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Martin v. Home Ins. Co.6/14/1994
The opinion of the court was delivered by
VILLANUEVA, J.A.D.
This consolidated insurance action involves issues of reimbursement among payors of PIP benefits following two different automobile accidents involving separate out-of-state insurers of vehicles operated in New Jersey. One issue is whether an out-of-state automobile insurer authorized to transact business in New Jersey is entitled under New Jersey law to reimbursement from the Unsatisfied Claim and Judgment Fund ("UCJF") for medical expenses in excess of $75,000 that it paid when its insured severely injured another party in an accident in New Jersey. The other issues are whether the injured party's general health benefits insurer, who paid medical benefits, may obtain reimbursement from the out-of-state automobile insurer and whether the out-of-state automobile insurer may obtain reimbursement directly from the tortfeasors.
A. Robinson Litigation
On May 6, 1988, an automobile driven on the New Jersey Turnpike by Robert L. Mattie ("Robert Mattie"), a Virginia resident, collided with a tractor-trailer owned by L. G. DeWitt Trucking Company ("DeWitt") and driven by Collie B. Adams ("Adams"). The DeWitt truck crossed the center divider, entered the northbound lanes and struck head-on the Mattie vehicle. Edith M. Robinson ("Robinson"), also a Virginia resident and a passenger in the Mattie vehicle along with Teresa Mattie, sustained severe bodily injuries. As of July 1992, Robinson's medical expenses exceeded $700,000.
Robert Mattie insured his automobile under a policy issued in Virginia by Progressive Casualty Insurance Company ("Progressive") which provided for only $500 in medical payments and no personal injury protection ("PIP") benefits. Progressive admitted that it was also licensed by the State of New Jersey to issue automobile liability insurance policies for private passenger automobiles operated in New Jersey.
When Robinson demanded PIP benefits from Progressive, Progressive responded that, because its Virginia policy must be construed as providing the required New Jersey PIP coverage, it would not make payments in excess of $75,000 unless the UCJF agreed to reimburse it for amounts in excess of that sum. When Progressive also notified the UCJF of its intention to seek reimbursement for PIP benefits in excess of $75,000 that it paid on behalf of Robinson, the UCJF responded that because the Progressive policy was not written in New Jersey, the UCJF would not reimburse Progressive.
Prior to the accident, New York Life Insurance Company and Wholesaler-Distributors Insurance Trust ("New York Life") issued, from the State of Illinois , a group policy providing life, medical, dental, and accidental death or dismemberment insurance to Robinson as an employee of Mattie's Graphics, a Virginia business, which policy was in effect at the time of the accident. As of July 1992, New York Life had paid medical benefits of approximately $475,000 to Robinson.
On September 5, 1989, Edith M. Robinson by her guardian D. Lewis Mattie, Teresa Mattie, Thomas Everett Robinson III by his guardian ad litem Thomas Everett Robinson, II, Ellen Mattie and D. Lewis Mattie on his own behalf, filed a complaint in the United States District Court for the District of New Jersey against DeWitt and Adams for personal injuries. In April 1990, plaintiffs amended their complaint to name the New Jersey Turnpike Authority as an additional defendant.
On October 4, 1989, Robert Mattie also filed a separate action against DeWitt, Ada
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