Title: Haines v. Taft
Citation: N/A
Docket Number: 
State: new-jersey
Issuer: new-jersey Supreme Court
Date: March 26, 2019

Haines v. Taft Annotate this Case Justia Opinion Summary In a consolidated appeal, the New Jersey Supreme Court considered one central issue: whether the New Jersey Legislature intended to deviate from its highly regulated no-fault system of first-party self-insurance to cover medical expenses arising from automobile accidents when it amended the statutory scheme to allow an insured to elect smaller amounts of personal injury protection (PIP) under a standard policy. Each plaintiff in this appeal was injured in a car accident. Each was insured under a standard policy with insurance that provided for $15,000 in PIP coverage instead of the default amount of $250,000. Neither was able to sustain a claim for bodily injury (noneconomic loss) due to each policy’s limitation-on-lawsuit option. Each sued for outstanding medical bills in excess of their elected PIP coverage ($28,000 and $10,000, respectively). The trial courts ruled against plaintiffs in each matter and prohibited plaintiffs from admitting evidence of their medical expenses that exceeded their $15,000 PIP limits. The Appellate Division consolidated the cases on appeal, and, in a published opinion, reversed both trial court orders. After its review, the Supreme Court could not concluded there was evidence of a clear intention on the part of the Legislature to deviate from the carefully constructed no-fault first-party PIP system of regulated coverage of contained medical expenses and return to fault-based suits consisting solely of economic damages claims for medical expenses in excess of an elected lesser amount of available PIP coverage. "Unless the Legislature makes such an intent clearly known, the Court will not assume that such a change was intended by the Legislature through its amendments to the no-fault system in the Automobile Insurance Cost Reduction Act." Read more Want to stay in the know about new opinions from the Supreme Court of New Jersey? Sign up for free summaries delivered directly to your inbox. Learn More › You already receive new opinion summaries from Supreme Court of New Jersey. Did you know we offer summary newsletters for even more practice areas and jurisdictions? Explore them here . SYLLABUSThis syllabus is not part of the opinion of the Court. It has been prepared by the Office of the Clerk for the convenience of the reader. It has been neither reviewed nor approved by the Court. In the interest of brevity, portions of an opinion may not have been summarized. Joshua Haines v. Jacob W. Taft (A-13/14-17) (079600)Argued October 22, 2018 -- Decided March 26, 2019LaVECCHIA, J., writing for the Court. In this consolidated appeal, the Court considers one question of law: Did the Legislature intend to deviate from its highly regulated no-fault system of first-party self- insurance to cover medical expenses arising from automobile accidents when it amended the statutory scheme to allow an insured to elect smaller amounts of personal injury protection (PIP) under a standard policy? Each plaintiff in this appeal was injured in a car accident. Each was insured under a standard policy with insurance that provided for $15,000 in PIP coverage instead of the default amount of $250,000. Neither plaintiff was able to sustain a claim for bodily injury (noneconomic loss) due to each policy’s limitation-on-lawsuit option. Each was suing for outstanding medical provider charges in excess of their elected PIP coverage ($28,000 and $10,000, respectively). Each plaintiff filed a personal injury claim, and each defendant moved to preclude plaintiff from presenting evidence of medical expenses that exceeded their $15,000 PIP limits. Defendants relied on N.J.S.A. 39:6A-12 (Section 12), which addresses the inadmissibility of evidence of losses collectible under personal injury protection, and Roig v. Kelsey, 135 N.J. 500 (1994). In Roig, the Court held that the public policies underlying the no-fault system required that Section 12 be construed to prohibit injured parties from recovering medical deductibles and copayments from a tortfeasor. 135 N.J. at 513, 515. In opposition to the motion, plaintiff Joshua Haines maintained that medical bills exceeding PIP coverage constitute “economic loss” as that term presently is defined in N.J.S.A. 39:6A-2(k) and that evidence of such medical bills should thus be admissible. Similarly, plaintiff Tuwona Little distinguished the present case from Roig, stating that, in amending the definition of economic loss to include “medical expenses” after Roig, the Legislature “clearly evinced its intention to allow recovery [in tort] for medical expenses.” The trial courts ruled against plaintiffs in each matter and prohibited plaintiffs from admitting evidence of their medical expenses that exceeded their $15,000 PIP limits. The Appellate Division consolidated the cases on appeal, and, in a published opinion, reversed both trial court orders. 450 N.J. Super. 295, 309-10 (App. Div. 2017). The Court granted defendants’ petitions for certification. 231 N.J. 179 (2017); 231 N.J. 155 (2017). 1 HELD: The Court cannot conclude that there is evidence of a clear intention on the part of the Legislature to deviate from the carefully constructed no-fault first-party PIP system of regulated coverage of contained medical expenses and return to fault-based suits consisting solely of economic damages claims for medical expenses in excess of an elected lesser amount of available PIP coverage. Unless the Legislature makes such an intent clearly known, the Court will not assume that such a change was intended by the Legislature through its amendments to the no-fault system in the Automobile Insurance Cost Reduction Act.1. Section 12 addresses evidence that is admissible or not in a claim for bodily injury. Despite the provision’s narrow focus on evidentiary matters in trials for noneconomic losses, plaintiffs construe the third paragraph’s language -- “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” -- in concert with the present definition of “economic loss” in N.J.S.A. 39:6A-2(k), to give rise to a stand-alone right to pursue a third-party liability claim against a tortfeasor exclusively for uncompensated economic loss of medical benefits not covered due to having a lesser amount of PIP coverage. Section 12 does not unmistakably compel plaintiffs’ interpretation. Indeed, one can envision an equally plausible construction that such uncompensated economic losses may be recovered from the tortfeasor within the context of a viable suit for bodily injury. In light of the ambiguity within Section 12 and due to the consequences that would flow from interpreting that section in line with plaintiffs’ construction and as the appellate panel did, the Court examines the question in light of the historical development of New Jersey’s no-fault law. (pp. 11-17)2. The history of no-fault insurance is one of changing priorities, shifting from full coverage to cost containment. The Court summarizes the law’s historical evolution. (pp. 18-23)3. Against that backdrop came the most recent amendments to the insurance law provisions that are at the heart of the instant case, accomplished through the Automobile Insurance Cost Reduction Act (AICRA). L. 1998, c. 21. The Legislature declared in AICRA’s opening section that its goals were “to preserve the no-fault system, while at the same time reducing unnecessary costs which drive premiums higher.” N.J.S.A. 39:6A-1.1(b) (1998). AICRA changed the arbitration process used for benefit disputes, established bases for determining whether treatments and diagnostic tests are medically necessary, revised the threshold for suits for noneconomic loss, and created insurance options with decreased coverage in exchange for lower premiums. Some provisions indicate that the Legislature was concerned that people might be subject to the lower PIP coverage limits without making the conscious decision to do so -- a concern that would seem overblown if a private cause of action remained to recover any medical costs above the selected PIP ceiling. (pp. 23-26)4. AICRA’s regulatory scheme ensured that benefits were paid according to their medical necessity, keeping premiums at a manageable level, while preventing such claims from inundating the court system. AICRA also established new procedures and assigned considerable resources to combat fraud in the delivery of medical benefits. (pp. 26-27) 2 5. AICRA’s legislative history demonstrates that there was a legislative awareness of the possibility of creating a gap in medical coverage should PIP coverage be lowered, which presumes the absence of other forms of reimbursement, such as suits in tort, to fill that gap. (pp. 28-29)6. Interpreting Section 12 to allow the admission of evidence of medical expenses falling between the insured’s PIP policy limit and the presumptive PIP amount of $250,000 transgresses the overall legislative design of the No-Fault Law to “reduc[e] court congestion[,] . . . lower[] the cost of automobile insurance[,]” and most importantly, avoid fault-based suits in a no-fault system, as acknowledged in Roig. 135 N.J. at 516. Efforts to subject medical costs to careful review and control through AICRA’s extensive regulatory programs and, to a lesser degree, its fraud prevention methods, would be undercut by the ability of a third party to sue for medical expenses above their PIP policy coverage limit but below the presumptive amount of $250,000. Those suits would commandeer the judicial resources that the arbitration system was enacted to preserve. The result of plaintiffs’ reading of AICRA could allow the unintended -- and, one could assert, absurd -- consequence whereby someone who chooses a lower PIP coverage option could receive a higher overall reimbursement. The Court cannot envision that the Legislature countenanced such results. Under the No-Fault Law, the ability to sue is the exception, not the rule. The Legislature has determined that the benefits of creating limited but automatic medical reimbursement for injured motor-vehicle-accident victims