SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-1473-98T3
CNA INSURANCE COMPANIES,
Plaintiff-Respondent,
v.
PETER CAVE,
Defendant-Appellant.
__________________________________
Argued April 5, 2000 - Decided June 20, 2000
Before Judges Baime, Eichen and Wecker.
On appeal from the Superior Court, Law
Division, Middlesex County.
Stephen D. Brown argued the cause for
appellant.
John C. Simons argued the cause for
respondent (Hoagland, Longo, Moran, Dunst &
Doukas, attorneys; Mr. Simons on the brief).
The opinion of the court was delivered by
WECKER, J.A.D.
This appeal raises once again the question of the effect of
a LongworthSee footnote 11 violation on a carrier's obligation to provide
underinsured motorist (UIM) coverage to its insured.
Plaintiff, CNA Insurance Companies, contends that because
defendant, Peter Cave, settled his case against two defendants on
the trial date, without giving notice to CNA of one defendant's
last-minute offer, that settlement bars any UIM recovery by Cave
and excuses CNA from participating in UIM arbitration. The Law
Division Judge granted plaintiff's summary judgment motion
without explaining the reasons for his decision, merely saying "I
think the law is with CNA. Clearly, this is one for the
Appellate Division." The question presented is whether the
carrier nevertheless is obligated to participate in UIM
arbitration to allow the claimant to establish that the settling
defendant in the auto accident case was not a tortfeasor, thereby
proving that the carrier was not prejudiced by claimant's
acceptance of the offer and the carrier's resulting loss of
subrogation rights. We conclude that on these facts, the carrier
must participate in UIM arbitration.
The motion judge's failure to explain the reasons for his
decision is contrary to court rules. See R. 1:7-4; R. 2:5-1(b).
The failure is particularly troubling when the unexplained
decision grants summary judgment disposing of a party's claim.
Indeed, the motion judge's apparent recognition that his
decision was likely to be appealed was all the more reason to
clearly enunciate both the findings of fact and the legal
reasoning that supported the decision. Leaving it to the
Appellate Division to sort out the record and the issues is a
disservice to the parties and the court. Curtis v. Finneran, 83
N.J. 563, 569-70 (1980).
The relevant facts are these. Defendant, Peter Cave, was a
passenger in a car driven by Joshua Brandt, who died as a result
of the 1994 accident. It appears that Brandt went through a
blinking red light and collided with a car driven by William
Giles. Cave was seriously injured in the accident. The UIM
endorsement under the CNA policy covering Cave provided $100,000
maximum UIM coverage.See footnote 22 Brandt carried a minimum $15,000/$30,000
policy issued by Allstate Insurance Company. Giles was covered
by a $500,000 single limit policy issued by Hanover Insurance
Company.
Cave filed a complaint against both Brandt's estate and
Giles in February 1996. On February 27, 1997, Cave's attorney
wrote to CNA to advise that he had received a $10,000 offer from
Brandt's carrier. That offer reflected payment of equal sums to
three injured parties, thereby exhausting Brandt's $30,000 policy
limit. Cave's letter notice to CNA was consistent with the
procedures outlined in Longworth v. Van Houten,
223 N.J. Super. 174 (App. Div. 1988). The letter asked CNA to decide within
thirty days whether it wished to preserve its right to subrogate
against Brandt. On March 5, 1997, in a phone call between Cave's
attorney and a CNA representative, the attorney advised that
Brandt was dead, that Giles' carrier had taken a "no-pay"
position, and that a trial date was scheduled for April 1.See footnote 33 By
letter confirming that conversation, CNA requested additional
information from Cave's attorney and indicated that after receipt
of the information sought, CNA would advise him of its decision.
Although Cave's attorney apparently did not provide CNA with all
of the requested information, CNA determined that Brandt had no
assets and decided not to seek subrogation as to Brandt.
Cave's liability expert as well as Giles's liability expert
provided pretrial reports opining that Brandt's negligence was
the sole cause of the accident, that Giles was not negligent, and
that Giles's conduct was not a proximate cause of the accident.
Thus at a time when Cave had every motivation to establish
Giles's responsibility for the accident, he himself offered
evidence that Giles was not a tortfeasor.
