On certification to the Superior Court, Appellate Division.
(This 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 Supreme Court. Please note that, in the interests of brevity, portions of any opinion may not have been summarized).
This appeal raises issues arising out of the lawsuit threshold provision of the Automobile Insurance Cost Reduction Act (AICRA).
On November 12, 2001, Tracey Johnson was driving her minivan on Route 130 in Bordentown, when she was struck by a vehicle driven by Benedict Scaccetti. The accident occurred at an intersection when Mr. Scaccetti disregarded a red light. The force of the impact knocked the minivan over. It skidded until it hit a median when it rolled over right side up.
Ms. Johnson immediately went to a local hospital where x-rays revealed that she had not broken her neck. She was instructed to see her doctor the following day. Once home, every part of her body hurt. Ms. Johnson soon discovered that the tips of her two eye teeth were missing. The next day she saw her dentist, who filed and capped her teeth, which remain sensitive.
The day following the accident, due to pain in her neck, lower back, and arms, Ms. Johnson sought treatment from a physician. The doctor prescribed medication, neck and hand braces, and physical therapy.
A month later, Ms. Johnson was still suffering persistent pain. She underwent an MRI of her cervical spine, which revealed a herniated disc. A pain management specialist administered steroid injections and acupuncture to relieve inflammation and treat muscle spasms. Because the pain in her lower back did not abate, Ms. Johnson underwent another MRI in 2002. This revealed grade one spondylolisthesis in lumbar and sacral vertebrae and a small disc herniation.
A third MRI in January 2003 disclosed no increase in the severity of the spondylolisthesis, but the herniation of the disc had enlarged. Ms. Johnson had a discogram, which revealed a herniated disc at the lumbarsacral site.
As a result of the tests, in May 2003 Ms. Johnson had spinal fusion surgery at the University of Pennsylvania Hospital. Following the surgery, Ms. Johnson wore a fiberglass body brace that extended from just underneath her chest to her right thigh. For three months, she was able to remove the brace only thirty minutes a day and required extensive assistance from her husband and others. Following removal of the body brace, Ms. Johnson engaged in very painful physical therapy until December 2003.
Ms. Johnson and her husband sued Mr. Scaccetti in January 2003, seeking damages for pain and suffering and for Mr. Johnson's loss of consortium. To comply with the lawsuit threshold requirement of their insurance policy, Ms. Johnson's treating dentist, Dr. Alina Lyons, certified that the chipped teeth constituted "displaced fractures" within the meaning of AICRA.
The matter went to trial in January 2005. At trial, Ms. Johnson testified to the manner in which the accident radically changed her lifestyle, with many activities either restricted or eliminated from her life.
Ms. Johnson's prior medical history became an issue at the trial. She had hurt her back in 1991 and had further incidents in 1993, 1997, and 1998. Her expert, Dr. David Lessing, acknowledged Ms. Johnson's prior injuries but concluded that the accident had aggravated and accelerated the condition that led to the spinal fusion surgery. That, in turn, produced "massive permanent changes" in her back. Overall, Dr. Lessing offered a "poor prognosis" for Ms. Johnson in respect of her lower back.
Dr. Lessing also offered his expert opinion on Ms. Johnson's neck injury. There, too, he concluded that she has a "poor prognosis," that the injury is permanent, and that the cervical disk will deteriorate at an accelerating rate.
Dr. Irving Ratner testified as defendant's expert. In his opinion, Ms. Johnson's back problems were not related to the accident but rather to pre-existing degenerative changes that "everyone gets along the way."
Before the case went to the jury, the trial court ruled as a matter of law that Ms. Johnson's chipped teeth --which Mr. Scaccetti stipulated had been caused by the accident -- constituted "displaced fractures" under AICRA. The court held that Mr. and Mrs. Johnson had met the threshold requirement and that the jury could consider all of her injuries proximately caused by the accident.
The jury found defendant liable for Ms. Johnson's injuries and awarded pain and suffering damages in the amount of $2.5 million. The jury also awarded Mr. Johnson $500,000 for his loss of consortium. Mr. Scaccetti moved for a new trial. Although the trial court denied that motion, he granted defendant's motion for a reduction in the damage award. The court lowered the awards to $1.5 million for Ms. Johnson and $250,000 for Mr. Johnson.
Both sides appealed to the Appellate Division. That court affirmed all of the decisions of the trial court except the damage awards. In respect of that, the Appellate Division reinstated the original amounts found by the jury.
The Court granted defendant's petition for certification.
HELD: Chipped teeth are not "displaced fractures" under the lawsuit threshold of the Automobile Insurance Cost Reduction Act (AICRA), N.J.S.A. 39:6A-1.1 to -35. Once a plaintiff suffers a single bodily injury that satisfies a threshold category under AICRA, the jury may consider all other injuries in determining non-economic damages. As a matter of law, plaintiff's spinal injury in the within matter satisfied the limitation on lawsuit threshold. Finally, the trial court failed to articulate sufficient reasons to justify a remittitur in this action.
