Westchester Fire Insurance v. Nesbitt

86 A.D.2d 23, 449 N.Y.S.2d 102, 1982 N.Y. App. Div. LEXIS 14996

This text of 86 A.D.2d 23 (Westchester Fire Insurance v. Nesbitt) is published on Counsel Stack Legal Research, covering Appellate Division of the Supreme Court of the State of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Westchester Fire Insurance v. Nesbitt, 86 A.D.2d 23, 449 N.Y.S.2d 102, 1982 N.Y. App. Div. LEXIS 14996 (N.Y. Ct. App. 1982).

Opinion

[24]*24OPINION OF THE COURT

Schnepp, J.

Plaintiff is the insurer of the owner of an automobile which, while being operated by one Caplick in his garage business, struck and injured a ped.estrian. Caplick had a garageman’s policy of liability insurance and his insurer settled the pedestrian’s personal injury action. Plaintiff, which has paid first-party no-fa;ult benefits to the pedestrian, seeks to impose a lien on the settlement under subdivision 2 of section 673 of the Insurance Law contending that Caplick is a “noncovered” person. We reject this contention and hold that plaintiff has no basis for reimbursement because Caplick is a “covered person” under the New York State No-Fault Law (Insurance Law, art 18, Comprehensive Automobile Insurance Reparations Act).

The underlying facts are undisputed. On November 18, 1976 the defendant, James C. Nesbitt, a pedestrian, sustained serious injuries including the loss of a limb when he was struck by an automobile owned by Leopold Gallo and operated by Joseph Caplick in connection with Caplick’s automobile repair business. Gallo had an owner’s policy of automobile liability insurance issued by the plaintiff Westchester Fire Insurance Company which contained a no-fault indorsement (see Insurance Law, § 672, subd 1). This policy excluded, liability coverage when the automobile was vised by “any person * * * engaged in the automobile business”. Caplick was insured by the defendant Fireman’s Fund Insurance Companies under a garageman’s liability policy which did not provide no-fault coverage. Since the accident Westchester has paid first-party benefits to Nesbitt in excess of $27,000 (see Insurance Law, § 672, subd 1, par [a]).

On January 6, 1977 Nesbitt commenced a personal injury action against both Gallo and Caplick and alleged in his complaint that he had “sustained a serious injury as defined in the Insurance Law of the State of New York, and economic loss greater than the basic economic loss as de;fined in said Insurance Law; and that, among other injuries, the plaintiff sustained loss of limb, as well as [25]*25medical expenses far in excess of the sum of $500.00”.1 Westchester defended Gallo in this action which was settled and discontinued by stipulation on January 12, 1979 upon payment by Fireman’s to Nesbitt of the sum of $135,000. Nesbitt’s general release to Caplick and Gallo contained the following provisions:

“This release shall not affect the right of any No Fault carrier for reimbursement pursuant to the New York State Insurance Law.
“This release shall not affect the rights of james c. nesbitt to continuing or additional No Fault benefits in accordance with provisions of the New York State Insurance Law.
“This release is for non-economic loss only, pursuant to Article 18 of the Insurance Law of the State of New York.”

On March 12,1980 Westchester commenced this present action against Nesbitt and Fireman’s alleging that Caplick is a “noncovered person”, that Nesbitt’s action against Caplick was by a “covered person” against a “noncovered person”, and that, by reason of subdivision 2 of section 673 of the Insurance Law, Westchester has a lien against the settlement proceeds to the extent of the first-party benefits it paid to Nesbitt. Each party moved for summary judgment. Westchester contended that the defendants cannot defeat its lien by providing in their release that the settlement is for “non-economic loss only”, and that Nesbitt cannot sever his “non-economic loss” and “economic loss” claims against Caplick and then settle his “non-economic loss” claim in order to defeat Westchester’s lien. The defendants asserted that Caplick is a “covered person” like Nesbitt and that, accordingly, Westchester has no statutory lien.

Special Term found that Caplick is a “covered person” because he “was operating an auto which was covered by an insurance policy which provided no-fault protection to anyone injured as a result of an accident with said auto” and that Nesbitt cannot be compelled to pay the no-fault [26]*26benefits that he received out of his settlement for “non-economic loss”.

