Pinto v. New Jersey Mfrs. Ins. Co.

839 A.2d 134, 365 N.J. Super. 378
CourtNew Jersey Superior Court Appellate Division
DecidedJanuary 21, 2004
StatusPublished
Cited by11 cases

This text of 839 A.2d 134 (Pinto v. New Jersey 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
Pinto v. New Jersey Mfrs. Ins. Co., 839 A.2d 134, 365 N.J. Super. 378 (N.J. Ct. App. 2004).

Opinion

839 A.2d 134 (2004)
365 N.J. Super. 378

Raymond PINTO, Jr., Plaintiff-Respondent,
v.
NEW JERSEY MANUFACTURERS INSURANCE COMPANY, Defendant-Appellant.

Superior Court of New Jersey, Appellate Division.

Argued November 10, 2003.
Decided January 21, 2004.

*136 Glenn T. Dyer, argued the cause for appellant (Connell Foley, attorneys; Brian G. Steller, of counsel, Roseland; Mr. Dyer, on the brief).

John M. Vlasac, Jr., argued the cause for respondent (Gill & Chamas, attorneys, Woodbridge; Mr. Vlasac, on the brief).

Before Judges HAVEY, FALL and HOENS.

*135 The opinion of the court was delivered by FALL, J.A.D.

The issue posed by this appeal is whether the underinsured motorists (UIM) benefits claim of an employee, injured while operating a motor vehicle owned and insured by his employer, is effectively reduced by the "step-down" coverage clause contained in the UIM endorsement of the employer's business auto policy to the limit of UIM coverage contained in the employee's personal auto policy when that employee is listed as an individual "named insured" in his personal auto policy but is not listed as an individual named insured under the employer's business auto policy.

Here, plaintiff Raymond Pinto, Jr. was injured in an auto accident while operating a vehicle owned by his employer that was insured by defendant New Jersey Manufacturers Insurance Company (NJM) under a business auto policy. The NJM policy contained a $1 million UM/UIM coverage limit, and a step-down clause in its UM/UIM endorsement that limited UM/UIM claims to the UM/UIM coverage limit contained in any other policy having similar coverage that listed the claimant as an individual named insured when that claimant was not an individual named insured under the NJM policy. The tortfeasor's auto policy had $300,000 in auto liability coverage. Plaintiff had a personal auto policy naming him as a named insured with $100,000 in UIM coverage.

We conclude that because plaintiff was a "named insured" under his personal auto policy and was not a named insured under his employer's business auto policy issued by NJM, his claim for UIM coverage under the business auto policy was limited by the step-down clause contained in that policy's UM/UIM endorsement to the amount of UIM coverage he elected in his personal auto policy. We find the language of the step-down, coverage-limitation clause to be clear, unambiguous and uncontroverted by any other provisions contained in the business auto policy issued by NJM. Furthermore, because the limit of liability coverage contained in the tortfeasor's policy exceeded the limit of UIM coverage contained in plaintiff's personal auto policy, plaintiff was not an "underinsured motorist" as defined in the NJM policy. We therefore reverse the November 22, 2002 order entered in the Law Division that had granted summary judgment in favor of plaintiff and remand for entry of judgment in favor of NJM on the UIM coverage issue.

In reaching these conclusions, we discern no bright-line test or rule for determining competing UIM claims in the context of multiple policies that contain UIM *137 coverage. The critical factor in resolving competing claims for UIM coverage is the language of the policies. If clear, unambiguous and uncontroverted by any other provisions contained in the policy, courts should apply the policy language to the peculiar facts and circumstances of each case in determining coverage issues.

In this case, the following factual and procedural history is relevant to our consideration of the arguments advanced on appeal. Plaintiff was employed by R.W. Vogel, Inc. (Vogel). Environmentally Clean Naturally, Inc. (ECN) was engaged in a street-cleaning project on the northbound lanes of Route 9 in Howell Township pursuant to its subcontract with Reilly Sweeping, Inc. Because of a manpower shortage, ECN prevailed upon Vogel to work on the street-cleaning job. On December 22, 1997, plaintiff was driving the lead truck in a three-vehicle street-cleaning convoy. The vehicle being operated by plaintiff was owned by Holgate Property Associates (Holgate), another company owned and operated by the owners of Vogel, and had been rented by ECN.

At that time and place, a Ford Expedition vehicle being operated by Theresa Trotter struck plaintiff's vehicle from the rear, resulting in severe personal injuries to plaintiff. The Trotter vehicle was insured by New Jersey Re-Insurance Company, which provided liability coverage of $300,000 on a combined, single-limit basis.

Plaintiff was a "named insured" under a personal auto policy he had purchased from Liberty Mutual/Liberty Guard (Liberty Mutual), under which he had selected UM/UIM coverage protection in the amount of $100,000 per person and $300,000 per accident. Vogel and Holgate were "named insureds" under the business auto policy issued by NJM which provided UIM coverage limits of up to $1 million. At the time of the December 22, 1997 accident, the NJM business auto policy identified no natural persons as "named insureds."

The NJM business auto policy contained a "step-down" clause in the policy's UM/UIM endorsement, limiting its UIM coverage to "the highest applicable limit of insurance under any coverage form or policy providing coverage to that insured as an individual named insured." Plaintiff filed a claim with NJM, seeking UIM coverage for his injuries up to the policy limit of $1 million. NJM denied coverage based upon the step-down clause in its policy pertaining to UIM coverage.

The following appeared on the first page of the NJM business auto policy in effect at the time of the December 22, 1997 accident:

BUSINESS AUTO COVERAGE FORM
Various provisions in this policy restrict coverage. Read the entire policy carefully to determine rights, duties and what is and is not covered.
Throughout this policy the words you and your refer to the Named Insured shown in the Declarations. The words we, us, and our refer to the Company providing this insurance.

Under its policy, NJM agreed to "pay all sums the insured [was] legally entitled to recover as compensatory damages from the owner or driver of an uninsured motor vehicle or an underinsured motor vehicle[.]" The definition of "insured" includes "[a]nyone else occupying a covered auto[.]"

The step-down clause in dispute in the NJM business auto policy provided in pertinent part:

D. LIMIT OF INSURANCE

1. Regardless of the number of covered autos, insureds, premiums paid, *138 claims made or vehicles involved in the accident, the LIMIT OF INSURANCE shown in the Declarations for Uninsured Motorists Coverage and Underinsured Motorists Coverage is the most we will pay for all damages resulting from any one accident with an uninsured motor vehicle or an underinsured motor vehicle.

a. However, subject to our maximum Limit Of Insurance for this coverage, if:
(1) An insured is not the individual named insured under this policy;
(2) That insured is an individual named insured under one or more other policies providing similar coverage; and
(3) All such other policies have a limit of insurance for similar coverage which is less than the Limit Of Insurance for this coverage;

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Bluebook (online)
839 A.2d 134, 365 N.J. Super. 378, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pinto-v-new-jersey-mfrs-ins-co-njsuperctappdiv-2004.