SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-2870-01T5
OHIO CASUALTY INSURANCE COMPANY,
Plaintiff-Appellant,
v.
LEWIS R. BORNSTEIN and
PAMELA BORNSTEIN,
Defendants-Respondents.
__________________________________
Argued: December 3, 2002 - Decided:
February 6, 2003
Before Judges Wallace, Jr., Axelrad and Hoens.
On appeal from the Superior Court of New
Jersey, Law Division, Burlington County, L-
2365-01.
George A. Prutting, Jr., argued the cause for
appellant (Prutting & Lombardi, attorneys; Mr.
Prutting, on the brief).
Lewis R. Bornstein argued the cause for
respondents (Morgan, Bornstein & Morgan,
attorneys; Mr. Bornstein, on the brief).
The opinion of the court was delivered by
AXELRAD, J.T.C. (temporarily assigned).
The issue in this case is whether an insured has a right to
settle a claim against a tortfeasor for considerably less than that
party's coverage and then proceed against his own uninsured
motorist (UIM) carrier, giving the carrier full credit for the
tortfeasor's policy. The trial judge reviewed the insured's
reasons for accepting the settlement and the carrier's arguments to
the contrary and ordered the carrier to provide coverage for
damages in excess of the tortfeasor's policy limits. The carrier
appealed. We affirm.
Defendant Lewis R. BornsteinSee footnote 11, who was a passenger in a
taxicab in New York City, sustained injuries when the driver rear-
ended another car. As a result of the accident, defendant filed
suit in New York against the owners and operators of the taxicab
and the second vehicle which had been struck in the rear by the
taxicab. The tortfeasor taxicab company had liability limits of
$100,000. The second vehicle, which had liability limits of
$15,000, neither offered nor paid any money in connection with the
motor vehicle accident in which it had been rear-ended.
At the time of the accident, defendants had an automobile
liability policy with plaintiff, Ohio Casualty Insurance Company,
which had $500,000 UIM coverage. Under the insuring agreement,
plaintiff promised to pay "compensatory damages which an 'insured'
is legally entitled to recover from the owner or operator of an .
. . 'underinsured motor vehicle.'" The policy defines an
"underinsured motor vehicle" as a motor vehicle "to which a
liability bond or policy applies at the time of the accident but
its limit for liability is less than the limit of liability for
this coverage." The policy incorporates the Longworth v. Van
Houten,
223 N.J. Super. 174, 194 (App. Div. l988), procedure and
requires notice of a tentative settlement, thereby allowing the
insurer to exercise its subrogation rights if it so chooses. To
exercise those rights, plaintiff must pay its insured the amount of
the settlement within thirty days, but the insured is still
entitled to UIM benefits up to the limits of the policy. The
policy does not condition payment of UIM benefits upon the
insured's exhaustion of the limits of the tortfeasor's policy.
Instead, the carrier's limit of liability with respect to an
accident with an uninsured vehicle is "reduced by all sums paid .
. . by or on behalf of persons or organizations who may be legally
responsible."
On February 5, 1999, defendant notified plaintiff of the
pending New York action, indicated he intended to file a UIM claim,
and invited plaintiff to participate in the lawsuit. On July 20,
2001, in accordance with Longworth v. Van Houten, supra, 223 N.J.
Super. at 194, defendant notified plaintiff he wanted to accept the
taxicab company tortfeasor's $60,000 settlement offer, and asked
plaintiff to inform him within thirty days whether it wished to
preserve its subrogation rights, in which case defendant would
assign his claim to plaintiff in exchange for $60,000. Plaintiff
then filed this declaratory judgment action, asserting it should be
relieved from any obligation to pay UIM benefits because
defendant's settlement was substantially below the tortfeasor's
policy limit.
In response, defendant offered, consistent with Longworth, id.
at 191, to credit plaintiff with the tortfeasor's full $100,000
policy limit. Defendant explained his reasons for accepting 60% of
the tortfeasor's policy:
1) Empire Insurance Company, the tortfeasor's
carrier, [a C++ company], may be going into
liquidation which had the potential to cause
delay, administrative obstacles, interim loss
of the use of money, and "perhaps a less than
dollar for dollar recovery based upon the true
value of the claim."
