
thirty-seven years of residing in Bergenfield, plaintiffs Benjamin
and Beatrice Aden sold their house and purchased a condominium unit
for $48,000 in Sussex County. Benjamin Aden (Aden), who was a
retired building inspector, contacted Robert F. Fortsh to secure
coverage for his new unit. Fortsh was a special agent for
Prudential Insurance Company and had been plaintiffs' insurance
broker for many years, having sold them automobile and homeowners
insurance.
Aden and Fortsh spoke a few times on the telephone concerning
coverage for the condominium unit. The substance of those
conversations was seriously contested at trial. Aden claims he
told Fortsh to secure "a policy that would cover any losses [he]
might have in [his] condo ... [that he just] wanted coverage." He
further stated that Fortsh asked him about the value of the
contents and the price of the unit, and that sometime after their
first conversation, advised him that the premium would be about $98
per year.See footnote 11 Aden testified that Fortsh asked him no other questions
and never told him to inquire whether the master deed or the
condominium association by-laws provided any insurance coverage for
the unit. Aden acknowledged receiving the policy and its renewal,
but admits he never read either of them.See footnote 22
Fortsh contradicted Aden's testimony. According to Fortsh,
Aden told him he only wanted "minimum" coverage and acknowledged
the $1,000 coverage limitation on interior structural damage. He
stated that he fully explained to Aden the type and amount of
coverage, claiming he told Aden that plaintiffs would only be
covered for $1,000 for interior structural damage, but equivocated
on this point during cross-examination. He stated that he told
Aden twice to inquire whether there was other coverage provided by
the by-laws or in the master deed. Fortsh further testified that
he believed Aden would find out what coverage already existed under
the master deed or by-laws and advise him if plaintiffs wanted more
than the "default" minimum coverage of $1,000 for the interior
structure. He further stated that he thought Aden "was very well
aware that I would not be looking at the master deed.... My advice
was to call the association ... [to] see what you're covered for."
Based on his prior experience with condominium insurance, Fortsh
stated that he assumed the condominium would indeed provide
adequate coverage in case of fire damage to the interior structure
of the unit. In fact, no such coverage existed.
On June 26, 1996, a fire damaged the interior structural walls
and fixtures of the condominium unit. The cost of repairs was
approximately $20,000. After learning of the $1,000 policy limit,
plaintiffs commenced this action.
At trial, plaintiffs presented expert testimony that it was
Fortsh's duty to know the coverage provided by the master deed and
by-laws before issuing a condominium policy, and that he was
negligent in issuing the policy without that information. Fortsh's
expert presented contrary testimony. He stated that a broker's
customary duty is only to explain the nature of the coverage
requested and inform the insured to investigate whether the
condominium association offered coverage for interior structural
damage, and to advise the broker if it did not have such coverage.
Prior to the judge's instructions to the jury, Fortsh
submitted written "Requests for Charge," requesting that the jury
be instructed concerning plaintiffs' comparative fault based on
their failure to read the policy or renewal documents.
The trial judge rejected Fortsh's request for a comparative
negligence charge and did not instruct the jury that it could
consider plaintiffs' conduct and surrounding circumstances in
allocating percentages of fault between the parties. It was the
judge's view that unless the jury concluded that plaintiffs were
the sole cause of the inadequate coverage, Fortsh could not
prevail. The only reference to plaintiff's conduct came in the
proximate cause portion of the charge where, after defining
"proximate cause," the judge stated:
Now, defendant has offered testimony that the
plaintiff Aden's own actions or inactions were
the sole proximate cause of having virtually
no interior structural and fixture insurance
coverage for the fire damage to his
condominium. If you find that defendant has
proven by a preponderance of evidence that
plaintiff was the sole proximate cause of this
lack of insurance coverage, you will find in
favor of defendant and dismiss plaintiff's
case.
