Citizens United Reciprocal Exchange v. Northern Nj ( 2016 )

NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-0945-14T2
CITIZENS UNITED RECIPROCAL EXCHANGE,
Plaintiff-Appellant, APPROVED FOR PUBLICATION
May 6, 2016
v.
APPELLATE DIVISION
NORTHERN NJ ORTHOPEDIC SPECIALISTS,
Defendant-Respondent.
__________________________________________
Argued December 8, 2015 – Decided May 6, 2016
Before Judges Hoffman, Leone and Whipple.1
On appeal from the Superior Court of New
Jersey, Law Division, Passaic County, Docket
No. L-2901-14.
Sonya Lopez-Bright argued the cause for
appellant (Bright & Sponder, attorneys; Evan
D. Haggerty, of counsel and on the briefs).
Kimberly A. Kopp argued the cause for
respondent (Massood & Bronsnick, LLC,
attorneys; Michael T. Madaio, of counsel and
on the brief).
The opinion of the court was delivered by
LEONE, J.A.D.
Plaintiff Citizens United Reciprocal Exchange (CURE)
appeals from the Law Division's September 11, 2014 order,
1
Judge Whipple did not participate in oral argument. She joins
the opinion with counsel's consent. R. 2:13-2(b).
dismissing as untimely CURE's summary action challenging a
personal injury protection (PIP) arbitration award. We hold
that if a party files an application to modify under N.J.S.A.
2A:23A-12(d), or an application to modify or clarify under the
rules of the PIP dispute resolution organization, a party must
file any summary action "within 30 days after receipt of" the
order granting or denying the application. N.J.S.A. 2A:23A-
13(a). Accordingly, we affirm.
I.
The following facts are taken from the documents filed
before the Law Division and the Dispute Resolution Professional
(DRP).2 In 2009, a passenger in a vehicle insured by CURE
sustained personal injuries in an accident. Defendant Northern
NJ Orthopedic Specialists (Orthopedic) performed spinal surgery
on the passenger in 2011. Orthopedic submitted a bill for
$89,266 to CURE, which initially denied the claim.
Orthopedic made a demand for PIP arbitration to be
conducted by Forthright Solutions (Forthright). Orthopedic
claimed PIP benefits of $55,410.29. On April 8, 2013, the
2
"Dispute Resolution Professional" is the title for the
arbitrator used in the PIP arbitration statute, N.J.S.A. 39:6A-
5.1, and the PIP arbitration regulations, N.J.A.C. 11:3-5.1 to -
5.12. See, e.g., N.J.A.C. 11:3-5.2. In N.J.S.A. 2A:23A-13(a),
the arbitrator is referred to as an "umpire." We use both terms
to encompass the DRP here.
2 A-0945-14T2
Forthright DRP granted Orthopedic $16,433.05, together with
counsel fees, costs, and interest.
Orthopedic filed a summary action in the Law Division. The
court entered a consent judgment vacating the award and
remanding to Forthright, pursuant to N.J.S.A. 2A:23A-13(c)(5),
so the DRP could consider certain evidence.
After a second hearing, the DRP awarded Orthopedic
$31,939.99, plus additional counsel fees. The new award was
sent to the parties by Forthright's letter dated March 31, 2014.
Thirty-five days later, on May 5, 2014, CURE made an
application for "clarification/modification," asking Forthright
for "clarification" of the award "pursuant to Forthright Rule
24(a)." Forthright Rule 24 is entitled "Modification/
Clarification of Award." Rule 24(a) provides that a party may
submit a request to "clarify the Award." The rule further
provides that: "[a]ny party may make the request by written
application . . . received by Forthright within 35 days after
the date of Forthright's letter sending the Award to the
parties"; "[a]ll other parties may submit a response to the
request . . . within 45 days after the date of Forthright's
letter sending the Award to the parties"; and "[t]he DRP shall
3 A-0945-14T2
issue an Order within 35 days of Forthright's submission [of the
request and any responses] to the DRP."3
The DRP denied CURE's application for clarification,
finding the issues were "sufficiently addressed." Both the
DRP's "Clarification Denied Order," and Forthright's letter
sending it to the parties, were dated June 20, 2014. Forty-five
days later, on August 4, 2014, CURE filed in the Law Division a
complaint and a request for an order to show cause, asking that
the DRP's award be vacated under N.J.S.A. 2A:23A-13.
