Zacarias v. Allstate Insurance

775 A.2d 1262, 168 N.J. 590, 2001 N.J. LEXIS 788
CourtSupreme Court of New Jersey
DecidedJuly 3, 2001
StatusPublished
Cited by228 cases

This text of 775 A.2d 1262 (Zacarias v. Allstate Insurance) is published on Counsel Stack Legal Research, covering Supreme Court of New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Zacarias v. Allstate Insurance, 775 A.2d 1262, 168 N.J. 590, 2001 N.J. LEXIS 788 (N.J. 2001).

Opinions

The opinion of the Court was delivered by

VERNIERO, J.

In this declaratory judgment action, plaintiff seeks indemnification from defendant insurer in connection with a suit brought against him by his wife for injuries sustained in a boating accident. Specifically, plaintiff asks that we set aside the intra-family exclusion in his boatowner’s insurance policy. The trial court ruled in favor of the insurer. A divided panel of the Appellate Division likewise denied plaintiff his requested relief, concluding that the exclusion was plainly written and thus valid. We agree and affirm.

I.

Plaintiff owned a boat insured by Allstate Insurance Company (Allstate). Plaintiffs boatowner’s policy consists of eighteen pages, including the table of contents, with two columns of print on each page, in addition to a two-page declarations sheet. The declarations sheet outlines the coverages and limits of liability in dollar amounts as well as the premiums by item. The declarations sheet also indicates that the coverages and limits of liability are “SUBJECT TO THE FOLLOWING FORMS AND ENDORSEMENTS.” There are four such forms and endorsements listed, the first of which is “BOATOWNERS POLICY.”

The boatowner’s policy is written in regular and bold type. On page three, the definitions page, the policy reads, “ ‘Insured person’ — means you and, if a resident of your household: a) any relative; and b) any dependent person in your care.” On page twelve, there is a heading “Losses We Do Not Cover.” On the next page, still under that heading, the policy includes an intrafamily exclusion that reads: “We do not cover bodily injury to an insured person or property damage to property owned by an insured person.”

[594]*594On September 3, 1995, plaintiff was operating his boat with his wife on board. During that trip, plaintiff allegedly operated the boat in a negligent manner and, as a result, his wife suffered injuries. Plaintiff submitted a claim to Allstate on behalf of his wife, but the carrier disclaimed coverage based on the intra-family exclusion in the policy. Thereafter, plaintiffs wife sued plaintiff for her injuries.

Allstate provided a defense for plaintiff under a reservation of rights. Plaintiff then filed this declaratory judgment action against Allstate seeking to void the intra-family exclusion. In the alternative, plaintiff sought to compel the carrier to indemnify him because of the insurer’s alleged failure to inform plaintiff of the exclusion. The underlying injury case and the declaratory action were consolidated. Both parties filed motions for summary judgment. The trial court denied plaintiffs motion and granted defendant’s motion, thereby dismissing plaintiffs action.

With one member of the panel dissenting, the Appellate Division affirmed the trial court’s disposition. Zacarias v. Allstate Ins. Co., 330 N.J.Super. 231, 749 A.2d 394 (App.Div.2000). The majority held that the policy was free of ambiguity and was to be given its “plain and ordinary meaning.” Id. at 234, 749 A.2d 394. The dissenter concluded that the policy should be read to conform to the reasonable expectations of the insured, explaining that plaintiff had purchased insurance with the intention of covering all legally cognizable liability claims arising from the use of his boat. Id. at 236-37, 749 A.2d 394 (Pressler, P.J.A.D., dissenting). Plaintiff filed this appeal as of right. R. 2:2-1 (a).

II.

A.

We give special scrutiny to insurance contracts because of the stark imbalance between insurance companies and insureds in their respective understanding of the terms and conditions of insurance policies. Gibson v. Callaghan, 158 N.J. 662, 669, 730 [595]*595A.2d 1278 (1999). In the first instance, the words of an insurance policy are to be given their plain, ordinary meaning. “In the absence of any ambiguity, courts should not write for the insured a better policy of insurance than the one purchased.” Id. at 670, 730 A.2d 1278 (quotation and citation omitted). However, “[ijnsurance policies are contracts of adhesion and as such, are subject to special rules of interpretation.” Ibid, (citing Longobardi v. Chubb Ins. Co., 121 N.J. 530, 537, 582 A.2d 1257 (1990); Meier v. N.J. Life Ins. Co., 101 N.J. 597, 611-12, 503 A.2d 862 (1986)). When there is ambiguity in an insurance contract, courts interpret the contract to comport with the reasonable expectations of the insured, even if a close reading of the written text reveals a contrary meaning. Id. at 671, 503 A.2d 862. “ ‘The objectively reasonable expectations of applicants and intended beneficiaries regarding the terms of insurance contracts will be honored even though painstaking study of the policy provisions would have negated those expectations.’ ” Sparks v. St. Paul Ins. Co., 100 N.J. 325, 338-39, 495 A.2d 406 (1985) (quoting R. Keeton, Insurance Law 351 (1971); R. Keeton, Insurance Law Rights at Variance with Policy Provisions, 83 Harv. L.Rev. 961, 967 (1970)).

That fundamental rule of interpretation, known as the doctrine of reasonable expectations, has long been a part of our law. This Court invoked the doctrine in Kievit v. Loyal Protective Life Insurance Co., 34 N.J. 475, 170 A.2d 22 (1961). In Kievit, the plaintiff owned an accident insurance policy that covered losses “‘resulting directly and independently of all other causes from accidental bodily injuries,’” but not losses “‘resulting from or contributed to by any disease or ailment.’ ” Id. at 477, 170 A.2d 22. While at work, the plaintiff sustained an injury that activated or caused Parkinson’s disease-like symptoms over his entire body. Id. at 478, 170 A.2d 22. The symptoms completely disabled him. Ibid. The insurer compensated the plaintiff for several months, then stopped payment on the ground that a pre-existing disease or ailment was contributing to his losses. Ibid.

[596]*596The Court held that a pre-existing, dormant condition was not a disqualifier under the terms of the contract. Id. at 490-91, 170 A.2d 22. The Court reasoned that the distinction between accidental injuries that cause disability on their own and accidental injuries that trigger pre-existing ailments was too fine for a layperson to anticipate in advance of purchasing an insurance policy.

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Bluebook (online)
775 A.2d 1262, 168 N.J. 590, 2001 N.J. LEXIS 788, Counsel Stack Legal Research, https://law.counselstack.com/opinion/zacarias-v-allstate-insurance-nj-2001.