outweigh the ability of a minority of injured parties to recover larger amounts in tort. (pp. 30-33)7. Accordingly, the Court concludes that the Appellate Division judgment must be reversed. The interpretation given to Section 12 by the panel must, in the Court’s view, abide a time when the Legislature has more clearly indicated its intention. Without greater clarity of statutory language, any other reading of AICRA results in too large of a shift from the historical priorities and purposes of the statute. (pp. 33-34) The judgment of the Appellate Division is REVERSED and the matters are REMANDED to the trial courts for entry of their respective judgments of dismissal. JUSTICE ALBIN, dissenting, expresses the view that N.J.S.A. 39:6A-12 is intended to prevent a double recovery of damages, not to deny an automobile accident victim a just recovery of damages, and that the majority’s interpretation is at odds with the plain wording of N.J.S.A. 39:6A-12, the legislative history of the No Fault Act, and public policy. Justice Albin expresses concern that the Court’s opinion will have a catastrophic impact on the right of low-income automobile accident victims to recover their medical costs from the wrongdoers who cause their injuries and stresses that the Legislature can make clear that today’s decision is not what it meant or ever envisioned.CHIEF JUSTICE RABNER and JUSTICE SOLOMON join in JUSTICE LaVECCHIA’s opinion. JUSTICE ALBIN filed a dissenting opinion, in which JUDGE FUENTES (temporarily assigned) joins. JUSTICES PATTERSON, FERNANDEZ- VINA, and TIMPONE did not participate. 3 SUPREME COURT OF NEW JERSEY A-13/ 14 September Term 2017 079600 Joshua Haines, Plaintiff-Respondent, v. Jacob W. Taft, Bonnie L. Taft, jointly, severally and/or in the alternative, Defendants-Appellants, and John McHenry, Defendant. Tuwona Little, Plaintiff-Respondent, v. Jayne Nishimura, Defendant-Appellant. On certification to the Superior Court, Appellate Division, whose opinion is reported at 450 N.J. Super. 295 (App. Div. 2017). 1 Argued Decided October 22, 2018 March 26, 2019 Michael J. Marone argued the cause for appellants Jacob W. Taft, Bonnie L. Taft, and Jayne Nishimura (McElroy, Deutsch, Mulvaney & Carpenter, attorneys; Michael J. Marone, of counsel and on the briefs, and Eric G. Siegel, on the briefs). Vincent A. Campo argued the cause for respondent Joshua Haines (Malamut & Associates, attorneys; Vincent A. Campo, on the brief). Jeffrey M. Thiel argued the cause for respondent Tuwona Little (Petrillo & Goldberg, attorneys; Jeffrey M. Thiel, on the brief). Susan Stryker argued the cause for amici curiae Insurance Council of New Jersey and The Property Casualty Insurers Association of America (Bressler, Amery & Ross, attorneys; Susan Stryker, of counsel and on the brief). Stephen J. Foley, Jr., argued the cause for amicus curiae New Jersey Defense Association (Campbell, Foley, Delano & Adams, attorneys; Stephen J. Foley, Jr., on the brief). Kenneth G. Andres, Jr., argued the cause for amicus curiae New Jersey Association for Justice (Andres & Berger, attorneys; Kenneth G. Andres, Jr., of counsel and on the brief, and Tommie Ann Gibney, on the brief).JUSTICE LaVECCHIA delivered the opinion of the Court. 2 In this consolidated appeal, we consider one question of law: Did theLegislature intend to deviate from its highly regulated no-fault system of first-party self-insurance to cover medical expenses arising from automobileaccidents when it amended the statutory scheme to allow an insured to electsmaller amounts of personal injury protection (PIP) under a standard policy? Each plaintiff in this appeal was injured in a car accident. Each wasinsured under a standard policy with insurance that provided for $15,000 inPIP coverage instead of the default amount of $250,000. Neither plaintiff wasable to sustain a claim for bodily injury (noneconomic loss) due to eachpolicy’s limitation-on-lawsuit option. Each was suing for outstanding medicalprovider charges in excess of their elected PIP coverage ($28,000 and $10,000,respectively). The trial court record reveals that the outstanding providercharges had not been subjected to the cost containment requirements under thePIP regulatory scheme. The Appellate Division concluded that plaintiffs could introduceevidence of their outstanding medical bills in excess of the elected PIP policycoverage in support of fault-based claims for economic damages against theirrespective tortfeasors. For the reasons that follow, we reverse. We cannot conclude that thereis evidence of a clear intention on the part of the Legislature to deviate from 3 the carefully constructed no-fault first-party PIP system of regulated coverageof contained medical expenses and return to fault-based suits consisting solelyof economic damages claims for medical expenses in excess of an electedlesser amount of available PIP coverage. Unless the Legislature makes suchan intent clearly known, we will not assume that such a change was intendedby the Legislature through its amendments to the no-fault system in theAutomobile Insurance Cost Reduction Act (AICRA). Indeed, in the opening findings and declarations section of AICRA, itwas the Legislature’s belief that “it is good public policy to provide medicalbenefits on a first party basis, without regard to fault, to persons injured inautomobile accidents,” but “in order to keep premium costs down, the cost ofthe benefit must be offset by a reduction in the cost of other coverages, mostnotably a restriction on the right of persons who have non-permanent or non-serious injuries to sue for pain and suffering.” N.J.S.A. 39:6A-1.1(b) (1998).Upon consideration of the coordinated amendments accomplished throughAICRA to tighten up medical utilization, contain insurance costs, and makefirst-party no-fault insurance coverage more affordable and available, we findthe Appellate Division’s conclusion counter-intuitive and look for greaterguidance from the Legislative Branch. 4 I. On October 19, 2011, plaintiff Joshua Haines was in an automobileaccident. While driving his father’s car, he was struck by a car driven bydefendant Jacob W. Taft. 1 Not having any health insurance, Haines soughtcoverage for medical treatment for his injuries under the PIP plan in hisfather’s standard automobile insurance policy. The PIP plan provided for$15,000 of coverage -- the minimum amount permitted under N.J.S.A. 39:6A-4.3(e). Haines exhausted the PIP coverage. He claims to have approximately$28,000 in outstanding medical claims that providers are seeking from him.The record before the motion court reveals that Haines’ counsel representedthat the majority of the $28,000 in costs were not subjected to applicable PIPfee schedules but rather are based on the full amount billed by the provider s. On September 13, 2016, the motor vehicle driven by plaintiff TuwonaLittle was rear-ended by defendant Jayne Nishimura’s vehicle. Little also wasinsured under a standard insurance policy that provided $15,000 in PIPcoverage. She sought treatment for the personal injuries she sustained in theaccident. Like Haines, Little eventually exhausted her PIP coverage. Sheclaims that she has $10,488 in unpaid medical expenses. Similar to the record1 Bonnie L. Taft, Jacob’s wife, is also a defendant in this matter because she was the vehicle’s owner at the time of the accident. 5 in Haines, the record considered by the motion court indicated that theindividual medical expenses had not been subjected to any detailed review todetermine if they were “reasonable and necessary,” and the court did not deemit essential to resolve that factual matter before proceeding with the legalquestion before it. Each plaintiff filed a personal injury claim against the respectivedefendant-driver and requested a jury trial. Each defendant filed a pre-trialmotion to preclude plaintiff from presenting evidence of medical expenses thatexceeded the $15,000 PIP limits. Defendants relied on N.J.S.A. 39:6A-12(Section 12), which addresses the inadmissibility of evidence of lossescollectible under personal injury protection, and Roig v. Kelsey, 135 N.J. 500(1994). In Roig, our Court reasoned that the public policies underlying the no-fault system required that we construe Section 12 to prohibit injured partiesfrom recovering medical deductibles and copayments from a tortfeasor. 135 N.J. at 513, 515. In opposition to the motion, Haines maintained that medical billsexceeding PIP coverage constitute “economic loss” as that term presently isdefined in N.J.S.A. 39:6A-2(k) and that evidence of such medical bills shouldthus be admissible at trial. Similarly, Little distinguished the present case,stating that, in amending the definition of economic loss to include a reference 6 to “medical expenses” after the Roig decision, the Legislature “clearly evincedits intention to allow recovery [in tort] for medical expenses.” The trial courts ruled against plaintiffs in each matter and prohibitedplaintiffs from admitting evidence of their medical expenses that exceededtheir $15,000 PIP limits. In Little’s case, the trial court reasoned that “underthe AICRA, the Legislature did not intend to have ancillary litigation or tohave litigation over medical bills not covered by the PIP limits that [Little]selected.” In Haines’s case, the trial court reasoned that a person who choosesa $15,000 PIP plan should not be allowed to recover in excess of that amountbecause he or she has made an affirmative decision to buy less insurance forless money. The court concluded that the purpose of the no-fault system is tokeep premiums lower by allowing insureds to buy smaller policies, and anecessary component of that goal, as discussed in Roig, is eliminatinglitigation over claims for medical expenses exceeding an insured’s PIP limit. The Appellate Division consolidated the cases on appeal, and, in apublished opinion, reversed both trial court orders. Haines v. Taft, 450 N.J.Super. 