SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
A-4850-95T2
COLLEEN DONATO,
Plaintiff-Respondent,
v.
MARKET TRANSITION FACILITY OF
NEW JERSEY, serviced by AMGRO,
INC., and AMGRO, INC.,
Defendants-Appellants.
_____________________________________________
Argued March 12, 1997 - Decided March 21, 1997
Before Judges Shebell, P.G. Levy and Braithwaite.
On appeal from the Superior Court of New Jersey,
Law Division, Camden County.
Patricia W. Holden argued the cause for appellants
(Martin, Gunn & Martin, attorneys; Ms. Holden and
William J. Martin, on the brief).
John J. Palitto, Jr. argued the cause for
respondent.
The opinion of the court was delivered by
SHEBELL, P.J.A.D.
Defendant, Market Transition Facility of New Jersey ("MTF"),
appeals from a summary judgment order requiring it to provide
Underinsured (UIM) coverage to plaintiff, Colleen Donato, as well
as the denial of its motion for summary judgment. We affirm.
On June 16, 1992, plaintiff was an occupant in a motor
vehicle owned by her male domestic companion. She was injured
when the vehicle of a tortfeasor struck the vehicle in which she
was a passenger. It appears that at the time of the accident,
although plaintiff was living with her companion, they were not
married and she was not a named insured on his policy, which he
had purchased from MTF. Plaintiff did not own a vehicle of her
own, nor was she a named insured under any other insurance
policy. The MTF policy had uninsured motorist coverage in the
amount of $250,000 per person/$500,000 per accident. UIM
coverage was included under the UM coverage. An "insured" for
the purposes of the UIM coverage was defined as the insured
himself or any family member or any other person occupying the
covered auto.
The tortfeasor had coverage in the amount of $25,000 per
person. The tortfeasor's insurance carrier offered to settle
with plaintiff for the maximum amount of the policy. Plaintiff,
pursuant to Longworth v. Van Houten,
223 N.J. Super. 174 (App.
Div. 1988), informed MTF of the settlement offer and requested
that MTF indicate whether it intended to waive its subrogation
rights. Also included in plaintiff's letter was the following:
Please be advised in consideration of
the recent decision in Aubrey v. The
Harleysville Insurance Companies,See footnote 1 that
Colleen Donato had no policy of insurance at
the time of the accident, and her affidavit
of no insurance is already in your files.
In reply, MTF waived its subrogation rights and requested that
plaintiff choose an arbitrator so that "we can begin to move this
case toward a resolution." Plaintiff accepted the $25,000 and
both parties named arbitrators. The matter was given an
arbitration date, however, arbitration was delayed due to MTF's
request to have plaintiff examined by an independent doctor. MTF
then advised plaintiff, in a letter dated November 6, 1995, that
it was denying her claim based on Aubrey. As a result, plaintiff
filed a Complaint in the Law Division for a declaratory judgment
that she was covered under the MTF policy's UIM provision. MTF
filed an Answer denying liability. Both parties moved for
summary judgment, and after oral argument on March 29, 1996, the
judge denied MTF's motion, granted plaintiff's motion and ordered
arbitration. The judge then stayed his order pending appeal.
With consent of the parties, the judge deemed his orders final
pursuant to R. 4:42-1(b).
MTF's sole argument on appeal is that under Aubrey it was
entitled to summary judgment since the insurance policy was not
"personal" to plaintiff, and therefore, she should not be
permitted recover under it. We reject this argument and express
our hope that the result here will highlight the confusion,
unfairness, and extensive litigation that has followed Aubrey.
See Anthony J. Monaco, Underinsured Motorist Benefits Should Not
Run with the Insured,
147 N.J.L.J. 1104 (March 10, 1997). We
implore our Supreme Court to revisit the issue, which we believe
to be of constitutional dimensions.
