Price v. New Jersey Mfrs. Ins. Co.

846 A.2d 617, 368 N.J. Super. 356
CourtNew Jersey Superior Court Appellate Division
DecidedApril 12, 2004
StatusPublished
Cited by5 cases

This text of 846 A.2d 617 (Price 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
Price v. New Jersey Mfrs. Ins. Co., 846 A.2d 617, 368 N.J. Super. 356 (N.J. Ct. App. 2004).

Opinion

846 A.2d 617 (2004)
368 N.J. Super. 356

Theodore PRICE, Plaintiff-Respondent,
v.
NEW JERSEY MANUFACTURERS INSURANCE COMPANY, Defendant-Appellant.

Superior Court of New Jersey, Appellate Division.

Argued February 2, 2004.
Decided April 12, 2004.

*619 Stephen O. Mortensen, argued the cause for appellant (Mortensen and Pomeroy, attorneys; Daniel J. Pomeroy, Springfield and Karen E. Heller, on the brief).

John R. Gorman, New Brunswick, argued the cause for respondent (Lutz, Shafranski, Gorman and Mahoney, attorneys; Mr. Gorman, on the brief).

Before Judges WEFING, COLLESTER and FUENTES.

*618 The opinion of the court was delivered by

FUENTES, J.A.D.

Defendant New Jersey Manufacturers Insurance Company (NJM) appeals from an order of the Law Division directing it to submit to uninsured motorist (UM) coverage arbitration in connection with a claim filed by plaintiff, Theodore Price. The court found that NJM's course of conduct had lulled plaintiff's attorney into a false sense of having timely made a UM claim. We agree and affirm.[1]

On August 30, 1995, plaintiff, while in the course of his employment, was involved in an auto accident as a pedestrian. The vehicle that struck him was uninsured. NJM had issued an automobile insurance policy to plaintiff during the time period encompassing the accident. The UM coverage section of the policy provides as follows:

ARBITRATION
A. If we and an insured do not agree:
1. Whether that insured is legally entitled to recover damages; or
2. As to the amount of damages which are recoverable by that insured; from the owner or operator of an uninsured motor vehicle or an underinsured motor vehicle, then the matter may be arbitrated.

....

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.

[Emphasis added.]

Thus, in order to invoke the arbitration provisions there must first be a disagreement as to either (1) the threshold issue of entitlement to recover damages or (2) the amount of the claim. If either one of these conditions precedent exists, "[e]ither party may make a written demand for arbitration."

By letter dated February 12, 1998, plaintiff's counsel wrote to NJM advising it of the accident and enclosing documents which revealed that the tortfeasor was uninsured. The letter concludes as follows:

Therefore, my client will be presenting an uninsured motorist claim arising from this accident. Please establish an uninsured motorists claim file and ask that adjuster to contact me as soon as possible.

NJM acknowledged receipt of the February 12, 1998 letter "putting [it] on notice of a potential uninsured motorist claim." NJM assigned a file number to the case *620 and requested information concerning (1) the amount of the workers' compensation lien (operating under the assumption that such a case had been filed and settled) and (2) plaintiff's injuries.

Two months later, NJM's claims representative sent another letter to plaintiff's counsel emphasizing that the case was "some three years old" and again requesting information as to any lien. Forty days thereafter, plaintiff's counsel responded by forwarding the information requested to "allow you [NJM] to begin to evaluate this claim...." The letter also advised NJM that a suit had been filed against the tortfeasor to "protect" [NJM's] subrogation rights. The letter further requested that NJM advise whether it intended to pursue the subrogation action. "If you do not, [the letter continued] I presume you have no objection to my dismissing the suit." Approximately three months later, NJM authorized plaintiff's counsel to dismiss the complaint against the tortfeasor.

On October 8, 1998, a newly assigned NJM claims representative wrote to plaintiff's counsel requesting information as to the "status of this matter," medical bills and reports and a copy of plaintiff's insurance declaration sheet to verify his tort threshold. The letter closed by advising counsel to contact the claims representative if he "wish[ed] to discuss any aspect of this claim." In response thereto, on February 8, 1999, plaintiff's counsel sent NJM copies of medical treatment records. Three months later, NJM scheduled plaintiff to be examined by its own physician.

By letter dated August 6, 1999, NJM directed plaintiff's counsel to notify plaintiff's employer "with regard to the above noted claim" and requested a copy of the employer's workers' compensation policy. On September 14, 1999, plaintiff underwent the physical examination arranged by NJM for the purpose of ascertaining the extent of his injuries and the progress he had made in treatment. Despite numerous demands, NJM refused to provide plaintiff's counsel with copies of the report of the physical examination. In response, plaintiff's counsel sent NJM a letter dated April 3, 2000, which included the following passage:

New Jersey Manufacturers had my client examined by Dr. Bosniak for his UM claim. Under Rincon v. Delapaz, 279 N.J.Super. 682, 653 A.2d 1205 (App. Div.1995), I am entitled to a copy of Dr. Bosniak's report. Your refusal to provide a copy is baseless.
I will object to any attempted use of Dr. Bosniak's report at arbitration or at trial, if necessary. My client will not submit to any further medical examinations for this UM claim.

NJM responded by letter dated April 13, 2000, standing by its position.

The next piece of correspondence between the parties is a letter from plaintiff's counsel to NJM dated January 15, 2001, transmitting a medical report. Two other letters from counsel followed on March 1, 2001 and April 5, 2001 enclosing plaintiff's employment records relative to the 1995 accident, medical treatment records, a workers' compensation lien letter from plaintiff's employer and a medical authorization form signed by plaintiff.

The last correspondence sent by NJM to plaintiff's counsel was dated August 21, 2001, just nine days from the six-year anniversary of the accident. The letter began by thanking counsel for his past cooperation, and requested the following additional documentation: (1) plaintiff's workers' compensation file; (2) plaintiff's employer's "policy language regarding their UM limits and exposure to this loss"; and (3) original MRI films dated December 20, 1996, February 12, 1998 and November 20, 1998.

*621 Plaintiff's counsel sent NJM the requested documentation via letter dated September 20, 2001. Contrary to its practice in this case, NJM did not acknowledge receipt of this letter. In fact, NJM failed to acknowledge or otherwise respond to four more letters sent by plaintiff's counsel after the six-year anniversary of the accident. Specifically:

(1) Letter dated October 1, 2001 enclosing employment related information.
(2) Letter dated March 27, 2002 enclosing additional employment related information.
(3) April 23, 2002 transmitting a copy of medical report from plaintiff's treating physician.

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

Related

Olson v. State Farm Mutual Automobile Insurance Co.
174 P.3d 849 (Colorado Court of Appeals, 2007)
Trinity Church v. Lawson-Bell
925 A.2d 720 (New Jersey Superior Court App Division, 2007)
Price v. New Jersey Manufacturers Insurance
867 A.2d 1181 (Supreme Court of New Jersey, 2005)

Cite This Page — Counsel Stack

Bluebook (online)
846 A.2d 617, 368 N.J. Super. 356, Counsel Stack Legal Research, https://law.counselstack.com/opinion/price-v-new-jersey-mfrs-ins-co-njsuperctappdiv-2004.