JOSHUA HAINES VS. JACOB W. TAFTÂ TUWONA LITTLE VS. JAYNE NISHIMURAÂ (L-4310-13 AND L-0536-14, CAMDEN COUNTY AND STATEWIDE)(CONSOLIDATED)

NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-5503-14T4
A-0727-15T2
JOSHUA HAINES,
Plaintiff-Appellant,
v. APPROVED FOR PUBLICATION
June 1, 2017
JACOB W. TAFT, BONNIE
L. TAFT, jointly, severally APPELLATE DIVISION
and/or in the alternative,
Defendants-Respondents,
and
JOHN MCHENRY,
Defendant.
___________________________________________
TUWONA LITTLE,
Plaintiff-Appellant,
v.
JAYNE NISHIMURA,
Defendant-Respondent.
____________________________________________
Argued (A-5503-14) and Submitted (A-0727-15)
April 27, 2017 – Decided June 1, 2017
Before Judges Lihotz, O'Connor and Mawla.
On appeal from Superior Court of New Jersey,
Law Division, Camden County, Docket Nos.
L-4310-13 and L-0536-14.
Vincent A. Campo argued the cause for
appellant Joshua Haines in A-5503-14 (Mr.
Campo, on the brief).
Michael J. Marone argued the cause for
respondents Jacob W. Taft and Bonnie L. Taft
in A-5503-14 (McElroy, Deutsch, Mulvaney &
Carpenter, L.L.P., attorneys; Mr. Marone, of
counsel and on the brief; Eric G. Siegel, on
the brief).
Susan Stryker argued the cause for amicus
curiae Insurance Council of New Jersey and
The Property Casualty Insurers Association
of America (Bressler, Amery & Ross, P.C.,
attorneys, Ms. Stryker, of counsel and on
the brief).
Stephen J. Foley, Jr., argued the cause for
amicus curiae, The New Jersey Defense
Association (Campbell, Foley, Delano &
Adams, LLC, attorneys, Mr. Foley, on the
brief).
Petrillo & Goldberg, PC, attorneys for
appellant Tuwona Little in A-0727-15
(Jeffrey M. Thiel, on the brief).
McElroy, Deutsch, Mulvaney & Carpenter,
L.L.P., attorneys for respondent Jayne
Nishimura in A-0727-15 (Michael J. Marone,
of counsel and on the brief; Eric G. Siegel,
on the brief).
Bressler, Amery & Ross, P.C., attorneys for
amicus curiae Insurance Council of New
Jersey and The Property Casualty Insurers
Association of America (Susan Stryker, of
counsel and on the brief).
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Campbell, Foley, Delano & Adams LLC,
attorneys for amicus curiae, New Jersey
Defense Association (Stephen J. Foley, Jr.,
on the brief).
The opinion of the court was delivered by
O'CONNOR, J.A.D.
These back-to-back automobile negligence actions are
addressed in a single opinion because they share a common legal
question. In their respective actions, plaintiff Joshua L.
Haines and plaintiff Tuwona Little sought to recover medical
expenses that exceeded the $15,000 personal injury protection
(PIP) limits provided in each plaintiff's automobile insurance
policy. The judges reviewing these matters each entered an
order barring the admission of these expenses; Haines and Little
now appeal from those respective orders.
The Insurance Council of New Jersey, the Property Casualty
Insurers Association of America, and the New Jersey Defense
Association were granted amicus curiae status and filed briefs
advocating the position presented by defendants, urging an
insured may not recover such expenses from a tortfeasor.
Therefore, the question presented is whether N.J.S.A. 39:6A-12
precludes the recovery of medical expenses above those
collectible or paid under an insured's PIP provision in a
standard automobile insurance policy, including medical expenses
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exceeding any elected PIP option allowed in a standard policy
pursuant to N.J.S.A. 39:6A-4.3(e).
For the reasons that follow, we conclude it does not and
reverse both orders.
