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Ingersoll v. Aetna Cas. and Sur. Co.

Decided: December 13, 1994.

BONNIE INGERSOLL, PLAINTIFF, AND BRIAN LIHOU, PLAINTIFF-APPELLANT,
v.
AETNA CASUALTY AND SURETY COMPANY, A/K/A AETNA LIFE AND CASUALTY, A/K/A AETNA, DEFENDANT-RESPONDENT, AND THE NEW JERSEY AUTOMOBILE FULL INSURANCE UNDERWRITING ASSOCIATION, HERBERT E. GASKILL INSURANCE AGENCY, HERBERT E. GASKILL, JR., AND JOHN DOE(S), A THROUGH Z, FICTITIOUS NAME(S), PERSON(S) OR UNDERWRITER(S), INDIVIDUALLY JOINTLY, SEVERALLY AND IN THE ALTERNATIVE, DEFENDANTS.



On certification to the Superior Court, Appellate Division, whose opinion is reported at 269 N.J. Super. 192 (1993).

Chief Justice Wilentz and Justices Clifford, Handler, Pollock, O'Hern, Garibaldi, and Stein join in this opinion.

Per Curiam

The New Jersey Automobile Reparation Reform Act, N.J.S.A. 39:6A-1 to -35 (No-Fault Law), contains what is commonly known as an anti-stacking provision, N.J.S.A. 39:6A-4.2 (section 4.2). That statute prohibits recovery of personal-injury-protection (PIP) benefits under more than one automobile-insurance policy for injuries sustained in any one accident. The question posed by this appeal is whether that statutory prohibition against "stacking" is limited to basic PIP benefits or whether it forecloses as well recovery of extended medical-expense benefits under two policies when the "stacking" would not result in double recovery of medical expenses.

The trial court ruled that under the statutory bar such "stacking" was not permitted. The Appellate Division affirmed, 269 N.J. Super. 192 (1993), and we granted certification, 135 N.J. 299 (1994). We reverse.

I

Plaintiff Brian Lihou was the owner of an automobile insured with New Jersey Full Automobile Insurance Underwriting Association (JUA). In October 1987, Brian was riding his brother's motorcycle when it collided with an automobile operated by one Lisa Hamilton. As a result of that accident Brian sustained catastrophic injuries and incurred medical bills in excess of $35,000.

Because he was riding a motorcycle when the accident occurred, Brian was not eligible to recover his medical expenses under the basic PIP coverage of his automobile policy with JUA. See N.J.S.A. 39:6A-4, -2a. However, in keeping with the regulatory mandate of the Commissioner of Insurance, see N.J.A.C. 11:3-7.3(b), Brian's JUA policy contained an extended-medical-expense-benefits provision, which furnished coverage for medical expenses resulting from a broader scope of accidents, including those incurred while driving a motorcycle under certain circumstances. The limit of that coverage was $10,000, which JUA paid to Brian.

At the time of the accident, Brian was living with his mother, plaintiff Bonnie Ingersoll. (References hereinafter to "plaintiff" are to Brian.) Ingersoll owned an automobile that was insured by Aetna Casualty & Surety Co. (Aetna), whose policy extended coverage to Brian as well inasmuch as he was a "relative" of the named insured, defined in the standard policy as "a person related to the named insured by blood, marriage or adoption * * * who is a resident of the same household as the named insured." See Cynthia M. Craig & Daniel J. Pomeroy, New Jersey Auto Insurance Law app. C-1 at 561 (1995).

Like the JUA policy, the Aetna policy also contained an extended-medical-expense-benef its provision with a limit of $10,000. When plaintiff sought recovery under that provision, Aetna denied coverage on the ground that section 4.2 prohibited the "stacking" of PIP benefits and that the extended medical-expense benefits constituted PIP benefits for purposes of that statute. Plaintiff sued to recover the $10,000 under Aetna's extended-medical-expense-benefits provision.

In affirming the trial court's summary judgment for Aetna, the Appellate Division relied not only on the anti-stacking provision of section 4.2 but also on the language in Aetna's policy. 269 N.J. Super. at 196-98.

II

The No-Fault Law prohibits the stacking of PIP benefits. Section 4.2 provides, in ...


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