JOSHUA HAINES VS. JACOB W. TAFT, ET AL/ TUWONA LITTLE VS. JAYNE NISHIMURA
A-5503-14T4/ A-0727-15T2(CONSOLIDATED)
In these automobile negligence actions, plaintiffs were injured in a car accident and incurred more than $15,000 in medical expenses. The PIP coverage in each plaintiff's policy (both plaintiffs had standard automobile policies) was limited to $15,000 per person, per accident. Plaintiffs sought to recover those expenses exceeding $15,000 from the alleged negligent defendants.
Defendants and amici (interest groups which represented the insurance industry) argued various PIP statutes precluded insureds from recovering medical expenses above the PIP limit. Among other things, they contended permitting the recovery of medical expenses above an injured insured's PIP limit will bring back the days when court calendars were clogged with law suits that required a determination of who was at fault for the accident causing a plaintiff's injuries, a result the No-Fault Act intended to eliminate.
Whether an injured insured may recover medical expenses above his or her PIP limits has never been determined by an appellate court, and trial courts have been providing conflicting rulings. After examining the subject statutes, including the legislative history for each, and Supreme Court precedent, we concluded the Legislature intended an insured covered with a standard policy may recover from the tortfeasor medical expenses above the PIP limit in his or her policy, up to $250,000. While certain minor medical expenses, such as copayments and deductibles cannot be recovered, the Legislature did not intend to preclude the recovery of the medical expenses at issue here, which exceeded the $15,000 PIP limit by approximately $10,000 in one and $28,000 in the other matter.