I
A
In his complaint, Haines sought damages for the injuries he
sustained in an automobile accident he claims was caused by the
negligence of defendants Jacob W. Taft and John McHenry.1
Defendant Bonnie L. Taft owned the car Taft was driving.2 At the
time of the accident, Haines lived in his father's household and
was covered under his father's standard automobile insurance
policy. That policy was subject to the limitation on lawsuit
threshold, see N.J.S.A. 39:6A-8(a) and 8.1(a), and provided PIP
coverage of $15,000, with a $2500 deductible.
Although Haines' father, the named insured, designated his
health insurance provider as the primary payer of PIP benefits,
see N.J.S.A. 39:6A-4.3(d), Haines did not have health insurance
at the time of the accident. Under the terms of the policy,
1
On February 20, 2015, the court entered an order granting
defendant McHenry summary judgment dismissal. Haines has not
appealed from this order.
2
For ease of reference, unless otherwise specified, we refer
to defendants Jacob W. Taft and Bonnie L. Taft as "Taft."
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Haines' lack of health insurance mandated he pay a penalty of
$750 in addition to the $2500 deductible. The policy further
provided he was responsible for a twenty percent copayment for
each medical bill incurred above the deductible and penalty,
which when aggregated was $3250, and the sum of $5000.
As a result of the injuries he sustained, Haines incurred
$43,000 in medical bills, leaving $28,000 in unreimbursed
medical expenses after the $15,000 in PIP benefits was
exhausted. Before trial, Haines dismissed his claim for non-
economic damages, but sought to recover from Taft the $28,000 in
uncompensated medical expenses. Thereafter, the court granted
defendant Taft's motion to bar Haines from introducing into
evidence the $28,000 in medical bills not covered by PIP
benefits. While not entirely clear from the record, it appears
when the court granted Taft's motion, no other issues remained
and the complaint was dismissed.
B
In her complaint, Little alleged she suffered injuries in a
car accident she claimed was caused by defendant Jayne
Nishimura's negligence. At the time of the accident, Little was
also covered under a standard automobile insurance policy. She
had selected the limitation on lawsuit option and a $15,000
limit of her PIP benefits, with a $500 deductible. The policy
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also provided she pay twenty percent of those bills between the
deductible amount and $5000.
By the time of trial, Little had incurred $25,488 in
medical expenses, and sought to recover from Nishimura the
$10,488 in medical bills not satisfied by PIP benefits. Before
trial, the court granted Nishimura's motion to bar the admission
of any bill that exceeded the PIP limits in Little's policy.
The jury found Little did not vault the limitation on
lawsuit threshold, and a judgment was entered dismissing her
complaint.3 Although the jury found Little was not entitled to
non-economic damages, were it not for the trial court's ruling,
Little would have pursued her claim for those medical bills
exceeding the $15,000 limit of her PIP benefits.
II
On appeal, Haines and Little contend the trial courts in
their respective actions erred by barring the introduction of
medical bills that exceeded the $15,000 limit in PIP benefits
provided in each plaintiff's policy. The issue is one of
statutory construction, which we review de novo. State ex rel.
K.O., 217 N.J. 83, 91 (2014).
3
Little does not appeal from this judgment.
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N.J.S.A. 39:6A-12 and N.J.S.A. 39:6A-2(k) principally
control the resolution of the issue presented on appeal.
N.J.S.A. 39:6A-12 (Section 12) provides in pertinent part:
Except as may be required in an action
brought pursuant to . . . [N.J.S.A. 39:6A-
9.1], evidence of the amounts collectible or
paid under a standard automobile insurance
policy pursuant to . . . [N.J.S.A. 39:6A-4
and N.J.S.A. 39:6A-10], amounts collectible
or paid for medical expense benefits under a
basic automobile insurance policy pursuant
to . . . [N.J.S.A. 39:6A-3.1] and amounts
collectible or paid for benefits under a
special automobile insurance policy pursuant
to . . . [N.J.S.A. 39:6A-3.3], to an injured
person, including the amounts of any
deductibles, copayments or exclusions,
including exclusions pursuant to . . .
