Derfuss v. NJ Mfrs. Ins. Co.

666 A.2d 599, 285 N.J. Super. 125
CourtNew Jersey Superior Court Appellate Division
DecidedNovember 8, 1995
StatusPublished
Cited by8 cases

This text of 666 A.2d 599 (Derfuss v. NJ Mfrs. 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
Derfuss v. NJ Mfrs. Ins. Co., 666 A.2d 599, 285 N.J. Super. 125 (N.J. Ct. App. 1995).

Opinion

285 N.J. Super. 125 (1995)
666 A.2d 599

KARIN I. DERFUSS, PLAINTIFF-RESPONDENT AND CROSS-APPELLANT,
v.
NEW JERSEY MANUFACTURERS INSURANCE COMPANY, DEFENDANT-APPELLANT AND CROSS-RESPONDENT.

Superior Court of New Jersey, Appellate Division.

Argued October 2, 1995.
Decided November 8, 1995.

*127 Before Judges HAVEY, D'ANNUNZIO and CONLEY.

Brian G. Steller argued the cause for appellant/cross-respondent (Connell, Foley & Geiser, attorneys; Mr. Steller, of counsel; Glenn T. Dyer, on the briefs).

James Hely argued the cause for respondent/cross-appellant (Weiseman Hely, attorneys; Mr. Hely, on the brief).

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

Plaintiff Karin I. Derfuss is insured by defendant New Jersey Manufacturers Insurance Company (NJM) under a policy providing underinsured motorist (UIM) coverage. Plaintiff sustained injuries as a result of an automobile accident with an underinsured tortfeasor. Pursuant to the terms of the policy, an arbitration panel awarded plaintiff $350,000 and apportioned forty percent liability against her. The Law Division judge granted plaintiff a trial de novo on both the damage and liability issues. A jury thereupon awarded her $500,000 and found her twenty percent liable for the accident.

*128 We conclude that the arbitrators' determination as to liability was binding, and thus, plaintiff had no right to a trial de novo on the issue. We therefore reverse the order granting plaintiff a trial de novo on liability and reduce plaintiff's $500,000 damage verdict rendered by the jury to $300,000, to reflect the arbitrators' allocation of forty percent liability against plaintiff. We affirm the award of prejudgment interest.

Plaintiff was injured in an August 31, 1990, two-car accident in a shopping mall parking lot in South Plainfield. She settled with the tortfeasor for $100,000, the limit under the tortfeasor's liability policy.

On August 3, 1992, plaintiff filed a complaint against NJM because of a dispute concerning her entitlement to personal injury protection (PIP) coverage under her policy. The parties were also unable to settle plaintiff's UIM claim. NJM's UIM endorsement provides for arbitration if the parties do not agree as to whether the insured is "legally entitled to recover damages" or as to the "amount of damages." It also provides:

Unless both parties agree otherwise, arbitration will take place in the county in which the insured lives. Local rules of law as to procedure and evidence will apply. 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. This applies only if the amount does not exceed the minimum limit for liability specified by the financial responsibility law of New Jersey. If the amount exceeds the limit, either party may demand the right to a trial. This demand must be made within 60 days of the arbitrators' decision. If this demand is not made, the amount of damages agreed to by the arbitrators will be binding.

On February 23, 1993, plaintiff's UIM claim was arbitrated, and the arbitrators unanimously found plaintiff forty percent responsible for the accident and awarded damages in the amount of $350,000.

Plaintiff moved to amend her complaint to seek a trial de novo on her UIM claim. On March 19, 1993, the motion was granted, but only as to the quantum of damages. On plaintiff's reconsideration motion, the judge concluded that plaintiff was entitled to a de *129 novo review as to both damages and liability since, according to the judge, the UIM arbitration provision was "ambiguous."

During the jury trial, plaintiff, her mother, and two friends testified concerning plaintiff's injury and the impact it had on her life. The de bene esse testimony of neurosurgeon Paul C. McCormick, M.D., was also offered by plaintiff. Extensive testimony from reconstruction specialists was presented by both sides concerning liability. The jury found plaintiff twenty percent liable and awarded her $500,000 in damages.

