A Look at No Fault in 2018



The State of New Jersey adopted a comprehensive system of automobile insurance statutes in 1972 to provide that “persons injured in motor vehicle accidents are compensated promptly” and to insure that there are “financially responsible” persons available to meet those claims. Craig & Pomeroy, New Jersey Auto Insurance Law, Gann. The triple pillars of the system are the Compulsory Insurance Law (which requires liability insurance), the No Fault Act (which requires personal injury protection benefits), and the Uninsured Motorist Act (which requires uninsured and underinsured motorist coverage).

Every year since 1992, I have written an Automobile Injury Supplement for the New Jersey Law Journal entitled “A Look at No Fault.” The primary purpose of this supplement is to review every case, rule, regulation and statute dealing with the verbal threshold, PIP benefits and UM/UIM coverage. In addition, I review other cases that deal with “automobile injuries.”

Since 1988, there have been over 120 published cases that deal with some aspect of the verbal threshold. These cases are listed in chronological order by subject matter in the Verbal Threshold Citator included in this supplement.

This year, there were no new cases dealing with the verbal threshold. There were two cases dealing with UM/UIM benefits, Krzykalski (apportionment of fault) and Ferrante (notice to UIM carrier), and one case dealing with PIP benefits, State Farm/Hereford (in-person arbitration).

In addition, I have reviewed three cases that are relevant to “automobile injuries”: Rice (pedestrian crossings), Auttika Taing (deployment of airbags) and Abdurraheem (correlation between property damage and personal injuries).

Finally, I have prepared a separate article dealing with Evidence Rule 703: “The Admissibility of the Reports of Non-Testifying Experts.”

Underinsured Motorist Coverage: Notice to UIM Carrier



The New Jersey insurance statutes require insurance carriers to offer motor vehicle policies that include, at the option of the insured, underinsured motorist coverage (UIM) up to the liability limits of the policy but not to exceed $250/500,000 split limits or $500,000 single limit. A motor vehicle is “underinsured” when the liability limits of the defendant (the person against whom the claim is made) are less than the UIM limits of the plaintiff (the person who brings the claim).

While the obligation to provide UIM coverage is statutory, the relationship between the UIM carrier and the policyholder is contractual. The standard policy requires the policyholder to notify the UIM carrier promptly if any “legal papers” are filed against the tortfeasor, and to notify the UIM carrier in writing of any “tentative settlement” with the tortfeasor. The purpose of these notices is to preserve the subrogation rights of the UIM carrier against the tortfeasor (which would be extinguished if the claimant executed a general release to the tortfeasor).

The courts have long labored to protect the rights of both the injured policyholder and the UIM carrier against the insurance coverage and personal assets of the tortfeasor. First, in Longworth v. Van Houten, 223 N.J. Super. 174 (App. Div. 1988), the court noted that an insured has an initial obligation to pursue a liability claim against the tortfeasor before proceeding with a UIM claim against his own carrier. Once a UIM claim is made, the UIM carrier has the right to pursue a subrogation action against any personal assets of the tortfeasor.

In order to protect the subrogation rights of the UIM carrier, the claimant has an obligation to advise the UIM carrier of “an acceptable settlement offer” and to request the carrier’s consent to settle. The UIM carrier has two options: (1) Waive its subrogation rights and consent to the settlement, or (2) pay the amount of the settlement offer to the claimant in exchange for an assignment of the claimant’s right of subrogation against the tortfeasor.

Next, in Rutgers Casualty v. Vassas, 139 N.J. 183 (1995), the court identified three situations when the insured must notify the UIM carrier: (1) when the insured determines that the liability coverage of the tortfeasor is insufficient; (2) when the insured takes legal action against the tortfeasor; and (3) when the insured receives a settlement offer. The court “explicitly ratified” Longworth and held that, after receiving notice of a settlement offer, the UIM carrier could either consent to the settlement (thereby waiving its rights to subrogation) or pay the award (in exchange for the subrogation for the insured’s rights against the tortfeasor).

Finally, in Zirger v. General Accident, 144 N.J. 327 (1996), the court emphasized the duty of insureds to notify their UIM carrier whenever they institute suit against the tortfeasor. The court stated that “there is no flexibility in an insured’s obligation to communicate the lawsuit to the carrier.” Once the UIM carrier has been placed on notice of the lawsuit, they have a right to intervene and will be bound by the result, whether they intervene or not. (The trial court will determine the extent that the UIM carrier will participate in the trial).

