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Boyd v. Plymouth Rock Assurance Corp.

Superior Court of New Jersey, Appellate Division

May 28, 2013

JACOB BOYD, Individually and on behalf of a Class Similarly Situated, Plaintiff-Respondent,
v.
PLYMOUTH ROCK ASSURANCE CORPORATION, PLYMOUTH ROCK ASSURANCE NEW JERSEY and HIGH POINT PREFERRED INSURANCE COMPANY, Defendants-Appellants, and HILDA WENZ, Plaintiff, and PALISADES SAFETY INSURANCE ASSOCIATION, Defendant.

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION

Submitted May 14, 2013

On appeal from the Superior Court of New Jersey, Law Division, Essex County, Docket No. L-9959-11.

Skadden, Arps, Slate, Meagher & Flom, L.L.P., attorneys for appellants (Robert J. Del Tufo, of counsel and on the brief).

Nagel and Rice, L.L.P., attorneys for respondents (Bruce H. Nagel, of counsel and on the brief; Randee M. Matloff, on the brief).

Before Judges Reisner and Hoffman.

PER CURIAM

Defendant High Point Preferred Insurance Company (High Point)[1] appeals from a trial court order dated June 12, 2012, denying its motion to dismiss plaintiff Jacob Boyd's complaint and permitting Boyd to file an amended complaint, and from a September 28, 2012 order denying its motion for reconsideration.[2] For the reasons that follow, we reverse the orders on appeal and remand this matter to the Law Division for the limited purpose of entering an order enforcing arbitration.

I

Boyd filed a Class Action Complaint and Jury Demand against High Point, contending that the insurer had improperly reduced the available amount of his personal injury protection (PIP) benefits. Specifically, Boyd asserted that High Point improperly characterized as PIP benefits the administrative expenses that it paid to claims administrators, although those charges were not "medical expenses" as defined by N.J.S.A. 39:6A-2(e). Boyd claimed that, in his case, High Point had applied about $6600 in administrative costs against the "PIP ledger, " leading to the premature exhaustion of his PIP benefits. Boyd claimed that High Point's practice violated N.J.S.A. 39:6A-2(e), N.J.A.C. 11:3-28.6(a), and his insurance contract with High Point. He also sought to represent a class of insured persons who were or could in the future be affected by High Point's allegedly unlawful practice.

High Point filed a motion to dismiss the complaint pursuant to Rule 4:6-2(e). In support of the motion, High Point submitted a certification from its claims director attesting that Boyd had not exhausted the $250, 000 limits on his PIP benefits. High Point also submitted an authenticated copy of Boyd's insurance policy, which contained an arbitration clause.[3] The clause read as follows:

If we and any person seeking personal injury protection coverage . . . do not agree as to the recovery of personal injury protection coverage under this coverage, either party may submit the matter to dispute resolution in accordance with New Jersey Law or regulations.

The contract clause reflected the requirements of the Automobile Insurance Cost Reduction Act (AICRA), N.J.S.A. 39:6A-1.1 to -35, which likewise provides for arbitration of PIP claims:

Any dispute regarding the recovery of medical expense benefits or other benefits provided under personal injury protection coverage . . . arising out of the operation, ownership, maintenance or use of an automobile may be submitted to dispute resolution on ...

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