As of April 1, the day trial was to begin, Brown had not
heard from CNA regarding its decision on the $10,000 settlement
offer from Brandt's insurer, Allstate. On that date, in the
courthouse, Hanover, Giles's insurer, for the first time offered
Cave $5,000 in settlement of his claim against Giles. Cave
promptly accepted $10,000 from Brandt and $5,000 from Giles and
provided both defendants with general releases, without notifying
CNA of the Giles offer. The case was dismissed with prejudice.
On April 16, a CNA representative called plaintiff's
attorney seeking to learn Giles's policy limit and learned about
the settlements for the first time. CNA informed Cave's attorney
that CNA disputed his contention that Giles had no liability.
When Cave sought CNA's participation in arbitration on his UIM
claim, CNA brought this declaratory judgment action seeking a
determination that it was not obligated to participate in UIM
arbitration on account of Cave's violation of Longworth with
respect to his settlement with Giles.See footnote 44
At oral argument in the Law Division, the motion judge asked
Cave's counsel why he did not immediately notify CNA about the
day-of-trial offer. The following colloquy ensued:
THE COURT: So are you saying the judge didn't
give you enough time to make a phone call to
CNA and say, look, we were offered $5,000; do
you want to pay it or do you want to come
down here and try this case.
MR. BROWN: I _ I _ to be honest, Your Honor,
I _ I didn't even raise that as an issue at
that particular point in time. The case was
moving, the Judge had ordered the jury to
come down, and it was either we were going to
try to settle this case right now or we were
going to _ you know, we were going to send it
out.
Hindsight being 20/20, if it came up again
I probably would just go see the presiding
Judge and say we need an adjournment. But at
that particular point in time we were at
trial, CNA had notice. And when they had the
initial notice, all they had done was sit
down and send a letter asking for all of this
information.
I felt at that time if I would have picked
up the phone and called it wouldn't have
changed their position. They still would
have wanted additional time[.]
In Longworth, Judge Pressler anticipated the situation Cave
found himself in on the trial date, that is, that there would be
various circumstances that would affect the appropriate time
frame within which a UIM carrier must be notified of a settlement
offer and in turn must decide either to consent to the proposed
settlement and give up its right of subrogation against the
tortfeasor or pay the injured party the amount offered on behalf
of the tortfeasor and thereby preserve its subrogation rights.
[I]f the tortfeasor's offer is made very
shortly after the accident, the insurer may
need more time in which to evaluate the
claim. If, on the other hand, litigation has
already commenced, [the presumptive] 30 days
may be much too long. Thus, for example, if
the tortfeasor's offer is made shortly before
or at the commencement of trial, the 30-day
period may not terminate until the trial has
been concluded. In that situation, the UIM
insurer may have to respond within days,
hours or minutes in order for plaintiff to be
spared the necessity of continuing to trial
despite an acceptable offer.
[Longworth, supra, 223 N.J. Super. at 189
90.]
Cave's failure to notify CNA of the day-of-trial settlement
offer clearly violated the requirements of Longworth, as further
explicated in Rutgers Cas. Ins. Co. v. Vassas,
139 N.J. 163, 173
76 (1995) and Rivers v. Allstate Ins. Co.,
312 N.J. Super. 379,
383-84 (App. Div. 1998). CNA was entitled to some notice of the
Giles offer, however short, and the opportunity to choose between
the alternatives of paying Cave $5,000 and taking over trial
against Giles or agreeing to the settlement and waiving any
further claim against him.See footnote 55 Nevertheless, as we said in
Breitenbach v. Motor Club of Am. Ins. Co.,
295 N.J. Super. 328,
334-35 (App. Div. 1996), settling a case in violation of
Longworth and Vassas is not a per se bar to UIM coverage. In
Breitenbach we rejected "an irrebuttable presumption of
prejudice." 295 N.J. Super. at 332.
[A]ccepting a settlement within the thirty
day period ... 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.
[Id. at 334.]
In Rivers, we also said:
We do not read the Supreme Court's opinion in
Vassas to create a bright-line rule that the
insured's failure to protect the insurer's
right of subrogation amounts to prejudice per
se, sufficient under all circumstances to
deny the insured UIM benefits and excuse the
insurer from its coverage obligation.
[312 N.J. Super. at 386.]
A plaintiff who defaults on his obligations under Longworth must
be allowed to prove "that his premature release of the insurer's
subrogation rights caused the insurer no damage." Id. In
Rivers, we recognized that Breitenbach
would apparently ... allow an insured relief
if the insured was capable of proving a "lack
of prejudice" to the insurer, even though the
insurer's subrogation right had been
extinguished by the release. Presumably this
means, by way of example, if an insured can
demonstrate that the underinsured tortfeasor
is assetless, and that it is improbable that
an insurer would choose to subrogate against
the tortfeasor, UIM benefits should not be
withheld from the insured. This is another
way of saying that the insured's breach of
the contract was not material under the
circumstances.
