(This syllabus is not part of the opinion of the Court. It has been prepared by the Office of the Clerk for
the convenience of the reader. It has been neither reviewed nor approved by the Supreme Court. Please
note that, in the interests of brevity, portions of any opinion may not have been summarized).
CHARLES MARTIN V. HOME INSURANCE COMPANY V. UNSATISFIED CLAIM AND JUDGMENT
FUND (and other related matters) (A-114-94)
Argued March 14, 1995 -- Decided July 31, 1995
O'HERN, J., writing for a unanimous Court.
The New Jersey Automobile Reparation Reform Act (No-Fault Law) requires that every private-passenger automobile registered in New Jersey be insured under a policy containing personal-injury-protection (PIP) benefits. Since 1977, pursuant to N.J.S.A. 39:6A-4(a) (the PIP Act) the responsibility of any
PIP carrier for medical expenses has been limited to the first $75,000. The burden for any remaining
expenses are to be covered by the Unsatisfied Claim and Judgment Fund (UCJF). Pursuant to N.J.S.A.
39:6-73.1 (the reimbursement provision), the UCJF is to "reimburse" carriers for such PIP benefits in excess
of $75,000.
As a condition of doing business in New Jersey, pursuant to N.J.S.A. 17:28-1.4 (the conformity
statute), an insurance company must, in accordance with New Jersey law, provide PIP coverage for an out-of-state vehicle. Under the conformity statute, any policy issued by an insurance company qualified to do
business in New Jersey covering a vehicle, while it is being operated in New Jersey, is to be construed as
providing the same type of PIP benefits as are required under New Jersey law. Thus, the occupants of an
out-of-state car travelling in New Jersey have the same financial protections as occupants of in-state cars
travelling the same roadways.
The issue before the Court is whether the UCJF must reimburse insurers of out-of-state vehicles for
PIP medical benefits in excess of $75,000 paid under the conformity statute.
At the time of her automobile accident, Edith Robinson was a resident of Virginia. On May 6,
1988, she was injured in New Jersey while a passenger in an automobile insured under a Virginia automobile
insurance policy issued by Progressive Casualty Insurance Co. (Progressive). Robinson's injuries from the
accident were severe, and by July 1992, her medical expenses exceeded $700,000. She sued Progressive,
claiming entitlement to New Jersey PIP benefits, including the payment of reasonable medical expenses.
Progressive claimed that the UCJF was required to participate in the payment of Robinson's medical
expenses. The Law Division ruled that the UCJF was not responsible for providing reimbursement to
Progressive for any excess PIP benefits paid to Robinson.
On September 28, 1987, New Jersey resident Charles Martin was struck, while riding his bicycle, by
an out-of-state vehicle driven by Diana Celeste and insured by Home Insurance Co. (Home). Martin was
seriously injured, and by 1989, he had incurred medical expenses in excess of $100,000. The auto was insured
under a policy issued to Antonia Celeste, a Pennsylvania resident. Home is authorized to issue automobile
liability insurance in New Jersey. Martin sued Home to compel payment of New Jersey PIP benefits. Home
then joined the UCJF in the lawsuit, asserting a right to reimbursement of medical expense benefits. The
Law Division held that Home was entitled to the reimbursement provisions of the UCJF.
The Robinson and Martin appeals were consolidated in the Appellate Division. That court affirmed the decision in Martin and reversed the decision in Robinson, concluding that the No-Fault Law authorized the reimbursement sought by the insurers in both cases. The Appellate Division held that the conformity statute should be construed in conjunction with the PIP Act and the reimbursement provisions because those
statutes deal with the same subject matter and seek to achieve the same legislative purpose. According to
the court, reimbursement was authorized by those statutes.
The Supreme Court granted the UCJF's petition for certification.
HELD: The Unsatisfied Claim and Judgment Fund is not required to reimburse insurers of out-of-state
vehicles for personal-injury-protection medical benefits in excess of $75,000 paid under the
conformity statute, N.J.S.A. 17:28-1.4.
