RAYMOND NESBY VS. SHERYL FLEURMOND (L-1923-16, MIDDLESEX COUNTY AND STATEWIDE) ( 2019 )

NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-0958-16T4
RAYMOND NESBY and
LAUREN NESBY,
APPROVED FOR PUBLICATION
Plaintiffs-Appellants, November 18, 2019
v. APPELLATE DIVISION
SHERYL FLEURMOND, CHRIS
R. DECARO, XEROX RECOVERY
SERVICES,1 and HORIZON BLUE
CROSS BLUE SHIELD OF NEW
JERSEY,2
Defendants,
and
GOVERNMENT EMPLOYEES
INSURANCE COMPANY3
and AAA MID-ATLANTIC
INSURANCE COMPANY OF
NEW JERSEY,4
Defendants-Respondents.
1
Improperly pled as Zerox Recovery Services.
2
Improperly pled as Blue Cross & Blue Shield of New Jersey.
3
Improperly pled as GEICO.
4
Improperly pled as AAA Mid-Atlantic Insurance Co.
Argued October 3, 2019 – Decided November 18, 2019
Before Judges Fisher, Gilson and Rose.
On appeal from the Superior Court of New Jersey, Law
Division, Middlesex County, Docket No. L-1923-16.
John J. Hopkins, III, argued the cause for appellants.
Donald M. Barone argued the cause for respondent
AAA Mid-Atlantic Insurance Company of New Jersey
(Barone Mooney Newman & Foreman, attorneys;
Donald M. Barone on the brief).
Mario John Delano argued the cause for respondent
Government Employees Insurance Company
(Campbell Foley Delano & Adams LLC, attorneys;
Mario John Delano, on the briefs).
The opinion of the court was delivered by
ROSE, J.A.D.
Plaintiff Raymond Nesby 5 appeals from Law Division orders granting
summary judgment to defendants Government Employers Insurance Company
(GEICO) and AAA Mid-Atlantic Insurance Company of New Jersey (AAA
MAIC), dismissing his complaint against the insurers. Because we conclude
5
Lauren Nesby is a co-plaintiff in this case only because of her per quod claim
deriving from her spouse's injury, therefore references to "plaintiff" pertain
solely to Raymond Nesby.
A-0958-16T4
2
plaintiff lacked any basis to assert a claim against GEICO or AAA MAIC, we
affirm.
The facts, viewed most favorably to plaintiff, Brill v. Guardian Life Ins.
Co. of Am., 142 N.J. 520, 540 (1995), are essentially undisputed. In October
2014, plaintiff was injured in an automobile accident when the car he was
driving was struck from behind by the vehicle driven by defendant Sheryl
Fleurmond, owned by defendant Chris R. Decaro, and insured by Progressive
Garden State Insurance Company (Progressive). Fleurmond neither owned a
vehicle nor had her own automobile insurance policy; 6 she lived with her mother
and sister.7 GEICO issued a policy to Fleurmond's sister and AAA MAIC issued
a policy to her mother. 8 Neither vehicle was involved in the accident.
6
Citing the police report, plaintiff claims Fleurmond was listed as a driver on
Decaro's policy. Plaintiff did not include the Progressive policy in his appendix
on appeal.
7
AAA MAIC does not concede that Fleurmond lived with its insured at the time
of the accident; Fleurmond's residency is not material to the resolution of the
issues presented on appeal.
8
Neither policy was included in plaintiff's appendix on appeal. It is undisputed
that Fleurmond was not listed as an insured on either policy. Plaintiff and AAA
MAIC included a declaration page of that carrier's insured, listing Fl eurmond's
mother as a driver.
A-0958-16T4
3
Plaintiff claims his medical costs exceed $400,000 for the injuries he
suffered as a result of the collision. After his $15,000 personal injury protection
(PIP) benefits were exhausted, the remainder of plaintiff's medical bills were
paid by his personal health insurance carrier. Plaintiff then tendered a claim to
Progressive, which offered him the full $25,000 policy limit of Decaro's policy.
In exchange, plaintiff agreed to release Fleurmond and Decaro
from any and all claims, actions, causes of action[],
demands, rights, damages, costs, property damage, loss
of wages, expenses, hospital, medical and nursing
expenses, accrued or unaccrued claims for loss of
consortium, loss of support or affection, loss of society
and companionship on account of in any way growing
out of, any and all known and unknown personal
injuries and damages resulting from [the present]
automobile accident . . . .
Sometime before signing the release, plaintiff's counsel sent what he describes
as "a Longworth letter"9 to GEICO and AAA MAIC, notifying the carriers of
Progressive's offer. According to plaintiff, neither carrier objected to the
proposed settlement; both carriers later denied coverage.
9
Longworth v. Van Houten, 223 N.J. Super. 174 (App. Div. 1988).
