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UIM

In June, 2023, Plaintiff Michael Scott was injured in a car accident. At the time, he was driving a Jeep owned by his live-in girlfriend, Katie Opfer. Opfer was the lone named insured, Scott was listed as a driver, but not as a named insured. The driver at fault for the accident had a liability insurance policy carrying limits of $50,000. Opfer’s policy included uninsured and underinsured motorists (UM and UIM) coverage which provided $100,000 for each person, but contained explicit policy language that advised policy holders that the coverages in the policy may be limited by other  provisions in the policy. One such provision in the UM endorsement of the policy applied a “step-down” for UM/UIM coverage that narrowed the higher $100,000 UIM limits applying to only the named insured, resident spouse/civil union partner, and resident relatives; all others, specifically “any other person,” were only entitled to receive statutory minimum limits; $25,000 in New Jersey.

After filing suit against the at-fault party for his injuries and against Allstate for UIM benefits arising for his injuries out of the policy, Scott settled with the at-fault party for her full $50,000 policy limits. Allstate, claiming Scott, a listed driver but not a named insured, spouse, or relative, was not entitled to UIM benefits under the policy and asked the court to dismiss the suit. The trial court agreed and dismissed the suit against Allstate, causing Scott to appeal. The issue before the Appellate Division in Scott v. Snyder, 2026 N.J. Super. Unpub. LEXIS 177 (App. Div. Feb. 3, 2026) was whether Scott was in fact entitled to UIM coverage for his damages.

The Appellate Division looked at the policy and agreed with the trial court, affirming its decision in Allstate’s favor. Despite applicable law that requires courts to look at insurance contracts with “special scrutiny” due to the imbalance between insurer and their insureds in their understanding of insurance policies, the Court determined that the clear and unambiguous language of the policy did not provide UIM coverage for Scott. The Court specifically pointed to the language identifying who was entitled to UIM insurance, finding that Scott was neither a named insured, spouse/partner, or resident relative. As a result, he fell into the “step-down” category of “any other person,” to whom New Jersey’s minimum UIM coverage of $25,000 applied. More importantly, because the policy was limited by New Jersey statute, Scott would only be able to recover UIM benefits from Allstate if the UIM limits were in excess of his liability recovery from the at-fault driver. As a result, because the Court determined his UIM limits were $25,000, which is less than his liability recovery of $50,000, he was not entitled to UIM benefits from Allstate. If the Court had found he was entitled to the $100,000 UIM limits as a named insured, he would have been entitled to up to $50,000 of UIM coverage.

On January 10, 2018, plaintiff Amy Vanrell was driving a motor vehicle covered by an insurance policy with USAA and was in an accident.  She sued the other driver for her injuries but failed to make a claim against her insurance company, USAA, for underinsured motorist coverage until May 2, 2022.  The issue in Vanrell v. United Services Auto Assn., 2025 N.J. Super Unpub. LEXIS 1479 (App. Div. Aug. 6, 2025) was whether plaintiff failed to timely file an underinsured motorist claim under the terms of her insurance policy.

The other driver (the tortfeasor) involved in the accident had limited liability coverage of $50,000 per person/$100,000 per accident.  Plaintiff’s insurance policy with USAA provided underinsured motorist coverage (“UIM”) for bodily injuries of up to $300,000 per person/$500,000 per accident.

The day after the accident, on January 11, 2018, plaintiff notified USAA of her claim for property damages and personal injury protection benefits.  While she filed suit against the other driver on December 23, 2019 for her injuries, she failed to notify USAA of her suit at the time it was filed.

The first communication she had with USAA concerning an underinsured motorist claim was on May 2, 2022, when she sent USAA a letter seeking permission to settle her claims against the other driver for $43,000 (a “Longworth” letter).  In that letter, she identified the tortfeasor (the other driver) as an underinsured motorist and provided the name and docket number of plaintiff’s suit against the tortfeasor.

In her Longworth letter, she requested permission to settle her claims against the tortfeasor and asked whether USAA wished to waive subrogation of its claims against the tortfeasor.  USAA responded on May 4, 2022, approving the request to settle and waiving a potential subrogation claim but did not guarantee that the UIM coverage had been triggered by that loss.

On the day after, plaintiff’s counsel wrote to USAA demanding its $300,000 policy “to amicably resolve this matter.”  Thereafter, there were a number of correspondences back and forth in which USAA was asking for medical records to evaluate plaintiff’s settlement demand.  On February 24, 2023, USAA did offer to settle plaintiff’s UIM claim for $85,000.  However, plaintiff rejected that demand.  Eventually, USAA increased its offer to $100,000 to settle.

On May 17, 2023, plaintiff filed a lawsuit against USAA seeking UIM coverage.  USAA filed an Answer, which asserted as an affirmative defense that the complaint was barred by the statute of limitations and plaintiff failed to comply with the terms of the policy.  Discovery was thereafter exchanged.  Before the close of discovery, USAA moved to dismiss the complaint as untimely under the terms of the policy.  It argued that the policy required plaintiff to file her UIM claim within four years after the accident or one year of when she was aware or should have been aware of her UIM claim, whichever was later. 

Plaintiff opposed this motion, arguing that the six-year statute of limitations for breach of contract claims applied.