1. The language of the relevant statutes do not plainly resolve the issues. Therefore, the intent of the
Legislature must be discerned not only from the terms of the No-Fault Act but also from its structure,
history and purpose. If there is one definite principle that emerges from PIP law, policy and precedent, it is
that there shall be no double recovery of PIP benefits. Moreover, limiting reimbursement to the insurers of
in-state automobiles does not mean that the operators of out-of-state motor vehicles will forfeit the defense
of the verbal threshold. (pp. 8-13)
2. The policy concerns and the probable intent of the Legislature regarding the verbal threshold, tort
immunity, and subrogation are different from the concerns regarding reimbursement from the UCJF. The
occupants of out-of-state cars are treated the same as the occupants of an in-state car; however, car insurers
are different from car occupants. The insurer of the out-of-state automobile has not made the same
contribution to the UCJF as the in-state carrier. The legislative history of the reimbursement provisions
relate to New Jersey insurers and the New Jersey insurance market; reimbursement is paid by the UCJF, to
which insurers contribute a proportion to their percentage of the market; and, the relevant insurers under the
reimbursement provisions are insurers writing policies on New Jersey vehicles. That history suggests that
reimbursement is to be provided solely to New Jersey insurers writing policies on New Jersey automobiles.
(pp. 13-15)
3. Although there are sound policy reasons that favor reimbursement of the insurers of out-of-state vehicles,
the question comes down to an assessment of legislative intent. The "internal sense" of the law does not
require the UCJF to reimburse insurers of out-of-state vehicles. While the opposing arguments are strong,
they do not outweigh the reasons for the Court's conclusion that reimbursement is not required here.
(pp. 15-16)
4. Because of the procedural posture of this case, the Court does not address the issue of administrative due
process with respect to the adoption of the UCJF's no-reimbursement policy or the issue of lack of equal
protection due to the classification that denies reimbursement rights to the insurers of non-resident
motorists. If the Legislature agrees with the Court's interpretation of the No-Fault Law, the Court is
satisfied that the UCJF's implementation of legislative intent does not require the adoption of a regulation
that its classification is reasonable. (pp. 16-17)
Judgment of the Appellate Division is REVERSED. The judgment of the Law Division is
REINSTATED in Robinson. Martin is REMANDED to the Law Division for further proceedings consistent
with this opinion.
JUSTICES HANDLER, POLLOCK, GARIBALDI, STEIN, and COLEMAN join in JUSTICE
O'HERN's opinion. CHIEF JUSTICE WILENTZ did not participate.
SUPREME COURT OF NEW JERSEY
A-
114 September Term 1994
CHARLES MARTIN,
Plaintiff,
v.
HOME INSURANCE COMPANY,
Defendant and Third-Party
Plaintiff-Respondent,
v.
UNSATISFIED CLAIM AND JUDGMENT
FUND,
Third-Party
Defendant-Appellant.
-----------------------------------
EDITH M. ROBINSON, by her Guardian,
D. LEWIS MATTIE, TERESA L. MATTIE,
THOMAS EVERETT ROBINSON, III, by
his Guardian Ad Litem, THOMAS
EVERETT ROBINSON, II, D. LEWIS
MATTIE, ELLEN MATTIE, and ROBERT L.
MATTIE,
Plaintiffs,
and
PROGRESSIVE CASUALTY INSURANCE
COMPANY,
Plaintiff-Respondent,
v.
L.G. DEWITT TRUCKING COMPANY, INC.,
COLLIE B. ADAMS and THE NEW JERSEY
TURNPIKE AUTHORITY,
Defendants.
-----------------------------------EDITH M. ROBINSON, by her Guardian
D. LEWIS MATTIE,
Plaintiffs,
v.
PROGRESSIVE CASUALTY INSURANCE
COMPANY,
Defendant-Respondent,
and
UNSATISFIED CLAIM AND JUDGMENT FUND
and SAMUEL F. FORTUNATO,
Commissioner of Insurance,
Defendants-Appellants,
and
PRUDENTIAL PROPERTY AND CASUALTY
COMPANY,
Intervenor-Respondent.
-----------------------------------NEW YORK LIFE INSURANCE COMPANY and
WHOLESALER-DISTRIBUTORS INSURANCE
TRUST,
Plaintiffs,
v.
PROGRESSIVE CASUALTY INSURANCE
COMPANY,
Defendant-Respondent,
and
L.G. DEWITT TRUCKING COMPANY,
COLLIE B. ADAMS, and EDITH M.
ROBINSON,
Defendants,
and
THE UNSATISFIED CLAIM AND JUDGMENT
FUND and SAMUEL F. FORTUNATO,
Commissioner of Insurance,
Defendants-Appellants.