The trial judge denied NJM's motion for a new trial or for remittitur and granted plaintiff prejudgment interest from March 19, 1993, the date she was granted leave to amend her complaint to seek a trial de novo as to her UIM claim.

I

NJM argues that the motion judge erred in finding ambiguity in the arbitration clause. It correctly notes that since the motion judge's determination, the Law Division in Salib v. Alston, 276 N.J. Super. 108, 111-12, 647 A.2d 484 (Law Div. 1994), has construed the same UM/UIM arbitration clause that is before us, and concluded that it unambiguously allows for a trial de novo solely in regard to the amount of damages and "only ... when the amount of damages falls within a specified range." Id. at 112, 647 A.2d 484.[1]

Plaintiff counters by contending that Salib was erroneously decided. She argues that paragraph one, requiring the arbitrators to decide "whether the insured is legally entitled to recover damages" may simply require the arbitrators to answer "yes" or "no" as to the insured's "entitlement to some recovery." She asserts that paragraph two, which applies to the "amount of *130 damages," requires an apportionment of fault to determine the insured's "net" damages, and if such damages exceed the statutory minimum,[2] she is entitled to a "right to a trial" as to both damages and the liability apportionment. She claims that because there is at least an ambiguity, the language should be construed in her favor as an insured by offering a trial de novo as to both liability and damages.

We reject the argument and adopt Salib's holding that the arbitration clause provides for a "right to a trial" on damages only, provided that the award exceeds the statutory minimum. We do so even if we accept plaintiff's argument that the language in the clause is ambiguous.

The well-settled principle construing ambiguities in insurance contracts in favor of the insured generally applies to issues concerning the terms of coverage. See Voorhees v. Preferred Mutual Ins. Co., 128 N.J. 165, 177-79, 607 A.2d 1255 (1992) (interpreting "bodily injury" in a homeowner's policy to cover emotional distress injuries); Mazzilli v. Accident & Casualty Ins. Co., 35 N.J. 1, 7, 19, 170 A.2d 800 (1961) (construing the phrase "resident of the household" to cover insured's wife); Kievit v. Loyal Protective Life Ins. Co., 34 N.J. 475, 482, 170 A.2d 22 (1961) (construing provision covering loss "resulting directly and independently of all other causes from accidental bodily injury" to include insured's pre-existing condition activated by accident); Franklin Mutual Ins. Co. v. Security Indemn. Ins. Co., 275 N.J. Super. 335, 340, 646 A.2d 443 (App.Div.) (policy endorsement covering accidents "arising out of the ... use" of premises construed to mean "originating from the use" or "growing out of the use of"), certif. denied, 139 N.J. 185, 652 A.2d 173 (1994). The principle is rooted in the notion that members of the public "are entitled to the broad measure of protection necessary to fulfill *131 their reasonable expectations," Kievit v.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

AEP2, LLC v. BMW of North America, LLC
Court of Appeals of South Carolina, 2021
Augustine W. Badiali v. New Jersey Manufacturers Insurance Group (071931)
107 A.3d 1281 (Supreme Court of New Jersey, 2015)
GUACIARO v. Gonzales
991 A.2d 844 (New Jersey Superior Court App Division, 2010)
Taddei v. State Farm Indem. Co.
951 A.2d 1041 (New Jersey Superior Court App Division, 2008)
LoBianco v. Harleysville Ins. Co.
847 A.2d 584 (New Jersey Superior Court App Division, 2004)
Wylie v. Hamilton
838 A.2d 514 (New Jersey Superior Court App Division, 2004)
Martellio v. Burbank
775 A.2d 620 (New Jersey Superior Court App Division, 2001)
Electric Mobility Corp. v. Bourns Sensors/Controls, Inc.
87 F. Supp. 2d 394 (D. New Jersey, 2000)

Cite This Page — Counsel Stack

Bluebook (online)
666 A.2d 599, 285 N.J. Super. 125, Counsel Stack Legal Research, https://law.counselstack.com/opinion/derfuss-v-nj-mfrs-ins-co-njsuperctappdiv-1995.