SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
A-2148-99T1
HARRIET BERGER,
Plaintiff-Appellant,
v.
FIRST TRENTON INDEMNITY
COMPANY,
Defendant-Respondent.
________________________________
Argued April 3, 2001 _ Decided April 23, 2001
Before Judges Skillman, Conley and Lesemann.
On appeal from Superior Court of New Jersey,
Law Division, Burlington County, L-2111-99.
David W. Burns argued the cause for appellants
(Segal, Gibney, Burns & Cedar, attorneys; Mr.
Burns, of counsel and on the brief).
Michael G.B. David argued the cause for respondent
(Truesdale & David, attorneys; Mr. David, of counsel
and on the brief).
The opinion of the court was delivered by
CONLEY, J.A.D.
This is an uninsured motorist (UM) appeal. Plaintiff
insured appeals an order granting defendant insurer summary
judgment and dismissing her complaint that sought to compel UM
arbitration. As far as we can tell from the "decision" below,
the dismissal was based upon a "for fee" exclusion in the UM
endorsement contained in plaintiff's automobile policy issued by
defendant. We are convinced the "for fee" UM exclusion conflicts
with the governing statutory provisions and, thus, is
unenforceable. We remand for consideration of additional
coverage issues that were not decided by the motion judge.
Preliminarily, we briefly comment on the "decision" below.
There were a number of coverage issues presented by the motion.
Plaintiff asserted the trial judge lacked jurisdiction to decide
them as the policy's arbitration provision required they be
submitted to an arbitrator. The coverage issues included not
only the "for fee" exclusion but also defendant's contention that
the notice and reasonable investigation obligations under its
policy provisions and N.J.S.A. 39:6-78(e) had not been complied
with. As to the latter, plaintiff asserted a defense of estoppel
and argued that the governing policy provisions on notice and
investigation were unenforceable. Following oral argument on
October 15, 1999, the judge reserved decision. By letter dated
October 26, 1999, the judge sent counsel "a copy of the
memorandum" on the motion, directing defendant's counsel to
submit a proposed order. The "memorandum" appears to be a law
clerk memo and addresses only the "for fee" exclusion.
We expect all trial judges to be cognizant of and comply
with their responsibility to address the issues and provide
findings of fact and conclusions of law when deciding motions.
R. 1:7-4; R. 4:46-2(c); Filippone v. Lee,
304 N.J. Super. 301,
306-07 (App. Div. 1997). "It should, of course, be obvious that
a judge does not and may not fulfill the obligation to make fact-
finding by delegating that responsibility to a law clerk. . . . "
Pressler, Current N.J. Court Rules, Comment 2 on R. 1:7-4(a)
(2001). See Hungerford v. Greate Bay Casino Corp.,
213 N.J.
Super. 398, 402 (App. Div. 1986). Sending the attorneys a copy
of a clerk's memo does not comply with R. 1:7-4 or R. 4:46-2(c).
Neither does it properly serve the interests of the litigants.
The facts are not particularly complex. On April 5, 1994,
plaintiff and her husband, New Jersey residents, were visiting
Washington, D.C. and were passengers in the backseat of a taxi
cab. The cab stopped suddenly, causing plaintiff to be thrown
forward thereby striking the front seat of the cab. At that
time, she felt "a little" pain on her left side.
When plaintiff and her husband reached their destination,
they exited the cab, and it departed. Neither the identity of
the cab nor the operator was ever obtained. Plaintiff could
describe the taxi cab only as a black and white station wagon and
the operator as a middle-aged foreigner, possibly Arabic, who was
wearing a turban. No one reported the incident to the police.
That same day, upon the couple's return to New Jersey,
plaintiff's pain persisted and her family physician was called.
The physician advised plaintiff to go directly to Burlington
Memorial Hospital where she was hospitalized for having multiple
fractured ribs and shortness of breath. On April 10, 1994, she
was released from the hospital.
On April 21, 1994, plaintiff submitted to defendant an
application for PIP benefits and, by counsel's letter dated July
8, 1994, defendant was advised of a claim for UM benefits. By
letter dated August 3, 1994, defendant rejected the UM claim
because the taxi cab did not qualify as an "uninsured motor
vehicle" because "[i]t is apparent that [she] was a passenger in
a taxi cab . . . and could have properly identified the taxi and
driver." The record is not entirely clear as to plaintiff's PIP
claim, but it does contain an August 31, 1994, note from the PIP
adjuster indicating that the hospital's bill had been received
and was being audited. The note further reflects "I note you
were in a commercial vehicle at the time of the accident. N.J.
No Fault regulations are such that only medical payments are
covered. Essential services are not reimbursable."