Argued March 14, 1995 -- Decided July 31, 1995
On certification to the Superior Court,
Appellate Division, whose opinion is reported
at
276 N.J. Super. 378 (1994).
Karen L. Jordan, Deputy Attorney General,
argued the cause for appellants (James J.
Ciancia, Acting Attorney General of New
Jersey, attorney; Joseph L. Yannotti,
Assistant Attorney General, of counsel).
Elliott Abrutyn argued the cause for
respondent Home Insurance Company (Morgan,
Melhuish, Monaghan, Arvidson, Abrutyn &
Lisowski, attorneys; Sandra Lawrence Paz, on
the brief).
Kevin R. Gardner argued the cause for
respondent Progressive Casualty Insurance
Company (Connell, Foley & Geiser, attorneys;
Mr. Gardner and George J. Kenny, of counsel).
Ross A. Lewin argued the cause for respondent
Prudential Property and Casualty Insurance
Company (Jamieson, Moore, Peskin & Spicer,
attorneys; Thomas P. Weidner, of counsel).
The opinion of the Court was delivered by
O'HERN, J.
In 1972, the Legislature enacted a no-fault automobile
insurance scheme. L. 1972, c. 70. The New Jersey Automobile
Reparation Reform Act (No-Fault Law), N.J.S.A. 39:6A-1 to -35,
requires that every private-passenger automobile registered in
New Jersey be insured under a policy containing personal-injury
protection (PIP) benefits. PIP benefits are designed to cover
certain basic expenses incurred in automobile accidents by the
occupants of an insured vehicle, the members of each car owner's
family, and, in certain instances, pedestrians. At first,
medical-expense benefits under PIP were unlimited, posing
enormous open-ended liability for insurance companies. In 1977,
the Legislature revised the PIP laws, limiting the responsibility
of any PIP carrier for medical expenses to the first $75,000, and
shifting the burden for any remaining expenses to the Unsatisfied
Claim and Judgment Fund (UCJF).See footnote 1 N.J.S.A. 39:6A-4a. Under that
law the UCJF was to "reimburse" carriers for such PIP benefits in
excess of $75,000. N.J.S.A. 39:6-73.1.
Many accidents on New Jersey highways involve out-of-state
vehicles not required by the laws of their states to maintain the
liability insurance of New Jersey vehicles. The Legislature
realized that litigation might remain the norm in such cases if
it did not address that problem. To achieve the purposes of the
No-Fault Law (swift reparations and reduction of court
congestion), the Legislature in 1985 required that any policy
issued by an insurance company qualified to do business in New
Jersey covering a vehicle while it is being operated in New
Jersey be construed as providing the same type of PIP benefits as
are required under New Jersey law. N.J.S.A. 17:28-1.4.
Therefore, as a condition of doing business in New Jersey, an
insurance company must, in accordance with New Jersey law,
provide PIP coverage for the out-of-state vehicle. Thus, the
occupants of an out-of-state car traveling in New Jersey have the
same financial protections as occupants of in-state cars
traveling the same roadways. The question in this case is
whether the UCJF must reimburse insurers of out-of-state vehicles
for PIP medical benefits in excess of the $75,000 paid under New
Jersey's conformity statute, N.J.S.A. 17:28-1.4.
For purposes of this appeal, we rely generally on briefs of Progressive Casualty Insurance Company (Progressive) for the procedural history and facts of Robinson, and on briefs of Home Insurance Company (Home) for the procedural history and facts of Martin.
At the time of the automobile accident, plaintiff Edith Robinson was a resident of Virginia. She was injured in New Jersey while a passenger in an automobile insured under a Virginia automobile insurance policy issued by Progressive. The accident occurred on May 6, 1988, when an automobile driven by Robert Mattie, collided with a tractor trailer owned by L. G. DeWitt Trucking Company (DeWitt) and driven by one of its employees, Collie Adams. Robinson's injuries from the accident were severe, and by July 1992, her expenses exceeded $700,000. She sued Progressive, claiming entitlement to New Jersey PIP benefits, including the payment of her reasonable medical
expenses.See footnote 2 Progressive claimed that the UCJF was required to
participate in the payment of Robinson's medical expenses.
The Law Division ruled that the UCJF was not responsible for
providing reimbursement to Progressive for any excess PIP
benefits paid to Robinson. In a related ruling, the Law Division
denied DeWitt's motion to dismiss Progressive's subrogation
claims against it and its employee to recover any PIP medical
benefits that Progressive was required to pay Robinson.
