Plaintiffs to be Given Priority Over PIP Carriers Under Proposed Bill

On December 13, 2010, the NJ Assembly voted 75 to 0 to approve legislation granting plaintiffs priority over PIP carriers seeking reimbursement for PIP benefits against a tortfeasor’s insurance policy (the Senate passed its version of this bill 37 to 0 on October 18, 2010). This bill was proposed to reverse the New Jersey Supreme Court’s decision in Fernandez v. Nationwide Mutual First Insurance Company, 199 NJ 591 (2009), which found that an injured plaintiff does not have priority to the insurance proceeds of a tortfeasor when a carrier seeks to be reimbursed for PIP benefits it had paid out to that plaintiff.

The Fernandez matter involved a tractor trailer striking Mr. Fernandez and causing significant injuries. Fernandez received $250,000 in PIP benefits under his automobile policy issued by Nationwide. In April 2004, Fernandez sued the trucking company, which was insured by Proformance Insurance Company. In July 2004, Nationwide filed a subrogation claim through arbitration against Proformance seeking reimbursement of the $250,000 in PIP benefits paid to Fernandez. Subsequently, Fernandez settled with Proformance for his personal injuries for $1,000,000. However, Proformance paid Fernandez only $750,000 and deposited $250,000 in court pending the outcome of the PIP arbitration filed by Nationwide.

Fernandez objected to Proformance depositing the $250,000 into court and filed an action seeking the release of those funds to him in fulfillment of his settlement agreement. The trial court found that Fernandez had priority to the Proformance policy and Nationwide was only allowed to recover that amount still available under the Proformance policy (if any) after Fernandez’ recovery. The Appellate Division reversed the trial court and found that Nationwide should be reimbursed for those PIP benefits paid even if Fernandez did not receive his total settlement. Ultimately the Supreme Court upheld the Appellate Division’s decision and found that an injured individual did not have priority to a tortfeasor’s policy of insurance.

The bill passed by the Assembly and Senate amends the existing PIP statute regarding reimbursement to provide:

Any recovery by an insurer, health maintenance organization or governmental agency…shall be subject to any claim against the insured tortfeasor’s insurer by the injured party and shall be paid only after satisfaction of that claim, up to the limits of the insured tortfeasor’s motor vehicle or other liability policy.

The bill now goes to Governor Christie for his consideration.

— Erik Anderson, Esq.

Reardon Anderson represents the interests of businesses, insurance companies and individuals throughout New Jersey and the metropolitan New York City area. Please visit our website at http://reardonanderson.com to learn more about our firm.

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