295, 309-10 (App. Div. 2017). The panel found persuasive plaintiffs’ argument in favor of a plain-language approach to N.J.S.A. 39:6A-12 and also agreed that allowingrecovery of uncompensated medical expenses is not contrary to the statute’s 7 principal goal of avoiding double recovery of medical expenses by plaintiffs.Id. at 302, 307. Examining N.J.S.A. 39:6A-12 and the statutory provisions referred totherein, the Appellate Division concluded that “amounts collectible or paidunder a standard automobile insurance policy” did not “refer[] solely to themaximum PIP coverage, or $250,000, that is potentially available in a standardpolicy.” Id. at 302. The panel reasoned that “because the statutory languageexpressly allows varying levels of PIP benefits paid or collectible under astandard policy,” ibid. (citing N.J.S.A. 39:6A-4.3(e)), Haines and Little werebarred from admitting evidence of medical expenses up to their $15,000 PI Ppolicy limit. The panel concluded, however, that evidence of their medicalexpenses between $15,000 and $250,000 was not barred by Section 12 andtherefore was “admissible and recoverable against the tortfeasors.” Id. at 303. The panel declined to accept defendants’ position that the policiesunderlying AICRA necessitated the exclusion of recovery for medicalexpenses between $15,000 and $250,000. Id. at 306-07. Similarly, the panelwas unpersuaded that allowing admission of medical expenses above aninsured’s PIP policy limit, but below the $250,000 PIP limit, would insert afault-based aspect into a no-fault system even though a plaintiff would have to 8 first prove that the defendant was at fault for their injuries before he or shewould be entitled to recovery. Ibid. The panel did not find that our Court’s earlier decision in Roig precludedits result because, in the panel’s view, Roig did not “bar an injured insuredfrom recovering any medical bills in excess of an insured’s PIP limits.” Id. at305. In reaching that conclusion, the panel noted that it was “significant” that“Section 12 remained intact even after the Legislature expanded the definitionof 'economic loss’ in 1998 to include uncompensated medical expenses.” Id.at 306; see also id. at 308-09. And the panel highlighted that, in Roig, theCourt recognized a legislative intent “to bar the recovery of minor expenses.”Id. at 306-07. In a footnote, the panel observed that although the Roigdecision never defined a “minor” medical expense, the Roig Court didhighlight a quotation from Governor Cahill’s First Annual Message, whichnoted that “minor automobile negligence case[s]” are those that “result[] in ajudgment of settlement under $3000.” Id. at 306 n.5 (quoting Roig, 135 N.J at 510). Ultimately, the panel reasoned that “copayments and deductibles areinsufficiently analogous to the kind of expenses at issue here,” referring toHaines and Little’s outstanding medical expenses as “hardly minor.” Id. at307. Quoting an earlier published trial court decision, the panel noted that, 9 unlike copayments and deductibles, the severity of an accident victim’sinjuries and the resultant medical expenses cannot be anticipated and “AICRAis devoid of any legislative intent to have insureds bargain for potentiallybankrupting medical bills, in exchange for lower premiums.” Ibid. (quotingWise v. Marienski, 425 N.J. Super. 110, 124-25 (Law Div. 2011)). Ultimately, the panel crafted an exception to its interpretation andapplication of N.J.S.A. 39:6A-12 by noting that there may be instances inwhich medical expenses at issue may minimally exceed a plaintiff’s PIP policylimits and that arguably under those circumstances they might be consideredminor and, thus, unrecoverable. Id. at 310. The panel ultimately left the issueof what constitutes minor expenses unanswered, but made clear its view thatHaines’ and Little’s unpaid medical bills were not minor. Ibid. We granted defendants’ petitions for certification. 231 N.J. 179 (2017); 231 N.J. 155 (2017). We also granted amicus curiae status to the New JerseyAssociation for Justice (NJAJ). The Insurance Council of New Jersey (ICNJ),the Property Casualty Insurers Association of America (PCI), and the NewJersey Defense Association (NJDA), who participated before the AppellateDivision, also served as amici before this Court. Our analysis of this matterincorporates their arguments, along with those of the parties. 10 II. Plaintiffs, as well as their supporting amici, focus on certain language in N.J.S.A. 39:6A-12. That statute provides in full: Except as may be required in an action brought pursuant to section 20 of L. 1983, c. 362 ([N.J.S.A.] 39:6A-9.1), evidence of the amounts collectible or paid under a standard automobile insurance policy pursuant to sections 4 and 10 of L. 1972, c. 70 ([ N.J.S.A.] 39:6A- 4 and 39:6A-10), amounts collectible or paid for medical expense benefits under a basic automobile insurance policy pursuant to section 4 of L. 1998, c. 21 ([ N.J.S.A.] 39:6A-3.1) and amounts collectible or paid for benefits under a special automobile insurance policy pursuant to section 45 of L. 2003, c. 89 ([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 subsection d. of section 13 of L. 1983, c. 362 ([ 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. The court shall instruct the jury that, in arriving at a verdict as to the amount of the damages for noneconomic loss to be recovered by the injured person, the jury shall not speculate as to the amount of the medical expense benefits paid or payable by an automobile insurer under personal injury protection coverage payable under a standard automobile insurance policy pursuant to sections 4 and 10 of L. 1972, c. 70 ([ N.J.S.A.] 39:6A-4 and 39:6A-10), medical expense benefits under a basic automobile insurance policy pursuant to section 4 of L. 1998, c. 21 ([ N.J.S.A.] 39:6A-3.1) or benefits under a special automobile insurance policy pursuant to section 45 of L. 2003, c. 89 ([ N.J.S.A.] 39:6A-3.3) to the injured person, nor shall they speculate as to the amount of 11 benefits paid or payable by a health insurer, health maintenance organization or governmental agency under subsection d. of section 13 of L. 1983, c. 362 ([ N.J.S.A.] 39:6A-4.3). 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-12 (emphases added).] Reading that statute’s closing language in concert with the presentdefinition of “economic loss” in N.J.S.A. 39:6A-2(k) (“uncompensated loss ofincome or property, or other uncompensated expenses, including, but notlimited to, medical expenses”), those advocates claim, in essence, that there isno need to go beyond a plain-language analysis of Section 12. See DiProsperov. Penn, 183 N.J. 477, 492 (2005) (“A court should not 'resort to extrinsicinterpretative aids’ when 'the statutory language is clear and unambiguous,and susceptible to only one interpretation.’” (quoting Lozano v. Frank DeLucaConst., 178 N.J. 513, 522 (2004))). That approach, they assert, controls thestatutory construction issue here and compels the conclusion reached by theappellate panel. Although plaintiffs’ argument is no doubt a plausible interpretation, wecannot agree that the language of this provision is as clear as is contended. An 12 inherent tension appears to exist between Section 12 and its final reference touncompensated economic loss. At the outset, one must recognize that Section 12 addresses evidence thatis admissible or not in a claim for bodily injury. The first paragraph sets thatstage for the section. And, as is universally understood, authorization to bringclaims for bodily injury under our regulated system of motor vehicle insurancelaw is heavily circumscribed. Indeed, in this matter, both plaintiffs had thelimitation-on-lawsuit option controlling their ability to bring a claim for bodilyinjury and neither could exceed the necessary threshold. So, we areconsidering this issue in the context of a stand-alone claim to be able to sue foronly uncompensated medical expenses in a case where the limitation-on-lawsuit policy option prevented a claim for bodily injury. 2 Even though there is no bodily injury claim here, plaintiffs advance theirplain-language argument notwithstanding the following structure to thesubstance of Section 12. Section 12’s opening paragraph limits theadmissibility of “collectible or paid” PIP or medical expense evidence in civil 2 N.J.S.A. 39:6A-8(a) limits an injured-insured party from recovering for noneconomic loss “unless that person has sustained a bodily injury which results in death; dismemberment; significant disfigurement or significant scarring; displaced fractures; loss of a fetus; or a permanent injury within a reasonable degree of medical probability, other than scarring or disfigurement.” 13 claims for recovery of bodily injury by injured persons. The section’s secondparagraph commands the trial court to instruct the jury against speculatingabout the amounts paid or payable by an insurer for PIP or medical expensebenefits when calculating noneconomic loss for a bodily injury claim. Despitethe provision’s narrow focus on evidentiary matters in trials for noneconomiclosses, plaintiffs construe the third paragraph’s language to give rise to astand-alone right to pursue a third-party liability claim against a tortfeasorexclusively for uncompensated economic loss of medical benefits not covereddue to having a lesser amount of PIP coverage. We cannot agree that there is an unambiguous “plain-language” readingto be gleaned from Section 12 that, even with the related definition ofeconomic loss,3 supports plaintiffs’ preferred interpretation. Section 12 doesnot unmistakably compel plaintiffs’ interpretation. Nor is the reasoning sooverwhelmingly persuasive that a reviewing court must be precluded from anyexamination of the overall legislative scheme, its history, purpose, and intentwhen assessing the merit of the conclusion that plaintiffs assert. DiProspero, 183 N.J. at 492-93 (“[I]f there is ambiguity in the statutory language that leadsto more than one plausible interpretation, we may turn to extrinsic evidence 3 In 1998, the Legislature amended the definition of “economic loss” in N.J.S.A. 39:6A-2(k) to include uncompensated medical expenses. L. 1998, c. 21, § 2. 