SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-6089-98T3
IFA INSURANCE COMPANY,
Plaintiff-Appellant,
v.
ATLANTIC MUTUAL INSURANCE
COMPANY,
Defendant-Respondent.
________________________________________
Argued May 10, 2000 - Decided June 1, 2000
Before Judges Baime, Brochin and Eichen.
On appeal from the Superior Court of New
Jersey, Law Division, Union County.
Gary L. Riveles argued the cause for appellant
(Dughi & Hewit, attorneys; Mr. Riveles, on the
brief).
Linda L. Keesey argued the cause for
respondent (Smetana & Mahoney, attorneys; Ms.
Keesey, on the brief).
The opinion of the court was delivered by
EICHEN, J.A.D.
On this appeal, we are confronted with essentially the same
issue presented in Rutgers Casualty Ins. Co. v. Ohio Casualty Ins.
Co.,
299 N.J. Super. 249 (App. Div, 1997), aff'd,
153 N.J. 205
(1998): whether an insurance carrier that pays personal injury
protection (PIP) benefits to a claimant injured in an automobile
accident is entitled to pro rata contribution under N.J.S.A. 39:6A
11See footnote 11 from another insurance carrier that is also required to provide
PIP coverage under N.J.S.A. 39:6A-4. The Supreme Court concluded
that the carrier that paid the PIP benefits in that case was not
entitled to contribution from the defendant carrier, Ohio Casualty
Insurance Company (Ohio), because Ohio had effectively excluded PIP
coverage under the "follow-the-family" provision in its policy, and
because the Legislature had eliminated PIP contribution as a matter
of law by enacting N.J.S.A. 39:6A-7b(3). See Rutgers, supra, 153
N.J. at 210.
Briefly stated, these are the facts in this case. Kenneth
DiNicola, Jr. was the named insured under a policy issued by
plaintiff IFA Insurance Company (IFA) insuring his personal
vehicle. On December 12, 1997, DiNicola was involved in an
automobile accident while he was driving a car owned by his
employer EMCO Plastic Distributors (EMCO), which he used for
business and personal use. The EMCO car was insured by defendant
Atlantic Mutual Insurance Company (Atlantic Mutual). The only
named insured under the Atlantic Mutual policy was EMCO.
As a result of the injuries he sustained in the accident,
DiNicola applied for and received PIP benefits from IFA under his
personal policy. IFA sought inter-company arbitration to compel
Atlantic Mutual to contribute its share of the PIP expenses.
Atlantic Mutual refused, citing the "follow-the-family" exclusion
in its policy which excludes payments of PIP benefits to "to any
person other than the 'named insured' or any 'family member' if
such person is entitled to New Jersey personal injury protection
... as a 'named insured' or 'family member' under the terms of any
other policy with respect to such coverage...." Relying on its
"exclusion," i.e., the fact that DiNicola was a named insured on
IFA's policy, Atlantic Mutual declined to participate in inter
company arbitration under N.J.S.A. 39:4-11.
On a motion for summary judgment, the Law Division ruled in
favor of Atlantic Mutual, dismissing its complaint and this appeal
ensued. We affirm.
In Rutgers, supra, 153 N.J. at 209, the Supreme Court affirmed
our decision, agreeing with us that under the "follow-the-family"
provision in the policy issued by Ohio to its insureds it was
rendered not "liable" for the payment of PIP benefits to anyone
other than its named insured and the named insured's otherwise
uninsured resident relatives because the injured persons there had
PIP coverage under their own policies. See
299 N.J. Super. 249,
263 (App. Div. 1997). In so doing, the Court noted our observation
that the "follow-the-family" provision "effectuates" the
legislative goal of "transactional efficiency" by permitting
insurance companies to avoid the "cumbersome and uneconomic
shifting of dollars" that results from contribution claims. See
Rutgers, supra, 153 N.J. at 263. The Court further remarked that
the explanatory note to the recently enacted amendment to N.J.S.A.
39:6A-7, N.J.S.A. 39:6A-7b(3)See footnote 22 states that "the bill eliminates PIP
contribution." Rutgers, supra, 153 N.J. at 210. The explanatory
note states in its entirety as follows:
This bill provides that insurers do not have
to pay certain personal injury protection
(PIP) benefits if the injured person already
has PIP benefits coverage under another
policy.
Pursuant to section 11 of P.L.1972, c. 70
(C.39:6A-11), if two or more insurers are
liable to pay PIP benefits, any insurer paying
the benefits can recover from the other
insurers an equitable pro-rata share of the
benefits paid. This process is commonly
referred to as "PIP contribution." Most
insurers have recognized that PIP
contributions, in most cases, result in a
"wash," and accordingly, insurers have not
generally exercised the contribution option.