A-0958-16T4
4
Plaintiff then filed a complaint 10 against Fleurmond and Decaro, seeking
damages for injuries he sustained in the accident. Although plaintiff did not
specifically name GEICO or AAA MAIC as defendants, the fourth count of his
complaint sought to "[c]ompel [i]nsurance [c]overage" from both carriers. Prior
to the commencement of discovery, plaintiff moved for declaratory judgment
against GEICO and AAA MAIC, seeking coverage under the policies issued to
Fleurmond's sister and mother. GEICO and AAA MAIC cross-moved for the
same relief. Following oral argument, the motion judge reserved decision,
eventually denying plaintiff's motion and granting defendants' cross-motions for
reasons expressed in a written opinion. 11
Recognizing additional facts were unnecessary to the determination of
defendants' motions, the judge found plaintiff settled his claims with Fleurmond
and Decaro, and he had no relationship with GEICO and AAA MAIC, which
would otherwise entitle him to coverage under their policies. Because plaintiff
was not seeking underinsured motorist (UIM) coverage from his insurance
10
After venue was transferred from Monmouth County for reasons that are not
pertinent to this appeal, plaintiff filed an amended complaint to reflect venue i n
Middlesex County, but it was otherwise identical to his initial complaint.
11
The judge granted plaintiff's motion to amend the complaint to add as parties
his personal health insurance carrier, Horizon Blue Cross Blue Shield of New
Jersey and its subrogation representative, Xerox Recovery Services.
A-0958-16T4
5
carriers, the judge determined Longworth was "inapplicable and distinguishable
from the facts here." This appeal followed.
On appeal, plaintiff raises overlapping arguments, claiming he is entitled
to PIP coverage and bodily injury benefits under the GEICO and AAA MAIC
policies. More particularly, he presents the following points for our
consideration:
I. The Trial Judge Erred in Granting Summary
Judgment Prior to the End Of Discovery Without
Considering Extrinsic Evidence.
II. . . . Plaintiff Was Injured in an Automobile
Accident In Which Multiple Insurance Policies Are
Involved and this Court must Determine Which PIP
Policies Cover the Medical Treatment for the Injuries
in this Accident.
III. It Is Appropriate for the Court [to] Make a
Declaratory Judgment Determination as to Which
Insurance Policies Cover the Bodily Injuries in this
Matter.
IV. . . . Plaintiff[] Settled [His] Claim with the First
Carrier Pursuant to Longworth and Now May Proceed
Against the Other Two Carriers.
V. . . . Plaintiff Exceeded His Insurance P[IP]
Coverage So the P[IP] of the Additional Policies must
Cover the Excess.[12]
12
Plaintiff filed a supplemental letter pursuant to Rule 2:6-11(d), bringing to
our attention recent legislation amending N.J.S.A. 39:6A-12, which "permits a
A-0958-16T4
6
We review a grant of summary judgment de novo, applying the same
standard as the trial court. Templo Fuente De Vida Corp. v. Nat'l Union Fire
Ins. Co. of Pittsburgh, 224 N.J. 189, 199 (2016); Brill, 142 N.J. at 539-40.
Summary judgment is appropriate where the record demonstrates "no genuine
issue as to any material fact challenged and . . . the moving party is entitled to a
judgment or order as a matter of law." R. 4:46-2(c); Henry v. N.J. Dep't of
Human Servs., 204 N.J. 320, 329 (2010); Brill, 142 N.J. at 528-29. Where, as
here, "there is no genuine issue of material fact, we must then decide whether
the trial court correctly interpreted the law." DepoLink Court Reporting & Litig.
Support Servs. v. Rochman, 430 N.J. Super. 325, 333 (App. Div. 2013) (internal
quotation marks and citation omitted). We therefore accord no deference to the
motion judge's conclusions on issues of law. Nicholas v. Mynster, 213 N.J. 463,
478 (2013).
Distilled to its essence, the issue presented in this appeal is whether
plaintiff can somehow seek PIP coverage for his unpaid medical expenses under
party injured in an automobile accident to recover, as part of the recovery of
uncompensated economic loss, all unreimbursed medical expenses not covered
by the . . . [PIP] limits applicable to the injured party and sustained by the injured
party." Sponsor's Statement to S.B. 3963 1 (L. 2019, c. 245, § 2). Because the
amendment was not effective until August 1, 2019, it has no bearing on our
resolution of the present appeal. We therefore decline to decide what, if any ,
application the amendment has to these unique circumstances.
A-0958-16T4
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policies issued by GEICO and AAA MAIC to the tortfeasor's resident relatives,
covering vehicles that were not involved in the accident – after plaintiff settled
any and all claims arising from the accident with the tortfeasor. We conclude
none of plaintiff's attempts to extend well-settled principles of insurance law is
availing.