14 . . . .”). Indeed, one can envision an equally plausible construction, from theintertwined thrust and sense of this section overall and its three componentparagraphs, that such uncompensated economic losses may be recovered fromthe tortfeasor within the context of a viable suit for bodily injury. Defendants and their supporting amici make powerful arguments that theinterpretative question posed by plaintiffs’ claims in these matters requiresconsideration of whether it is at odds with the overall intent of the legislativescheme for no-fault insurance. Indeed, as amici ICNJ and PCI dramaticallyasserted in their briefing filed in this appeal, the Appellate Division “decisionblows open the black hole of automobile tort litigation New Jersey’sLegislature so carefully sought to close over the past four decades.” It isasserted that the panel’s interpretation of N.J.S.A. 39A:6A-12 will lead to anew statutory scheme at odds with the policies underlying the no-fault systembecause it relieves insureds of the intended consequence of minimizingcoverage in exchange for less money and thereby creates a fault-based system.That fault-based system will require “full-blown trial[s] with expert medicaltestimony” where plaintiffs will bear the burden of establishing defendantliability and will have to show that their medical treatment and expenses werereasonable and necessary. ICNJ and PCI further argue that the AppellateDivision’s decision not only will increase the overall volume of litigation but 15 will also “creat[e] an additional level of complexity by requiring a case -by-case, subjective analysis of what constitutes 'minor’ uncompensated medicalexpenses in each case.” Defendants and related amici argue that the statute prohibits admissionof “amounts collectible or paid” under a standard, basic, or special automobileinsurance policy. But, they maintain, nowhere in the statute is the term“collectible,” as it is used in that phrase, defined. Indeed, defendants andrelated amici contend that the “amounts collectible” refers to $250,000 ratherthan the insured’s policy limit because $250,000 is the amount of PIP coverageavailable to every consumer; plaintiffs, on the other hand, contend that“amounts collectible” refers to the insured’s policy limit because that is theamount that the insured consumer may collect. In light of the latent tension and ambiguity within Section 12 and,further, due to the consequences that would flow from interpreting that sectionin line with plaintiffs’ construction and as the appellate panel did, we would beremiss not to examine the question before us in light of the historicaldevelopment of New Jersey’s no-fault law. Our search is for legislative intent.Frugis v. Bracigliano, 177 N.J. 250, 280 (2003) (“[W]hen interpreting astatute, our overriding goal must be to determine the Legislature’s intent.”(quoting Cornblatt, P.A. v. Barow, 153 N.J. 218, 231 (1998))). In this matter, 16 we find it necessary to examine all the aids we can muster in our effort todiscern that intent and give it effect. III. A. As our Court noted in Roig v. Kelsey, legislative intent controls because“statutes are to be read sensibly rather than literally and the controllinglegislative intent is to be presumed as consonant to reason and gooddiscretion.” 135 N.J. at 515 (quoting State v. State Troopers Fraternal Ass’n, 134 N.J. 393, 418 (1993) (internal quotation marks omitted)). When“discerning that [legislative] intent we consider not only the particular statutein question, but also the entire legislative scheme of which it is a part.” Ibid.(alteration in original) (quoting Kimmelman v. Henkels & McCoy, Inc., 108 N.J. 123, 129 (1987)). This Court’s last opportunity to discuss the limits of medical expenserecovery under New Jersey’s no-fault insurance system occurred in Roig, and,there, we determined that a plaintiff could not recover out-of-pocket costs forPIP deductibles and co-payments in a negligence suit. Id. at 501. In comingto that conclusion, the Court recognized that the history of the no-fault statutewas a series of “trade-off[s].” Id. at 502-07. At its inception, drivers received“payment of medical expenses, regardless of fault,” in exchange “for 'either a 17 limitation on or the elimination of conventional tort-based personal-injurylawsuits.’” Id. at 503 (quoting Oswin v. Shaw, 129 N.J. 290, 295 (1992)).Subsequently, the Legislature introduced the option for PIP deductibles --another trade-off “reduc[ing] the cost of automobile insurance by shiftingsome of the rising medical-expense costs to alternative forms of healthinsurance.” Id. at 504-05. In that same amendment, the Legislature added a“Tort Limitation Option” where “[o]nce again, motorists were presented withanother trade-off option: lower premiums in exchange for increased tortthresholds.” Id. at 505. The entire history of no-fault insurance is one of changing priorities,shifting from full coverage to cost containment. We find that those prioritiesinform our consideration of the statutory scheme as it exists today, and wetherefore summarize the law’s historical evolution. B. The no-fault system was first enacted as part of the New JerseyAutomobile Reparation Reform Act (“No-Fault Law”). L. 1972, c. 70. Therecommendation to adopt a no-fault system came from the AutomobileInsurance Study Commission, and was received favorably by GovernorWilliam Cahill. Governor William T. Cahill, Second Annual Message 55 (Jan.11, 1972). He believed that the proposed system would “result in the motoring 18 public’s securing protection at a lesser cost, expediting the relief of theaccident victim . . . and yet preserv[e] that victim’s right to full and adequatecompensation.” Ibid. Additionally, he believed a no-fault system would bringabout a “reduction in insurance premiums” and a “reduction of the presentcourt backlog.” Id. at 56. Effective as of 1973, the No-Fault Law required insurance companies toprovide insureds unlimited medical expense benefits without regard to fault. N.J.S.A. 39:6A-4 (1973). As a trade-off, the law limited the right to sue forpain and suffering, requiring parties to have over $200 in medical expensesbefore they would have standing for a negligence suit. N.J.S.A. 39:6A-8(1973). The legislation was openly intended to provide “prompt compensationfor all [of a driver’s] economic losses,” and to “ease the burden placed upon[New Jersey] courts by the present system.” Governor’s Signing Statement toA. 667 (L. 1972, c. 70). Subsequent measures addressed a perceived need toconsider financial practicalities. At first, cost-shifting was the solution ofchoice. In 1977, the Legislature amended the No-Fault Law to limit insurers’exposure for PIP claims. L. 1977, c. 310. Insurers were still responsible forproviding benefits for the first $75,000 of a claim, but reimbursements above 19 $75,000 were shifted to the Unsatisfied Claim and Judgment Fund (UCJF). N.J.S.A. 39:6A-4(a) (1977). The impetus for that amendment came from the consequences of the No-Fault Law’s escalation of insurance premiums. To cover catastrophic injuryclaims, small- to mid-sized insurance companies were forced to buyreinsurance policies that were “not State regulated” and extremely costly -- anexpense that trickled down to the consumer. Governor’s Signing Message toS. 1380 (L. 1977, c. 310). The amendment was meant to strike a balance underwhich “accident victims w[ould] continue to receive full compensation formedical expenses and at the same time relieve[d] insurance companies of thefinancial burdens of unlimited medical expense coverage under the presentlaw.” See Senate Judiciary Comm. Statement to S. 1380 1 (L. 1977, c. 310). Despite that change, increases in the cost of insurance premiums did notsubside. In an effort to “bring about long sought after reductions in premiumsfor New Jersey motorists,” the Legislature passed the New Jersey AutomobileInsurance Freedom of Choice and Cost Containment Act of 1984. Governor’sSigning Statement to A. 3981 (L. 1983, c. 362). That amendment to the No-Fault Law offered a series of policy options to consumers, who could decreasetheir insurance coverage in exchange for a lower insurance premium. See N.J.S.A. 39:6A-4 (1984). 20 The choices included allowing motorists to select policies withdeductibles, N.J.S.A. 39:6A-4.3(a) (1984), and to forego coverage for lostwages, essential services, and funeral expenses, N.J.S.A. 39:6A-4.3(b) (1984),as well as a provision for limitations on lawsuits for noneconomic loss, N.J.S.A. 39:6A-8 (1984). The Legislature acknowledged that in someinstances the foregone coverage would be replaced by another form ofinsurance, leaving the motorist fully covered. See, e.g., Sponsor’s Statementto A. 3981 1 (L. 1983, c. 362) (noting that selecting PIP insurance with adeductible “permit[s] an insured to coordinate his automobile insurancecoverage with other forms of health coverage”). However, the 1983amendment did not require that a motorist have alternative insurance to makeup for the waived benefits, marking the beginning of the Legislature’s shiftfrom a paramount priority of full coverage to one of cost containment. The high prioritization of cost containment continued with the 1988amendments to the No-Fault Law. L. 1988, c. 119. The amendments weredescribed as intended to rectify a system that was “grossly out of balance.”Governor’s Veto Statement to S. 2637 (3d Reprint) (Aug. 4, 1988). While theno-fault system was based on an “implicit promise” of “prompt payment ofmedical bills without regard for fault in exchange for a significant limitationon frivolous lawsuits for non-economic damages, such as pain and suffering,” 21 the then-existing $200 threshold for suits was too low to act as a sufficientcurb. Ibid. The amendments increased thresholds for limitations on lawsuits. N.J.S.A. 39:6A-8 (1988). The legislative sponsor of the bill expressed thehope that those limitations would “promote availability and affordability ofautomobile insurance.” Sponsor’s Statement to S. 2637 1 (L. 1988, c. 119).Similarly, at signing, Governor Kean characterized the amendment as “a firststep toward implementing changes in a system which has penalized NewJersey drivers and driven insurance costs beyond the reach of man y motorists.”Governor’s Signing Statement to S. 2637 (L. 1988, c. 119). Two years later, the Legislature enacted further cost-containmentmeasures via the “Fair Automobile Insurance Reform Act