Schaefer v. Allstate NJ Ins. Co.

870 A.2d 745, 376 N.J. Super. 475
CourtNew Jersey Superior Court Appellate Division
DecidedApril 15, 2005
StatusPublished
Cited by5 cases

This text of 870 A.2d 745 (Schaefer v. Allstate NJ 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
Schaefer v. Allstate NJ Ins. Co., 870 A.2d 745, 376 N.J. Super. 475 (N.J. Ct. App. 2005).

Opinion

870 A.2d 745 (2005)
376 N.J. Super. 475

Charlotte SCHAEFER, Plaintiff-Respondent,
v.
ALLSTATE NEW JERSEY INSURANCE COMPANY, Defendant-Respondent, and
U.S. Fidelity & Guaranty Co., Defendant-Appellant.
Cynthia Lee, Plaintiff-Respondent,
v.
U.S. Fidelity & Guaranty Co., Defendant-Appellant, and
Liberty Mutual Fire Insurance Co., Defendant-Respondent.
Denise Sottilare, Plaintiff-Respondent/Cross-Appellant,
v.
Olympia Trails Bus Company, Olympia Trails, Inc., Coach USA and Sedgwick CMS, Defendants, and
USF&G, Defendant-Appellant/Cross-Respondent, and
Liberty Mutual Insurance Company, Defendant-Respondent.

Superior Court of New Jersey, Appellate Division.

Argued March 15, 2005.
Decided April 15, 2005.

*747 Michael K. Tuzzio, argued the cause for appellant U.S. Fidelity and Guaranty Co. in A-5757-03T1 and A-6668-03T5 and appellant-cross-respondent U.S. Fidelity and Guaranty Co. in A-4478-03T3 (Ronan, Tuzzio & Giannone, attorneys; Mr. Tuzzio, of counsel, Tinton Falls and on the brief and Kenneth R. Ebner, Jr., on the brief, Bothwyn, PA).

Vincent Jesuele, Westfield, argued the cause for respondent Charlotte Schaefer in A-5757-03T1 (Kessler, DiGiovanni, & Jesuele, attorneys; Frank DiGiovanni, on the brief).

David J. Dickinson, Millburn, argued the cause for respondent Allstate New Jersey Insurance Company in A-5757-03T1 (McDermott & McGee, attorneys; Mr. Dickinson, of counsel; Lindsay K. O'Shaughnessy, on the brief).

Richard W. Gaeckle, New Brunswick, argued the cause for respondent-cross-appellant Denise Sottilare in A-4478-03T3 (Hoagland, Longo, Moran, Dunst & Doukas, attorneys; Douglas M. Fasciale, of counsel; Mr. Gaeckle, on the brief).

Robert P. Clark, Sea Girt, argued the cause for respondent Liberty Mutual Insurance Company in A-4478-03T3 (Clark & DiStefano, attorneys; Mr. Clark, on the brief).

Amanda M. Dowd, argued the cause for respondent Liberty Mutual Fire Insurance Company in A-6668-03T5 (Sherman & Viscomi, attorneys; Ms. Dowd, on the brief).

Respondent Cynthia Lee in A-6668-03T5, did not file a brief.

Before Judges SKILLMAN, GRALL and GILROY.

The opinion of the court was delivered by

SKILLMAN, P.J.A.D.

The common issue presented by these appeals is whether the medical expense benefits an insurer of a bus company is required to provide a person who is injured while a passenger on a bus must be paid by an automobile insurer that provides personal injury protection coverage to the injured passenger. We conclude that the insurer of the bus company remains solely responsible for the payment of medical expense benefits even though the injured bus passenger is insured under an automobile policy that provides personal injury protection benefits.

Plaintiffs suffered personal injuries in accidents that occurred while they were passengers on buses insured by defendant United States Fidelity & Guaranty Co. (USF&G). Sottilare fell as she was getting off a bus; Schaefer slipped and fell in a bus bathroom; and Lee was injured when the bus in which she was riding was involved in an accident.