Charles Martin is a resident of New Jersey. On September
28, 1987, while riding his bicycle, he was struck by an out-of-state vehicle driven by Diana Celeste and insured by Home.
Martin was seriously injured, and by December 1989, he had
incurred medical expenses in excess of $100,000. The auto was
insured under a policy issued to Antonio Celeste, a Pennsylvania
resident. Home is authorized to issue automobile liability
insurance in New Jersey. Martin sued Home to compel payment of
New Jersey PIP benefits. Home then joined the UCJF, asserting a
right to reimbursement of excess medical expense benefits. The
Law Division held that "it appears * * * that [Home] * * * is
entitled to the reimbursement provisions of the fund."
The two appeals were consolidated in the Appellate Division.
That court affirmed the decision in Martin and reversed the
decision in Robinson.
276 N.J. Super. 378 (1994). The court
concluded that when read together, N.J.S.A. 39:6-73.1, N.J.S.A.
39:6-62, and N.J.S.A. 39:6A-4a authorized the reimbursement
sought by the insurers in both cases. 276 N.J. Super. at 391.
N.J.S.A. 39:6-73.1 grants a right of reimbursement to any insurer
paying PIP benefits in accordance with N.J.S.A. 39:6A-4a.
(Medical expense benefits are a form of PIP benefits.) N.J.S.A.
39:6-62 defines an insurer as "any insurer authorized in this
State to write the kinds of insurance specified in [N.J.S.A.]
17:17-1."
The Appellate Division concluded that the conformity
statute, N.J.S.A. 17:28-1.4, should be construed with N.J.S.A.
39:6A-4a (the PIP Act) and N.J.S.A. 39:6-73.1 (the reimbursement
provision) because all of the statutes deal with the same subject
matter and seek to achieve the same legislative purpose. That
is, they all deal with the "provision of automobile liability
insurance and allocation of coverage costs," and they all seek to
achieve "automobile no-fault insurance reform." 276 N.J. Super.
at 392. Additionally, the court concluded that the definition of
an "insurer" in N.J.S.A. 39:6-62 was relevant because the
conformity statute did not separately define an insurer. Ibid.
The court, therefore, concluded that reimbursement was
authorized.
We granted UCJF's petition for certification.
139 N.J. 184
(1994).
The conformity statute, N.J.S.A. 17:28-1.4, provides:
Any insurer authorized to transact or transacting automobile or motor vehicle insurance business in this State * * * which sells a policy providing automobile or motor vehicle liability insurance coverage * * * in any other state or in any province of Canada, shall include in each policy coverage to satisfy * * * personal injury protection [PIP] benefits coverage pursuant to [N.J.S.A. 39:6A-4] * * * whenever the automobile or motor vehicle insured under the policy is used or operated in this State.
Among the PIP benefits required to be provided under N.J.S.A.
39:6A-4 are medical expense benefits. N.J.S.A. 39:6A-4a. The
reimbursement provision, N.J.S.A. 39:6-73.1, provides:
In the event medical expense benefits
paid by an insurer, in accordance with
subsection a. [of N.J.S.A. 39:6A-4], are in
excess of $75,000.00 on account of personal
injury to any one person in any one accident,
the Unsatisfied Claim and Judgment Fund shall
assume such excess up to $250,000 and
reimburse the insurer therefor in accordance
with rules and regulations promulgated by the
commissioner * * * .
See N.J.A.C. 11:3-28.7 (outlining reimbursement procedures).
Each party relies on the language of the statutes. The UCJF
claims that because reimbursement is called for only on policies
written "in accordance with [N.J.S.A. 39:6A-4a]," i.e., policies
required to be placed on New Jersey cars, it is not responsible
to provide reimbursement for medical benefits paid on out-of-state policies in accordance with the conformity statute,
N.J.S.A. 17:28-1.4. Progressive and Home insist that their
policies are written pursuant to N.J.S.A. 39:6A-4 because they
must provide the benefits set forth in that statute as required
by N.J.S.A. 17:28-1.4. Therefore, they argue that because
N.J.S.A. 39:6-73.1 provides for reimbursement of excess medical
expenses paid pursuant to N.J.S.A. 39:6A-4, the UCJF must
reimburse medical expenses paid under an out-of-state policy.