of 1990.” L. 1990,c. 8. In that act, the Legislature stated that the past reform of the No-FaultLaw had aspired to “provide to the motorists of the State a comprehensive[insurance scheme] that is equitable, efficient and economical.” N.J.S.A.17:33B-2(b) (1990). However, the findings acknowledged that it had “becomeincreasingly obvious to the Legislature and the public that . . . one of theprincipal goals [of reform] ha[d] not been attained: economy.” N.J.S.A.17:33B-2(d) (1990). As part of the 1990 round of reforms, the Legislaturemoved from limitless required PIP coverage to $250,000 in PIP coverage, 22 N.J.S.A. 39:6A-4(a) (1990), demonstrating the Legislature’s willingness tocreate some gaps in coverage in an attempt to reap the benefits of widespreaddecreased premiums. C. 1. Against that backdrop came the most recent amendments to theinsurance law provisions that are at the heart of the instant case. Thosealterations were part of a comprehensive set of legislative amendmentsaccomplished through the Automobile Insurance Cost Reduction Act(AICRA). L. 1998, c. 21. The Legislature declared in AICRA’s opening section that its goals were“to preserve the no-fault system, while at the same time reducing unnecessarycosts which drive premiums higher.” N.J.S.A. 39:6A-1.1(b) (1998). Itattributed those “unnecessary costs” to medical benefits, which were“overutilized for the purpose of gaining standing to sue for pain andsuffering.” Ibid. As a result of those unnecessary costs and the resultingincrease in insurance premiums, the Legislature determined that “many lower-income residents . . . ha[d] been forced to drop or lapse their coverage.” Ibid. The Legislature set out to maintain the system while cutting coststhrough AICRA’s multi-pronged plan, which adhered to the recognized 23 “philosophical basis of the no-fault system . . . a trade-off of . . . providingmedical benefits in return for a limitation on the right to sue for non-seriousinjuries.” Ibid. AICRA changed the arbitration process used for benefitdisputes, N.J.S.A. 39:6A-5.1 (1998), established bases for determining whethertreatments and diagnostic tests are medically necessary, N.J.S.A. 39:6A-4.7(1998), revised the threshold for suits for noneconomic loss, N.J.S.A. 39:6A-8(b) (1998), and created insurance options with decreased coverage inexchange for lower premiums, N.J.S.A. 39:6A-3.1 (1998). 2. With respect to the availability of decreased PIP coverage, provisionswithin AICRA take care to ensure that the decision to carry less-than-full PIPcoverage is an informed and conscious one. The statute requires that the“coverage election form” used to select an insurance plan contain “in 12-pointbold type . . . that . . . election of a basic automobile insurance policy willresult in less coverage than the $250,000 medical expense benefits coveragemandated” prior to AICRA. N.J.S.A. 39:6A-3.2(a) (1998); N.J.S.A. 39:6A-4.3(e) (1998). The same provision contains no requirement about discussionof private causes of action for that gap in coverage. The “Buyer’s Guide” --required to be given to all insurance consumers -- also contains no suchinformation regarding private causes of action. The absence of that 24 information, in a provision and a document whose purposes are to help driversmake a fully informed decision about their insurance options, most logicallyfits within a scheme that did not intend for private causes of action to exist. That reasoning formed part of the basis for this Court’s decision in Roig,where a plaintiff sought to collect reimbursement for his out-of-pocketdeductible and co-insurance costs from an allegedly negligent driver. 135 N.J.at 501, 505. The Court noted that insurance companies were required to tell“policyholders that they should consider a high deductible if they '[were]already covered by a health insurance policy or a health maintenanceorganization’ because '[i]n most cases, those plans [would] pay part of themedical bills which auto insurance [would] not pay.’” Id. at 505 (alterations inoriginal) (quoting N.J.A.C. 11:3-15.6). However, insurers were not required toinform drivers that “they could recover their below-deductible expenses from athird party.” Ibid. That choice, among other evidence of legislative intent, ledthis Court to conclude that the policies and purpose of the no-fault insurancescheme would be undermined if parties were allowed to sue in tort fordeductibles and co-payments. Id. at 516. The protections surrounding the use of lower PIP coverage options arenot limited to notice prior to selection. AICRA provided that full PIPcoverage will be assumed for a driver, unless a lower option is “affirmatively 25 chosen in writing.” N.J.S.A. 39:6A-4.3(e) (1998). Further, once selected, thelower coverage option applies only to the named insured and householdmembers who are not named insureds under another policy -- not to “any otherperson eligible for personal injury protection benefits required to be provided.” N.J.S.A. 39:6A-4.3(f) (1998). Those provisions indicate that the Legislaturewas concerned that people might be subject to the lower PIP coverage limitswithout making the conscious decision to do so -- a concern that would seemoverblown if a private cause of action remained to recover any medical costsabove the selected PIP ceiling. 3. AICRA’s Sponsor’s Statement noted that “the overutilization of medicalbenefits under automobile insurance policies” was “the principal cause of theescalation in premiums in recent years.” Senate Sponsor’s Statement to S. 3 1(L. 1998, c. 21). To help control those costs, the Legislature determined totask the Division of Consumer Affairs’ professional licensing boards withpromulgating “a list of valid diagnostic tests to be used in conjunction with theappropriate health care protocols in the treatment of persons sustaining bodilyinjury.” N.J.S.A. 39:6A-4.7 (1998); see also N.J. Coal. of Health Care Prof’ls,Inc. v. DOBI, 323 N.J. Super. 207, 223-24, 269-70 (App. Div. 1999)(upholding N.J.A.C. 11:3-4, which implemented N.J.S.A. 39:6A-4.7 and 26 created “care paths” to “maintain quality of care while . . . discouragingmedically unnecessary treatments and diagnostic tests” from being claimedunder PIP policies). Additionally, disputes about the payment of benefits under an insured’sPIP policy were kept out of the courts, and were instead required to proceedthrough a dispute resolution process established by the Commissioner ofBanking and Insurance. N.J.S.A. 39:6A-5.1 (1998). The entire regulatoryscheme ensured that benefits were paid according to their medical necessity,keeping premiums at a manageable level, while preventing such claims frominundating the court system. Consistent with that effort to preserve the courts from inundation withnumerous litigated matters concerning medical overutilization, medicalnecessity, and the like, AICRA also established new procedures and assignedconsiderable resources to combat fraud in the delivery of medical benefits. N.J.S.A. 17:33A-16 to -30 (1998). In exchange, AICRA provided a 3%premium reduction in auto insurance to account for “the effect of the enhancedinsurance fraud provisions” of AICRA. N.J.S.A. 17:29A-51(a)(4) (1998). Theanti-fraud provisions reinforced a legislatively anticipated shift away fromlitigation -- where the adversarial process previously was required to act as itsown fraud filter. 27 4. Although the enacted changes in AICRA provide best evidence of likelylegislative intent, we note that the extrinsic aid of legislative history adds a bitmore information on the subject of this appeal. AICRA’s legislative history demonstrates that there was a legislativeawareness of the possibility of creating a gap in medical coverage should PIPcoverage be lowered. At a meeting of the Joint Committee on AutomobileInsurance Reform, the committee heard from a representative of theAssociation of Trial Lawyers of America-New Jersey. Testimony RegardingPersonal Injury Protection (PIP) Reforms and Related Issues before the JointComm. on Auto. Ins. Reform, 36-64 (Jan. 22, 1998). The representativeadvocated for a repeal of the no-fault system or, in the alternative, for a$10,000 “med pay provision.” Id. at 43. The representative acknowledgedthat the proposal would leave a gap of coverage between the proposed $10,000med pay provision and the $75,000 threshold for coverage under the UCJF, butexplained that costs in that gap could “simply shift to the private healthcarriers and to Medicare.” Ibid. In response to that proposal, a Joint Committee assemblyman voicedconcerns about injured drivers “in the gap.” Id. at 76. He urged that thecommittee should have more information about the number of drivers who 28 would fall in this gap and should investigate the financial feasibility oflowering UCJF coverage to begin at $10,000 to close the gap. Ibid. However,even though that concern was raised at the hearing, there was no discussion ofcreating a part no-fault, part-fault system by allowing for private rights ofaction for injuries over the $10,000 med pay. While in no way dispositive, theexcerpted discussion demonstrated an awareness by the joint legislativecommittee that lowering permissible medical coverage could create a “gap” forsome drivers -- which presumes the absence of other forms of reimbursement,such as suits in tort, to fill that gap.44 The same Joint Committee meeting also sheds some light on the scope of the gap in coverage, as the Legislature understood it to be. Senate President DiFrancesco, when referring to a statistic put forward that eighty-five percent of medical claims under PIP were for less than $10,000, stated that this figure was “basically in line with the information provided to us.” Id. at 52. That statistic can support two inferences. One is that most medical claims would be captured even if the minimum PIP amount was reduced to $15,000, as it was. We acknowledge that inference also could suggest that, by allowing fault based claims for economic losses above the $15,000, such suits would not be so numerous. Thus, they would have less of an impact on judicial resources if the Legislature intended to allow for the introduction of fault-based, stand-alone claims for medical expenses over the more minimal PIP thresholds. However, the small percentage of claims affected also could be interpreted to demonstrate that the Legislature found the number of such claims that likely would fall on private health insurers to be a fair trade-off for the savings in premiums. 