[N.J.S.A. 39:6A-4.3], otherwise compensated
is inadmissible in a civil action for
recovery of damages for bodily injury by
such injured person.
. . . .
Nothing in this section shall be construed
to limit the right of recovery, against the
tortfeasor, of uncompensated economic loss
sustained by the injured party.
N.J.S.A. 39:6A-2(k) defines "economic loss" as "uncompensated
loss of income or property, or other uncompensated expenses,
including, but not limited to, medical expenses."
There is no dispute the relevant language in the first
paragraph of Section 12 makes inadmissible evidence of the
amounts collectible or paid under a provision for PIP benefits
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in a standard policy. If these amounts are not admissible, they
are not recoverable. Defendants' specific contention is the
first paragraph makes inadmissible evidence of the first
$250,000 in medical expenses an insured incurs, because $250,000
is the PIP limit provided in a standard policy, unless otherwise
requested by the named insured. Plaintiffs, on the other hand,
claim this paragraph makes inadmissible only evidence of those
medical expenses that have been or are eligible to be paid under
an insured's PIP coverage provision. Given the controversy, we
review the subject language of Section 12.
The first paragraph in Section 12 refers to "amounts
collectible or paid under a standard automobile insurance policy
pursuant to . . . [N.J.S.A. 39:6A-4]." A standard automobile
insurance policy is defined as a "policy with at least the
coverage required pursuant to . . . [N.J.S.A. 39:6A-4]." See
N.J.S.A. 39:6A-2(n). N.J.S.A. 39:6A-4 states, in relevant part,
that every standard automobile policy shall provide PIP benefits
for the named insured and members of his family residing in his
household in an amount not to exceed $250,000 per person per
accident. However, benefits payable under N.J.S.A. 39:6A-4 are
"subject to any option elected by the policyholder pursuant to
. . . [N.J.S.A. 39:6A-4.3]."
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N.J.S.A. 39:6A-4.3 requires automobile insurers to provide
the options for PIP coverage set forth in this statute. These
include "[m]edical expense benefits in amounts of $150,000,
$75,000, $50,000 or $15,000 per person per accident." N.J.S.A.
39:6A-4.3(e). Additionally, N.J.S.A. 39:6A-4.3 provides if none
of these four medical expense benefits options is chosen, the
policy shall provide $250,000 in medical expense benefits
coverage. Ibid.Here, the named insureds on the policies providing coverage
to plaintiffs chose the $15,000 medical expense benefit option.
Plaintiffs do not contend defendants are responsible for the
first $15,000 in medical bills they incurred, as these amounts
have been satisfied by plaintiffs' respective PIP benefits and
are undeniably inadmissible under Section 12. Plaintiffs do
argue if they prove defendants are responsible for their medical
expenses, defendants must compensate them for those medical
expenses exceeding the $15,000 PIP limit, up to $250,000.
Defendants and amici argue defendants are not liable for
any medical expenses between $15,000 and $250,000, contending a
standard policy provides $250,000 in PIP benefits, unless a
named insured affirmatively chooses one of the four options
available for reduced PIP coverage. Therefore, they maintain
all medical expenses up to $250,000 – the usual PIP limit in a
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standard policy – are inadmissible, making plaintiffs'
uncompensated medical bills between $15,000 and $250,000
inadmissible and unrecoverable.
We cannot agree the phrase in Section 12, "amounts
collectible or paid under a standard automobile insurance policy
pursuant," refers solely to the maximum PIP coverage, or
$250,000, that is potentially available in a standard policy,
because the statutory language expressly allows varying levels
of PIP benefits paid or collectible under a standard policy.
N.J.S.A. 39:6A-4.3(e). Specifically, PIP benefits under a
standard policy are what a named insured chooses from the four
options provided: $15,000, $50,000, $75,000, or $150,000;
however, if the named insured fails to choose an option, he or
she is deemed to have chosen, by default, $250,000 in PIP
benefits.