1. AICRA does not define "displaced fractures." Uniform authority as reflected in medical and dental texts, non-medical reference books, and case law makes it clear that the ordinary meaning and significance of a displaced fracture is the complete separation of a bone. A chipped tooth does not meet that definition. (pp. 16-20)
2. The jury specifically found that the November 2001 accident proximately caused plaintiff's back injuries. The record leaves little doubt that those injuries also met the standard for permanency under AICRA, notwithstanding that the jury did not render a verdict on this precise issue. (pp. 20-21)
3. In determining whether, for the purpose of recovering non-economic damages, AICRA permits a single injury satisfying a threshold category to enable the jury to consider all other injuries regardless of whether they independently meet the threshold requirements, the Court has to look beyond the ambiguous statutory language. In 1994, the Appellate Division held -- in a pre-AICRA case -- that a single injury satisfying a threshold category allows the jury to consider all injuries in calculating pain and suffering damages. The Legislature had the opportunity to eliminate the Appellate Division's construction of the existing no-fault law by amending the language when it passed AICRA, but it did not do so. The Court finds the Legislature's apparent acceptance of the 1994 decision to be a strong indication of its intention to retain that interpretation. (pp. 22-27)
4. The Court rejects defendant's policy argument that allowing plaintiff to collect non-economic damages for all injuries proximately caused by an automobile accident when only a single injury satisfies a threshold category will frustrate the cost-cutting goals animating AICRA. That was not, in fact, the only goal of the Legislature. Further, it is far from certain that limiting a plaintiff's right to recover pain and suffering damages as proposed by defendant would actually decrease insurance costs. Rather, it is more likely that defendant's proposal would produce more litigation and perhaps an unmanageable scheme to administer. (pp. 27-29)
5. In respect of the remittitur of the damages verdict, a trial court should not reduce a jury's award unless it is so clearly disproportionate to the injury -- and a plaintiff's pain and suffering and loss of enjoyment of life -- that it may be said to shock the judicial conscience. In other words, the trial court must be clearly and convincingly persuaded that it would be manifestly unjust to sustain the award. Here, the trial court acknowledged that the jury acted in good faith and that the verdict was not tainted by sympathy or prejudice. It is equally clear that the trial court proceeded in good faith, grappling with a difficult and close issue. Although the jury's award is undoubtedly high, the trial court failed to articulate sufficient reasons to justify a remittitur. (pp. 30-36)
The judgment of the Appellate Division is MODIFIED and, as modified, is AFFIRMED. The matter is REMANDED to the trial court for further proceedings consistent with this opinion.
CHIEF JUSTICE ZAZZALI and JUSTICES LONG, LaVECCHIA, WALLACE, RIVERA-SOTO, and HOENS join in JUSTICE ALBIN's opinion.
The opinion of the court was delivered by: Justice Albin
An automobile insurance policyholder who opts for the limitation on lawsuit threshold of the Automobile Insurance Cost Reduction Act (AICRA), N.J.S.A. 39:6A-1.1 to -35, accepts, in exchange for lower insurance premium payments, restrictions on the right to sue for non-economic damages (pain and suffering) if injured in an accident.*fn1 A policyholder bound by the lawsuit threshold may not sue for non-economic damages unless she suffers "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." N.J.S.A. 39:6A-8(a).
In this case, which is governed by the lawsuit threshold, plaintiff Tracey Johnson suffered numerous injuries in an automobile accident, including back injuries and two chipped or broken teeth. She and her husband filed a negligence action. Both the trial court and Appellate Division found that her chipped teeth constituted "displaced fractures." Because Tracey vaulted the lawsuit threshold in that category, both courts also found that, for the purpose of calculating non-economic damages, the jury could consider all of her other injuries, regardless of whether those injuries independently satisfied a threshold category.
A jury awarded Tracey $2,500,000 in damages for pain and suffering and her husband $500,000 in damages for loss of consortium. The trial court determined that award to be grossly excessive and remitted it, allocating $1,500,000 to Tracey and $250,000 to her husband. The Appellate Division reversed and reinstated the jury award.
We now hold that chipped teeth are not "displaced fractures" under AICRA. We further hold that once a plaintiff suffers a single bodily injury that satisfies a threshold category, the jury may consider all other injuries in determining non-economic damages. We also affirm the Appellate Division's conclusion that, as a matter of law, Tracey's spinal injury satisfied the limitation on lawsuit threshold of N.J.S.A. 39:6A-8(a), entitling her to recover non-economic damages for all of her injuries proximately caused by the accident. Last, we affirm the Appellate Division's decision to reverse the remittitur and reinstate the jury award.
On November 12, 2001, plaintiff Tracey Johnson was driving a Ford Windstar minivan on Route 130 in Bordentown when defendant Benedict Scaccetti disregarded a red light at the Crosswick Street intersection, colliding into the passenger's side of her vehicle.*fn2 The force of the collision knocked the Ford minivan over and sent it skidding down the road on its driver's side until it struck a median, at which point the van rolled over right side up. As the van slid on its side toward the median, Tracey feared that her arm would be "chewed off" and that she was going to die.
Emergency personnel arrived at the scene and transported Tracey to Robert Wood Johnson Hospital in Hamilton where x-rays revealed that she had not broken her neck. She was released from the hospital wearing a cervical collar and told to see her doctor the next day.
Tracey, age thirty-nine, first called her husband, plaintiff Christopher Johnson, a network engineer in the United States Air Force who was on assignment in Qatar, and then returned to her home located on McGuire Air Force Base. Once home, every part of her body hurt, and soon Tracey realized that the tips of two eye teeth were missing. The next day, she visited her dentist, Dr. Alina E. Lyons, who filed down her teeth and capped them with bonding material. Tracey was informed that she likely suffered nerve damage and would need a root canal.*fn3 To this day, she still experiences sensitivity in her teeth.
The day following the accident, due to the pain in her neck, lower back, and arms, Tracey sought treatment from a physician on the base. The doctor prescribed valium, vicodin, and Tylenol; neck and hand braces; and physical therapy. To care for Tracey and assume responsibility for Tracey's two daughters, ages fifteen and thirteen, her parents flew in from Oregon. Additionally, Christopher was released from his ...