The trial court found that plaintiff did not timely file the complaint but did not specify which of the policy limitation periods applied, either the four year or one year, in reaching its decision.  It also did not address plaintiff’s conformity-to-law and equitable estoppel arguments.

This appeal ensued.  The plaintiff made the arguments that the six-year statute of limitations applied, that USAA was equitably estopped from raising the timeliness of plaintiff’s complaint, that it waived its timeliness argument by not raising it in its Answer and that the four year period in the policy, if applicable, was tolled until USAA denied UIM coverage.

The Appellate Division noted that the primary issue before the court was which of the two limitations period applied to plaintiff’s UIM claim – the six-year statute of limitations that applies to contract claims or the four-year statute of limitations in the policy.

The Court noted that New Jersey law holds that the six-year statute of limitations would ordinarily apply to insurance actions.  However, under New Jersey case law, the courts have found that period may be shortened by the terms of an insurance contract. 

The Appellate Division found that the USAA policy contained an unequivocal provision shortening the time period in which plaintiff must file her UIM claims to four years from the date of accident or one year from the date she was aware or should have been aware that she had a UIM claim, whichever was later.

It found that four years from the date of the January 10, 2018 accident would have been January 10, 2022.  While plaintiff did not identify the date on which she became aware or should have become aware that she had a UIM claim, she presumably became aware of the extent of her injuries and the limits of the tortfeasor’s insurance coverage while her lawsuit against the tortfeasor was pending in the Law Division.  At the very latest, she was aware of her UIM claim on May 2, 2022, when she requested USAA’s consent to settle her claims against a tortfeasor for less than what plaintiff alleged her damages from the accident.

Plaintiff did not file a lawsuit against USAA for the UIM claim until May 17, 2023, which was more than a year and four months after the January 10, 2022 date and fifteen days after May 2, 2023.  Therefore, the Appellate Division found that under either prong of the contractual limitations, (either the four-year period or the one-year period), plaintiff’s complaint was untimely.

The Court found that legal precedent has permitted parties to an insurance contract to agree to a shorter limitations period than is provided by the statute.  Further, the Court’s review of the record did not reveal any basis on which to apply equitable estoppel to bar USAA from raising the timeliness of plaintiff’s complaint. 

The Appellate Division also rejected Plaintiff’s other arguments.  Hence, the Court affirmed the trial court’s decision, barring the plaintiff’s uninsured motorist claim due to the failure to comply with the policy’s statute of limitations. 

Plaintiff Calise Belin was injured in a two vehicle accident after stopping at a stop sign on Lafayette Road in Voorhees, preparing to turn left on Haddonfield-Berlin Road. Plaintiff looked both ways and not seeing anyone coming, turned left. She collided with a vehicle being driven by Debra Lawless-Gattone who was travelling northbound on Haddonfield-Berlin Road. The issue in Belin v. New Jersey Manufacturers Ins. Co., 2022 N.J. Super. Unpub. LEXIS 1400 (App. Div. Aug. 5, 2022), was whether Plaintiff Belin was more than 50% at fault, precluding her from recovering any underinsured motorist benefits from her insurance company, NJM.

Plaintiff had been driving to a basketball game after work in a car owned by her parents. At the time of the accident, it was dark and rainy. The other driver, Lawless-Gattone, was on her way to pick up her son from hockey practice. She was in the left lane of Haddonfield-Berlin Road, deciding whether to move to the right lane when she saw Plaintiff’s car approach the stop sign on Lafayette Road. She was satisfied that Plaintiff would stop and checked her rear view mirror to see if it was safe to move into the right lane. Lawless-Gattone’s path of travel was not controlled by any traffic sign or signal. When she turned back, Plaintiff was coming out of Lafayette Road, turning in front of her. She braked and turned her wheel in an attempt to avoid Plaintiff but did not have sufficient time to stop before colliding with Plaintiff’s driver’s side door.

Plaintiff claimed that she stopped and that the fault of the accident lay with Lawless-Gattone because she hit Plaintiff. She claims that Lawless-Gattone could have paid better attention to avoid the accident. Plaintiff claimed that Lawless-Gattone was speeding or, at least, driving too fast for existing weather conditions. She also alleged that Lawless-Gattone was distracted by looking around to change lanes.

Under New Jersey law, it was the Plaintiff’s burden to establish that Lawless-Gattone was at least 50 percent negligent for the accident to permit Plaintiff to recover against NJM (for underinsured motorist benefits). The trial court judge, Judge Belgard, disagreed with Plaintiff’s claim that Lawless-Gattone was at fault and dismissed the case. Although Lawless-Gattone may have given different statements about the speed limit on Haddonfield-Berlin Road where the accident happened, her testimony was consistent that she was not speeding. Plaintiff offered no contrary testimony. The judge also found no evidence in the record that Lawless-Gattone was distracted.

This decision was appealed to the Appellate Division, which agreed with the trial court judge. Plaintiff had failed to offer evidence “to permit a rational factfinder to conclude Lawless-Gattone was speeding or distracted or that plaintiff who was making a left turn in front of Lawless-Gattone from a side street controlled by a stop sign, had the right of way, even when viewed in the light most favorable to plaintiff.”  To prevent summary judgment from being granted, a plaintiff must “demonstrate by competent evidential material that a genuine issue of fact existed.”  The Court noted that plaintiff failed to do so and affirmed the entry of summary judgment in favor of NJM, dismissing the lawsuit.

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