Gazis v. Miller

874 A.2d 591, 378 N.J. Super. 59
CourtNew Jersey Superior Court Appellate Division
DecidedJune 6, 2005
StatusPublished
Cited by5 cases

This text of 874 A.2d 591 (Gazis v. Miller) 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
Gazis v. Miller, 874 A.2d 591, 378 N.J. Super. 59 (N.J. Ct. App. 2005).

Opinion

874 A.2d 591 (2005)
378 N.J. Super. 59

John A. GAZIS, Plaintiff/Appellant,
v.
Fred B. MILLER and Archdiocese of Newark, Defendants/Third-Party Plaintiffs,
v.
The National Catholic Risk Retention Group, Inc., Third-Party Defendant/Respondent.

Superior Court of New Jersey, Appellate Division.

Submitted April 19, 2005.
Decided June 6, 2005.

*592 Ryan, Brown, McDonnell, Berger & Gibbons, attorneys for appellant (Michael T. McDonnell, III, on the brief).

Landman Corsi Ballaine & Ford, attorneys for respondent (Gerald T. Ford and Steven A. Torrini, New York, NY, on the brief).

Before Judges COBURN, WECKER and GRAVES.

The opinion of the court was delivered by

COBURN, J.A.D.

The issuer of an occurrence based excess automobile insurance policy obtained summary judgment forfeiting the insured's right to coverage based on the insured's violation of the policy's notice provision even though the violation did not cause the issuer any appreciable prejudice. We reverse because in the absence of prejudice, the contractual violation was immaterial and the ruling caused a disproportionate forfeiture.

I

On January 9, 2000, Miller was driving a car owned by his employer, the Archdiocese of Newark. While driving in Brick Township, the car collided with a pedestrian, plaintiff John Gazis, causing a severe fracture of his ankle, facial fractures, brain contusions, a subdural hematoma, and other injuries. After hospitalization and treatment in a rehabilitation center, Gazis was released in March 2000 with, among other things, permanent loss of his sense of smell and most of his sense of taste.

On the day after the accident, Miller reported the accident to Kemper National Account Service, Co. ("Kemper"), the claims servicing company that administered automobile claims for the Archdiocese under a policy of insurance issued by Lumberman's Mutual Casualty, a Kemper company, which provided occurrence based liability protection of $250,000. The Archdiocese *593 was further insured for liability under a $750,000 excess policy issued by third-party defendant, The National Catholic Risk Retention Group, Inc. ("National"). Kemper, National, and the Archdiocese had agreed that Kemper would be responsible for all appropriate notices to National, which, in turn, had reinsurance with American Re. In short, the coverage provided for one accident, was $250,000 from Kemper, then $350,000 from National, and finally $400,000 from American Re. The annual premium for the National policy was approximately $340,000. This policy provided for indemnity only and not for defense.

National is not an ordinary commercial insurance company issuing policies to the general public. Rather, it is a risk retention group operating pursuant to the Liability Risk Retention Act of 1986, 15 U.S.C.A. § 3901 to -3906, which means that it could provide liability insurance to entities engaged in similar or related activities. National's owners and insureds are its membership, approximately sixty-three dioceses and other Roman Catholic organizations throughout the United States. Its board of directors consists of representatives from those groups.

The notice of claim provision of National's policy provides, in relevant part, as follows:

[The insured] shall give written notice to the Company as soon as practicable but no more than 120 days after receiving notice of any event which ... may give rise to a covered loss irrespective of any apparent liability, when the event results in any of the following:
. . .
(2) Brain damage
(3) Multiple Injuries requiring hospitalization for more than thirty days
. . .
(7) Any loss for which the Underlying Insurer has established a reserve (including expense) of $125,000 or more.
. . .
In the event the Insured fails to provide such notice within a 120 day period after receiving notice of any event, this Policy will not apply to any such injury.
[Emphasis added.]

By April 1, 2000, Kemper knew that Gazis had retained counsel, and by October 2 Kemper was well aware of the seriousness of Gazis's injuries, had set its reserve at $275,000, and knew that it should give notice to National. Without excuse, the notice was not given until June 21, 2001. On July 11, 2001, National denied coverage for Gazis's claim based solely on the failure to give it notice within the 120 day period required by its policy.

Gazis filed his complaint in January 2002, six months after National declined coverage, and the Archdiocese impleaded National in February, demanding indemnification. On June 13, 2003, following the completion of discovery, Gazis's case was submitted to arbitration, resulting in an award of over $1 million. The Archdiocese obtained a trial de novo, and later reached a $500,000 settlement with Gazis, who received the entire Kemper policy of $250,000 plus an assignment of the Archdiocese's rights, if any, to recover the balance of $250,000 from National.

Motions and cross-motions for summary judgment were filed by National, Gazis and the Archdiocese. National relied on the Archdiocese's admitted violation of the 120 day notice provision, asserting that breach was sufficient without the presence of prejudice to support its denial of coverage. Alternatively, it asserted that the late notice had caused prejudice, relying *594 on a certification of its director of claims management, Douglas W. Grund, who made these assertions:

6. Normally, when [National] receives notice of a serious claim, such as the Gazis claim, we follow the claim very closely and work with our policyholders and/or its third party claim administrator to develop a litigation plan, identify acceptable methods of early resolution, coordinate disposition and utilize a structured settlement strategy if appropriate.
7. In my experience, our methodology of following serious claims from an early stage and working towards an early settlement and favorable resolution has resulted in more timely settlements at a more favorable rate.
8. Had we received notice of the Gazis claim when we should have, we would have followed the claim closely, and worked with Kemper, the Archdiocese, defense counsel and Mr. Gazis' attorney to resolve the liability, injury and settlement issues quickly given the serious injuries and obvious liability problems. I would have reviewed the police and hospital records from the night of the accident to establish whether or not plaintiff was intoxicated.
9. Given my experience in handling claims of this nature, I believe there is a reasonable chance that we would have settled the case for less than the $500,000 ultimately needed to settle the case. We would have emphasized to plaintiff's attorney the significant time and expenses that would be avoided by settling the case prior to suit being filed and the advantages of utilizing a structured settlement.
10. When [National] received notice of the Gazis claim on June 21, 2001, I did not engage in our normal methodology because the notice clearly violated the 120-day requirement in the Policy.

During the argument on the motions, the judge found as a fact that National had suffered no prejudice as a result of the late notice.

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Cite This Page — Counsel Stack

Bluebook (online)
874 A.2d 591, 378 N.J. Super. 59, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gazis-v-miller-njsuperctappdiv-2005.