On September 11, 2014, Judge Thomas F. Brogan ruled that
"N.J.S.A. 2A:23A-13(a) required [CURE] to file the Order to Show
Cause and complaint within 30 days of the date [CURE] received
the Modification/Clarification Denied Order instead of within 45
days of the date [CURE] received the Modification/Clarification
Denied Order." Because CURE filed beyond thirty days, the court
dismissed CURE's filings with prejudice. CURE filed an appeal
to this court.
3
Forthright, New Jersey No-Fault PIP Arbitration Rules, at 14-15
(eff. April 15, 2013), http://www.nj-no-
fault.com/users/nj/resources/NJ%20PIP%20Arbitration%20Rules%20-
%20Amended%20April%2015%20%202013.pdf. Forthright Rule 25 also
allows the parties to "appeal an Award or an Order granting
dismissal to a panel of 3 designated DRPs." Id. at 15. Because
no such appeal was taken here, Forthright Rule 25 is not before
us.
4 A-0945-14T2
II.
Orthopedic contends CURE is barred from appealing to this
court by the Alternative Procedure for Dispute Resolution Act
(APDRA), N.J.S.A. 2A:23A-1 to -19. Under the APDRA, a party to
the arbitration may "commence a summary application in the
Superior Court for its vacation, modification or correction."
N.J.S.A. 2A:23A-13(a). "Upon the granting of an order
confirming, modifying or correcting an award, a judgment or
decree shall be entered by the [trial] court[.]" N.J.S.A.
2A:23A-18(b). N.J.S.A. 2A:23A-18(b) then provides: "There shall
be no further appeal or review of the judgment or decree."
Our Supreme Court upheld N.J.S.A. 2A:23A-18(b) in Mt. Hope
Dev. Assocs. v. Mt. Hope Waterpower Project, L.P., 154 N.J. 141,
148-52 (1998). The Court ruled that "the language of APDRA
unmistakably informs parties that by utilizing its procedures
they are waiving [their] right" to appeal beyond the trial
court, and that such a waiver generally must be enforced. Id.
at 148. However, the Court recognized there may be "'rare
circumstances' grounded in public policy that might compel . . .
limited appellate review." Id. at 152.
We have held that N.J.S.A. 2A:23A-18(b) "does not bar our
review of . . . the judge's dismissal of the action on
timeliness grounds." Liberty Mut. Ins. Co. v. Garden State
5 A-0945-14T2
Surgical Ctr., L.L.C., 413 N.J. Super. 513, 517 (App. Div.
2010). Thus, we have the "authority to examine . . . the order
dismissing the complaint as untimely." Id. at 521-24 (reversing
the Law Division's dismissal "insofar as it was based on the
time-bar contained in N.J.S.A. 2A:23A-13(a)").
Such review is particularly appropriate here because "[t]he
unsettled questions of statutory interpretation" here have "yet
to be resolved in a published opinion," and "[t]he repeat
players in the PIP system — claimants, insurers, DRPs, lawyers,
and trial judges — all can benefit from definitive precedential
guidance." Kimba Med. Supply v. Allstate Ins. Co., 431 N.J.
Super. 463, 482-83 (App. Div. 2013), certif. granted, 217 N.J.
286, certif. dism'd as improvidently granted, 223 N.J. 347
(2014). Accordingly, we address and resolve the statutory
timeliness issues raised by CURE's appeal.
III.
Under the PIP arbitration statute, N.J.S.A. 39:6A-5.1,
"'[d]isputes between an insurer and a claimant as to whether
benefits are due under the PIP [arbitration] statute may be
resolved, at the election of either party, by binding
arbitration or by civil litigation.'" Kimba Med. Supply, supra,
431 N.J. Super. at 467 (citation omitted). "The Legislature has
empowered the Commissioner of Banking and Insurance to designate
6 A-0945-14T2
an organization to serve as an arbitration forum for such PIP
disputes, where the parties have elected that procedure." Id.
at 467-68 (citing N.J.S.A. 39:6A-5.1(b)); see also N.J.A.C.
