Cutitta v. Selective Ins. Co.

604 A.2d 989, 255 N.J. Super. 252
CourtNew Jersey Superior Court Appellate Division
DecidedApril 1, 1992
StatusPublished
Cited by6 cases

This text of 604 A.2d 989 (Cutitta v. Selective Ins. Co.) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cutitta v. Selective Ins. Co., 604 A.2d 989, 255 N.J. Super. 252 (N.J. Ct. App. 1992).

Opinion

255 N.J. Super. 252 (1992)
604 A.2d 989

FRANK CUTITTA, PLAINTIFF-APPELLANT,
v.
SELECTIVE INSURANCE COMPANY OF AMERICA, DEFENDANT-RESPONDENT.

Superior Court of New Jersey, Appellate Division.

Argued January 23, 1992.
Decided April 1, 1992.

*253 Before Judges KING, GRUCCIO and BROCHIN.

Gerald H. Baker argued the cause for appellant (Taenzer, Friedman, Ettenson & Stockton, attorneys; Joshua Friedman, on the brief).

Michael E. Carson, argued the cause for respondent.

The opinion of the court was delivered by GRUCCIO, J.A.D.

On this appeal we must interpret New Jersey's current uninsured/underinsured motorist (UM-UIM) statute and its interplay with arbitration in the determination of verbal threshold issues. We conclude that where an arbitration clause directs *254 arbitration of disputes as to severity of injury and extent of damages, an arbitrator, not a court, must resolve these issues.

Plaintiff Frank Cutitta sought damages from his insurer, defendant Selective Insurance Co. of America (Selective), following a motor vehicle collision caused by the operator of an uninsured vehicle. Selective denied plaintiff's uninsured motorist claims "on the basis that Mr. Cutitta has not met the requirements of his verbal threshold." Thereafter, plaintiff's counsel submitted the demand for arbitration in accordance with the insurance policy. In response, Selective stated that it would not participate in arbitration since defendant had not "overcome his verbal threshold" and was ineligible for coverage.

A verified complaint was filed on behalf of plaintiff and sought an order compelling Selective to show cause why it should not participate in arbitration. The Law Division judge issued an order the same day which directed defendant to show cause why the court should not enter judgment ordering Selective's participation in arbitration proceedings. Selective responded.

The Law Division judge then entered an order denying plaintiff's petition after oral argument. She ruled that "the question of whether the plaintiff has met the threshold and is entitled to pursue his claim with the uninsured benefit is not an issue to be determined by the arbitrators, but rather is an issue that is determined at some other point and some other time. And it may be that that is an issue that rather than having the arbitrators determine, that the court needs to determine." The judge also specifically rejected plaintiff's suggestion that, because the New Jersey insurance statute was an exact replica of the New York insurance statute, the New York case law speaking specifically to this issue should be followed.

The facts are as follows. Plaintiff, a resident of Riverside, New Jersey, was the owner and operator of a motor vehicle insured by Selective. On July 10, 1989, plaintiff was injured *255 when his vehicle was struck from behind in New York City by an uninsured automobile owned and operated by a resident of Clifton, New Jersey. Plaintiff received treatment for his injuries and then asserted a claim for damages under his UM-UIM policy provision. Plaintiff was age 63 at the time of the accident and suffered a strain injury to his left shoulder which exacerbated existing tendinitis.

The policy in question states:

INSURING AGREEMENT
We will pay damages which an "insured" is legally entitled to recover from the owner or operator of an "uninsured motor vehicle" or "underinsured motor vehicle" where such coverage is indicated as applicable in the schedule of declarations because of: (1) "bodily injury" sustained by an "insured" and caused by an accident; ... the owner's or operator's liability for these damages must arise out of the ownership, maintenance, or use of the "uninsured motor vehicle" or the "underinsured motor vehicle."
EXCLUSIONS
We do not provide coverage under this endorsement for "property damage" or "bodily injury" sustained by any person: ... (2) for damages for pain, suffering and inconvenience resulting in "bodily injury" caused by an accident involving an "uninsured motor vehicle" unless the injured person has the legal right to recover damages for such pain, suffering and inconvenience under the New Jersey No-Fault Law. The injured person's legal right to recover damages for pain, suffering and inconvenience under the New Jersey No-Fault Law will be determined by the liability tort limitation, if any, applicable to that person.
ARBITRATION
If we and an "insured" do not agree: (1) whether that person is legally entitled to recover damages under this endorsement; or (2) as to the amount of damages; either party may make a written demand for arbitration. In this event, each party will select an arbitrator. The two arbitrators will select a third. If they cannot agree within 30 days, either may request that selection be made by a judge of a court having jurisdiction.... A decision agreed to by two of the arbitrators will be binding as to: (1) whether the insured is legally entitled to recover damages; and (2) the amount of damages.

Selective refused to participate in arbitration on the basis that, by statute and under the terms of his insurance policy, plaintiff's claim was subject to the verbal threshold set forth in N.J.S.A. 17:28-1.1(a)(2). Selective contends that as a precondition to arbitration plaintiff must first present his medical proofs in the Superior Court. Thereafter, if a court of law determines *256 that plaintiff has met the verbal threshold, Selective will participate in arbitration.

Plaintiff contends that he is not required to meet the verbal threshold since his accident occurred in New York and he is insured in New Jersey. This issue was not raised at the trial level. We, nonetheless, consider the matter.

In support of his argument plaintiff cites N.J.S.A. 39:6A-8 which limits the exemption from tort liability to claims of insured occupants "suffering bodily injury, arising out of ownership, operation, maintenance or use of the automobile in this state." Ibid. A continued reading, however, reveals that uninsured motorist coverage extends to accidents which occur "anywhere within the United States or Canada." Ibid. Moreover, the conjunctive "or" in the statute indicates that ownership or use of the automobile in this state are alternative bases for the exemption. Therefore, if one owns a car in New Jersey and is insured here, he is subject to the exemption. The fact that an accident occurs outside New Jersey does not exempt a claimant insured here from meeting the verbal threshold described in his contract of insurance.

Plaintiff next contends that the Law Division judge's determination that in uninsured motorists cases, a court and not a jury, must determine plaintiff's qualification for non-economic losses, was baseless. The Law Division judge ruled that in proceedings involving threshold issues under the new insurance law, a judge should determine whether a plaintiff has suffered non-economic loss sufficient to satisfy the statutory threshold for coverage. The judge based her decision to shift the role, which traditionally belonged to the jury, on Governor Kean's Reconsideration and Recommendations Statement. There the Governor stated:

The verbal threshold contained in this recommendation is patterned after that in force in New York State (See New York Insurance Law §§ 5102, 5104).

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Bluebook (online)
604 A.2d 989, 255 N.J. Super. 252, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cutitta-v-selective-ins-co-njsuperctappdiv-1992.