The plaintiff in Aubrey, supra, was involved in a car
accident while operating a vehicle owned by Chris Koch Toyota
("Koch") with Koch's permission. 140 N.J. at 399. She was under
contract with Koch to purchase the vehicle, but was awaiting
approval of financing in order to close the sale and transfer
title. Ibid. Plaintiff had an automobile insurance policy with
UIM limits of $15,000 and liability limits of $15,000 per
person/$30,000 per accident. Id. at 399-400. She sustained
injuries as a result of an accident while driving the Koch
vehicle and settled with the insurance companies of the
tortfeasors for $15,000 and $25,000, the limits of both policies.
Id. at 400. Since she had recovered $40,000 under the
tortfeasors' insurance policies, she was not "underinsured," as
defined by N.J.S.A. 17:28-1.1e, with respect to her own policy.
Ibid. Therefore, she attempted to recover under Koch's insurance
policy, issued by the Harleysville Insurance Companies
("Harleysville"), which had $1,000,000 of liability and UIM
coverage and extended this coverage to occupants of the vehicle.
Id. at 400-01.
Plaintiff filed a declaratory judgment action to establish
UIM coverage under the Harleysville policy. Id. at 401.
Harleysville's cross-motion to dismiss was granted by the Law
Division. Ibid. We reversed and held that plaintiff was
entitled to UIM coverage. Id. at 402. The Supreme Court
reversed and concluded "that UIM coverage, which is limited to
the amount contained in the insured's policy, is `personal' to
the insured." Id. at 403. The Court reasoned as follows:
Coverage is linked to the injured person, not
the covered vehicle. UIM coverage provides
"as much coverage as the insured is willing
to purchase, for his or her protection
subject only to the owner's policy liability
limits for personal injury and property
damages to others."
[Id. at 403 (citations omitted).]
The Court further reasoned that Aubrey's expectations, when she
purchased her insurance, were such that she could not have
reasonably anticipated "the possibility of receiving benefits
under UIM endorsements issued in favor of Koch." Id. at 404. We
do not quarrel with the ultimate outcome in Aubrey, as we believe
that both the "step-down" clause and the reasonable expectation
of Koch, the purchaser of the policy, militate against coverage.
However, the Aubrey Court declared:
The right to recover UIM benefits depends on
the UIM limits chosen by the insured.
Recovery does not depend on the limits of
other UIM policies, such as the mother's
policy in Landi, or Koch's policy in the
instant case.
[Id. at 405.]
In Landi v. Gray, 228 N.J. Super. 619 (App. Div. 1988), we allowed the injured plaintiff, who had purchased insurance for herself, but was not underinsured as to her own policy, to obtain coverage from the UIM provision in her mother's insurance policy because she was a family member. Id. at 623-24. Landi was injured in an accident when she borrowed her brother's car and allowed a friend, who was not insured, to operate the car. Id. at 620. The friend lost control of the car and hit a tree. Ibid. Plaintiff's brother's insurance policy had liability
coverage of $15,000 per person/$30,000 per accident. Id. at 620-21. Plaintiff had purchased auto insurance with the same
liability coverage as her brother's policy and UIM coverage of
$15,000. Id. at 623. They both lived with their mother who had
purchased auto insurance in the amount of $100,000 per
person/$300,000 per accident with $100,000 UIM coverage. Id. at
621. Plaintiff sought to recover under her mother's UIM
coverage, as she was not underinsured with respect to her
brother's policy. Id. at 621-22, 624. We held that plaintiff
was entitled to recover under her mother's policy, as that was
"[t]he only policy under which plaintiff is afforded underinsured
motorist coverage that covers this accident ...." Id. at 624.
The Aubrey court considered this result inappropriate, apparently
because Landi's recovery was in excess of the limits of her own
UIM coverage. Aubrey, supra, 140 N.J. at 405.
In Aubrey, supra, the Supreme Court relied in part on its
reasoning that UIM coverage is "personal" to the insured, and is
"linked" to the injured person and not the "covered" vehicle.
140 N.J. at 403. The Court also supported its holding by
reference to the reasonable expectations of the "insured," but it
looked only to the reasonable expectations of the injured party
(Aubrey) under that person's contract of insurance, even though
no issue concerning interpretation of the injured party's policy
was before the Court. Id. at 404. Instead, in both Aubrey and
Landi the issue was whether the purchaser reasonably expected
that the injured plaintiff would be covered under the purchaser's
insurance contract. That contract, being unambiguous, could not
constitutionally be impaired absent substantial conflict with
public policy, which in these circumstances just does not appear
to exist.
