Court Opinion

ID: 9901150
Source: CourtListenerOpinion
Date Created: 2023-11-21 15:07:52.810327+00
Date Added: 2024-06-11T09:21:27.411429
License: Public Domain

NOT FOR PUBLICATION WITHOUT THE
                               APPROVAL OF THE APPELLATE DIVISION
        This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the
     internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.

                                                        SUPERIOR COURT OF NEW JERSEY
                                                        APPELLATE DIVISION
                                                        DOCKET NO. A-0103-22

RAMON TOULSON,

          Plaintiff-Appellant,

v.

JOSEPH HARTMAN and
MICHAEL MARIGLIANO, JR.,

          Defendants,

and

GEICO INDEMNITY COMPANY,1

          Defendant-Respondent.

                   Argued October 4, 2023 – Decided November 21, 2023

                   Before Judges Currier and Firko.

                   On appeal from the Superior Court of New Jersey, Law
                   Division, Atlantic County, Docket No. L-2309-21.

1
   Government Employees Insurance Company asserts it was improperly
designated in the lawsuit and its proper name is GEICO Indemnity Company
(GEICO).
            Dominic R. DePamphilis argued the cause for appellant
            (D'Arcy Johnson Day, attorneys; Richard J.
            Albuquerque and Dominic R. DePamphilis, on the
            briefs).

            Paul DiGasbarro argued the cause for respondent
            (Pomeroy, Heller, Ley, DiGasbarro & Noonan, LLC,
            attorneys; Daniel J. Pomeroy and Karen E. Heller, on
            the brief).

PER CURIAM

      In this matter arising out of a motor vehicle accident, plaintiff appeals

from the September 13, 2022 order dismissing her complaint with prejudice.

Because plaintiff's total recovery from the applicable tortfeasors' liability

policies was greater than the underinsured motorist (UIM) coverage afforded

under her policy with GEICO, she was not entitled to collect UIM benefits from

GEICO. We affirm.

      While stopped in traffic, plaintiff's vehicle was struck simultaneously by

two vehicles; the first was operated by defendant Joseph Hartman and owned by

defendant Michael Marigliano, Jr. (defendants), and the second vehicle was

owned and operated by Giovanni Bufardeci.

      GEICO provided motor vehicle insurance to Bufardeci which included

bodily injury liability coverage of $15,000 per person. Marigliano had a motor

vehicle insurance policy with United Services Automobile Association (USAA)

                                                                          A-0103-22
                                       2
with bodily injury liability coverage of $300,000 per person and $ 500,000 per

accident. In investigating the accident, GEICO, as Bufardeci's insurance carrier,

informed USAA of its conclusion that Hartman and Bufardeci were equally

negligent and responsible for the accident and plaintiff's injuries. Plaintiff had

a motor vehicle insurance policy with GEICO with UIM coverage of $50,000

per person and $100,000 per accident.

      Plaintiff asserted claims for her damages against Bufardeci and

defendants. In September 2020, GEICO offered plaintiff its $15,000 bodily

injury liability coverage limits to settle her bodily injury claim against

Bufardeci. Thereafter, plaintiff sought approval from GEICO to accept the

settlement offer as required under Longworth v. Van Houten, 223 N.J. Super.

174, 194-95 (App. Div. 1988).

      In an October 30, 2020 letter, GEICO granted plaintiff approval to settle

with Bufardeci.     GEICO requested plaintiff provide certain documents and

advised it would evaluate plaintiff's UIM claim upon its review of the

documents. The letter stated that "[g]ranting permission to settle is not intended

to imply coverage or waive our right to a full coverage investigation. UIM

Coverage, if afforded, will be reduced by the full value of the [tortfeasors']

available liability limits."

                                                                            A-0103-22
                                        3
       After accepting Bufardeci's settlement offer, plaintiff demanded GEICO

pay her the difference between the $15,000 settlement and her $50,000 UIM

coverage. GEICO denied the request.