*748 At the time of their accidents, plaintiffs were all named insureds under personal automobile insurance policies that provided personal injury protection (PIP) benefits, as required by N.J.S.A. 39:6A-4. The policies that USF&G issued to the owners of the buses in which plaintiffs suffered their accidents provided motor bus passenger medical expense benefits (MEB) coverage, as required by N.J.S.A. 17:28-1.6.

Plaintiffs incurred medical expenses as a result of their injuries and submitted claims for reimbursement to both USF&G and their own automobile insurance companies. In all three cases, both insurers denied coverage, asserting that plaintiffs' claims were covered by the other insurer's policies.

Consequently, plaintiffs were forced to bring these actions against USF&G and their automobile insurers for declaratory judgments as to which insurer's coverage applied to their claims.[1] The cases were decided by three separate trial courts. Lee's action was brought before the court by an order to show cause. In the other two actions, the parties filed cross-motions for summary judgment.

The trial courts all determined that plaintiffs were entitled to MEB under the policies USF&G issued to the bus companies and that the PIP provisions of plaintiffs' automobile policies did not provide coverage because the accidents did not occur while plaintiffs were occupying, entering into, or alighting from automobiles. In Lee, the trial court also granted plaintiff's application for counsel fees and costs in the amount of $5448, but in Sottilare the court denied plaintiff's application for counsel fees and costs.[2]

In each of the three actions, USF&G filed appeals from the trial courts' declarations that it has an obligation to pay MEB for plaintiffs' medical expenses and that plaintiffs' claims are not covered by their automobile policies. In Sottilare, plaintiff filed a cross-appeal from the court's denial of her application for counsel fees and costs. We consolidate the three appeals.

We affirm the declaratory judgments that USF&G is responsible for the payment of plaintiffs' MEB. We reverse the denial of Sottilare's application for counsel fees and costs.

I

The New Jersey Automobile Reparation Reform Act, N.J.S.A. 39:6A-1 to -35, commonly referred to as the "No Fault Act," requires "every standard automobile liability insurance policy" to provide PIP benefits, which include reimbursement of medical expenses, N.J.S.A. 39:6A-4(a), "to the named insured and members of his family residing in his household who sustain bodily injury as a result of an accident while occupying, entering into, alighting from or using an automobile," N.J.S.A. 39:6A-4. "Automobile" is defined as:

[A] private passenger automobile of a private passenger or station wagon type that is owned or hired and is neither used as a public or livery conveyance for passengers nor rented to others with a driver; and a motor vehicle with a pickup body, a delivery sedan, a van, or a panel truck or a camper type vehicle *749 used for recreational purposes owned by an individual or by husband and wife who are residents of the same household, not customarily used in the occupation, profession or business of the insured other than farming or ranching.
[N.J.S.A. 39:6A-2(a).]

Thus, for the purpose of determining eligibility for PIP benefits under N.J.S.A. 39:6A-4, the term "automobile" does not include a bus.

In 1991, the Legislature enacted N.J.S.A. 17:28-1.6, which provides for the payment of no fault medical expense benefits up to $250,000 "to any passenger who sustained bodily injury as a result of an accident while occupying, entering into or alighting from a motor bus."[3] In the same enactment, the Legislature provided that any bus passenger who brings suit against the owner or operator of a bus for non-economic damages is subject to the same "verbal threshold" that governs actions under the No Fault Act, N.J.S.A. 17:28-1.7.

It is clear on the face of these statutory provisions that a person who is injured while occupying, entering into or alighting from a bus is not entitled to PIP benefits under N.J.S.A. 39:6A-4 because a bus is not included in the definition of an automobile set forth in N.J.S.A.

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Bluebook (online)
870 A.2d 745, 376 N.J. Super. 475, Counsel Stack Legal Research, https://law.counselstack.com/opinion/schaefer-v-allstate-nj-ins-co-njsuperctappdiv-2005.