Because a standard policy is capable of providing one of
five different limits of PIP benefits, we reject the premise the
subject language in Section 12 only refers to a standard
automobile liability policy providing $250,000 in PIP benefits.
In context, the language refers to those PIP limits in a
standard policy covering the subject insured, making
inadmissible only those medical expenses up to and including the
PIP limits in that insured's standard policy. The "amounts
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collectible or paid" referred to in Section 12 depend upon the
limit of the insured's PIP coverage, which in this case is
$15,000 for both plaintiffs. Therefore, plaintiffs are barred
from admitting evidence of medical expenses up to that amount,
but evidence of their medical expenses between $15,000 and
$250,000 are admissible and recoverable against the tortfeasors,
subject to other statutory limitations discussed below.
Defendants and amici urge Roig v. Kelsey, 135 N.J. 500(1994), stands for the premise an injured insured may not
recover medical expenses beyond the insured's PIP limits. In
Roig, the defendant was a passenger in a vehicle struck from
behind by an automobile driven by the plaintiff. The defendant
incurred $1769 in medical expenses. Id. at 501. PIP benefits
covered the defendant's medical bills, but for his copayment and
deductible. Ibid. Specifically, the defendant sought to
recover $538.80 from the plaintiff, who in turn filed a
declaratory judgment action to establish his obligation to pay
the disputed sum to the defendant. Id. at 511. At that time,
the definition of economic loss in N.J.S.A. 39:6A-2(k) did not
include uncompensated medical expenses.
The Court defined the issue before it as "whether N.J.S.A.
39:6A-12 . . . prohibits an injured party from recovering from a
tortfeasor the medical-expense deductible and twenty-percent
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copayment under a personal-injury-protection (PIP) policy."
Roig, supra, 135 N.J. at 501. The Court concluded the
Legislature intended the No-Fault Act, N.J.S.A. 39:6A-1 to -35,
enacted in 1972, to bar this "type of fault-based recovery."
Ibid.In its opinion, the Court provided a comprehensive summary
of the legislative history of the No-Fault Act, commenting the
impetus behind its enactment was to address increasing
automobile-insurance premiums and to eliminate the need to
determine fault in a lawsuit before an injured party could
recover medical expenses. Id. at 503. No-Fault benefits were
to be provided to an injured insured regardless of fault and
serve as the exclusive remedy for satisfying medical expenses.
Ibid. As a trade-off, there was to be "either a limitation on
or the elimination of conventional tort-based personal-injury
lawsuits." Ibid. (quoting Oswin v. Shaw, 129 N.J. 290, 295
(1992)). As part of the "trade-off," Section 12 was enacted,
providing:
Evidence of the amounts collectible or paid
pursuant to sections 4 and 10 of this act to
an injured person is inadmissible in a civil
action for recovery of damages for bodily
injury by such injured person.
[Id. at 504.]
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The purpose of prohibiting the introduction of evidence of PIP
payments was to prevent double recovery. Id. at 512.
Significantly, the Court noted the kind of lawsuits the
Legislature sought to eliminate were those pertaining to minor
claims. Id. at 511. "[F]rom the inception of the no-fault
statutory scheme, the Legislature intended to eliminate minor
personal-injury-automobile-negligence cases from the court
system." Id. at 510 (emphasis added). "[T]he proponents of the
legislation anticipated that the elimination of minor personal-
injury claims from the court system not only would reduce
insurance premiums but also would provide prompt payment of
medical expenses to injured parties." Id. at 503. After the
No-Fault Act was passed, the Legislature amended this law in
1983, 1988, and 1990 "[i]n frequent attempts to lower the cost
of insurance and eliminate minor personal-injury claims." Id.
at 504.
One of the measures enacted and in effect at the time Roig
was decided was that an insured pay a medical-expense deductible
of $250 and a twenty-percent copayment.4 Id. at 509. In Roig,
4
Currently, an automobile insurer must provide named insureds
the option of choosing $500, $1000, $2000, and $2500 in medical
expense benefit deductibles. See N.J.S.A. 39:6A-4.3(a).