29 IV. Because we do not find that the plain language of Section 12 isunambiguous and leads to only one interpretation, we approach the question athand after careful consideration of the overall goals of the no-fault statutoryscheme, its evolution, and the legislative history. As in Roig, ourinterpretative task here must be guided by the principle that legislative intentcontrols and we must read statutes sensibly with “the controlling legislativeintent . . . to be presumed as consonant to reason and good discretion.” 135 N.J. at 515 (internal quotations omitted). And, “[i]n addition to the provisionin question, we also consider the overall legislative scheme.” SASCO 1997NI, LLC v. Zudkewich, 166 N.J. 579, 586 (2001) (citing Fiore v. Consol.Freightways, 140 N.J. 452, 466 (1995)). Here, interpreting Section 12 to allow the admission of evidence ofmedical expenses falling between the insured’s PIP policy limit and the$250,000 PIP statutory ceiling transgresses the overall legislative design of theNo-Fault Law to “reduc[e] court congestion[,] . . . lower[] the cost ofautomobile insurance[,]” and most importantly, avoid fault-based suits in a no-fault system, as we previously acknowledged in Roig. 135 N.J. at 516. Based on the strong evidence of a legislative effort to avoid fault-basedsuits in the realm of medical expenses in the No-Fault Law, we cannot 30 conclude that the Legislature clearly intended Section 12 to allow fault-basedsuits consisting solely of economic damages claims for medical expenses inexcess of an elected lesser amount of available PIP coverage. As this Courtconcluded in Roig, to do so would be to “lose sight of the overwhelming goalsof reducing court congestion and lowering the cost of automobile insurance.” 5Ibid. Nor are we convinced that the third paragraph was intended to suddenlyauthorize suits for economic damages for unpaid medical expenses merelybecause the definition of economic loss was amended. The thrust of thatamendment does not support the full effect urged by plaintiffs -- namely, aright to bring a new cause of action where before one could not. The extensive efforts to subject medical utilization and associated coststo careful review and control through AICRA’s extensive regulatory programsand, to a lesser degree, its fraud prevention methods, would be undercut by theability of a third party to sue for medical expenses above their PIP policycoverage limit but below the presumptive amount of $250,000. Those suitswould commandeer the judicial resources that the arbitration system wasenacted to preserve. And, as the NJDA highlights, trial courts would have no5 Even under the potential carve-out contemplated in Roig, deductibles and copayments would have necessarily been based on charges already determined to be within the fee schedule and utilization framework of the cost- containment mechanisms of the PIP program. 31 discernible basis to determine whether unpaid medical expenses are minor orhow fee schedule adjustments or adjustments made pursuant to Medicare orMedicaid “would reduce the amounts actually recoverable to 'minor’amounts.” Additionally, once in court, the plaintiff’s suit could expand wellbeyond the administratively deemed medically-necessary treatments anddiagnostic tests, fostering cottage industries of expensive litigation that arenowhere hinted at throughout the legislative development of AICRA. In fact, the result of plaintiffs’ reading of AICRA could allow theunintended -- and, one could assert, absurd -- consequence whereby someonewho chooses a lower PIP coverage option could receive a higher overallreimbursement. For example, if a driver has $40,000 in treatment costs, butonly $20,000 of those expenses are deemed medically necessary underAICRA, the driver would receive $20,000 in reimbursements and beconsidered fully reimbursed by the AICRA guidelines if he or she maintainedthe $250,000 “full coverage” policy. If, however, the driver had only $15,000of PIP coverage, he or she would have a cause of action under plaintiff’sinterpretation of the statute for the remaining $5000 of medically necessaryexpenses and, with that, could bring suit against the other driver for theremaining costs that would not otherwise be reimbursable -- allowing thedriver with less PIP coverage to, theoretically, receive a higher overall 32 reimbursement. We cannot envision that the Legislature countenanced suchresults. We acknowledge the importance of the common law right to sue, but wereiterate that the Legislature’s intent to abrogate the right of an injured party tohave a day in court has underpinned the no-fault system since its inception.See Section III, supra. Under the No-Fault Law, the ability to sue is theexception, not the rule. Despite the fact that other aspects of our automobileinsurance law are fault-based (e.g., property damage and pain and sufferingcaused by bodily injury), the Legislature has consistently determined thatmedical costs are of a special breed. The Legislature has determined that thebenefits of creating limited but automatic medical reimbursement for injuredmotor-vehicle-accident victims outweigh the ability of a minority of injuredparties to recover larger amounts in tort. Accordingly, we conclude that the Appellate Division judgment must bereversed. The interpretation given to Section 12 by the panel must, in ourview, abide a time when the Legislature has more clearly indicated itsintention. In closing, we recognize that there are plausible readings of AICRA --such as those adopted by the Appellate Division and plaintiffs and their 33 supportive amici -- that result in a different outcome than we come to today. 6Should the Legislature disagree with our restrained interpretation of itsstatutory scheme, we invite the Legislature to make its intention to introducefault-based suits into the no-fault medical reimbursement scheme moreexplicit. Without greater clarity of statutory language, we find any otherreading of AICRA results in too large of a shift from the historical prioritiesand purposes of the statute. 76 We further recognize that, in at least one instance, a trial court adopted that interpretation as well. See Wise v. Marienski, 425 N.J. Super. 110, 124-25 (Law Div. 2011). To the extent that the parties argue that the Wise ruling, if incorrect, would have instigated action from the Legislature, we find that argument unconvincing. It would not be reasonable to import to the Legislature knowledge of every trial court decision. Moreover, the persuasive weight to be derived, if at all, from legislative inaction is undercut when other trial court decisions, such as those in the instant cases, reached an opposite conclusion. For similar reasons, it is inappropriate to speculate about the effect that a non-binding decision may or may not have had on the practice within a vicinage. Infra at ___ (slip op. at 16) (Albin, J., dissenting). 7 The dissent glosses over the legislative history to the no-fault system. That history reflects a decades-long attempt by the Legislature to balance a number of factors regarding its medical reimbursement scheme, including maintenance of prompt PIP payment without regard to fault, reduced premiums, and cost containment. In addition, the dissent never acknowledges the extensive legislative efforts under AICRA to contain medical utilization and control costs and to keep disputes related to utilization and cost containment out of the courts and in arbitration instead. Although the dissent makes a passionate case for what it believes New Jersey’s policy in this highly legislated area should be, infra at ___ (slip op. at 17) (Albin, J., dissenting), that is for the Legislature, not the court system, to decide. 34 V. The judgment of the Appellate Division is reversed and the matters areremanded to the trial courts for entry of their respective judgments of dismissalof the actions. CHIEF JUSTICE RABNER and JUSTICE SOLOMON join in JUSTICE LaVECCHIA’s opinion. JUSTICE ALBIN filed a dissenting opinion, in which JUDGE FUENTES (temporarily assigned) joins. JUSTICES PATTERSON, FERNANDEZ-VINA, and TIMPONE did not participate. 35 Joshua Haines, Plaintiff-Respondent, v. Jacob W. Taft, Bonnie L. Taft, jointly, severally and/or in the alternative, Defendants-Appellants, and John McHenry, Defendant. Tuwona Little, Plaintiff-Respondent, v. Jayne Nishimura, Defendant-Appellant. JUSTICE ALBIN, dissenting. Today’s opinion will have a catastrophic impact on the right of low-income automobile accident victims to recover their medical costs from thewrongdoers who cause their injuries. The decision leaves innocent automobileaccident victims without the legal right to sue negligent and reckless drivers 1 for recovery of their unpaid medical bills -- medical bills that will bankruptsome and financially crush others. The majority’s mistaken interpretation of N.J.S.A. 39:6A-12 will widen the divide among economic classes in our civiljustice system. N.J.S.A. 39:6A-12 is intended to prevent a double recovery of damages.It is not intended to deny an automobile accident victim a just recovery ofdamages. N.J.S.A. 39:6A-12 provides that an insured accident victim cannotsue the wrongdoer for the recovery of economic costs when the insured hadbeen or will be paid those costs through Personal Injury Protection (PIP)coverage. That statute, however, also provides that “[n]othing in this sectionshall be construed to limit the right of recovery, against the tortfeasor, ofuncompensated economic loss sustained by the injured party.” N.J.S.A.39:6A-12. Despite the absolute clarity of that language, the majority construesthe statute “to limit the right of recovery, against the tortfeasor, ofuncompensated economic loss sustained by the injured party.” See ibid. The Legislature has gone to great lengths to make automobile insuranceaffordable to low-income residents, allowing them to opt for lesser PIPcoverage