This bill eliminates PIP contributions and
thereby eliminates an unnecessary expense in
the current system without reducing coverage
to the consumer.
Allows insurers to deny PIP benefits to
persons with PIP coverage under another
policy. (Emphasis added.)
In light of the foregoing, the Court observed that both "the
policy exclusion and the statutory exclusion thus prohibits an
insurance carrier that has paid out PIP benefits pursuant to
N.J.S.A. 39:6A-4.2See footnote 33 from receiving contribution from other carriers
potentially liable under N.J.S.A. 39:6A-4, -11."
Based on the foregoing, we are constrained to conclude that
because DiNicola is a named insured in the IFA policy and is
entitled to, and did receive PIP benefits from his carrier, and
because Atlantic Mutual's policy includes a "follow-the-family"
provision, Atlantic Mutual cannot be "liable" to IFA for
contribution toward DiNicola's PIP expenses and the Law Division
judge was correct in dismissing its complaint.
Nonetheless, we believe it is appropriate to make these added
observations. We are keenly aware that the facts in Rutgers are
decidedly different from those in the instant case. There, in each
situation, the person injured in the accident was either a
pedestrian or passenger in a car he did not own. In light of
Ohio's policy exclusion, the injured person's personal insurance
carrier was required to pay without contribution from the
tortfeasor's carrier. In this case, the person was injured while
driving his employer's vehicle. The named insured on the policy
covering the vehicle is a corporation (EMCO). Theoretically, the
named insured cannot sustain injuries, nor can it have any
"resident relatives" capable of sustaining injuries while traveling
in another person's automobile. In that sense, the PIP coverage
appears somewhat illusory. In addition, it does not appear
economically rational to charge the cost of PIP benefits to
DiNicola's personal policy when as an employee, he uses his
corporate vehicle for most of his driving needs. Under such
circumstances, EMCO's carrier should expect to be obligated for PIP
benefits. Arguably, it would seem more rational for a corporate
policy to be interpreted to mean that the terms "named insured" and
"resident family members" include "employees."
On the other hand, we must also acknowledge that in the next
case, the tables will undoubtedly be turned, and it will be IFA
that has a corporate "named insured" and a "follow-the-family"
provision in its policy that will insulate it from having to
contribute to PIP costs for one of its corporate insured's
employees. Thus, in the long run, by disallowing contribution in
cases where there is a "follow-the-family" provision, the
legislative goal of "transactional efficiency" ("the legislative
grail of the no-fault scheme") will be accomplished. Rutgers,
supra, 299 N.J. Super. at 263.
Lastly, we note that IFA's reliance on French v. New Jersey
Sch. Bd. Assoc. Ins. Group,
149 N.J. 478 (1997), is misplaced.
French involved the availability of underinsured motorist (UIM)
coverage to an employee under her employer's policy, not PIP
coverage. If plaintiff's employer's UIM coverage was not
considered in determining whether the tortfeasor was underinsured,
the injured employee in French would not have recovered
sufficiently for her losses. See Lindstrom v. Hanover Ins. Co.,
138 N.J. 242, 249 (1994) (noting the differences between PIP and
UIM as based on significantly different needs). Here, the injured
person stands to receive full PIP benefits irrespective of who is
primarily held responsible for his PIP payments.
The motion judge properly found that IFA's claim for
contribution was barred. Accordingly, we affirm the order
dismissing plaintiff's complaint.
Footnote: 1 1 N.J.S.A. 39:6A-11 then stated:
[I]f two or more insurers are liable to pay
benefits under section 4 and 10 of this act
for the same bodily injury, or death, of any
one person, the maximum amount payable shall
be as specified in section 4 and 10 if
additional first party coverage applies and
any insurer paying the benefits shall be
entitled to recover from each of the other
insurers, only by inter-company arbitration
or inter-company agreement, an equitable pro
rata share of the benefits paid.
This section was amended in 1998, but the revisions did not
change the parts relevant to this appeal.
Footnote: 2 2 N.J.S.A. 39:6A-7b(3) provides on its face that an insurance
carrier may exclude from coverage any person who is entitled to
coverage as a named insured or resident relative under the terms of
another policy. See 153 N.J. at 210.
Footnote: 3 3 N.J.S.A. 39:6A-4.2 states, in relevant part:
[T]he personal injury protection coverage of the named insured shall be the primary coverage for the named insured and any resident relative in the named insured's household who is not a named insured under an automobile insurance policy of his own. No person shall recover personal injury protection benefits under more than one automobile insurance policy for injuries sustained in any one accident.