Defendant's payment of plaintiff's PIP claim is not part of
the present litigation. However, when defendant continued to
deny UM coverage, plaintiff filed her complaint seeking to compel
UM arbitration.
In all of the cases cited by the Court as examples of the
"standard" UM clause, coverage issues were construed to be with
the jurisdiction of the court, while the arbitrator was limited
to the issues of the tortfeasor/uninsured motorist liability and
damages. The critical language specified as arbitratable only
disputes over legal entitlement to recovery of damages from an
uninsured vehicle (i.e., from the tortfeasor) in addition to
damage disputes.
In contrast, the arbitration clause in Bocelli v. Hanover
Metro Ins. Co., supra, 219 N.J. Super. at 8, provided for
arbitration in the event:
we and a covered person do not agree . . .
[w]hether that person is legally entitled to
recover damages under this endorsement. . . .
[Emphasis added.]
Similarly, the arbitration clause in Turck provided for
arbitration of a dispute over "[w]hether [the covered person] is
legally entitled to recover damages under this endorsement; or
[as] to the amount of damages. . . . " United Serv. Auto. Ass'n
v. Turck, supra, 156 N.J. at 483. (Emphasis added.) In both
cases, the arbitration clauses were construed to encompass
coverage issues because of the "under this endorsement" phrase.
Id. at 493-94; Bocelli v. Hanover Metro. Ins. Co., supra, 219
N.J. Super. at 9.
Here, defendant's arbitration clause states:
The insured's right to recover these damages
from the owner or operator of an uninsured
motor vehicle or underinsured motor vehicle
and the amount of these damages will be
agreed to by the insured and us.
Disagreement as to such right or amounts of
damages will be settled by arbitration.
Disagreement as to any other issue may not be
arbitrated.
The clause, then, provides for arbitration of the "right to
recover these damages" and "the amount of these damages." "These
damages" refers to "damages that the insured is legally entitled
to recover from the owner or operator of an uninsured motor
vehicle," i.e., the tortfeasor. There is no reference to
disputes concerning entitlement "under [the UM] endorsement."
Although, therefore, not precisely identical to the "standard" UM
language as described in Turck, it is comparable. The focus is
upon the liability of the tortfeasor/uninsured motorist and
damages. It is certainly not as broad as the "nonstandard"
language in the Turck or the Bocelli UM endorsements which were
construed as providing for arbitration of coverage issues. The
trial court, then, had jurisdiction to resolve the coverage
disputes here.
Although we ultimately concluded the exclusion was enforceable
under N.J.S.A. 17:28-1.1 in the context of UIM benefits, we said
as to UM benefits:
Plaintiffs' claim for UM coverage is
barred by the settlement they reached with
Livolsi's carrier, and that is so regardless
of the carrier's initial position denying
coverage and despite the absence of any
formal admission of coverage. Kerwien v.
Melone,
288 N.J. Super. 268, 274-75 (App.
Div. 1996). Thus, we should not address the
issue on which the trial court focused its
attention: whether the exclusion in
question, in relation to UM coverage,
violates public policy because it goes beyond
those exclusions permitted by statute. See
N.J.S.A. 17:28-1.1; cf. CSC Ins. Servs.,
supra, 293 N.J. Super. at 248; Progressive
Cas. Ins. Co., supra, 501 N.W.
2d at 693
(Davies, J., concurring (expressing the view
that in a UM case, acceptance of this
exclusion "would defeat the strong policy
underlying Minnesota's system of compulsory
insurance").
[Id. at 507 (emphasis added).]
While, therefore, we declined to address the issue, we signaled
our reservation as to the enforceability of a "for fee" exclusion
in the context of UM benefits.
Our discussion in Campbell of the exclusion in the context
of UIM benefits might be viewed as forecasting that conclusion.
In rejecting the contention that, as applicable to UIM benefits,
the "for fee" exclusion was "violative of public policy" by
"frustrating the purposes of UIM coverage," we contrasted the
statutorily mandated UM coverage with the optional UIM coverage,
observing:
There are important distinctions between
UM and UIM coverage. UM coverage must be
included in every policy of insurance.
N.J.S.A. 17:28-1.1a. One of its primary
purposes is to alleviate financial burdens on
the Unsatisfied Claim and Judgment Fund
which, absent UM coverage, would be required
to respond to the claims of injured parties.
Riccio v. Prudential Property & Cas. Ins.