in standard, basic, and special policies. The Legislature did notrequire low-income accident victims to surrender their right to sue thewrongdoer for their uncompensated medical costs because they could not 2 afford higher PIP coverage. The majority construes N.J.S.A. 39:6A-12 to baran innocent automobile accident victim, only able to afford PIP benefitcoverage of $15,000, from suing a wrongdoer for unpaid medical expensesexceeding $15,000 but less than $250,000. Under the majority’sinterpretation, a victim with $15,000 in PIP coverage who suffers $249,000 ineconomic damages is unable to sue for $234,000 in unpaid medical costs. Butan affluent victim who can afford $250,000 in PIP coverage and who sufferseconomic damages of $250,100 can sue the tortfeasors for $100 in unpaidmedical expenses. To reach that absurd result, the majority not only misreads the plainwording of N.J.S.A. 39:6A-12 and the legislative history of the No Fault Act, N.J.S.A. 39:6A-1 to -35, but also advances an interpretation of the law atcomplete odds with public policy. The majority’s erroneous interpretation ofthe statute is not without a remedy. The Legislature can make clear thattoday’s decision is not what it meant or ever envisioned. I therefore respectfully dissent. I. Joshua Haines and Tuwona Little suffered serious physical injuriescaused by the alleged negligence of drivers who struck their vehicles. Hainesand Little filed separate personal-injury lawsuits against the alleged 3 wrongdoers to recover the unpaid medical expenses incurred for the treatmentof their injuries. Haines’s automobile insurance policy provided $15,000 inPIP benefits. He accumulated $43,000 in medical expenses, leaving him with$28,000 in unreimbursed expenses. Little’s automobile insurance policyprovided $15,000 in PIP benefits. She accumulated $25,488 in medicalexpenses, leaving her with $10,488 in unpaid expenses. The majority has concluded that Haines and Little cannot sue for therecovery of the $28,000 and $10,488 in uncompensated economic losses thatthey suffered because of their wrongdoers’ negligence. That result cannot besquared with the history of our common law and with our current statutes. A. Under the common law, a person injured by the negligent acts of anotherhad an unqualified right to the recovery of medical expenses from thewrongdoer. See Sotomayor v. Vasquez, 109 N.J. 258, 261 (1988). At theinception of New Jersey’s Automobile Reparation Reform Act (No Fault Act),an insured automobile accident victim had no need to sue for uncompensatedmedical expenses because the new law mandated that the victim’s insurancecarrier make “prompt 'payment of out-of-pocket medical expenses’ withoutregard to fault.” See DiProspero v. Penn, 183 N.J. 477, 485 (2005) (quotingCaviglia v. Royal Tours of Am., 178 N.J. 460, 466 (2004)). “The No Fault Act 4 ushered in 'a system of first-party self-insurance’ . . .” Ibid. (quoting Caviglia, 178 N.J. at 466). The new law required every automobile insurance policycarrier to provide the named insured and his family household members“personal injury protection [PIP] benefits” -- medical expense benefits -- in theevent they were injured in an automobile accident, regardless of their fault.Caviglia, 178 N.J. at 466 (alteration in original) (quoting N.J.S.A. 39:6A-4.1). Unlike today, the first iteration of the No Fault Act required insurancecarriers to provide unlimited PIP coverage. N.J.S.A. 39:6A-4 (1973). Withunlimited PIP coverage, the law was designed as a true no-fault system for thepayment of medical expenses. Nevertheless, an automobile accident victimstill had the right to sue for noneconomic damages, such as pain and suffering ,based on fault, if the victim suffered permanent injuries or incurred treatmentcosts of $200 or more. Caviglia, 178 N.J. at 467. Then, as now, theautomobile tort system had fault and no-fault components. In promoting theadoption of the No Fault Act, Governor William Cahill expressed confidencethat the new law would “preserv[e] th[e] victim’s right to full and adequatecompensation.” Governor William T. Cahill, Second Annual Message 55 (Jan.11, 1972). From the beginning, our automobile tort system did not envisionthat a victim would be left with uncompensated medical costs while thewrongdoer walked away scot-free. 5 The bright hopes for our no-fault system did not match the financialreality. “In the decades that followed the birth of No Fault, the Legislaturegrappled with the intractable problem of the spiraling cost of automobileinsurance.” Caviglia, 178 N.J. at 468. The Legislature repeatedly amendedthe No Fault Act, “seeking to achieve the elusive balance of making premiumsaffordable while allowing injured automobile accident victims to pursuecompensation for their injuries.” DiProspero, 183 N.J. at 485. In 1990, the cost of escalating insurance rates led the Legislature to capfor the first time medical expense (PIP) benefits at “$250,000[] per person peraccident.” N.J.S.A. 39:6A-4(a) (1990) (emphasis omitted); N.J.S.A. 17:33B-2(d) (1990). Nothing in the amended law barred an automobile accidentvictim from suing the wrongdoer for uncompensated costs exceeding$250,000. The 1990 amendments to the No Fault Act did not solve the crisisof rising insurance premiums that made automobile insurance unaffordable formany residents. In 1998, the Legislature addressed again the climbing costs ofautomobile insurance coverage that caused many low-income residents toforgo insurance entirely. With the passage of the Automobile Insurance CostReduction Act (AICRA), N.J.S.A. 39:6A-1.1 to -35, the Legislature declaredthe need to make automobile insurance more affordable to low-income 6 residents: The high cost of automobile insurance in New Jersey has presented a significant problem for many-lower income residents of the state, many of whom have been forced to drop or lapse their coverage in violation of the State’s mandatory motor vehicle insurance laws, making it necessary to provide a lower-cost option to protect people by providing coverage to pay their medical expenses if they are injured. [N.J.S.A. 39:6A-1.1(b).] The Legislature determined that one means of achieving the goal ofaffordable automobile insurance for low-income residents was to give them thechoice of reduced premium payments in exchange for lesser PIP benefitcoverage. Ibid. AICRA allowed residents to select between a standard andbasic insurance policy. A standard policy permits an insured, in exchange forreduced premiums, the option of choosing “[m]edical expense benefits inamounts of $150,000, $75,000, $50,000 or $15,000 per person per accident”instead of the default amount of $250,000. N.J.S.A. 39:6A-4.3(e); N.J.S.A.39:6A-4. The basic policy also provides PIP benefit coverage “in an amountnot to exceed $15,000 per person” for non-catastrophic injuries. N.J.S.A.39:6A-3.1(a). In 2003, the Legislature established the “special policy,” a newautomobile insurance policy designed “to assist certain low income individualsin this State and encourage their greater compliance in satisfying the 7 mandatory private passenger automobile insurance requirements.” N.J.S.A.39:6A-3.3(a) (2003). In exchange for the lowest possible premium, an insuredcan select the special policy, which provides medical expense benefits only for“payment of treatment for emergency care in an amount not to exceed$250,000 per person per accident.” See N.J.S.A. 39:6A-3.3(b)(1). The Legislature enacted AICRA and other amendments to makeinsurance more affordable -- not to deny our citizens the right to recover theirmedical costs. See Wise v. Marienski, 425 N.J. Super. 110, 126 (Law. Div.2011) (“[T]he provision for lesser amounts of coverage was to enable lower-income drivers to enter the no-fault system, not have them take on potentiallyinsurmountable medical bills in the event of a serious accident, with no meansof recovery.”). None of the No Fault amendments suggested that the trade-offfor low-income residents purchasing policies with PIP coverage of less than$250,000 -- the only policies they presumably could afford -- was that theymust sacrifice their common law right to sue for uncompensated medicalexpenses. B. From its inception, the No Fault Act barred an injured driver “fromsuing the tortfeasor for the very PIP benefits reimbursable through his owninsurance carrier.” Caviglia, 178 N.J. at 467; N.J.S.A. 39:6A-12 (1973). That 8 ensured that the victim did not receive a double recovery, limited litigationover paid PIP benefits, and provided relief to congested court calendars. Roigv. Kelsey, 135 N.J. 500, 513 (1994). The plain language of N.J.S.A. 39:6A-12 makes clear that an automobileaccident victim who receives PIP benefits cannot sue the wrongdoer forreimbursed medical expenses. N.J.S.A. 39:6A-12 provides that “evidence ofthe amounts collectible or paid” under a standard, basic, or special automobileinsurance policy “to an injured person, including the amounts of anydeductibles, copayments or exclusions, including exclusions pursuant to[N.J.S.A. 39:6A-4.3], otherwise compensated is inadmissible in a civil actionfor recovery of damages for bodily injury by such injured person.” Thatstatute further provides: “Nothing in this section shall be construed to limitthe right of recovery, against the tortfeasor, of uncompensated economic losssustained by the injured party.” Ibid. “For decades, courts have repeatedly stated that the primary purpose of N.J.S.A. 39:6A-12 is to prevent double recovery of damages.” Wise, 425 N.J.Super. at 123 (collecting cases); see also Roig, 135 N.J. at 512 (“The fear ofdouble recovery, i.e., collecting PIP benefits and recovering through a civilaction, had been the earliest concern about cost control . . . .”). The statuteprevents double recovery of damages by barring the introduction of “evidence 9 of the amounts collectible or paid” under a standard, basic, or specialautomobile insurance policy in a civil action. See N.J.S.A. 39:6A-12. N.J.S.A. 39:6A-4, in conjunction with N.J.S.A. 39:6A-4.3, provides forfive PIP coverage options in a standard automobile insurance policy: $15,000,$50,000, $75,000, $150,000, or $250,000. PIP coverage of $250,000 is thedefault option unless the insured “affirmatively chose[] in writing” a lesser PIPcoverage option. 