On the other hand, if you find that the
plaintiff has proven by a preponderance of
evidence the negligence of the defendant in
providing inadequate and incomplete advice and
procurement of insurance coverage, and that
that was a substantial factor in bringing
about the losses that occurred, and that some
harm to the plaintiff was foreseeable from the
defendant Fortsh's negligence, then you will
find in favor of the plaintiff. (Emphasis
added.)
After the judge completed the charge, defendant's counsel
again requested a comparative fault charge in respect of
plaintiffs' failure to read the policy as well as their failure to
inquire as to the existence of additional coverage for interior
structural damage to the unit. The judge again denied the request.
During its deliberations, the jury requested the judge to explain
again the meaning of "proximate cause," and the judge acceded to
its request.
The jury returned a verdict finding Fortsh's negligence was a
proximate cause of plaintiffs' loss and judgment was entered in
favor of plaintiffs in the sum of $20,877.45. The judge denied
Fortsh's motion for a new trial, which was based on the judge's
refusal to charge comparative negligence to the jury.
On appeal, Fortsh contends that the proximate cause charge and
the failure to give a comparative negligence charge to the jury
resulted in a miscarriage of justice.
Our review of the record and the arguments advanced, in the
light of the applicable legal principles, persuades us that the
jury charge was erroneous in that it did not allow the jury to
properly allocate fault between the parties. We conclude that this
error was "clearly capable of producing an unjust result." R.
2:10-2. Accordingly, we reverse the judgment and direct a new
trial.
One who holds himself out to the public as an insurance broker
must exercise reasonable skill, care, and diligence in the
execution of his responsibilities. Rider v. Lynch,
42 N.J. 465,
476 (1964). In Rider, the Court stated that an insurance broker
is expected to possess reasonable knowledge of
the types of policies, their different terms,
and the coverage available in the area in
which his principal seeks to be protected. If
he neglects to procure the insurance or if the
policy is void or materially deficient or does
not provide the coverage he undertook to
supply, because of his failure to exercise the
requisite skill or diligence, he becomes
liable to his principal for the loss sustained
thereby.
[Ibid.]
However, an insured's own negligence may operate to avoid a
broker's liability for failure to exercise the required skill, care
and diligence. See Schustrin v. Globe Indemnity Co. of New York,
44 N.J. Super. 462, 466 (App. Div. 1957) (citing Restatement of
Agency § 415 comment b (1933)).
In Schustrin, the insured failed to read the insurance policy
and we held that such failure should be considered on the question
of the insured's own negligence. In that context, we stated:
In an action by a principal against his broker
for negligence by reason of his failure to
perform an undertaking, the mere failure on
the part of an insured to read a policy does
not Per se bar a recovery, but is a
circumstance to be considered on the question
of the plaintiff's contributory negligence.
The insured may be able to explain
satisfactorily his failure to read the policy
and show that he exercised that degree of care
which a reasonably prudent person would
ordinarily use under the same circumstances.
16 Appleman, Insurance Law and Practice, §
8834, p. 307.
[Id. at 467 (emphasis added).]
Indeed, from as early as 1926, the general rule has been that
an insured is under a duty to read his policies and to advise his
insurance agent if the coverage is inconsistent with his desires.
Martinez v. John Hancock Mutual Life Ins. Co.,
145 N.J. Super. 301,
310 (App. Div. 1976), certif. denied,
74 N.J. 253 (1977) (citing
Crescent Ring Co. v. Travelers Indem. Co.,
102 N.J.L. 85, 92 (E. &
A. 1926)).
Despite this well-settled legal principle, plaintiffs argue
that Rider is the prevailing law in that it states that an
insured's failure to read his or her insurance policy does not
support a defense of contributory negligence. Rider, supra, 42
N.J. at 482. We disagree and conclude that plaintiffs' reliance on
this "passing" observation in Rider is misplaced.