Clear language providing UIM coverage to both family members
and occupants of a covered vehicle is standard in most insurance
policies where the insured has purchased UIM coverage. See New
Jersey Manufacturers v. Breen, ___ N.J. Super. ___, ___ (App.
Div. 1997) (slip op. at 11-12); Calabrese v. Selective Insurance
Company of America, ___ N.J. Super. ___, ___ (App. Div. 1997)
(slip op. at 10-11); Cook-Sauvageau v. PMA Group,
295 N.J. Super. 620, 622 (App. Div. 1996); Market Transition Facility v. Parisi-Lusardi,
293 N.J. Super. 471, 475-76 (App. Div. 1996); and Taylor
v. National Union Fire Ins. Co.,
289 N.J. Super. 593, 596-97
(App. Div.), certif. denied,
145 N.J. 376 (1996). Undoubtedly,
this coverage has been contemplated by both the carrier and the
insurance industry, and is reflected in the premiums charged to
vehicle owners. Viewed objectively, it is the consumer's
reasonable expectation that the insurer will provide the coverage
described in the insurance contract and paid for through
premiums. We fail to see how contracts between the insurer and
the insured can be limited in the manner sought by insurers in
the heavy litigation following Aubrey, as the policy provisions
are not contrary to any statutory or constitutional mandate or
any established public policy. There were no allegations of that
nature in Aubrey and there are certainly no such allegations in
this case.
The facts in Parisi-Lusardi, a decision which distinguishes
Aubrey, are similar to the facts of the present appeal. Theresa
Parisi-Lusardi ("claimant") did not own a vehicle nor did she
have auto insurance. Parisi-Lusardi, supra, 293 N.J. Super. at
473. While operating the vehicle of her live-in companion she
was in a collision with a tortfeasor. Ibid. Her companion had
purchased an insurance policy with UIM coverage of $100,000 per
person. Ibid. Claimant and her companion resided together in
the home of claimant's brother, who also had insurance with UIM
coverage of $100,000 per person. Ibid. The tortfeasor's
insurance policy provided coverage of $15,000 per person/$30,000
per accident. Ibid. Claimant settled with the tortfeasor's
insurance company for $15,000 and then brought a claim against
both her companion's and her brother's insurance companies for
UIM benefits. Id. at 473-74.
We examined the cases cited by the Aubrey Court, id. at 476-81, and we distinguished many of those cases from claimant's
case. We stated:
The common theme in Aubrey, Landi,
Clegg, and Prudential is that each injured
claimant had selected a UIM endorsement when
purchasing their own policy of insurance and
each UIM endorsement provided coverage less
than the UIM coverage on a policy against
which a claim was asserted. That common
theme is absent here: plaintiff neither
owned an automobile on the day she was
injured in an automobile accident nor
maintained in her name a policy of automobile
liability insurance containing an endorsement
providing UIM coverage.
[Id. at 481-82.]
Since claimant had not purchased insurance, we concluded that the
holding in Aubrey did not disqualify her from receiving UIM
coverage as a family member under her brother's policy. Id. at
482-84. We held claimant was entitled to UIM benefits under his
policy and stated:
Construing Aubrey in accord with [the
insurance company's] contention contravenes
the very specific contractual terms of the
endorsement that it issued to Parisi and
negates the reasonable expectation of Parisi,
i.e., that members of his family, including
his sister who resided in his household,
would be provided with the UIM benefits he
purchased to protect himself and his family
members.
[Id. at 483.]
We further stated that it was not reasonable to conclude that the
Supreme Court intended Aubrey to apply to this type of situation
where the claimant does not have any automobile insurance. Id.
at 484.