       In 2021, plaintiff instituted suit against defendants and GEICO. Plaintiff

alleged she was entitled to UIM coverage from GEICO, and its denial of the

coverage and refusal to reasonably settle the claim was "unreasonable conduct

pursuant to the New Jersey Insurance Fair Conduct Act 2 and bad faith pursuant

to New Jersey common law." On May 20, 2022, plaintiff executed a release

with defendants for $70,000 in settlement of her bodily injury claims. In total,

plaintiff received $85,000 from defendants and Bufardeci.

       Plaintiff and GEICO moved for summary judgment. Plaintiff contended

she was an underinsured motorist as to Bufardeci because his bodily injury

coverage limits were less than plaintiff's UIM coverage with GEICO. She

sought $35,000 from GEICO—the difference between the $15,000 settlement

with Bufardeci and her UIM limits. She also asserted she relied on GEICO's

letter granting her permission to settle with Bufardeci as an implicit

acknowledgment that she was entitled to UIM benefits.

2
    N.J.S.A. 17:29BB-1 to -3.
                                                                           A-0103-22
                                        4
      GEICO asserted there was no implication of UIM coverage in its letter

granting Longworth approval. In addition, since plaintiff recovered $85,000 in

settlement of her claims against the tortfeasors, an amount that exceeded her

UIM policy limits, she was not entitled to UIM benefits.

      In an order and written statement of reasons issued September 9, 2022,3

the court granted GEICO summary judgment and denied plaintiff's motion. The

court found plaintiff was not entitled to UIM coverage because the total amount

she recovered from the tortfeasors was greater than her UIM coverage. The

court also found GEICO did not implicitly acknowledge that plaintiff was

entitled to coverage under its UIM policy. To the contrary, the court stated that

"G[EICO]'s letter specifically stated G[EICO] was not implying coverage."

      On appeal, plaintiff renews her arguments, contending the trial court

misapplied the law in finding the sum of the tortfeasors' policy limits must be

compared with her UIM coverage limits to determine whether she is entitled to

UIM benefits. She asserts the liability coverage of each tortfeasor's vehicle

should be compared to her UIM coverage, and, therefore she is underinsured as

to Bufardeci. Plaintiff further contends there was an issue of fact whether

3
   On September 13, 2022, the court issued an amended order dismissing
plaintiff's complaint with prejudice.
                                                                           A-0103-22
                                       5
GEICO provided an implicit acknowledgment of the availability of UIM

coverage in its Longworth approval letter.

      Our review of a trial court's grant or denial of a motion for summary

judgment is de novo. Samolyk v. Berthe, 251 N.J. 73, 78 (2022) (citing Woytas

v. Greenwood Tree Experts, Inc., 237 N.J. 501, 511 (2019)). We "consider

whether the competent evidential materials presented, when viewed in the light

most favorable to the non-moving party, are sufficient to permit a rational

factfinder to resolve the alleged disputed issue in favor of the non-moving

party." Brill v. Guardian Life Ins. Co. of Am., 142 N.J. 520, 540 (1995). "The

court's function is not 'to weigh the evidence and determine the truth of the

matter but to determine whether there is a genuine issue for trial.'" Rios v. Meda

Pharm. Inc., 247 N.J. 1, 13 (2021) (quoting Brill, 142 N.J. at 540).

      "A trial court's interpretation of the law and the legal consequences that

flow from established facts are not entitled to any special deference."

Manalapan Realty, L.P. v. Twp. Comm. of Manalapan, 140 N.J. 366, 378 (1995).

      Under N.J.S.A. 17:28-1.1(e)(1),

            A motor vehicle is underinsured when the sum of the
            limits of liability under all bodily injury and property
            damage liability bonds and insurance policies available
            to a person against whom recovery is sought for bodily
            injury or property damage is, at the time of the accident,
            less than the applicable limits for underinsured motorist

                                                                            A-0103-22
                                        6
            coverage afforded under the motor vehicle insurance
            policy held by the person seeking that recovery. . . .
            The limits of underinsured motorists coverage available
            to an injured person shall be reduced by the amount he
            has recovered under all bodily injury liability insurance
            or bonds.