See Adams v. Keystone Ins. Co.,
264 N.J. Super. 367, 372 (App.
Div. 1993) (noting that "the UCJF * * * pursuant to N.J.S.A.
39:6A:4a * * * may be required to reimburse an [out-of-state]
insurer for PIP benefits in excess of $75,000").
As the U.S. Supreme Court has observed in another context,
"[e]ach [party's interpretation] is plausible, but no more
persuasive than that. The language relied upon by petitioners
* * * is ambiguous and does not speak directly to the question
presented here. The intent of [the Legislature] * * * must be
deduced * * * ." Equal Employment Opportunity Comm'n v. Arabian
Am. Oil Co.,
499 U.S. 244, 250-51,
111 S. Ct. 1227, 1231-32,
113 L. Ed.2d 274, 283 (1991). So, too, here the language of the
statutes does not, in our view, plainly resolve the issues. "In
the absence of specific guidance, our task is to discern the
intent of the Legislature not only from the terms of the Act, but
also from its structure, history and purpose." Fiore v.
Consolidated Freightways, ___ N.J. ___, ___ (1995) (slip op. at
20) (citing Roig v. Kelsey,
135 N.J. 500, 515 (1994)).
The policy argument against reimbursement is that
reimbursement of the out-of-state carriers does not advance any
of the purposes of the provisions limiting an insurer's
liability, the goals of which are to improve New Jersey's rate-making structure. That is, the elimination of an insurer's need
to maintain large reserves in anticipation of potentially large
medical-expense claims curtails the distortion of rates caused by
such reserves. Thus, the risks for the private-passenger
automobile-insurance market in New Jersey are stabilized, and,
instead, insurers in that market maintain adequate reserves for
their market participation through contribution to the UCJF. The
UCJF is funded primarily by contributions assessed against
insurers on the basis of insurance policies written on vehicles
garaged in New Jersey. (We are informed that more than 90" of
those funds are allocated for reimbursement.) If insurers of
out-of-state automobiles involved in accidents in New Jersey
receive a reimbursement, they will receive what the UCJF regards
as a "windfall," funded by New Jersey insurers, and indirectly
funded by New Jersey motorists, who will have to pay higher rates
as a result of increased contributions to the UCJF by their
carriers.
The insurance companies argue that there is no windfall
here. Each insurer has paid substantial sums into the UCJF on
account of the premiums written on their New Jersey-based
policies. (We are informed that Progressive has paid $3,000,000
into the UCJF, and Home has paid $1,000,000.) Pending out-of-state claims are estimated to be valued at $11,000,000. In
addition, the insurance companies argue that in-state drivers and
rate payers will indirectly benefit from the reimbursement if the
system is treated as a symmetrical whole, because the out-of-state claimants will bear the burden of the verbal threshold and
their insurance companies may not seek subrogation for PIP
benefits against the insurance companies of in-state drivers.
Thus, the countervailing policy argument made by the insurance
companies is that if PIP benefits paid under an out-of-state
insurance policy are not treated exactly as those paid under a
New Jersey policy, then many problems will arise in the
resolution of automobile-accident cases.
For example, it was argued below that if insurers are
thought not to make payments in such cases "under 39:6A-4," then
the evidential exclusion rule, N.J.S.A. 39:6A-12, might not
apply. That statute limits subrogation rights and prohibits the
admission into evidence of amounts paid pursuant to N.J.S.A.
39:6A-4 "in a civil action for recovery of damages for bodily
injury by [the] injured person." See UCJF v. New Jersey Mfrs.
Ins. Co.,
138 N.J. 185, 201 (1994) ("creation of any subrogation
right would be inconsistent with [N.J.S.A. 39:6A-12]").
Similarly, the exemptions from tort liability for non-economic
loss (pain and suffering) established in N.J.S.A. 39:6A-8, the
verbal threshold provisions, might not apply in such cases
because those provisions come into play only when N.J.S.A. 39:6A-4 is in effect. In those scenarios there would be a flood of
litigation in our courts whenever an out-of-state vehicle is
involved in an automobile accident within our borders.
With respect to concerns about the application of N.J.S.A.
39:6A-12 (prohibiting recovery of PIP expenses in tort actions),
it suffices to say that "[i]f there is one definite principle
that emerges from our PIP law, policy, and precedent, it is that
there shall be no double recovery of PIP benefits." Wilson v.