Further, "[m]edical expense benefits payable in any amount
between the deductible selected pursuant to subsection a. of
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the defendant argued the provision in Section 12 providing an
injured party the right to recover uncompensated losses from the
tortfeasor included the right to recover uncompensated
deductibles and copayments. Id. at 501.
The Court disagreed, finding that to allow the recovery of
minor expenses, such as uncompensated deductibles and co-
payments, would be contrary to the legislative intent to reduce
minor claims from the court system. Id. at 515. The Court
further remarked:
[F]rom the inception of the no-fault
statutory scheme, the Legislature intended
to eliminate minor personal-injury-
automobile-negligence cases from the court
system. [Defendant]'s interpretation of
section 12 would completely defeat that
purpose and would produce congestion in the
court system once again with minor personal-
injury claims, which here total $538.80.
. . .
Although we have not previously addressed
this specific section 12 issue, both this
Court and the lower courts have interpreted
various other provisions of the No-Fault
[Act]. An examination of those cases
indicates that our courts have consistently
recognized that the No-Fault [Act] was
intended to be a trade-off between the
prompt payment of medical expenses,
regardless of fault, and a restriction on
the right of an injured party to sue a
tortfeasor for minor personal injuries
stemming from automobile accidents.
this section and $5,000.00 shall be subject to the copayment
provided in the policy, if any." N.J.S.A. 39:6A-4.3.
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Legislators had hoped that that trade-off
would result in lower premiums and the
elimination of a substantial number of cases
from the calendar.
[Id. at 510-11.]
Defendant and amici cite the following passage from Roig as
supporting their argument the Legislature intended to bar an
injured insured from recovering any medical bills in excess of
an insured's PIP limits:
We are satisfied that the Legislature never
intended to leave the door open for fault-
based suits when enacting the No-Fault
[Act]. If we adopted [defendant]'s reading
of the statute, courts would again feel the
weight of a new generation of congestion-
causing suits, and automobile-insurance
premiums would again rise. If the
Legislature disagrees with our
interpretation of its intent, it is, of
course, empowered to enact clarifying
legislation.
[Id. at 516.]
Read in context with the entire opinion, we are satisfied
this language references the litigation of minor medical
expenses, such as copayments and deductibles, see id. at 515,
not all medical expenses.5 Consistent with the Legislature's
5
Although the Roig Court did not identify what constitutes a
"minor" medical expense, in the Court's summary of the
legislative history of the No-Fault Act, the Court quoted from
the Governor's First Annual Message of 1971, which informed,
"The minor automobile negligence case, which ultimately results
in a judgment of settlement under $3000, is a significant
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goal of barring smaller, less consequential bills from being
litigated, Roig recognized minor medical expenses collectible or
paid for PIP deductibles and copayments are not admissible in
evidence. Moreover, significant to our analysis is the fact
this exclusionary provision in Section 12 remained intact even
after the Legislature expanded the definition of "economic loss"
in 1998 to include uncompensated medical expenses.
Defendants and amici next argue the Court in Roig held
uncompensated copayments and deductibles were not recoverable,
even though the language in Section 12 permitted recovery of
uncompensated economic losses against a tortfeasor. From this,
defendants and amici conclude medical expenses in excess of an
insured's PIP limits must also be deemed unrecoverable. We
decline to adopt this inferential interpretation.
First, as just noted, after Roig, the Legislature amended
the definition of "economic losses" in Section 12 to
specifically include uncompensated medical expenses, see
N.J.S.A. 39:6A-2(k), yet preserved the provision excluding the
amounts of copayments and deductibles from evidence.
Second, the Roig Court found the Legislature intended minor
medical expenses be precluded from recovery because, if claims
contributing factor to the backlog in the civil courts." Roig,
supra, 135 N.J. at 510 (quoting Governor's First Annual Message
(1971)).