We start with plaintiff's claims for PIP coverage under the GEICO and
AAA MAIC policies. As our Supreme Court has recognized:
The Legislature provided for PIP benefits as part of
New Jersey's no-fault compulsory automobile-
insurance system in the New Jersey Automobile
Reparation Reform Act, N.J.S.A. 39:6A-1 to -35 . . . .
Stated generally, the benefits include payment of
medical expenses, without regard to fault, for the
named insured and resident members of his or her
family, others occupying a vehicle of the named
insured, or pedestrians injured in an automobile
accident.
[Palisades Safety & Ins. Ass'n v. Bastien, 175 N.J. 144,
147-48 (2003) (emphasis added) (citation omitted).]
Clearly, plaintiff was not an insured under the GEICO or AAA MAIC policies,
did not live with either insured and was not driving a vehicle insured under either
policy. Because he does not fall within any of those categories – that might
otherwise entitle him to PIP coverage – plaintiff is not entitled to PIP benefits
under either the GEICO or AAA MAIC policy.
A-0958-16T4
8
Accordingly, we are not persuaded by plaintiff's ancillary argument that
New Jersey permits "stacking of policies" for PIP benefits. On the contrary,
N.J.S.A. 39:6A-4.2 expressly prohibits an insured from recovering PIP benefits
from multiple policies, providing, in pertinent part:
the personal injury protection coverage of the named
insured shall be the primary coverage for the named
insured and any resident relative in the named insured's
household who is not a named insured under an
automobile insurance policy of his own. No person
shall recover personal injury protection benefits under
more than one automobile insurance policy for injuries
sustained in any one accident.
[(Emphasis added).]
Plaintiff's reliance on Ingersoll v. Aetna Cas. & Sur. Co., 138 N.J. 236
(1994), is misplaced. In Ingersoll, the plaintiff motorcyclist was ineligible for
PIP benefits. Id. at 238. Instead, the Court determined the statutory prohibition
against stacking PIP benefits did not foreclose the plaintiff's recovery for
extended medical expenses under two policies. Id. at 239. In doing so, the Court
expressly stated "[t]he No-Fault Law prohibits the stacking of PIP benefits." Id.
at 238.
We are equally unpersuaded by plaintiff's reliance on Gibson v.
Callaghan, 158 N.J. 662 (1999), to support his contention that "a policy in the
driver's household will cover the driver" where the tortfeasor driver is uninsured.
A-0958-16T4
9
We simply note the issue in Gibson involved the interpretation of "a clause in a
homeowners' liability insurance policy that provide[d] a defense and
indemnification to relatives of the named insured who are residents of the named
insured's household." Id. at 665. That issue could not be further from the issues
presented in this appeal.
Finally, even if plaintiff could have sought coverage under the GEICO or
AAA MAIC policies, he settled his claims with Fleurmond (and Decaro), fully
releasing the tortfeasor (and owner) of the vehicle from "any and all claims"
arising from the accident. See In re Terminated Aetna Agents, 248 N.J. Super.
255, 263 (App. Div. 1990) ("A general release ordinarily covers all claims and
demands due at the time of its execution and within the contemplation of the
parties."). Where a release's language refers to "any and all claims," courts do
not generally permit exceptions. Isetts v. Borough of Roseland, 364 N.J. Super.
247, 255-56 (App. Div. 2003) ("In parsing the release's critical passage, we
certainly agree that the phrase 'any and all' allows for no exception . . . .").
Because the release did not preserve plaintiff's right to proceed against either
GEICO or AAA MAIC, see Deblon v. Beaton, 103 N.J. Super. 345, 349 (Law
Div. 1968), he cannot litigate his settled claims against the insurers.
A-0958-16T4
10
Plaintiff fares no better with his misplaced reliance on Longworth, in
which we held that, in order to protect the UIM carrier's subrogation interest,
"an insured receiving an acceptable settlement offer from the tortfeasor should
notify his UIM carrier. The carrier may then promptly offer its insured that sum
in exchange for assignment to it by the insured of the claim against the
tortfeasor." 223 N.J. Super. at 194; see also Rutgers Cas. Ins. Co. v. Vassas,
139 N.J. 163, 174 (1995). As plaintiff acknowledges, he is not seeking UIM
coverage from GEICO or AAA MAIC. As such, any reservation of rights under
Longworth provides him no relief here. Instead, plaintiff sought excess
insurance under the GEICO and AAA MAIC policies. But, as we have stated,
plaintiff released the tortfeasor without a reservation of rights clause protecting
his claims against those insurers.
In sum, plaintiff was not a named insured under the GEICO or AAA
MAIC policies, did not reside with the named insureds, did not occupy a vehicle
insured under those policies, and released the tortfeasor from any and all claims
arising from the accident. Accordingly, his claims against the insurers fail.
Affirmed.
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