11:3-5.3(a). "The organization that presently serves in that
capacity is Forthright[.]" Kimba Med. Supply, supra, 431 N.J.
Super. at 468.
"The Legislature has further authorized the Commissioner to
adopt rules and regulations for the conduct of such PIP
arbitration proceedings." Ibid. (citing N.J.S.A. 39:6A-5.1(b)).
"The Commissioner has duly adopted such regulations, which are
codified at N.J.A.C. 11:3-5.1 to -5.12." Ibid. "[T]he
Commissioner has incorporated aspects of the APDRA to govern PIP
arbitrations in the designated forum." Ibid. In particular,
effective January 2013, N.J.A.C. 11:3-5.6(g) provides:
The final determination of the dispute
resolution professional shall be binding
upon the parties, but subject to
clarification/modification and/or appeal as
provided by the rules of the dispute
resolution organization, and/or vacation,
modification or correction by the Superior
Court in an action filed pursuant to
N.J.S.A. 2A:23A-13 for review of the award.
N.J.S.A. 2A:23A-13(a), the key provision here, provides:
A party to an alternative resolution
proceeding shall commence a summary
application in the Superior Court for its
vacation, modification or correction within
45 days after the award is delivered to the
applicant, or within 30 days after receipt
7 A-0945-14T2
of an award modified pursuant to subsection
d. of section 12 of this act,[4] unless the
parties shall extend the time in writing.
The award of the umpire shall become final
unless the action is commenced as required
by this subsection.
[(emphasis and footnote added).]
Thus, under N.J.S.A. 2A:23A-13(a), "[a]fter the award is
delivered by the umpire, the parties have forty-five days
(thirty days if the award is modified) to commence a summary
action in the Chancery Division of the Superior Court to vacate,
correct, or modify the award." Mt. Hope Dev. Assocs., supra,
154 N.J. at 146.5 However, CURE's appeal raises two unsettled
issues in the statutory construction of N.J.S.A. 2A:23A-13(a).
First, N.J.S.A. 2A:23A-13(a) "does not reveal the amount of
time a party has to challenge an award when an application to
modify has been denied." Liberty Mut. Ins. Co., supra, 413 N.J.
Super. at 523. Second, N.J.S.A. 2A:23A-13(a) does not reveal
4
Subsection 12(d) provides that, "[o]n written application of a
party to the umpire within 20 days after delivery of the award
to the applicant, the umpire may modify the award upon the
grounds stated in subsection e. of section 13 of this act."
N.J.S.A. 2A:23A-12(d); see also N.J.S.A. 2A:23A-13(e).
5
When Mount Hope was decided, N.J.S.A. 2A:23A-19 provided that
such summary actions "shall be heard in the Chancery Division."
L. 1987 c. 54, § 19. That requirement was later removed when
N.J.S.A. 2A:23A-19 was amended to provide that such summary
actions "shall be heard in accordance with any rules adopted by
the New Jersey Supreme Court." L. 2005 c. 338 § 1. Pursuant to
the Rules of Court, the parties here filed in the Law Division.
See R. 4:3-1(a).
8 A-0945-14T2
the amount of time a party has to challenge an award when the
application to modify is made not pursuant to N.J.S.A. 2A:23A-
12(d), but pursuant to the rules adopted by the organization.
"It is well settled that the goal of statutory
interpretation is to ascertain and effectuate the Legislature's
intent." Cashin v. Bello, 223 N.J. 328, 335 (2015). "'In most
instances, the best indicator of that intent is the plain
language chosen by the Legislature.'" Ibid. (citation omitted).
We "must read words 'with[in] their context' and give them
'their generally accepted meaning.'" Ibid. (quoting N.J.S.A.
1:1-1). "Statutory language is to be interpreted 'in a common
sense manner to accomplish the legislative purpose.'" State v.
Olivero, 221 N.J. 632, 639 (2015) (quoting N.E.R.I. Corp. v.