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of this nature were litigated, the court's docket would again
surge, one of the problems the Legislature sought to address by
enacting the No-Fault Act. See id. at 511. The Court also
recognized the Legislature intended to bar the recovery of minor
expenses, such as deductibles and copayments, as a trade-off for
lower premiums. See ibid. In our view, copayments and
deductibles are insufficiently analogous to the kind of expenses
at issue here. Haines seeks to recover $28,000 and Little
$10,488 in uncompensated medical expenses, hardly minor
expenses.
Further, "[c]ompensated medical deductibles and co-payments
are fixed and capable of calculation at the time the insured is
issued the policy. It is the insured who determines what type
of premium he or she will pay by selecting an appropriate
deductible in exchange for a premium reduction." Bennett v.
Hand, 284 N.J. Super. 43, 45-46 (App. Div. 1995). "Unlike
deductibles and copayments, an accident victim can hardly be
expected to anticipate the severity of his or her injuries, and
the consequent expense of his or her medical care[,]" and "AICRA
is devoid of any legislative intent to have insureds bargain for
potentially bankrupting medical bills, in exchange for lower
premiums." Wise v. Marienski, 425 N.J. Super. 110, 124-25 (Law
Div. 2011).
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We recognize the Roig Court observed if insureds choose one
of the deductibles provided in a PIP policy in exchange for a
lower premium and then sue to recover that deductible or the
copayment provided in their respective policies,
[insureds] choosing the highest deductible
would have the best deal: the lowest premium
and the right to recover the excluded
expenses in court against the tortfeasor.
. . . [The named insured], like all New
Jersey motorists, paid a lower annual
insurance premium because of the mandatory
PIP medical deductible and copayment. To
allow a claim for the deductible and the
copayment would be antithetical to the
entire No-Fault statutory scheme. That kind
of recovery could be available only if the
Legislature reinstituted a fault-based
system.
[Roig, supra, 135 N.J. at 514.]
However, as just discussed, copayments and deductibles are
different from other medical expenses and, after Roig, the
Legislature significantly broadened the definition of "economic
losses" to include uncompensated medical expenses. See N.J.S.A.
39:6A-2(k). In addition, having the right to recover a claim
against a tortfeasor for medical expenses not covered by PIP
does not result in a windfall to those who, in exchange for
reduced PIP benefits, paid a lower premium. As observed in
Wise:
Plaintiffs are not having their cake and
eating it, too. Their medical expenses are
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not instantly recoverable. Instead, they
must file suit, go through the discovery
process, and run the gauntlet of proving
defendant's liability, as well as the
necessity and reasonableness of the medical
bills, to a jury. That process typically
takes years. Even if they are successful in
this endeavor, they will still have to
collect their damages, which could be
impossible if a defendant is uninsured, or
underinsured. So, while plaintiffs have
been able to recoup a portion of their
medical expenses fairly quickly, they must
now labor without the assuredness of the no-
fault system and proceed through the tort
system to, hopefully, recover the remainder.
Moreover, if the excess medical expenses are
recovered, it is not a windfall to
plaintiffs, because these expenses are owed
to their medical providers.
[Wise, supra, 425 N.J. Super. at 125.]
In essence, those who purchase PIP benefits for less than
$250,000 in coverage get what they pay for. Although they pay
less for PIP premiums, they relinquish the significant
convenience of having substantial medical expenses paid without
regard to fault, obviating the need to litigate against a
tortfeasor, who ultimately may be judgment-proof.
Defendants and amici cite D'Aloia v. Georges, 372 N.J.
Super. 246, 251 (App. Div. 2004), in support of their argument
that, because we declined to permit the insured in that matter
to recover uncompensated copayments and deductibles from the
tortfeasor despite the inclusion of uncompensated medical
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expenses in the definition of "economic losses", see N.J.S.A.
39:6A-2(k), we are similarly prohibited from permitting the
recovery of medical expenses above an insured's PIP limits.