2) Defendant's treating medical providers
were located in South Jersey and he had been
advised that New York courts want "live"
testimony but for exceptional circumstances,
which would cause additional expense and
scheduling difficulties to plaintiff and his
medical experts.
3) Defendant would have to pay higher legal
fees to his New York counsel if the matter
went to trial.
4) Defendant would incur additional costs for
accommodations for himself and his witnesses
if the matter went to trial.
5) Defendant feared that a New York judge and
jury might be prejudiced against an out of
state resident.
6) As he understood it, prejudgment interest
is not allowed in New York on tort claims.
7) He was concerned about protracted appeals
in a foreign jurisdiction.
8) Defendant had "an emotional need to move
forward.
9) Defendant wanted to deliberate further
about whether to have surgery.
Defendant thus contended that because he agreed to give full
credit for the tortfeasor's coverage and because his reasons for
accepting less than the full policy were reasonable, he had
satisfied any obligation he had to his UIM carrier. Plaintiff
argued that the settlement was unreasonable on its face and that
the insured's explanations were insufficient. The court rejected
plaintiff's argument that Longworth, supra,
223 N.J. Super. 174,
precludes a claim for UIM benefits unless the insured obtains a
settlement "at or near" the tortfeasor's policy limits. The court
also rejected the arguments that the insured's decision to accept
a settlement of 60% of the tortfeasor's coverage was per se
unreasonable. The court, after reviewing defendant's reasons for
accepting the settlement and plaintiff's arguments to the contrary,
"was not prepared to say as a matter of law that that decision on
the insured's part [was] so wholly unreasonable that they should be
precluded in this instance from UIM benefits by their acceptance of
that settlement." The court further concluded that plaintiff was
not prejudiced by the settlement because it would only be
responsible for coverage of defendant's damages in excess of the
amount of the tortfeasor's policy limit.
On appeal, plaintiff contends that (1) public policy dictates
that a settlement of 60% of the tortfeasor's policy precludes any
claim for UIM coverage; (2) N.J.S.A. 17:28-1.1 requires the
settlement with the tortfeasor to be reasonable in order to strike
a fair balance between the insured and the UIM carrier; (3)
defendant's reasons for accepting 60% of the tortfeasor's liability
limits are not reasonable; and (4) plaintiff's policy language
requires the insured to obtain a reasonable settlement for the
tortfeasor to perfect a valid UIM claim. Plaintiff asks us to
determine as a matter of law that there is no reasonable
justification for accepting a settlement of 40% less than the
tortfeasor's policy limit, or alternatively, to remand for a fact-
finding hearing on whether this defendant's acceptance of the
settlement was reasonable.
We are not persuaded by plaintiff's arguments under the
circumstances of this case. Defendant informed plaintiff of the
New York litigation and gave it an opportunity to participate in
that lawsuit. He thereafter followed the procedure contained in
his policy and required by Longworth by advising plaintiff of the
substantial settlement offer and agreeing to the full credit.
While we would not agree that the insured has an unfettered
right to settle the underlying suit for a modest or insignificant
sum and pursue a UIM claim, here the settlement amount was a
substantial one when compared to the tortfeasor's policy limit.
There is, therefore, no per se bar to a UIM claim in light of the
settlement here. Moreover, defendant's reasons for accepting the
settlement are themselves reasonable. Those reasons amply support
his decision, under the circumstances of this case, to accept the
settlement and pursue his UIM remedy.
Finally, plaintiff is not prejudiced by this settlement. Even
though the language of defendant's policy does not condition
payment of UIM benefits upon the insured's exhaustion of the limits
of the tortfeasor's liability policy, defendant agreed to credit
plaintiff with the full coverage available under the taxicab
company's policy, consistent with our interpretation of N.J.S.A.
17:28-1.1. See Longworth, supra, 223 N.J. Super. at 191 ("if the
victim does accept less than the tortfeasor's policy limits, his
recovery against the UIM carrier must nevertheless be based on a
deduction of the full policy limits.") Thus, plaintiff is only
responsible for damages suffered by defendant in excess of
$100,000, even though defendant only received $60,000 from the
tortfeasor in settlement of his lawsuit.
Affirmed.
Footnote: 1 1For the sake of clarity, the term "defendant" refers to Lewis R. Bornstein while the term "defendants" refers to both he and his wife Pamela, who were the insureds under the Ohio Casualty Insurance Company policy.