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Cooper Hospital University Medical Center v. Prudential Insurance Co.

June 27, 2005

COOPER HOSPITAL UNIVERSITY MEDICAL CENTER, PLAINTIFF-APPELLANT,
v.
PRUDENTIAL INSURANCE COMPANY, DEFENDANT-RESPONDENT.



On appeal from the Superior Court of New Jersey, Law Division, Camden County, Docket No. L-7024-02.

The opinion of the court was delivered by: Parrillo, J.A.D.

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE COMMITTEE ON OPINIONS

APPROVED FOR PUBLICATION

Argued October 19, 2004

Before Judges Skillman, Collester and Parrillo.

At issue is whether the 1998 amendment to New Jersey's deemer statute, N.J.S.A. 17:28-1.4, L. 1997, c. 436, § 1, limits an insurer's obligation to provide the full benefits mandated by New Jersey law to an out-of-state insured injured in a New Jersey auto accident, when the insurer is authorized to transact auto insurance business in this State. The motion judge ruled that the statute as amended does not extend personal injury protection (PIP) benefits to non-residents of New Jersey and, therefore, granted summary judgment to defendant-respondent, Prudential Insurance Company (Prudential). Plaintiff, Cooper Hospital University Medical Center (Cooper), appeals. We now reverse.

The facts are not in dispute. In the evening of January 29, 2002, Ralph Turchi Jr., a Pennsylvania resident, was a passenger in his own vehicle, driven by his nephew, when it collided with another vehicle that had crossed the highway median on I-76 in Gloucester City. Turchi sustained serious injuries and was treated at Cooper where he remained for several days before his death on February 2, 2002. During his stay at Cooper, decedent incurred medical expenses of $123,036.

Decedent's vehicle was insured by Prudential, which, pursuant to Pennsylvania law, provided minimum coverage that included $10,000 in medical, $5,000 in basic income loss, and $1,500 in funeral benefits. Prudential is authorized to transact automobile insurance business in New Jersey.

Cooper demanded from Prudential payment of $123,036 on the outstanding balance for services rendered to Turchi during his hospitalization. Prudential denied payment to Cooper on the basis that the PIP benefits provided under the insured's Pennsylvania automobile insurance policy had been exhausted. Thereafter, Cooper sued Prudential, claiming a right to payment under the deemer statute. Prudential answered and, following discovery, moved for summary judgment on the ground that the 1998 amendment to N.J.S.A. 17:28-1.4 limited its obligation to pay New Jersey-mandated PIP minimums to out-of-state residents. The motion judge agreed, granted summary judgment to Prudential, and dismissed Cooper's complaint.

We begin our analysis by noting that "the meaning of a statute must . . . be sought in the language in which the act is framed, and if that is plain, . . . the sole function of the courts is to enforce it according to its terms." Sheeran v. Nationwide Mut. Ins. Co., 80 N.J. 548, 556 (1979) (quoting Caminetti v. United States, 242 U.S. 470, 485, 37 S.Ct. 192, 194, 61 L.Ed. 442, 452 (1917)). Interpretation of a statute commences with an analysis of the language of the statute, Higgins v. Pascack Valley Hosp., 158 N.J. 404, 418 (1999), which "ordinarily" governs if the plain language is unambiguous and clear. State v. Kittrell, 145 N.J. 112, 122-23 (1996); Board of Educ. of Tp. of Neptune v. Neptune Tp. Educ. Ass'n, 144 N.J. 16, 25 (1996). However, when the meaning of a word used in a statute is not explicit, or where the literal application of the word suggests more than one arguable meaning, the court's function is to ascertain the Legislature's purpose in enacting the statute. Burns v. Belafsky, 166 N.J. 466, 473 (2001). To that end, "words used may be expanded or limited according to the manifest reason and obvious purpose of the law. The spirit of the legislative direction prevails over the literal sense of the terms." New Capitol Bar & Grill Corp. v. Div. of Employment Sec., 25 N.J. 155, 160 (1957) (quoting Alexander v. New Jersey Power & Light Co., 21 N.J. 373, 378 (1956)).

Legislative intent may be determined by analyzing "legislative history, committee reports, and contemporaneous construction." Burns v. Belafsky, supra, 166 N.J. at 473. It may also be derived from an overall understanding of the words utilized and their relationship to other related provisions. State v. Afanador, 134 N.J. 162, 172 (1993). "There is need to keep in view . . . the structure of the statute, and the relation . . . between its several parts." Duparquet Huot & Moneuse Co. v. Evans, 297 U.S. 216, 218, 56 S.Ct. 412, 413, 80 L.Ed. 591 (1936). In other words, the meaning of a word or series of words may be ascertained by reference to a neighboring set of words or similar provisions in the same statutory scheme. State v. Mortimer, 135 N.J. 517, 536 (1993), cert. denied, 513 U.S. 970, 115 S.Ct. 440, 130 L.Ed. 2d 351 (1994). Our goal is to "try 'to make sense out of the legislation, so far as text and context may allow.'" City of Clifton v. Zweir, 36 N.J. 309, 322 (1962) (quoting Llewellyn, The Common Law Tradition: Deciding Appeals 529 (1960)).

Against this backdrop, we begin our statutory analysis. New Jersey's "deemer" statute was amended effective January 19, 1998 (1998 amendment). We recite the statute in full and underline the portions that were added by the 1998 amendment:

Any insurer authorized to transact or transacting automobile or motor vehicle business in this State, or controlling or controlled by, or under common control by, or with, an insurer authorized to transact or transacting insurance business in this State, which sells a policy providing automobile or motor vehicle liability insurance coverage, or any similar coverage, in any other state or in any province of Canada, shall include in each policy coverage to satisfy at least the personal injury protection benefits coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6-A4) or section 19 of P.L.1983, c.362 (C.17:28-1.3) for any New Jersey resident who is not required to maintain personal injury protection coverage pursuant to section 4 of P.L.1972, c.70 (C.39:6A-4) or section 4 of P.L.1998, c.21 (C.39:6A-3.1) and who is not otherwise eligible for such benefits, whenever the automobile or motor vehicle insured under the policy is used or operated in this State.

In addition, any insurer authorized to transact or transacting automobile or motor vehicle insurance business in this State, or controlling or controlled by, or under common control by, or with, an insurer authorized to transact or transacting automobile or motor vehicle insurance business in this State, which sells a policy providing automobile or motor vehicle liability insurance coverage, or any similar coverage, in any other state or in any province of Canada, shall include in each policy coverage to satisfy at least the liability insurance requirements of subsection a. of section 1 of P.L.1972, c.197 (C.39:6B-1) or section 3 of P.L.1972, c.70 (C.39:6A-3), the uninsured motorist insurance requirements of subsection a. of section 2 of P.L.1968, c.385 (C.17:28-1.1), and personal injury protection benefits coverage pursuant to ...


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