In Ferrante v. New Jersey Manufacturers, 232 N.J. 460 (2018), the court considered whether the plaintiff’s failure to notify his UIM carrier that he had filed suit and litigated his liability claim against a tortfeasor would extinguish his UIM claim. The plaintiff, Robert Ferrante, was injured in an automobile accident. He filed a negligence lawsuit against the tortfeasor (who had a policy limit of $100,000); participated in mandatory arbitration (which set damages at $90,000); rejected the arbitration award and requested a trial de novo; rejected a $50,000 settlement offer; entered into a high-low agreement between $25 - $100,000; participated in a jury trial (which awarded damages of $200,000); and entered a judgment for $100,000 (the “high” of the high-low agreement and the tortfeasor’s policy limit).

The plaintiff, Ferrante, was insured by the defendant, NJM, with UIM limits of $300,000. He never notified NJM of any of the elements of the liability claim against the tortfeasor. However, after the entry of judgment, he filed a UIM claim against NJM. During pretrial discovery, NJM learned for the first time of the plaintiff’s “past dealings” with the tortfeasor.

NJM filed a motion to dismiss the complaint because the plaintiff failed to provide any notification of the underlying litigation against the tortfeasor. The trial court granted the motion; however, the Appellate Division reversed (with dissent) and remanded to determine if NJM sustained any prejudice.

The Supreme Court reversed the Appellate Division and reinstated the order of the trial court dismissing the complaint. The court found that Ferrante “violated” his duty to inform NJM that he had initiated a lawsuit, received an arbitration award, entered into a high-low agreement and participated in a full jury trial.

Thus, Ferrante “improperly extinguished” NJM’s right of subrogation. If properly notified, NJM could have paid the settlement offer to the insured and then tried the case “as if in the insured’s shoes.” At a minimum, NJM could have intervened in the underlying negligence action and participated in the trial “to whatever extent the trial court allows.” Accordingly, Ferrante’s action “vitiated” his ability to receive UIM benefits from NJM.

Commentary: While the result in this case is based upon a contractual and common law duty to inform, the Supreme Court emphasized “the importance of candor by insureds and the obligation to act in a forthright, open, and honest manner with their carriers throughout the entire process of their claim.”

NJM suggested that the plaintiff “strategically opted” not to send the notice. Ferrante admitted that the Longworth notice was “defective” but claims that the failure was due to “negligence,” not the intent to “deceive.” The court held that Ferrante’s “state of mind” was not relevant and simply concluded that “we seek to avoid rewarding insureds for omitting key details in a UIM claim.”

There are no statistics available to determine the number of UIM claims; however, from my own experience, about 30 percent of all automobile liability cases are accompanied by a UIM claim. That’s a lot of cases. In addition, most UIM claims are for higher limits of coverage: $100,000 to $500,000. That’s a lot of money.

There are no simple UIM cases. At the outset, the plaintiff’s lawyer must determine the existence of all UIM policies that may be “available” to the plaintiff including the personal automobile and personal catastrophe umbrella covering the plaintiff, the host vehicle and in some cases, the plaintiff’s resident relatives. Then, the plaintiff’s lawyer must determine the existence of all liability policies including any personal automobile and personal catastrophe umbrellas that provide coverage to the defendant, the owner of the host vehicle and, in some cases, the defendant’s resident relatives.

In some cases, the defendant’s liability adjuster will advise the plaintiff’s lawyer as to the amount of the policy limit. If not, the plaintiff cannot get the information until suit has been filed and the plaintiff serves a Demand for Insurance Information.

The lesson learned from Ferrante is that the plaintiff must notify the UIM carrier as soon as there is any indication that the tortfeasor may be underinsured, whether suit has been instituted or not. If suit has already been instituted, then the plaintiff must immediately send a copy of the complaint to the UIM carrier. If suit has not already been instituted, then the plaintiff must send a copy of the complaint to the UIM carrier as soon as it has been filed.

As the Supreme Court said in Ferrante, “there is no flexibility in an insured’s obligation to communicate the lawsuit to the carrier.” The failure to do so will interfere with the UIM carrier’s right of subrogation and will “vitiate” the insured’s ability to seek UIM benefits.

There are some differences of opinion as to how to serve notice upon the UIM carrier. In Zirger, the court suggests that the plaintiff serve a Notice of Intervention. The UIM carrier can then elect to intervene in the underlying litigation or not. Some attorneys prefer to name the UIM carrier as a defendant in the same complaint that is filed against the tortfeasor. This procedure will force the UIM carrier to file an answer.