Prior to the June 17, 2017, Superior Court of New Jersey Appellate Division decisions in Haines v. Taft and Little v. Nishimura, New Jersey trial courts routinely ruled Plaintiffs were barred from seeking payment from tortfeasors of medical expenses they incurred if below the "standard policy" personal injury protection ("PIP") benefits provision of $250,000. This often occurred where the injured plaintiff maintained an automobile insurance policy providing limited PIP benefits of $15,000 rather than the "standard policy" PIP benefits provision of $250.000. In both Haines and Little, plaintiffs appealed such a trial court ruling.
In both cases, plaintiffs had opted for $15,000 in PIP coverage rather than the standard $250,000. Each injured plaintiff, however, incurred medical expenses far greater than $15,000. The trial court in each matter barred plaintiffs from seeking those costs from the tortfeasors. The trial courts' decisions were based – as many other New Jersey trial courts before – on N.J.S.A. 39:6A-12 which makes inadmissible "evidence of the amounts collectible or paid under a provision for PIP benefits in a standard policy." Defendants in the past argued, and most trial courts agreed, that because $250,000 is the PIP limit provided in a standard policy, the statute bars plaintiffs from collecting the first $250,000 in medical expenses incurred even if the injured Plaintiff had the lower $15,000 – less expensive – PIP provision in their automobile insurance policy. In these situations, although Plaintiffs were responsible for the medical expenses themselves in excess of their $15,000 of PIP benefits, they could not seek recoupment of those medical expenses as a measure of their damages from tortfeasors.
Addressing Plaintiffs' claims on appeal, the Appellate Division in a consolidated opinion noted that (by statute) automobile insurers must provide five different PIP coverage options of $250,000, $150,000, $75,000, $50,000, or $15,000. The Appellate Court held that the phrase "amounts collectible or paid under a standard policy" did not refer solely to policy limits of $250,000. The language instead refers to those PIP limits covering the particular insured, making only those medical expenses up to and including the chosen PIP limits not collectible from the tortfeasor. As both Plaintiffs in Haines and Little selected PIP coverage of $15,000, evidence of medical expenses between $15,000 and $250,000 was admissible and recoverable against the tortfeasors, subject to any other relevant statutory provisions.
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