In Rider, the Court held that the broker's implied
misrepresentation to the insured concerning available automobile
liability coverage estopped the broker from relying on the
insured's failure to read her policy. Ibid. This case does not
involve a misrepresentation by the broker. In the absence of
evidence of such wrongdoing, an insured must examine his or her
policy. See Dancy v. Popp,
114 N.J. 570, 572-73 (1989) (quoting
Harr v. Allstate Ins. Co.,
54 N.J. 287, 309-10 (1969)) ("an insured
is chargeable, for reasons of business utility, with knowledge of
the contents of a policy," unless fraud or inequitable conduct on
the part of the insurer is involved). See also Sears Mortgage
Corp. v. Rose,
134 N.J. 326, 348 (1993) (observing "[n]ormally,
insurance purchasers are expected to read their policies" and "'the
law may fairly impose upon [them] such restrictions, conditions and
limitations as the average insured would ascertain from such
reading.'") (quoting Bauman v. Royal Indem. Co.,
36 N.J. 12, 25
(1961)).
Moreover, since Rider, the Legislature has abolished
contributory negligence in favor of the doctrine of comparative
fault, see N.J.S.A. 2A:15-5.1 to -5.3 (the Act), requiring the
fact-finder to determine "the extent, in the form of a percentage,
of each party's negligence or fault," in all negligence cases,
including "professional malpractice." N.J.S.A. 2A:15-5.2. An
action by an insured against his insurance broker for negligently
failing to provide adequate coverage is a negligence action.
Therefore, in such an action, if an insured fails to examine his or
her policy, that failure may constitute negligence which a jury
should consider in allocating fault between the broker and the
insured. In addition, any other conduct by an insured that a
reasonable jury could conclude was unreasonable under the
circumstances, should be considered on the element of the insured's
comparative negligence.
Accordingly, we conclude the judge erred in not instructing
the jury on plaintiffs' comparative fault so that it could properly
consider and allocate the percentages of fault between the parties.
Instead of giving a comparative negligence charge, the judge
instructed the jury it had to find that plaintiffs were the sole
proximate cause of their loss before it could find in favor of
defendant. We are convinced that the jury could have been confused
and misled by this one-sided instruction. The instruction was
tantamount to requiring the jury to find plaintiffs 100" negligent
before it could exonerate defendant, whereas a finding of 51" fault
on the part of plaintiffs would have produced a verdict in favor of
defendant. Because the instruction had the clear capacity to
confuse and mislead the jury, we conclude it was clearly capable of
producing an unjust result. R. 2:10-2. See Conklin v. Hannoch
Weisman,
145 N.J. 395, 410 (1996); see also Vallejo v. Rahway
Police Dept.,
292 N.J. Super. 333, 342 (App. Div.), certif. denied,
147 N.J. 262 (1996). Consequently, we are constrained to reverse
the judgment.
At the retrial, in addition to explaining the duties of an
insurance broker, the judge should also instruct the jury on the
insured's obligation to examine his or her policy. In addition,
the judge should explain to the jury that if it believes Fortsh's
version of the events, it should consider, in the light of the
experts' opinions, whether plaintiffs were in any way at fault for
the inadequate insurance coverage.
Reversed and remanded for a new trial.
Footnote: 1 1 Aden apparently rejected Fortsh's first premium quote of
$120, which necessitated Fortsh's procuring coverage through
another agent, defendant Johl & Company, which represented Hartford
Insurance Company. Johl & Company paid $500 to plaintiffs to
settle the matter and was dismissed as a defendant from the action.
Footnote: 2 2 The condominium policy was a type of homeowners policy that
provided the following coverage: dwelling - $1,000; personal
property - $16,000; loss of use - $6,400; personal liability
$300,000; and medical payments - $1,000. It is not disputed that
the term "dwelling" refers to interior structure, i.e., walls and
fixtures.
The condominium policy was an annual policy covering the
period September 17, 1994 to September 17, 1995. Plaintiffs
renewed the policy for another year commencing on September 17,
1995. The declaration sheet of the renewal policy indicated in
large print the various monetary limitations, including $1,000 for
damage to the dwelling.