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Everett v. State Farm Indemnity Co.12/31/2002
olnar v. Hedden, 138 N.J. 96, 102 (1994), and Rivera v. Prudential Prop. and Cas. Ins. Co., 104 N.J. 32, 40 (1986). We agree that the Legislature may draw an arbitrary line that "fixes the time within which suit must be brought, it does not invite variations depending on what the equities of a case may be." Molnar, supra, 138 N.J. at 102 (quoting Rivera, supra, 104 N.J. at 40). Our disagreement with the dissent's line of reasoning is not with the necessarily arbitrary line which fixes a statute of limitations date, but rather with a construction which permits two claimants, whose claims both arose on the same side of the line, to be treated differently for purposes unrelated to the statute of limitations.
IV.
In summary, therefore, since the heating pad bill was applied to the insured's deductible on July 1, 1996, and since the bill was an expense caused by the accident, we conclude that the process of adjusting the bill to the fee schedule and applying the balance to the deductible constituted a "last payment of benefits" under the Act, making plaintiff's complaint, which was filed within two years of that date, timely. We therefore reverse and remand to the trial court for further proceedings consistent with this opinion.
Reversed and remanded.
FISHER, J.S.C. (t/a), dissenting.
An action for personal injury protection ("PIP") benefits, under these circumstances, must be deemed time-barred unless filed "not later than two years after the last payment of benefits." N.J.S.A. 39:6A-13.1a. Here, the insurer never paid any money but did acknowledge - within two years of the commencement of suit - that a small expense incurred by the insured fell within, but did not exceed, the applicable deductible. Because I cannot agree this bookkeeping event constitutes a "payment" of benefits, I respectfully dissent.
I The majority accurately describes the factual and procedural events and also fairly states the competing views of the parties. Plaintiff George C. Everett ("plaintiff") submitted a $56.03 bill to defendant State Farm Indemnity Company ("State Farm" or "insurer") for a heating pad allegedly required as a result of an auto accident. State Farm applied $46.64 of that bill against plaintiff's $250 deductible. It is conceded that State Farm paid nothing to plaintiff and paid nothing to the provider of the heating pad. Rather, State Farm made an entry in its records that (a) the bill was submitted, (b) $46.64 was "approved," (c) none of the $46.64 was paid, and (d) nothing had been "paid to date." This event - which can only be viewed, as accurately described by the motion judge, as a "bookkeeping" event - is what the majority views as a "payment of benefits."
The statute of limitations contained in the No Fault Law has raised one conundrum after another. These difficulties and the case-by-case struggles of our courts to wring clarity from this statute were recently canvassed in the majority and minority opinions in Aponte-Correa v. Allstate Ins. Co., 162 N.J. 318 (2000) and need not be repeated here. Notwithstanding the many prior encounters with this statute, the meaning of the word "payment" within the phrase "last payment of benefits" has not previously been considered or analyzed. Accordingly, we should look to the plain meaning of "payment," examine the manner in which that word has been judicially construed in other contexts, and consider whether the policies and goals of the No Fault Law will be served by a broad or narrow construction.
II.
Unlike the majority, I can find no ambiguity in the word "payment" in the present setting. I would conclude that "payment" simply means a transfer of money
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