N.J. Highway Auth., 147 N.J. 223, 236 (1996)). "When a statute
is ambiguous as written, however, a court may consider extrinsic
sources, including 'legislative history, committee reports, and
contemporaneous construction.'" Cashin, supra, 223 N.J. at 335-
36.
"As with all issues of statutory construction, our review
in this matter is de novo." Id. at 335. We must hew to that
standard of review.
9 A-0945-14T2
A.
The first unsettled issue concerns the applicable time
period under N.J.S.A. 2A:23A-13(a) after the denial of an
application to modify an award under N.J.S.A. 2A:23A-12(d) (a
"12(d) application"). N.J.S.A. 2A:23A-13(a) clearly addresses
two scenarios. First, if no party files a 12(d) application, a
party must file a summary action challenging the award "within
45 days after the award is delivered to the applicant." Ibid.
Second, if a party files a 12(d) application, and the umpire
issues a modified award, a party must file a summary action
challenging the modified award "within 30 days after receipt of
an award modified pursuant to [N.J.S.A. 2A:23A-12(d)]." Ibid.
However, N.J.S.A. 2A:23A-13(a) does not address the third
scenario where a party files a 12(d) application, and the umpire
issues an order denying modification of the award.
CURE argues that N.J.S.A. 2A:23A-13(a) allowed it to file
its summary action within forty-five days of its receipt of the
DRP's Clarification Denied Order, but that order is not "the
award." Ibid. Orthopedics argues that N.J.S.A. 2A:23A-13(a)
required CURE to file its summary action within thirty days of
its receipt of the Clarification Denied Order, but that order is
10 A-0945-14T2
not "an award modified pursuant to [N.J.S.A. 2A:23A-12(d)]."
Ibid.6
We find N.J.S.A. 2A:23A-13(a) to be ambiguous regarding the
time to commence a summary action in the third scenario where
the umpire issues an order denying modification of the award.
Unfortunately, the legislative history of N.J.S.A. 2A:23A-13
does not directly address that issue. "The Draftsman's
Legislative History, reprinted at N.J.S.A. 2A:23A-13,
specifically notes that subsection 13(a) of the APDRA was
derived from N.J.S.A. 2A:24-7 to -8, N.Y.C.P.L.R. § 7511, and 7
U.L.A. § 12(b)" of the Uniform Arbitration Act (1956). Kimba
Med. Supply, supra, 431 N.J. Super. at 485 n.11. However, those
provisions shed no light on this issue.
6
A third, alternative interpretation would require CURE to file
its summary action within forty-five days of its receipt of the
original award. That interpretation would require a party to
commence a summary action in court even though a party's 12(d)
application could still be pending before the umpire. A 12(d)
application must be made "within 20 days after delivery of the
award to the applicant"; "objection to modification must be
served . . . within 10 days of receipt of the notice" of the
application; and "[t]he umpire shall dispose of any application
. . . within 30 days after either written objection to
modification has been served or the time for serving an
objection has expired, whichever is earlier." N.J.S.A. 2A:23A-
12(d). We decline to interpret N.J.S.A. 2A:23A-13(a) to require
simultaneous and possibly unnecessary court proceedings while
the case is still before and may be resolved by the umpire. "A
statute should be considered in light of its surrounding
provisions," and "should not be construed in a way that would
produce an absurd result." In re Expungement Petition of J.S.,
223 N.J. 54, 72-73 (2015).
11 A-0945-14T2
We find guidance from the general purpose of the APDRA,
which emphasizes the need for expedition both in the dispute
resolution process and in any judicial review. The APDRA
emphasizes that it seeks "the expeditious resolution of the
alternative resolution proceedings," N.J.S.A. 2A:23A-3(a), (b),
and that judicial review of awards "shall be summary in nature
and expedited," N.J.S.A. 2A:23A-19; see also N.J.S.A. 2A:23-
13(b). Indeed, the Legislature directed that "[t]his act shall
be liberally construed to effectuate its remedial purpose of
allowing parties by agreement to have resolution of factual and
legal issues in accordance with informal proceedings and limited
judicial review in an expedited manner." N.J.S.A. 2A:23A-19.