[Rivers, 312 N.J. Super. at 385-86 (citation
omitted).]
However, we distinguished Breitenbach because the UIM carrier in
Rivers sought additional information in a timely fashion and the
plaintiff did not present evidence to support its claim that the
carrier suffered no prejudice.
There is no question that Cave's attorney failed to notify
CNA of Giles's last minute offer. The task before us is to
determine whether loss of Cave's UIM coverage is the appropriate
sanction. However unlikely it may be under the circumstances
that CNA would have forced the case to trial in order to maintain
its right to subrogation against Giles, CNA is entitled to
protection against any prejudice it reasonably may have suffered
as a result of Cave's unauthorized settlement with Giles. CNA is
not, however, entitled to a windfall.
We continue our analysis by considering the applicable
statutory definitions. N.J.S.A. 17:28-1.1e(1) defines
underinsured motorist coverage and an underinsured vehicle:
"underinsured motorist coverage" means
insurance for damages because of bodily
injury and property damage resulting from an
accident arising out of the ownership,
maintenance, operation or use of an
underinsured motor vehicle. Underinsured
motorist coverage shall not apply to an
uninsured motor vehicle. A motor vehicle is
underinsured when the sum of the limits of
liability under all bodily injury and
property damage liability bonds and insurance
policies available to a person against whom
recovery is sought for bodily injury or
property damage is, at the time of the
accident, less than the applicable limits for
underinsured motorist coverage afforded under
the motor vehicle insurance policy held by
the person seeking that recovery. A motor
vehicle shall not be considered an
underinsured motor vehicle under this section
unless the limits of all bodily injury
liability insurance or bonds applicable at
the time of the accident have been exhausted
by payment of settlements or judgments. The
limits of underinsured motorist coverage
available to an injured person shall be
reduced by the amount he has recovered under
all bodily injury liability insurance or
bonds...[.]
In UIM coverage disputes that do not involve a Longworth
violation, we have repeatedly held that "the availability of UIM
coverage depends solely on the aggregate liability of actual
tortfeasors and that the settlement of a claim against an alleged
tortfeasor does not bar the insured from seeking a determination
by an arbitrator that the settling party was not liable."
Prudential Property & Cas. Ins. Co. v. Kress,
241 N.J. Super. 81,
84 (App. Div. 1990) (emphasis added) (citing Gold v. Aetna Life &
Cas. Ins. Co.,
233 N.J. Super. 271, 276 (App. Div. 1989)). The
Supreme Court has quoted Gold with approval for the proposition
that the measure of "available" coverage under N.J.S.A. 17:28
1.1e for purposes of comparison with the insured's UIM limit, is
"that of persons who are actual responsible tortfeasors and not
that of those who may have been 'involved' in the accident
without being liable under the law." Green v. Selective Ins. Co.
of America,
144 N.J. 344, 352 (1996) (quoting Gold, 233 N.J.
Super. at 276).
Cave's Longworth violation should not affect the basic
principle that only an actual tortfeasor's insurance is to be
considered "available" in the first instance in determining
whether UIM coverage is available, and then in determining the
extent of that coverage.
The logical forum for determining the respective liability
of Brandt and Giles, as well as the fair value of Cave's
injuries, is in UIM arbitration. See Gold, 233 N.J. Super. at
276-78; Craig & Pomeroy, New Jersey Auto Insurance Law 28:2
(2000). As we held in both Breitenbach and Rivers, a plaintiff
who violates his duty to his UIM carrier does so at his own risk.
But the risk he incurs is the inability to prove that the carrier
was not prejudiced by the plaintiff's destruction of the
carrier's subrogation rights. As we said in Rivers, "[t]his is
another way of saying that the insured's breach of [the
insurance] contract was not material under the circumstances."
312 N.J. Super. at 385-86. Unlike the circumstances in Vassas,
where the claimant was found to have unfairly prejudiced the UIM
carrier's subrogation rights, and unlike Rivers, where we found
that the plaintiff had "failed to advance any facts demonstrating
a lack of prejudice to Allstate," 312 N.J. Super. at 386, here
the record strongly suggests a lack of prejudice to CNA. Cave
must be afforded the opportunity to prove the lack of prejudice
in an arbitration if CNA maintains that Giles was a tortfeasor.