1 N.J.S.A. 39:6A-4.3(e). The majority takes the position thatif the insured does not opt for $250,000 in PIP coverage, the insured withlesser-elected coverage cannot sue for unpaid medical benefits unless theyexceed $250,000. Whether insureds select a special or basic policy, which providesminimal PIP coverage, or one of the non-default standard policy options, suchas $15,000 PIP coverage, will likely depend on their income. A rationalpolicyholder who can afford $250,000 PIP coverage likely will opt for thatform of self-insurance coverage because payment of medical expenses will notdepend on the amount of liability insurance the wrongdoer carries or whetherthe wrongdoer is insolvent.1 For those who select the $150,000, $75,000, $50,000, or $15,000 PIP coverage options, PIP benefits are still payable “in an amount not to exceed $250,000 for all medically necessary treatment of permanent or significant” injuries as defined in N.J.S.A. 39:6A-4.3(e). 10 The majority makes the fanciful argument that an insured with $15,000in PIP benefits, who is permitted to sue for uncompensated economic loss upto $250,000, may be in a superior position to an insured with PIP coverage of$250,000. That argument ignores that those who are self-insured with$250,000 in PIP coverage do not have to go through the rigors, uncertainties,and expenses of the tort system for payment of their medical expenses if theyare negligently harmed. The low-income resident with $15,000 in PIPcoverage holds no preferred status under the legislative scheme. That personwould not have the right to immediate recovery of medical costs unlike hisaffluent counterpart. That person would have to file a lawsuit and takediscovery, and then prove liability and the reasonableness of medical billsbefore a jury -- a process that often takes years and with no certain outcome.See Wise, 425 N.J. Super. at 125. Insureds who can afford only $15,000 inPIP coverage do not reap a windfall because they have the burden of provingto a jury, rather than a PIP arbitrator, that their medical expenses arereasonable and necessary. Low-income residents do not have options available to affluent residents-- such as the option to purchase a platinum automobile insurance policy. TheLegislature cannot remove income inequality in our State. But it has given allresidents injured in automobile accidents access to our justice system for the 11 recovery of uncompensated medical costs caused by negligent wrongdoers.That is the point missed by the majority. The majority’s interpretation cannot be reconciled with the Legislature’smandate that “[n]othing in [N.J.S.A. 39:6A-12] shall be construed to limit theright of recovery, against the tortfeasor, of uncompensated economic losssustained by the injured party,” N.J.S.A. 39:6A-12, and that the definition ofeconomic loss includes “uncompensated . . . medical expenses,” N.J.S.A.39:6A-2(k). Let us look at the tale of two insureds under the majority’s interpretiveregime. Insureds Amy and Bill suffer injuries caused by negligent drivers andboth incur $245,000 in medical costs. Amy was able to afford $250,000 in PIPcoverage and therefore her medical costs will be paid in a timely manner byher carrier. Bill was able to afford only $15,000 in PIP coverage and is barredfrom suing the negligent driver who has $500,000 in liability insurance for the$230,000 in unpaid medical costs. Bill will have liens placed on his home, hiswages will be garnished, and his life will be left in economic ruins despite thefact he was an innocent victim of a tragic accident. The wrongdoer and hisinsurance carrier under this regime walk free of the financial carnage leftbehind. Barring an automobile accident victim bound to the $15,000 PIP 12 coverage option from seeking reimbursement of medical expenses exceeding$15,000 from the tortfeasor is not merely at odds with N.J.S.A. 39:6A-12’sclear language, but also renders the statutory scheme inequitable and irrational-- a result that the Legislature did not intend. In the Haines case, a son wasoperating his father’s car when he was injured in an accident due to thenegligence of others. The son was bound to his father’s selection of the$15,000 PIP coverage and left with approximately $28,000 in unpaid medicalexpenses that he could not recoup from the alleged wrongdoers. This unjustresult has further unforeseen consequences. Healthcare providers may refuseto offer medical services if the payment of their medical costs cannot beguaranteed. To the extent that some innocent victims of automobile accidentsmay turn to charity care, then the cost will be borne by all taxpayers. Even if N.J.S.A. 39:6A-12 were susceptible to two plausibleinterpretations, the “settled rule [is] that a statute in derogation of the commonlaw must be strictly construed.” Farmers Mut. Fire Ins. Co. of Salem v. N.J.Prop.-Liab. Ins. Guar. Ass’n, 215 N.J. 522, 545 n.6 (2013) (quoting Ross v.Miller, 115 N.J.L. 61, 64 (Sup. Ct. 1935)). The right to sue a wrongdoer forthe costs of injuries caused to an innocent victim is a hallmark of our commonlaw. Jersey Cent. Power & Light Co. v. Melcar Util. Co., 212 N.J. 576, 594(2013) (“Negligence liability is rooted in fundamental, common-law 'social, 13 moral and ethical policy’ . . . .” (quoting Wytupeck v. Camden, 25 N.J. 450,460 (1957))). It bears mentioning that under N.J.S.A. 39:6A-8(b), an insured mayselect the “[n]o limitation on lawsuit option,” which permits the filing of alawsuit for pain and suffering of an indeterminate dollar value, regardless ofwhether the victim suffered permanent injuries. If Haines’s father had selectedthe no limitation on lawsuit option, Haines theoretically could have recovered$28,000 in pain and suffering damages but, given the majority’s interpretationof N.J.S.A. 39:6A-12, not recover $28,000 in unpaid medical expenses.Looking at the statutory framework as a whole underscores the weakness ofthe majority’s position. The majority states that it “cannot conclude that the Legislature clearlyintended Section 12 to allow fault-based suits consisting solely of economicdamages claims for medical expenses in excess of an elected lesser amount ofavailable PIP coverage.” Ante at ___ (slip op. at 30-31). Presumably, themajority’s reasoning here would also bar tort victims with basic and specialpolicies from suing for medical expenses of less than $250,000 because, likeHaines and Little, those basic and special policyholders also had the option ofpurchasing a standard policy with the maximum $250,000 in benefits, butelected not to do so. 14 The Legislature did not frame a statute that denied innocent automobilevictims the right to sue for the recovery of their medical expenses merelybecause they could not afford to pay for a better insurance policy. It is not afair trade-off, as the majority argues, to deny an insured who can afford only$15,000 in PIP coverage the opportunity to recoup $235,000 in unpaid medicalcosts caused by a negligent wrongdoer. Last, the Court’s 1994 decision in Roig, 135 N.J. 500, does notcommand the inequitable outcome reached by the majority. In Roig, the Courtconstrued the then-version of N.J.S.A. 39:6A-12 as prohibiting the victim of amotor vehicle accident from recovering “from a tortfeasor the medical-expensedeductible and twenty-percent copayment under a personal-injury-protection(PIP) policy.” Id. at 501. The Court reasoned that, in passing the no-faultscheme, “the Legislature intended to eliminate minor personal-injury-automobile-negligence cases from the court system.” Id. at 510. In Roig, theplaintiff was suing to recoup the deductible and copayment for less than $600in medical expenses. Id. at 501. Cases such as Roig, in which plaintiffs mightseek recovery of copayments and deductibles represent the type of minorpersonal-injury actions that the Court feared would clog an already congestedcivil court system. Id. at 515 (“[T]he Legislature did not intend that theinsured could sue the tortfeasor for the minor amounts of unpaid deductibles 15 and copayments.”). The amounts at issue here are far from minimal. Significantly, four years after the Roig decision, the Legislature in 1998made clear that the definition of economic loss in N.J.S.A. 39:6A-12 includeduncompensated medical expenses, N.J.S.A. 39:6A-2(k) -- a move presumablyintended to interdict the misguided interpretation that the majority now givesto the statute. At least since 2011, after Judge Grispin’s decision in Wise, the EssexCounty vicinage has operated under an interpretation of N.J.S.A. 39:6A-12that allows accident victims to sue for uncompensated medical costs. Nothingin the record suggests that the machinery of justice in Essex County has cometo a grinding halt or is even lumbering along. Moreover, our courts routinelyhandle claims of less than $3000 in the Small Claims Section of the SpecialCivil Part, R. 6:1-2(a)(2), and claims of less than $15,000 in the regularSpecial Civil Part, R. 6:1-2(a)(1), in all manner of cases. In a judicial systemthat opens the courthouse door to even minor claims, the denial of the right ofan automobile accident victim to seek recovery of substantial amounts ofuncompensated medical costs from the wrongdoer is inconsistent with notionsof equal justice. II. Today’s decision will have a devastating impact on low-income insureds 16 who must settle for lesser PIP coverage options because they cannot afford thehighest coverage. Because of their financial circumstances, those insureds aredenied access to the courts to recover their uncompensated medical expensesfrom the wrongdoers who caused their injuries. Some automobile injuryvictims and their families may be bowed by crushing debt; others may bebankrupted. The message from the majority opinion is that the innocentinsured must bear the financial burden caused by the irresponsible wrongdoer.That perverse concept is not written into N.J.S.A. 39:6A-12, was not intendedby the Legislature, and is completely foreign to our common law. The Legislature can fix the inequity read into the statute by the majorityif it wishes to do so. For the reasons expressed, I respectfully dissent. 17