UCJF,
109 N.J. 271, 281 (1988); accord N.J.S.A. 2A:15-97
(collateral source rule); see also D'Orio v. West Jersey Health
Sys.,
797 F. Supp. 371 (D.N.J. 1993) (holding that evidential
exclusion rule in N.J.S.A. 39:6A-12 barred evidence at trial of
amounts paid by plaintiff for medical treatment resulting from an
automobile accident). And with respect to the application of
N.J.S.A. 39:6A-8 (prohibiting recovery for non-economic injuries
if standards of the verbal threshold are not met), we do not
believe that limiting reimbursement to the insurers of in-state
automobiles means that the operators of out-of-state motor
vehicles will forfeit the defense of the verbal threshold. See
Taylor v. Rorke,
279 N.J. Super. 63 (App. Div. 1995) (holding
that N.J.S.A. 17:28-1.4, which limits right of nonresident to sue
for non-economic loss by automatically assigning verbal threshold
tort option, does not violate Privileges and Immunities Clause);
Taylor-Segan v. Rajagopal,
275 N.J. Super. 286 (App. Div. 1994)
(holding that N.J.S.A. 17:28-1.4, which imposes a verbal
threshold on nonresident automobile owners who are insured under
no-verbal-threshold policies written by companies licensed to do
business in New Jersey, does not violate Equal Protection
Clause); Watkins v. Davis,
268 N.J. Super. 211 (App. Div. 1993)
(holding that an automatic reformation of out-of-state policies
issued by insurers doing business in New Jersey to apply verbal
threshold requirements is justified by significant and legitimate
public purpose, and does not violate Equal Protection Clause);
Phillips v. Phillips,
267 N.J. Super. 305 (App. Div. 1993)
(holding that out-of-state defendants are entitled to protections
of the verbal-threshold statute). The claim for subrogation in
the Robinson case is not against a vehicle required to maintain
the full measure of PIP benefits. N.J.S.A. 39:6A-9.1 now allows
for reimbursement in certain such instances but requires that the
claims be resolved by intercompany agreement or arbitration.
The policy concerns and the probable intent of the
Legislature regarding the verbal threshold, tort immunity, and
subrogation, are different from the concerns regarding
reimbursement from the UCJF. In one case, the issue is one of a
level playing field for the conduct of litigation in New Jersey,
and in the other, the issue involves an uneven playing field for
entitlement to reimbursement from the UCJF. The occupants of an
out-of-state car are treated the same as the occupants of an in-state car. The question is whether the insurance companies of
those two cars must be treated in the same manner.
Car insurers are different from car occupants. The insurer
of the out-of-state automobile has not made the same contribution
to the UCJF as the in-state carrier. N.J.S.A. 39:6-63(d)
requires the commissioner to calculate for each year the probable
amount of money that will be needed to support the UCJF during
the ensuing year. That amount is then assessed against insurers.
An insurer's contribution is determined by the net direct written
premiums each insurer bears in relation to the aggregate net
direct written premiums of all insurers. N.J.S.A. 39:6-62
defines "net direct written premiums" to include premiums written
on motor vehicles "principally garaged" in New Jersey. We are
informed that this assessment applies to commercial vehicles that
are not subject to the No-Fault Law. However, commercial-vehicle
insurers are required to "provide personal injury protection
coverage benefits, in accordance with [N.J.S.A. 39:6A-4] to
pedestrians * * * ," N.J.S.A. 17:28-1.3, and buses must maintain
no-fault medical expense benefits for passengers, N.J.S.A. 17:28-1.6. The UCJF argues that "an insurer [that] has written many
policies on New Jersey automobiles will make a relatively larger
contribution to the UCJF. This is appropriate, in view of the
greater risk that one or more of those automobiles will be
involved in an accident resulting in reimbursable medical
benefits."
The legislative history of the reimbursement provisions
relates to New Jersey insurers and the New Jersey insurance
market. The Legislature intended those provisions to alleviate
the burden of larger claims on smaller insurance companies, and
to eliminate the need for large loss reserves, thereby
eliminating increases in premiums necessitated by such reserves.
Moreover, reimbursement is paid by the UCJF, to which insurers
contribute in proportion to their percentage of the market. The
relevant market is the New Jersey insurance market; insurers are
assessed, and contribute to the UCJF, in proportion to their
share of that market. Consequently, the relevant insurers under
the reimbursement provisions are insurers writing policies on New
Jersey vehicles. That history suggests that reimbursement is to
be provided solely to New Jersey insurers writing policies on New
Jersey automobiles.