We see no grounds for punishing plaintiff for his attorney's
misstep by barring his UIM claim entirely, thereby allowing CNA
to avoid its contractual responsibility for Brandt's underinsured
condition. Both Cave and CNA will be fairly protected if CNA is
required to participate in UIM arbitration, where liability and
damages will be determined and apportioned between the two named
defendants, who may or may not both be tortfeasors.
Under the rationale of Longworth, as approved in Vassas,
there is no basis at this juncture for finding that CNA has no
coverage obligation to Cave. Of course, even if CNA's coverage
applies, there may be grounds for finding that no benefits are
recoverable on account of that coverage. That finding depends
upon a determination of comparative responsibility between Brandt
and Giles, as well as a determination of Cave's total damages.
UIM arbitration, an obligation undertaken by CNA in its insurance
contract, is the appropriate forum for those determinations. The
Brandt vehicle was underinsured, and to the extent that he was a
tortfeasor responsible to Cave for damages in excess of his
available and applicable insurance, there is no reason for CNA to
avoid the UIM coverage for which it contracted.
If Giles is found not to have been negligent, then he was
not a tortfeasor, and CNA will have suffered no prejudice
whatsoever as a result of the Giles settlement. In any event,
CNA will have the benefit of Giles's settlement, because CNA will
be entitled to pro tanto credit for the $5,000 Giles settlement
as well as the $10,000 Brandt settlement. See N.J.S.A. 17:28
1.1e(1); Gold, 233 N.J. Super. at 277-78. On the other hand,
should Giles be found negligent to any extent, the effect of such
a finding may raise questions that we need not reach at this
stage.
We perceive no inconsistency between our holding here and
our holding in Ainsworth v. State Farm Mut. Ins. Co.,
284 N.J.
Super. 117, 131-32 (App. Div. 1995), certif. denied,
143 N.J. 328
(1996). In Ainsworth we held that a UIM carrier cannot be
required to arbitrate a potential UIM claim until "plaintiff's
underlying action against [the tortfeasor] is finalized by an
offer of settlement of the policy limits or a judgment exhausting
the policy limits." Id. at 131. We declined to require the UIM
carrier "to participate in what may very well be meaningless
arbitration." Id. at 132. The arbitration we order today cannot
be meaningless under the given circumstances. Cave would have
been entitled to UIM arbitration even if CNA had had the
opportunity and had chosen to take over the trial against Giles.
As Judge Pressler said in Longworth,
Even if we were to assume that change of
attorney were practical in the given
circumstances, it is clear that the
litigation against the tortfeasor so
conducted could not be binding on the insured
vis-a-vis his UIM claim against the carrier.
This is so because of the evident conflict of
interest between insured and insurer as to
both the tortfeasor's liability and the
amount of the judgment against him. Thus,
arbitration of the UIM claim would still have
to take place.
[223 N.J. Super. at 190.]
Cave's attempt to argue a bad-faith claim against CNA on
this appeal, an issue not raised in the Law Division, is contrary
to the rules. R. 2:6-2. A party may not seek relief in the
Appellate Division on a cause of action not first raised at the
trial level, and we are not required to address that claim.
Neider v. Royal Indem. Ins. Co.,
62 N.J. 229, 234 (1973); compare
R. 2:10-5 (providing for original jurisdiction under limited
circumstances).
We reverse and remand for entry of an order requiring CNA to
participate in UIM arbitration.
Footnote: 1 1 Longworth v. Van Houten, 223 N.J. Super. 174 (App. Div. 1988). Footnote: 2 2 Cave was insured as a resident relative of a CNA policyholder, Jocelyn Roach. Footnote: 3 3 CNA contradicts itself in its brief, stating first that "at no point did Brown advise that the case carried a trial date ...," and later apparently conceding that "CNA was only advised of the trial date one month prior to trial ...." Footnote: 4 4 CNA does not contend that the settlement with Brandt violated Longworth. Footnote: 5 5 CNA argued for the first time at oral argument on this appeal that it was prejudiced because it lost the opportunity on the trial date to negotiate a better settlement with Giles's carrier. To the extent that we consider that argument, we are satisfied that the record does not support the contention that CNA was likely to have induced Giles's carrier to increase its offer.