PIP RECOVERY STATUTE OF LIMITATIONS RUNS TWO YEARS FROM RECEIPT OF THE FORMAL PIP APPLICATION
By: Noah Gradofsky, Esq.

N.J.S.A. 39:6A-9.1 states that an insurer paying PIP may recover PIP from a tortfeasor "not, at the time of the accident, required to maintain [PIP] . . . or although required did not maintain [PIP]." This right of recovery is limited to "within two years of the filing of the claim."

In New Jersey Manufacturers Ins. v. Holger Trucking Corp., 417 N.J. Super. 393 (App. Div. 2011), the Appellate Division held that the "filing of the claim" means the receipt, by the insurer, of the formal PIP application/claim form, even where the insurer had previously opened a file, assigned it a claim number, received medical bills and treatment plans and had approved a treatment plan.

 

 

PIP APPLICATION TRIGGERS SOL EVEN WHERE INSURER DID NOT REQUEST APPLICATION BUT REQUESTED OTHER DOCUMENTATION FOR PIP CLAIM
Law Offices of Jan Meyer Appellate Victory

Drive N.J. Insurance Company v. Sofield
New Jersey Appellate Division
Docket No. A-1989-14T4 (unpublished)
(March 4, 2016)

Plaintiff Drive New Jersey filed a Complaint seeking to compel arbitration of a PIP reimbursement claim (click here for a discussion of how to assert a PIP reimbursement claim where the adverse party is not a signatory to an arbitration agreement) two years after it received a PIP application from its insured. More than two years prior to the filing of the Complaint, Drive New Jersey sent forms to its insured describing the documentation required in order for medical treatments to be approved and subsequently received an "Attending Provider Treatment Plan" (APTP) from its insured's doctor. In fact, Drive New Jersey never requested a PIP application from its insured. Defendant argued that since the only document requested by Drive was the APTP, that document, rather than the PIP application triggered the Statute of Limitations, and thus Drive's Complaint was filed after the two-year Statute of Limitations expired. Defendant focused on language in the Holger decision (discussed above) to the effect that, "the submission of the claim form or application requested by the insurer" triggers the SOL. Holger 417 N.J. Super. at 401. The Law Division agreed and dismissed Drive's case.

On appeal, Noah Gradofsky of Law Offices of Jan Meyer argued that the focus on the words "requested by the insurer" was misplaced and that the true focus of Holger was on having a single, clearly identifiable document that triggers the SOL, namely, the PIP application. The Appellate Division agreed, reversed the Law Division's decision, and remanded the case back to the Law Division for entry of an order compelling arbitration. The Appellate Division declined to speculate on whether another document could trigger the SOL if a PIP application were never submitted, noting that in fact an application was submitted in the case, and only 10 weeks after receipt of the APTP. Reinforcing a point made in Holger, the court held that the PIP application could trigger the SOL even though its submission might not be required by the insurer. The court also noted that "the PIP Application form contained more detailed and varied information about the claim than the APTP form submitted by Dr. Furey, and, unlike the APTP form, was signed by [Drive's insured]."

A copy of this case can be downloaded here. The decision is subject to appeal to the New Jersey Supreme Court.

 

SPECIFIC PIP APPLICATION REQUESTED BY INSURER TRIGGERS SOL EVEN WHERE INSURED PREVIOUSLY SUBMITTED A GENERIC PIP APPLICATION, PROVIDED THERE IS NO EXCESSIVE DELAY CAUSED BY THE INSURER
Abdulai v. Casabona, A-3855-14T1 (April 6, 2016)
New Jersey Appellate Division
Docket No. A-3855-14T1(unpublished)
(April 6, 2016)
Text available from Google Scholar here

Two Mercury insureds were injured in an accident on June 26, 2011. Mercury mailed its PIP application to the injured parties on June 29, 2011. The completed forms were submitted on August 15, 2011. In the interim, for reasons that were not clear, Mercury received a one-page generic PIP pplication on July 11, 2011. Mercury filed a Complaint to initiate PIP recovery on August 2, 2013 and Defendants argued that the filing was after the statute of limitations. The Appelalte Division disagreed, emphasizing Holger's language that the statute of limitations is triggered by the application "requested by the insurer," and noting that the Mercury form allowed Mercury to request the information that it deemed most important in processing a PIP claim. Much like in Drive, discussed above, the court indicated a certain sensitivity to the fact that the Holger rule might cause the statute of limitations to be delayed excessively, but decided that this was not such a case:

Interestingly, the Abdulai decision focused on a narrow read of Holger's language that the statute of limitations is triggered by the application "requested by the insurer," while in Springer, the court said that a document other than an "application" could not trigger the statute of limitations, even if the document was requested by the insurer.

Please note that the information included on our website is subject to this disclaimer.

Please visit our Guide to Recovery of PIP in New Jersey for the text of the key New Jersey statutes regarding PIP recovery, together with an outline of those statutes, hyperlinks to definitions of key terms, discussions of key provisions of each statute, relevant case law, and other selected issues of New Jersey subrogation.

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