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Bernick v. Aetna Life and Casualty

April 7, 1978

ROSEMARIE BERNICK, PLAINTIFF,
v.
AETNA LIFE AND CASUALTY, DEFENDANT



Mackenzie, J.c.c. (temporarily assigned).

Mackenzie

[158 NJSuper Page 576] The sole issue in this case concerns the interrelationship between the personal injury protection benefits (PIP) provided in an automobile liability policy as required by the New Jersey Automobile Reform Act (No Fault Law), N.J.S.A. 39:6A-1

et seq. , and the medical expense benefits for work-related injuries under the Workers' Compensation Act, N.J.S.A. 34:15-1 et seq.

The facts are undisputed. Plaintiff Rosemarie Bernick, while operating an automobile owned by the Visiting Nurse Association of Plainfield (Association), suffered back and neck injuries when her car was struck from behind by a vehicle operated by Billy A. Snow. The accident occurred in Plainfield, New Jersey, on February 20, 1976 while Mrs. Bernick was in the course of her employment with the Association as a public health nurse. The Association held an automobile policy of insurance containing PIP benefits issued by Aetna Casualty and Surety Company (Aetna). The Association also had a workers' compensation policy issued by Aetna. Both policies insured plaintiff.

Plaintiff filed an employee's claim petition with the Division of Workers' Compensation. Aetna filed a timely answer to the claim petition. On August 4, 1977 an order for judgment was entered in the Workers' Compensation Division awarding Mrs. Bernick 4 1/2% of permanent disability, which amounted to $990. Under the compensation policy Aetna also paid Mrs. Bernick's medical expenses, which totalled $326.55. Aetna then asserted its compensation lien against Mrs. Bernick in the amount of $1,316.55. N.J.S.A. 34:15-29.

On October 5, 1976 Mrs. Bernick and her husband filed a negligence complaint in the Superior Court against Snow and his employer. The third-party action was settled between the parties on September 26, 1977 for $2,700. Honoring the carrier's lien, Mrs. Bernick repaid the full amount thereof, including the $326.55 medical expenses.

Immediately thereafter Mrs. Bernick applied in writing to Aetna for reimbursement of $326.55 under the terms of the PIP endorsement to the automobile insurance policy. On October 14, 1977 Aetna denied her claim. This action for first-party benefits followed.

Cross-motions for summary judgment are now before the court. Plaintiff seeks judgment compelling defendant to reimburse the medical expenses from the PIP coverage. Defendant contends this action is barred as a matter of law by the "collateral source rule" of N.J.S.A. 39:6A-6. The case is ripe for summary disposition R. 4:46, as made applicable by R. 6:6-1; Judson v. Peoples Bank and Trust Co. , 17 N.J. 67 (1954).

PIP medical expense benefits are payable to insured persons who suffer personal injuries under the No Fault Law. N.J.S.A. 39:6A-4(a). Aetna concedes that plaintiff's medical expenses were reasonable and necessary. The basis of Aetna's decision to deny PIP coverage was its reading of N.J.S.A. 39:6A-6.*fn1 The statute provides as follows:

The benefits provided in section 4a., b., c., d., and e. and section 10, [the basic and supplemental PIP benefits] shall be payable as loss accrues, upon written notice of such loss and without regard to collateral sources, except that benefits collectible under workmen's compensation insurance, employees temporary disability benefit statutes and medicare provided under Federal law, shall be deducted from the benefits collectible under section 4a., b., c., d., and e. and section 10.

The statutory scheme is that benefits collectible under workers' compensation are to be deducted from the benefits collectible under PIP. Plaintiff's argument is that she should be able to recover from her PIP carrier those workers' compensation benefits which she has reimbursed. This argument, while initially persuasive, falls in the face of the clear and mandatory language of the statute. The statute says that ...


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