      In Nikiper v. Motor Club of America Cos., this court considered the

relationship of UIM coverage in a situation where there are multiple tortfeasors.

232 N.J. Super. 393, 398 (App. Div. 1989). There, the plaintiff was involved in

a car accident with two tortfeasors. Id. at 395. She had $100,000 of UIM

coverage. Ibid. The plaintiff settled with one tortfeasor for its $100,000 bodily

injury policy limits and an additional $5,000 from its personal assets. Ibid. She

settled her claims with the second tortfeasor for its $50,000 bodily injury policy

limits. Ibid. In total, she recovered $155,000. Ibid. The plaintiff asserted that

the second tortfeasor was underinsured and she was entitled to recover the

difference between the second tortfeasor's bodily injury limits and her UIM

coverage. Ibid.

      This court held that when a plaintiff recovers in settlement with tortfeasors

an aggregate sum equal to or more than the amount of their UIM coverage, they

have no viable UIM claim. Id. at 397; see also Prudential Prop. & Cas. Ins. Co.

v. Johnson, 238 N.J. Super. 1, 5 (App. Div. 1989) ("Under the explicit and

unambiguous language of [N.J.S.A. 17:28-1.1(e)(1)], the insureds' underinsured

                                                                             A-0103-22
                                        7
motorist coverage is to be reduced by the amount that [they have] recovered

under all bodily injury insurance or bonds.").      We explained that the last

sentence of N.J.S.A. 17:28-1.1(e)(1) created a pro tanto setoff requirement.

Nikiper, 232 N.J. Super. at 398. Therefore, the total amount a plaintiff recovers

from all available insurance policies should be credited against their UIM

coverage. Id. at 400. The setoff requirement remains applicable even if one of

the tortfeasors is underinsured. See id. at 398.

      This court noted that UIM coverage is contractual and not based on the

number of individuals involved in an accident. Id. at 398-99. Therefore, an

individual can only recover up to the amount of the UIM policy limit they

purchased. Id. at 399; see Bauter v. Hanover Ins. Co., 247 N.J. Super. 94, 96

(App. Div. 1991) (explaining that while in some states, UIM coverage was

meant to fully compensate plaintiffs for their losses, "[t]he purpose of New

Jersey's statute [was] to protect the insured up to the UIM limits purchased and

not to make an injured person whole again").

      Plaintiff recovered $70,000 from defendants and $15,000 from Bufardeci.

The $85,000 she collected in settlement monies exceeded her $50,000 UIM

policy coverage with GEICO.        Therefore, plaintiff is not entitled to UIM

coverage.

                                                                           A-0103-22
                                        8
      We turn briefly to plaintiff's assertion that GEICO is estopped from

denying her UIM claim because it implicitly acknowledged she was entitled to

UIM coverage in its October 30, 2020 letter granting her approval to settle her

claim against Bufardeci.      We see no reason to disturb the trial court's

determination rejecting that argument. GEICO's letter did not state, implicitly

or otherwise, that plaintiff was entitled to UIM coverage under its policy. To

the contrary, the letter informed plaintiff that GEICO required certain

documents to investigate plaintiff's claims and after review of those documents

it would determine the availability of UIM coverage.

      GEICO's October 30, 2020 letter explicitly stated that "[g]ranting

permission to settle is not intended to imply coverage or waive our right to a full

coverage investigation. UIM Coverage, if afforded will be reduced by the full

value of the [tortfeasors'] available liability limits." Therefore, plaintiff was

informed there was not yet a determination regarding the availability of UIM

benefits, and if she was entitled to UIM benefits, they would be reduced by the

full value of the tortfeasors' available liability limits.       Plaintiff cannot

demonstrate an estoppel claim.       The trial court properly granted GEICO

summary judgment.

      Affirmed.

                                                                             A-0103-22
                                        9