Idea Transcript
CASE NO. 18 Z 600 20398 2
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AMERICAN ARBITRATION ASSOCIATION NO-FAULT/ACCIDENT CLAIMS In the Matter of the Arbitration between (Claimant) AAA CASE NO.: 18 Z 600 20398 2 INS. CO. CLAIMS NO: 02933665 DRP NAME: Herbert S. Alterman NATURE OF DISPUTE: Eligibility
v.
OHIO CASUALTY INS. CO. (Respondent)
AWARD OF DISPUTE RESOLUTION PROFESSIONAL I, THE UNDERSIGNED DISPUTE RESOLUTION PROFESSIONAL (DRP), designated by the American Arbitration Association under the Rules for the Arbitration of No-Fault Disputes in the State of New Jersey, adopted pursuant to the 1998 New Jersey “Automobile Insurance Cost Reduction Act” as governed by N.J.S.A. 39:6A-5, et. seq., and, I have been duly sworn and have considered such proofs and allegations as were submitted by the Parties. The Award is DETERMINED as follows: Injured Person(s) hereinafter referred to as: LD 1. ORAL HEARING held on
6/23/03
2. BOTH PARTIES APPEARED at the oral hearing(s). Respondent appeared telephonically. 3. Claims in the Demand for Arbitration were not amended at the oral hearing. (Amendments, if any, set forth below). STIPULATIONS were not made by the parties regarding the issues to be determined (Stipulations, if any, set forth below). 4. FINDINGS OF FACTS AND CONCLUSIONS OF LAW:
LD was involved n an accident on 3/27/02. His Affidavit of No Insurance indicates that he lived alone on that date and that no one in his household owned an automobile. The police report of the accident, however, shows his address to be the same address as is stated the Affidavit of No Insurance signed by MB, the driver of the vehicle in which LD was a passenger. MB’s affidavit also indicates that JB, the owner of the car, and 2 other persons live at the same address. JB is insured by Prudential, lists his address as 407 New York Avenue, Union City, N.J. . Claimants have neither submitted any evidence explaining the discrepancy between LD’s affidavit and the police report and the affidavit of MB, nor submitted any evidence supporting his Affidavit of No Insurance. I find that LD is not eligible to received PIP benefits under the Ohio Casualty policy of insurance. Claimants' rights rise no higher than those of their assignor. See, Allstate Ins. Co. v Lopez, 325 N.J.Super. 268 (Law Div. 1999); Tirgan v Mega Life & Health Ins., 304 N.J. Super 385 (Law Div. 1970). They are not entitled to PIP benefits under the Ohio Casualty policy.
CASE NO. 18 Z 600 20398 2
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Ohio Casualty seeks to recover PIP benefits erroneously paid to one or both of the claimants for services rendered to LD. However, it has not filed an arbitration to recover the same. In view of the finding that LD is not eligible for PIP benefits under the Ohio Casualty policy, it is unnecessary to address the other defense raised by respondent. 5. MEDICAL EXPENSE BENEFITS: Denied Provider
Amount Claimed
Amount Awarded
Payable to
Explanations of the application of the medical fee schedule, deductibles, co-payments, or other particular calculations of Amounts Awarded, are set forth below. 6. 7. 8. 9.
INCOME CONTINUATION BENEFITS: ESSENTIAL BENEFITS: DEATH BENEFITS: FUNERAL EXPENSE BENEFITS:
Not In Issue Not In Issue Not In Issue Not In Issue
10. I find that the CLAIMANT did not prevail, and I award no COSTS/ATTORNEYS FEES under N.J.S.A. 39:6A-5.2 and INTEREST under N.J.S.A. 39:6A-5h. (A) Other COSTS as follows: (payable to counsel of record for CLAIMANT unless otherwise indicated): (B) ATTORNEYS FEES as follows: (payable to counsel of record for CLAIMANT unless otherwise indicated): (C) INTEREST is as follows: This Award is in FULL SATISFACTION of all Claims submitted to this arbitration. October 31, 2003 Date
________________________ Herbert S. Alterman, Esq.