Moreover, in enacting the APDRA, the Legislature repeatedly
stressed that "[t]he purpose of this bill . . . is to establish
an efficient and expeditious procedure for the resolution of
civil disputes," and that the bill contemplated "expedited
summary review to the Chancery Division of Superior Court."
Sponsor's Statement Appended to Assemb. B. No. A296, at 12-13
(Jan. 14, 1986); Assemb. Judiciary Comm. Statement to Assemb. B.
No. A296, at 1-2 (June 16, 1986); Senate Judiciary Comm.
Statement to Assemb. B. No. A296, at 1-2 (Oct. 27, 1986); see
also Draftsman's Legis. History, reprinted before N.J.S.A.
2A:23A-1. The Governor agreed that the APDRA was "intended to
12 A-0945-14T2
provide a speedier and less expensive process for resolution of
disputes," and that "reviews of umpire rulings by the Superior
Court are to be expedited." Governor's Reconsideration and
Recommendation Statement to Assemb. B. No. 296, at 1 (Jan. 7,
1987), reprinted at N.J.S.A. 2A:23A-1. See also Mt. Hope Dev.
Assocs., supra, 154 N.J. at 145, 148.
We give great weight to the Legislature's emphasis on
expediting such proceedings, and its instruction to construe the
APDRA to effectuate its remedial purpose of proceeding "in an
expedited manner." N.J.S.A. 2A:23A-19. That purpose is better
served by construing N.J.S.A. 2A:23A-13(a) to require a party to
file a summary action within thirty days of its receipt of an
order denying its 12(d) application.
That construction also better fits the most plausible
reasons why the Legislature may have chosen to require a party
to file a summary action "within 45 days after the award is
delivered to the applicant" if no party files a 12(d)
application, while requiring a party to file a summary action
"within 30 days after receipt of an award modified pursuant to
[a 12(d) application]." N.J.S.A. 2A:23A-13(a). The Legislature
thus mandated filing within the shorter period when a party has
delayed the proceedings by filing a 12(d) application to modify
the original award, and when a party thus has had a longer
13 A-0945-14T2
period to become familiar with the original award's terms, some
of which may remain in force in the modified award. Similarly,
when a party files an unsuccessful 12(d) application, the party
has delayed the proceedings, and has had a longer period to
become familiar with the original award's terms, all of which
remain in force. Such a party should similarly have to file any
summary action within thirty days.
Accordingly, we hold that if a party files an application
to modify under N.J.S.A. 2A:23A-12(d) which is denied, a party
must file any summary action "within 30 days after receipt of"
the order denying modification. See N.J.S.A. 2A:23A-13(a).
B.
The second unsettled issue concerns the applicable time
period under N.J.S.A. 2A:23A-13(a) where a party files an
application for modification/clarification of a PIP award by the
DRP under the rules of the organization, here Forthright.
A PIP dispute resolution organization must provide the
Commissioner with "a dispute resolution plan, which shall
include procedures and rules governing the dispute resolution
process." N.J.S.A. 39:6A-5.1(b). The procedures and rules are
intended "to ensure adherence to the standards of performance
set forth in N.J.S.A. 39:6A-5.1 and 5.2 and [N.J.A.C. 11:3-5.1
to -5.12]." N.J.A.C. 11:3-5.3(d)(1). The organization must
14 A-0945-14T2
maintain, periodically review, and publish its rules, and must
make them available to the parties, which must follow them
during the proceedings. N.J.A.C. 11:3-5.4(a)(3), (a)(6), (b),
(b)(5); see also N.J.A.C. 11:3-5.2. N.J.A.C. 11:3-5.6(g)
provides that "[t]he final determination of the dispute
resolution professional shall be . . . subject to clarification/
modification and/or appeal as provided by the rules of the
dispute resolution organization[.]"
Here, Forthright's Rules have been repeatedly approved by
the Commissioner.7 Because Forthright Rule 24 allows a party to
request modification or clarification of an award by the DRP, it
serves a comparable purpose as N.J.S.A. 2A:23A-12(d) serves in
APDRA proceedings. Thus, it is appropriate to apply the same
construction of N.J.S.A. 2A:23A-13(a) to applications under
Forthright Rule 24 as applied to 12(d) applications. Applying
that construction serves the APDRA's interest in expedition
discussed above.