The Legislature has defined the meaning of a “covered person” and the rights of no-fault insurers which may arise upon the payment of first-party benefits. A “covered person” is defined to include any pedestrian injured through the operation of, or any operator of, a motor vehicle which has in effect the required financial security (Insurance Law, § 671, subd 10). In an action by a “covered person” against a “noncovered person”, where damages for personal injuries arising out of the operation of a motor vehicle may be recovered, an insurer which has paid first-party benefits has a lien against any recovery to the extent of the benefits paid by it to the “covered person” (Insurance Law, § 673, subd 2). The parties agree that Nesbitt is a “covered person” because he was a pedestrian injured by the operation of a motor vehicle which had the statutorily required insurance coverage. The status of Caplick as a “covered” or “noncovered” person, however, is a source of disagreement between the parties.

Fireman’s and Nesbitt argue that Caplick, as the operator of a motor vehicle which had the required financial security, is a “covered person” as that term is statutorily defined. Westchester concedes that Caplick fits the statutory definition of a “covered person”, but contends that the courts have recognized a definition of “noncovered person” which is applicable to Caplick. It argues that a person who is entitled to receive no-fault benefits but is not required to provide no-fault coverage is a “noncovered person” within the meaning of the term as it is used in the statutory lien provision.

The source of Westchester’s argument is the line of so-called “motorcycle cases”. In Montgomery v Daniels (38 NY2d 41, 62) the Court of Appeals stated that “[njoncovered persons under article 18 include: (1) an owner, operator or passenger on a motorcycle (§ 671, subd 6, par [b])”. Nonetheless, in Perkins v Merchants Mut. Ins. Co. (41 NY2d 394) the court held that motorcyclists are eligible for no-fault benefits.2 This seeming contradiction was ex [27]*27plained by the court in Perkins this way: “For the purposes of article XVIII those involved in automobile accidents may be regarded as falling in to either or both of two classifications. One consists of those required to provide ‘no-fault’ coverage from which benefits are to be paid. The other is made up of those who, as a result of sustaining recoverable losses, are persons to whom those benefits are to be paid. As already indicated, membership in one group is not necessarily dependent on membership in the other. Nor are they mutually exclusive”. (Perkins v Merchants Mut. Ins. Co., supra, p 396; see, also, Matter of New York City Tr. Auth. v Smith, 52 AD2d 624.) Thereafter, in United States Fid. & Guar. Co. v Stuyvesant Ins. Co. (61 AD2d 1122) we held that although a motorcyclist is entitled to receive no-fault benefits, he is a “noncovered person” for the purpose of the statutory lien provision of subdivision 2 of section 673 of the Insurance Law because he is not required to provide no-fault coverage for his motorcycle (see, also, Bond v Hitchcock, 71 AD2d 1052; Matter of Ackerman [Forbes], 66 AD2d 1027).

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Related

Slochower v. Board of Higher Ed. of New York City
350 U.S. 551 (Supreme Court, 1956)
Perkins v. Merchants Mutual Insurance
361 N.E.2d 997 (New York Court of Appeals, 1977)
Daniman v. Board of Education
119 N.E.2d 373 (New York Court of Appeals, 1954)
Montgomery v. Daniels
340 N.E.2d 444 (New York Court of Appeals, 1975)
New York City Transit Authority v. Smith
52 A.D.2d 624 (Appellate Division of the Supreme Court of New York, 1976)
United States Fidelity & Guaranty Co. v. Stuyvesant Insurance
61 A.D.2d 1122 (Appellate Division of the Supreme Court of New York, 1978)
Bond v. Hitchcock
71 A.D.2d 1052 (Appellate Division of the Supreme Court of New York, 1979)

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86 A.D.2d 23, 449 N.Y.S.2d 102, 1982 N.Y. App. Div. LEXIS 14996, Counsel Stack Legal Research, https://law.counselstack.com/opinion/westchester-fire-insurance-v-nesbitt-nyappdiv-1982.