We have had many opportunities to distinguish Aubrey from
the facts of other cases and have often concluded that Aubrey was
inapplicable. See Monaco, supra,
147 N.J.L.J. 1104. In Cook-Sauvageau, supra, a plaintiff was injured in an accident while
operating a motor vehicle owned by his employer. 295 N.J. Super.
at 622. The business policy which covered the automobile had a
UIM provision that provided $1,000,000 in coverage for anyone who
occupied the vehicle, while plaintiff's policy provided $50,000
of UIM coverage. Id. at 622. Plaintiff had settled with the
tortfeasor for $15,000. Id. at 622-23. Although the insurer,
PMA, had originally acknowledged coverage, they denied
plaintiff's claim after Aubrey was decided. Id. at 623. The Law
Division reversed this denial and found that plaintiff was
entitled to UIM coverage under the PMA policy. Ibid. We stated:
Aubrey does not stand for the proposition
that only the purchaser of an automobile
insurance policy may recover UIM benefits.
To the contrary, Aubrey explicitly states
that a purchaser of a personal automobile
policy "would reasonably and objectively
expect that he is buying such protection" not
only for himself but also for "his resident
spouse."
[Id. at 625-26 (citations omitted).]
We perceive that a consumer who purchases such insurance would
reasonably expect that the beneficiaries represented as covered
under the policy should be covered. Aubrey does not appear to
have considered this contract right of the purchaser of insurance
which covers the vehicle.
In Calabrese, supra, there were four people injured in a car
accident, all of whom resided in the same household. ___ N.J.
Super. at ___ (slip op. at 2). The tortfeasor had insurance of
$100,000 per person/$300,000 per accident and the four plaintiffs
settled with the tortfeasor for $75,000 per person or $300,000
total, with the consent of Selective Insurance Company
("Selective"). (slip op. at 2-3). The owner of the vehicle, who
was not involved in the accident, carried UIM coverage in the
amount of $300,000. (slip op. at 3). The driver of the vehicle
and her husband had purchased UIM coverage in the amount of
$300,000 as well. Ibid. After determining that the plaintiffs
were underinsured (slip op at 4-10), we held that the two
plaintiffs who did not own automobiles and had not purchased
policies were eligible to receive benefits under the automobile
owner's policy. (slip op. at 10-12). We explained that
[Plaintiffs] are also covered under
Marianne's policy because of their occupancy
of the vehicle. We do not perceive that the
holding in Aubrey militates against our
holding that Marianne's policy covers
Calabrese and Pace. .... In addition,
Calabrese and Pace, unlike the claimant in
Aubrey, did not purchase or hold the
insurance coverage made available to them
under the "family member" coverage of the
Rocchio policy.
[(slip op. at 11-12)(citing Parisi-Lusardi,
supra,
293 N.J. Super. 471).]
Again, in Taylor, supra, we held that Aubrey did not prevent
the plaintiff from receiving UIM coverage. 289 N.J. Super. at
595. There, plaintiff was driving an automobile, leased by his
employer for his personal use and insured at the company's
expense, when he was injured in a car accident while driving home
from work. Id. at 595-96. The tortfeasor's insurance company
paid plaintiff $100,000, the limits of that policy. Id. at 596.
Plaintiff's family owned two additional automobiles which were
insured by United States Automobile Association and the policy
covering those vehicles had UIM coverage of $100,000. Ibid.
Therefore, plaintiff was not underinsured as to that policy.
Ibid. However, the policy purchased by plaintiff's employer to
cover the automobile he was driving had UIM coverage of $250,000
per person/$500,000 per accident. Id. at 600-01. We held that
Aubrey did not bar plaintiff from coverage under his employer's
policy even though he did not purchase the insurance, because as
an employee he was a named insured on the policy. Id. at 596-600.
In the present case, plaintiff is entitled to benefits as
she is underinsured according to the statutory definition. Her
status as an occupant in the vehicle and the fact that MTF's
policy provides UIM coverage for persons occupying the covered
auto establishes contractual liability for UIM benefits.
Plaintiff correctly argues that Aubrey cannot be construed to
change the contract terms of the MTF policy. This insured chose
to purchase UIM coverage in the amount of $250,000 per
person/$500,000 per accident. It is also clear that he paid an
additional $40 for that option.