We realize that there are sound policy reasons to favor
reimbursement of the insurers of out-of-state vehicles. After
all, those insurance companies are, by definition, already
servicing the New Jersey market; otherwise, they would not be
subject to the conformity statute. It would be very difficult to
develop a formula to levy UCJF assessments against them. In
addition, the insurers of out-of-state automobiles could not have
developed, with any degree of predictability, rating experience
to present to their home-state regulators regarding, let us say,
the rating of a $10,000 policy in Virginia that might suffer a
$1,000,000 loss in New Jersey. (The maximum PIP exposure is now
$250,000.) Ultimately, it comes down to an assessment of
legislative intent.
In Roig v. Kelsey,
135 N.J. 500 (1994), we addressed a
similar issue left unresolved by the language of the amendments
to the No-Fault Law. The question was whether the medical-expense deductibles, which are not reimbursable as PIP benefits,
are nonetheless recoverable in a tort action against the alleged
tortfeasor. The language of the No-Fault Law did not preclude
such recovery. We noted, however, that legislative intent
controls over plain language. Id. at 515.
"The inquiry [into statutory meaning] in the
ultimate analysis is [to determine] the true
intention of the law; and, to this end, the
particular words are to be made responsive to
the essential principle of the law. It is
not the words but the internal sense of the
law that controls . . . "
[Id. at 516 (quoting Wollen v. Fort Lee,
27 N.J. 408, 418 (1958)).]
To us, the "internal sense" of the law does not require the UCJF
to reimburse insurers of out-of-state vehicles. We acknowledge
the strength of the counterarguments, but they do not outweigh
the reasons for our conclusion that reimbursement is not required
in this case.
Because the issues involved in this case are close, and
because very substantial sums of money turn on an assessment of
the Legislature's probable intent, the Legislature is free to
revise, even retroactively, our disposition and to direct
reimbursement by the UCJF. See Phillips v. Curiale,
128 N.J. 608
(1992) (discussing retroactive application of legislative
provisions). Because of the procedural posture of the case, we
do not address the issue of administrative due process (with
respect to the adoption of the UCJF's no-reimbursement policy) or
the issue of a lack of equal protection due to a classification
that denies reimbursement rights to the insurers of nonresident
motorists. If the Legislature agrees with our interpretation of
the No-Fault Law, we are satisfied that the UCJF's implementation
of legislative intent does not require the adoption of a
regulation and that its classification is reasonable.
The judgment of the Appellate Division is reversed. The
judgment of the Law Division is reinstated in Robinson. Martin
is remanded to the Law Division for further proceedings in
accordance with this opinion.
JUSTICES HANDLER, POLLOCK, GARIBALDI, STEIN, and COLEMAN join in JUSTICE O'HERN's opinion. CHIEF JUSTICE WILENTZ did not participate.
NO. A-114 SEPTEMBER TERM 1994
ON APPEAL FROM
ON CERTIFICATION TO Appellate Division, Superior Court
CHARLES MARTIN,
Plaintiff,
v.
HOME INSURANCE COMPANY,
Defendant and Third-Party
Plaintiff-Respondent,
v.
UNSATISFIED CLAIM AND JUDGMENT
FUND,
Third-Party
Defendant-Appellant.
(and other related matters)
DECIDED July 31, 1995
Justice Handler PRESIDING
OPINION BY Justice O'Hern
CONCURRING OPINION BY
DISSENTING OPINION BY
Footnote: 1A 1990 amendment to N.J.S.A. 39:6A-4a capped PIP benefits at $250,000. Presumably, the cost of automobile and accident reparations in excess of that sum will be paid through general health insurance, private insurers, or public-assistance health programs. Because of the dates of the accidents in these cases, that amendment is not applicable. Footnote: 2New York Life Insurance Company and Wholesaler-Distributors Insurance Trust (collectively New York Life) provided Robinson with medical, dental, and accidental death or dismemberment insurance through a group policy issued from the State of Illinois to Robinson's Virginia employer. Those companies paid medical benefits in excess of $400,000 to Robinson. Progressive, however, had a duty to pay Robinson's medical expenses as the "primary insurer," and New York Life was entitled to reimbursement from Progressive for benefits paid. 276 N.J. Super. 378, 396 (App. Div. 1994).