A Capehart Scatchard Blog

Whether Plaintiff Qualifies as an Insured Under UIM Endorsement Not Subject to Arbitration

By on June 8, 2018 in Arbitration with 0 Comments

Plaintiff Carole Zelig was injured in an automobile accident, while a passenger in a vehicle operated by a friend. She settled her personal injury claim against the tortfeasor and then filed an underinsured motorist (UIM) claim against the defendant Tower Group Companies, the carrier for a business partially owned by plaintiff. In Zelig v. Tower Group Companies, 2018 N.J. Super. Unpub. LEXIS 1217 (App. Div. May 25, 2018), the issue was whether the plaintiff qualified as an “insured” and should that determination be made by the court or by an arbitrator.

Defendant Tower Group Companies (“Tower”) issued its policy to This and That Uniform, LLC, a company partially owned by plaintiff. The legal issue to be determined was whether under the terms of the UIM endorsement the plaintiff was an “insured” under the basic insuring clause in the endorsement. Both parties filed for a summary judgment and the trial court judge ruled that the issue should be resolved in arbitration with the arbitrator resolving this legal question.

On appeal, the defendant carrier argued that the judge should not have required the parties to arbitrate whether the plaintiff qualifies as an “insured” under the endorsement. Defendant had asserted that plaintiff was not an “insured” because she was not occupying a covered vehicle as described in the endorsement. Rather, it contended this issue was a legal question that should have been decided by the judge.

The Appellate Division declined to exercise original jurisdiction to decide this issue. However, the Court agreed with the defendant carrier that the judge should have made this determination. The endorsement stated that “disputes concerning coverage . . . may not be arbitrated.” Thus, the Appellate Division found this dispute concerned coverage and reversed and remanded back to the trial court judge to decide the issue. The Court held that this issue was not one that should have been referred to an arbitrator to decide.


About the Author

About the Author:

Ms. Ramos is an Executive Committee Member and Co-Chair of the Litigation Department at Capehart Scatchard, P.A. located in Mount Laurel, New Jersey. She is an experienced litigator with over 30 years experience handling diverse matters. Practice areas include tort defense, business litigation, estate litigation, tort claims and civil rights defense, construction litigation, insurance coverage, employment litigation, shareholder disputes, and general litigation.

For the years 2020-2023, Ms. Ramos was selected for inclusion in The Best Lawyers in America© in the practice area of Litigation - Insurance. The attorneys on this list are selected based upon the consensus opinion of leading lawyers about the professional abilities of their colleagues within the same geographical area and legal practice area. A complete description of The Best Lawyers in America© methodology can be viewed via their website at: https://www.bestlawyers.com/methodology.

In 2021, Capehart Scatchard and Ms. Ramos received the “Best Law Firm” ranking in the area of Litigation – Insurance (Metro, Tier 3) published by U.S. News & World Report and Best Lawyers®. Law firms included on the list are recognized for professional excellence with consistently impressive ratings from clients and peers. To be eligible for a ranking, a firm must have at least one attorney who has been included in the current edition of Best Lawyers in America, which recognizes the top five percent of practicing lawyers in the United States. Betsy Ramos (Litigation – Insurance) was recognized for this prestigious award in the 2021 edition. For a description of the “Best Law Firm” selection methodology please visit: https://bestlawfirms.usnews.com/methodology.aspx.

“Best Law Firms” is published by Best Lawyers in partnership with U.S. News & World Report. For a description of the selection methodology please visit: https://bestlawfirms.usnews.com/methodology.aspx.

*No aspect of this advertisement has been submitted to or approved by the Supreme Court of New Jersey.


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