That construction is also "consistent with the [PIP
arbitration] statute's overall purpose to . . . expedite the
decision of claims." N.J. Healthcare Coal. v. N.J. Dep't of
Banking & Ins., 440 N.J. Super. 129, 144 (App. Div. 2015). "The
7
See Forthright, New Jersey No-Fault, http://www.nj-no-fault.com
(last visited April 22, 2016) (attaching the Commissioner's
approvals).
15 A-0945-14T2
evident purpose of [N.J.S.A. 39:6A-5.1] is to establish an
expeditious non-judicial procedure for resolving any dispute
regarding the payment of PIP benefits, in furtherance of the No-
Fault Act's objectives of facilitating 'prompt and efficient
provision of benefits for all accident injury victims[.]'" Endo
Surgi Ctr., P.C. v. Liberty Mut. Ins. Co., 391 N.J. Super. 588,
594 (App. Div. 2007) (quoting Gambino v. Royal Globe Ins. Cos.,
86 N.J. 100, 105, 107 (1981)).8
Accordingly, we hold that the thirty-day deadline under
N.J.S.A. 2A:23A-13(a) and N.J.A.C. 11:3-5.6(g) for filing a
summary action in a PIP arbitration also applies when a party
has filed an application for modification or clarification under
the rules of the organization. Thus, if a party files an
application under Forthright Rule 24, a party must file a
summary action "within 30 days after receipt of an award
8
Moreover, the alternative interpretation discussed in our
earlier footnote is even more absurd in the context of PIP
arbitration. As set forth above, the time periods for filing
and resolving an application under Forthright Rule 24 are longer
than those in N.J.S.A. 2A:23A-12(d). Thus, requiring a party to
commence a summary action within forty-five days of its receipt
of the original award would be even more likely to compel a
party to commence a summary action while a party's application
under Forthright Rule 24 was still pending before the DRP. "'A
premature entanglement of the judiciary in PIP arbitrations
would run at cross purposes with the legislative goal,'" and
contravene the "strong public policy against judicial
intervention in ongoing PIP arbitration proceedings." Allstate
N.J. Ins. Co. v. Neurology Pain Assocs., 418 N.J. Super. 246,
261 (App. Div. 2011) (citations omitted).
16 A-0945-14T2
modified [or clarified] pursuant to" Forthright Rule 24, or
receipt of the order denying clarification or modification. See
N.J.S.A. 2A:23A-13(a).9
Here, CURE did not commence its summary action in the Law
Division within thirty days after receipt of the DRP's order
denying clarification. Rather, it filed its summary action
forty-five days later. Thus, CURE's time to commence a summary
action "had already expired and the DRP's decision had become
final by the time it filed the present action." Orthopaedic
Assocs. v. Dep't of Banking & Ins., 405 N.J. Super. 54, 66 (App.
Div. 2009). Therefore, the Law Division properly dismissed with
prejudice CURE's complaint and request for an order to show
cause. See ibid.
CURE argues that it acted in good faith in filing its
summary action on the forty-fifth day after the denial of its
modification/clarification application. However, CURE has
offered no reason why it delayed filing until the last
conceivable day, despite our earlier warning that N.J.S.A.
9
This will generally give the party more time than a litigant
receives under the Rules of Court, which merely toll the "[t]he
running of the [forty-five-day] time for taking an appeal"
during the pendency of a timely application for reconsideration;
after the denial of the application, the litigant must file an
appeal within "the remaining time." R. 2:4-3(b); see also R.
2:4-1. In any event, CURE concedes that "there is no such
tolling" provision here, and "the outcome of this matter is
dictated by N.J.S.A. 2A:23A-13(a)."
17 A-0945-14T2
2A:23A-13(a) "does not reveal the amount of time a party has to
challenge an award when an application to modify has been
denied." Liberty Mut. Ins. Co., supra, 413 N.J. Super. at 523.
In any event, N.J.S.A. 2A:23A-13(a) specifically provides that
"[t]he award of the umpire shall become final unless the action
is commenced as required by this subsection." That statutory
language is clear, and we must follow it.
Affirmed.
18 A-0945-14T2