Co.,
108 N.J. 493 (1987). As a consequence,
in UM cases our courts have frequently struck
policy provisions which were more restrictive
that [sic] those mandated by statute. See,
e.g., Perez v. American Bankers Ins. Co. of
Florida,
81 N.J. 415 (1979); Ciecka v.
Transamerica Ins. Group,
81 N.J. 421 (1979);
Walkowitz v. Royal Globe Ins. Co.,
149 N.J.
Super. 442 (App. Div.), certif. dismissed,
75 N.J. 584 (1977).
UIM coverage, by contrast, must be offered
by an insurance company but need not be
accepted by the insured. N.J.S.A.
17:28-1.1b. As noted by the Court in French
v. New Jersey Sch. Bd. Ins. Group.,
149 N.J. 478 [, 491-92] (1997):
The different legislative concern
for the two forms of insurance is
that availability of uninsured
motorist benefits affects all
ratepayers of insurance (all auto
insurance companies pay a portion
of their premiums into the
Uninsured Motorist Fund), where the
availability of UIM benefits
affects only the parties insured
under the contract.
As a result, the French Court [, id. at 492,]
went on to hold as follows:
[I]t is fundamental that in the
absence of a statutory prohibition
to the contrary, an insurance
company has a right to impose [upon
UIM benefits] whatever conditions
it desires prior to assuming its
obligations.
[311 N.J. Super. at 507-08.]
The statutory scheme governing UM benefits is mandatory.
That is not to say that a UM endorsement cannot add to the
statutory mandates. Brown v. Selective Ins. Co.,
311 N.J. Super. 210, 213 (App. Div. 1998). But when a provision in the
endorsement operates:
to reduce or take away from the coverage
mandated in N.J.S.A. 17:28-1.1, the
contractual provision will almost certainly
be found void and the statutorily required
coverage read into the policy as a matter of
law. Time and time again, the courts of New
Jersey have struck down policy language more
restrictive than the statutory mandate and
held that coverage in accordance with the
remedial aims of the legislation must be
afforded regardless of the contractual
efforts to limit coverage.
[Craig & Pomeroy, supra, § 19:2 at 270.]
See Fernandez v. Selected Risk Ins. Co.,
82 N.J. 236, 240 (1980);
Perez v. American Bankers Ins. Co. of Fla.,
81 N.J. 415, 419
(1979); Ciekla v. Transamerican Ins. Group,
81 N.J. 421, 427
(1979); Pasterchick v. Insurance Co. of No. Am.,
150 N.J. Super. 90, 94 (App. Div. 1977). "Policy exclusions which attempt to
restrict [the UM] statutory class violate the expressed purposes
of such legislation." Fernandez v. Selected Risk Ins. Co.,
supra, 81 N.J. at 242.
Plaintiff claimed entitlement to UM coverage here pursuant
to N.J.S.A. 17:28-1.1e(2)(c) which includes in the definition of
an "uninsured motor vehicle" a "hit and run motor vehicle as
described in section 18 of P.L. 1952, c. 174 (C.39:6-78)."
N.J.S.A. 39:6-78 depicts a hit and run vehicle as a vehicle that
has caused injury to a person, but where the identity of it and
its operator or owner cannot be ascertained.
N.J.S.A. 17:28-1.1 does contain exclusions for vehicles that
would otherwise qualify as an uninsured motor vehicle. In this
respect, N.J.S.A. 17:28-1.1e(2) states in part:
"Uninsured motor vehicle" shall not include
an automobile covered by a basic automobile
insurance policy; an underinsured motor
vehicle; a motor vehicle owned by or
furnished for the regular use of the named
insured or any resident of the same
household; a self-insurer within the meaning
of any financial responsibility or similar
law of the state in which the motor vehicle
is registered or principally garaged; a motor
vehicle which is owned by the United States
or Canada, or a state, political subdivision
or agency of those governments or any of the
foregoing; a land motor vehicle or trailer
operated on rails or crawler treads; a motor
vehicle used as a residence or stationary
structure and not as a vehicle; or equipment
or vehicles designed for use principally off
public roads, except while actually upon
public roads.
There is no statutory exclusion for a "for fee" vehicle. It has
been noted that "[t]here is nothing in the purpose of N.J.S.A.
17:28-1.1 that would limit its application to passenger
automobiles as distinguished from other motor vehicles."
Transport of New Jersey v. Watler, supra, 161 N.J. Super. at 459
(finding that UM coverage applied to bus owned and operated by
the state, which was self-insured). A taxi cab, then, may
qualify as an "uninsured motor vehicle."
We are convinced, therefore, that defendant's "for fee"
exclusion restricts the coverage otherwise mandated by the
statute. As such, it is unenforceable.
Reversed and remanded for disposition of the remaining
issues raised below but not decided. As we have said,
disposition of these issues shall be accompanied by a judicial
decision that complies with R. 1:7-4 and R. 4:46-2(c). We
express no view as to these issues and do not retain
jurisdiction.