Mfrs. Ins. Gp. v. Holger Trucking

9 A.3d 1095, 417 N.J. Super. 393
CourtNew Jersey Superior Court Appellate Division
DecidedJanuary 7, 2011
DocketA-0365-09T3
StatusPublished
Cited by6 cases

This text of 9 A.3d 1095 (Mfrs. Ins. Gp. v. Holger Trucking) 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
Mfrs. Ins. Gp. v. Holger Trucking, 9 A.3d 1095, 417 N.J. Super. 393 (N.J. Ct. App. 2011).

Opinion

9 A.3d 1095 (2011)
417 N.J. Super. 393

NEW JERSEY MANUFACTURERS INSURANCE GROUP/GARRISON LANGE, Plaintiff-Respondent,
v.
HOLGER TRUCKING CORPORATION and ARI Insurance Companies, Defendants-Appellants.

No. A-0365-09T3.

Superior Court of New Jersey, Appellate Division.

Argued September 29, 2010.
Decided January 7, 2011.

William S. Bloom, Edison, argued the cause for appellants (Methfessel & Werbel, attorneys; Mr. Bloom, on the brief).

William H. Hanifen, IV, Collingswood, argued the cause for respondent.

Before Judges FISHER, SAPP-PETERSON and SIMONELLI.

The opinion of the court was delivered by

FISHER, J.A.D.

N.J.S.A. 39:6A-9.1 requires that an insurer, which has provided personal injury protection (PIP) benefits, must commence suit for reimbursement from a tortfeasor within two years of "the filing of the claim." The parties dispute whether the claim is filed when an insured or health care provider first requests reimbursement for PIP benefits or when the insured *1096 submits a claim form requested by the insurer—a determination critical to the survival of this action. After closely examining this difficult issue, we conclude the Legislature most likely intended that the "claim" is "filed" when the latter event occurs.

The facts are not in dispute. Garrison Lange was injured in an automobile accident in Sayreville on December 1, 2006, when his vehicle was struck by a vehicle owned by Holger Trucking Company and driven by a Holger employee. That day, Lange contacted his automobile insurer, plaintiff New Jersey Manufacturers Insurance Group (NJM), advising of the accident and claiming he had sustained neck and back injuries. On that same day, NJM created a file for Lange's PIP claim and assigned it a file number.

On December 4, 2006, Michael Feher, an NJM adjuster, mailed Lange a PIP application to be completed and returned. That same day, Lange was first treated by Dr. Edward Palluzzi, a chiropractor. On December 6, 2006, Dr. Palluzzi submitted medical bills to NJM for treatment rendered on December 4 and 5, 2006. NJM received Dr. Palluzzi's bills on December 8, 2006.

On December 8, 2006, Dr. Palluzzi sent NJM a letter of medical necessity, which referenced the file number NJM had assigned to Lange's PIP file, asserting that Lange's right and left shoulders required adjustment. Dr. Palluzzi requested NJM's approval of a one-month treatment plan, which was authorized by Feher on December 11, 2006. Dr. Palluzzi forwarded additional bills for treatment rendered on December 8 and 11, 2006, which were received by NJM on December 20, 2006.

On December 20, 2006, as requested, Lange sent NJM a completed PIP application, which NJM received on December 26, 2006.

On December 24, 2008, NJM filed its complaint in this action against Holger and its insurer, ARI Insurance Companies, seeking reimbursement of $53,323.29 in PIP benefits NJM paid on Lange's behalf. Because NJM's suit was filed more than two years after Lange first advised NJM of the accident and more than two years after NJM opened a file, assigned it a number, received medical bills and treatment plans regarding Lange's treatment, and approved Lange's treatment plan, Holger and ARI (defendants) moved for summary judgment based on N.J.S.A. 39:6A-9.1, which states in pertinent part:

An insurer ... paying [PIP] benefits... or medical expense benefits ... as a result of an accident occurring within this State, shall, within two years of the filing of the claim, have the right to recover the amount of payments from any tortfeasor who was not, at the time of the accident, required to maintain [PIP] protection or medical expense benefits coverage at the time of the accident.
[Emphasis added.]

NJM countered that the suit was timely filed because it did not receive Lange's formal PIP application until December 26, 2006, slightly less than two years before the filing of this suit. The trial judge agreed with NJM's proposed construction of the statute and denied defendants' motion. We affirm.

N.J.S.A. 39:6A-9.1 does not expressly define what is meant by "the claim" as used in this context. We have in the past broadly defined "claim" as "`a challenging request, a demand of a right, a calling upon another for something due, a demand for benefits or payment, a privilege to something, a title to something in the possession of another....'" Burlington Cnty. Abstract Co. v. QMA Assocs., *1097 167 N.J.Super. 398, 404, 400 A.2d 1211 (App.Div.) (quoting Lamberton v. Travelers Indem. Co., 325 A.2d 104, 107 (Del.Super.Ct.1974), aff'd, 346 A.2d 167 (Del. 1975)), certif. denied, 81 N.J. 280, 405 A.2d 824 (1979). The statutory framework for the rendering of PIP benefits, however, fully recognizes that an insured or health care provider may provide many such claims, and, as a result, there is significant uncertainty about which of the many demands for payment that might be submitted in a given case—or were submitted here—constitutes "the" claim that commenced the limitation period prescribed by N.J.S.A. 39:6A-9.1. For example, Dr. Palluzzi's various bills may be viewed as "claims," because they were submitted with the intent that NJM provide payment within the brief time frame contained in N.J.S.A. 39:6A-5(g). In addition, NJM requested Lange's submission of a completed PIP claim form, which might also be viewed as "the claim" referred to in N.J.S.A. 39:6A-9.1. Accordingly, in casting about the many demands that may be asserted in this setting for "the claim" that the Legislature referred to in N.J.S.A. 39:6A-9.1, we must resort to the familiar guidelines of statutory construction.

In interpreting a statute, we generally look to the particular wording of the statute, see, e.g., Germann v. Matriss, 55 N.J. 193, 220, 260 A.2d 825 (1970) (recognizing that "the meaning of words may be indicated and controlled by those with which they are associated"), as well as the overall sense and purpose of the statute, see, e.g., Lesniak v. Budzash, 133 N.J. 1, 8, 626 A.2d 1073 (1993) (holding that courts should consider the "legislative policy underlying the statute and any history which may be of aid"). These factors should also be considered in conjunction so that "a literal interpretation of individual statutory terms or provisions" is not permitted to override "the overall purpose of the statute." State Farm Mut. Auto. Ins. Co. v. Licensed Beverage Ins. Exch., 146 N.J. 1, 5, 679 A.2d 620 (1996) (quoting Young v. Schering Corp., 141 N.J. 16, 25, 660 A.2d 1153 (1995)). We are thus required to carefully examine the words chosen by the Legislature in expressing its intent as well as the overall purpose of N.J.S.A. 39:6A-9.1 and its neighboring and related provisions.

In looking first to the words of the statute and the critical phrase, we focus initially on the Legislature's use of the definite article. That is, in giving the words in the statute their common meaning, Darel v. Pennsylvania Mfrs. Assoc. Ins. Co., 114 N.J. 416, 425, 555 A.2d 570 (1989); N.J.S.A. 1:1-1, the Legislature's reference to the submission of "the claim" as the event triggering the running of the statute of limitations was likely intended to mean a single, definite event and not any one of a series of events. N.J.S.A. 39:6A-9.1 (emphasis added).[1]

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Bluebook (online)
9 A.3d 1095, 417 N.J. Super. 393, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mfrs-ins-gp-v-holger-trucking-njsuperctappdiv-2011.