N.J.S.A. 17:28-1.1 states, in pertinent part:
e. For the purpose of this section, (1)
"underinsured motorist coverage" means
insurance for damages because of bodily
injury and property damage resulting from an
accident arising out of the ownership,
maintenance or use of an underinsured 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.
[N.J.S.A. 17:28.1.1e.]
UIM coverage is not mandatory, though it must be offered to
the insured as an option when insurance is purchased. N.J.S.A.
17:28-1.1b. The applicable portion of the MTF policy entitled
"Uninsured Motorists Coverage," reads as follows:
A. We will pay damages which an "insured"
is legally entitled to recover from the
owner or operator of an "uninsured motor
vehicle" because of "bodily injury:"
1. Sustained by an "insured,"
and
2. Caused by an accident.
B. "Insured" as used in this Part means:
1. You or any "family member,"
2. Any other person occupying "your
covered auto"
3. Any person for damages that person
is entitled to recover because of
"bodily injury" to which this
coverage applies sustained by a
person described in 1. or 2. above.
[Emphasis added.]
Plaintiff clearly qualifies for UIM benefits based upon the
statutory definition of underinsured and MTF's UIM policy
provision. As the tortfeasor only had a $25,000 per person limit
and the owner of the vehicle plaintiff occupied had $250,000 per
person UIM coverage, "the sum of the limits of liability ...
available to a person against whom recovery is sought [(the
tortfeasor)] ..., is ... less than the applicable limits for
underinsured motorist coverage afforded under the motor vehicle
insurance policy held by the person seeking that recovery."
N.J.S.A. 17:28-1.1e. As an occupant of the vehicle, plaintiff
qualifies under a plain reading of the UIM provision contained in
the MTF policy.
It is objectively reasonable to assume that the purchaser
expected that his UIM coverage would extend to an occupant of his
vehicle. So also, the plaintiff, if shown the policy, would have
the same expectation as no other interpretation is possible.
Clearly, MTF understood that an occupant would be covered under
the UIM provisions of the policy and charged accordingly. See
Breen, supra, ___ N.J. Super. at ___ (slip op. at 12) ("Since the
insurers' potential liabilities under the coverage as they
understood it were likely to be greater than if only the named
insured was entitled to underinsured motorist insurance, the
insurance companies undoubtedly calculated and collected premiums
based on a literal interpretation of this coverage language").
Further, we have held that "so long as the statutorily mandated
coverage has been offered, the scope of the UIM benefits provided
under an automobile liability policy is determined by the
language of the policy and the reasonable expectations of the
persons insured thereunder." Cook-Sauvageau, supra, 295 N.J.
Super. at 624.
The dilemma is inescapable that even the Aubrey analysis
regarding the reasonable expectations of the injured claimant
cannot result in a denial of UIM coverage to plaintiff, as
plaintiff did not purchase insurance. The anomalous result
dictated by Aubrey is that one who has paid for personal UIM
coverage cannot collect on the UIM coverage of another, while one
who has paid nothing towards the cost of UIM coverage can collect
under the policy of another in the identical circumstances. We
fail to see the reasoning behind or fairness of such holdings.
Nonetheless, we will not, merely for the sake of consistency, as
appellant seeks, make the result here compatible with other
decisions under Aubrey rejecting coverage. To do so would
violate the constitutional rights of the insured, and his
beneficiaries, to be free from impairment of their contract of
insurance when no stated policy reason exists for intervention.
See State Farm v. State,
124 N.J. 32, 64 (1991); Matter of
Recycling & Salvage Corp.,
246 N.J. Super. 79, 100-01 (App. Div.
1991).
In view of our holding, we need not decide whether MTF may
be estopped from denying UIM benefits on the basis of its earlier
acceptance of plaintiff's claim. See Barrett v. New Jersey
Manufacturers Insurance,
295 N.J. Super. 613, 617-20 (App. Div.
1996).
Affirmed.
Footnote: 1Aubrey v. Harleysville Insurance Companies, 140 N.J. 397 (1995).