We reject this argument, as well. In D'Aloia we
recognized, as we do here, the Roig Court determined the
Legislature intended to prohibit lawsuits to recover PIP
deductibles and co-payments, even though at that time Section 12
permitted the recovery of uncompensated economic losses.
D'Aloia, supra, 372 N.J. Super. at 249. We also concluded the
Legislature intended to continue precluding the recovery of
copayments and deductibles from a tortfeasor despite expanding
the definition of "economic losses" to include uncompensated
medical expenses. Id. at 251. As we explained in D'Aloia:
Reading sections 12 and section 2k in pari
materia, State in the Interest of G.C., 179
N.J. 475, 481-82 (2004), we conclude that
section 2k makes clear that "economic loss,"
which section 12 permits an accident victim
to recover from the tortfeasor, includes
uncompensated medical expenses. However,
the AICRA amendments left unchanged the
specific limitation in the first paragraph
of section 12 which provides that the
amounts of PIP deductibles and copayments
are not admissible in automobile accident
lawsuits. . . .
In Roig, the Supreme Court invited the
Legislature to amend the statute if it
disagreed with the Court's holding. [Roig,
supra,] 135 N.J. at 516. We would expect
that, if the amendment to [N.J.S.A. 39:6A-
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2(k)] were intended as the Legislative
response to Roig, it would have specifically
referenced PIP copayments and deductibles.
We would also expect that section 12 would
have been amended to eliminate the provision
that makes those expenses inadmissible in
evidence. The Legislature did not make
either of those changes.
In enacting AICRA, the Legislature also left
intact a provision in N.J.S.A. 39:6A-
4(e)(2), that prohibits an insurer or health
provider from filing an action, under
subrogation principles, to recoup "benefits
paid pursuant to any deductible or copayment
under this section." Similar language
appears in N.J.S.A. 39:6A-4.3; AICRA did not
modify that provision either. Thus, we
conclude that the Legislature wanted to
preclude both accident victims and their
insurers from pursuing legal actions to
recover PIP deductibles and copayments.
[Id. at 250-51.]
The fact the Legislature persisted in precluding a party
from recovering copayments and deductibles after expanding the
definition of "economic losses" in N.J.S.A. 39:6A-2(k) to
include uncompensated medical expenses does not reveal, as
defendants and amici suggest, an intention to bar accident
victims from recovering medical expenses that exceed his or her
PIP coverage limits.
Finally, it cannot be overstated that "[o]ur task . . . is
to discern and give effect to the intent of the Legislature."
State v. O'Driscoll, 215 N.J. 461, 474 (2013). "Courts should
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be extremely reluctant to add terms to a statute, lest they
usurp the Legislature's authority." DiNapoli v. Bd. of Educ. of
Twp. of Verona, 434 N.J. Super. 233, 238 (App. Div.), certif.
denied, 217 N.J. 589 (2014).
In summary, we hold Section 12 does not make inadmissible
medical expenses between the PIP limit in an insured’s standard
automobile insurance policy and $250,000, less deductibles,
copayments, or exclusions. Such expenses are a kind of
uncompensated economic loss that an injured party may seek to
recover against a tortfeasor. See N.J.S.A. 39:6A-12 and
N.J.S.A. 39:6A-2(k). Because evidence of plaintiffs' medical
expenses above those paid by their respective PIP policies are
not inadmissible, the two orders under review are reversed.
We recognize an insured may incur medical expenses just
above his or her PIP limits that arguably might be minor.
Whether an insured is precluded from recovering such expenses
from a tortfeasor is a question we neither reach nor foreclose.
Here, however, it cannot be reasonably maintained plaintiffs'
uncompensated medical expenses are minor.
We have considered defendants' and amici's remaining
arguments, including the contention that, if an insured selects
one of the four alternative options for PIP coverage, the amount
between the limit chosen and $250,000 is an exclusion and
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inadmissible. We conclude these remaining arguments are without
sufficient merit to warrant discussion in a written opinion. R.
2:11-3(e)(1)(E).
Reversed.
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