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Chubb Group on Behalf of Conrad v. Trenton Bd. of Educ.8/7/1997
The opinion of the court was delivered by
EICHEN, J.A.D.
The question presented by this appeal is whether a personal injury protection (PIP) carrier's right to seek reimbursement in the Workers' Compensation Division for medical benefits paid for its minor insureds is extinguished by the minors' decision to file a common-law tort action for damages against their employer. We conclude the PIP carrier's right is not extinguished under such circumstances.
Petitioner Chubb Group (Chubb) appeals from the entry of an order by the Division of Workers' Compensation (the Division) denying its claim for reimbursement for PIP medical benefits in excess of $29,000. The benefits were paid on behalf of petitioner's insureds, minors Marie and George Conrad, Jr., on account of injuries they sustained in a single car accident on July 8, 1992 which occurred while they were acting within the scope of their employment for the respondent, the Trenton Board of Education. The minors had PIP coverage under their parents' automobile policy.
On July 8, 1994, Chubb filed a claim petition with the Division seeking reimbursement for the medical expenses paid on behalf of the minors. Respondent denied liability because George and Marie, as minors, had chosen to exercise their statutory right of election and pursue a common-law tort action against respondent, N.J.S.A. 34:15-10 (preserving a minor's right "to recover damages in a common law or other appropriate action or proceeding for injuries received by reason of the negligence of his or her master"), rather than pursue a workers' compensation remedy.
The matter was heard by a workers' compensation Judge who, following oral argument, ruled in favor of respondent and dismissed the petition. The Judge determined that "where an employee ... affirmatively files in the Superior Court and invokes the jurisdiction of the Superior Court, there isn't any possible workers' compensation action that can be brought." The Judge also concluded that policy reasons and issues of fairness preclude the imposition of an unanticipated monetary burden upon workers' compensation carriers where injured employees are treated by medical providers who are not selected by the workers' compensation carrier. The Judge reasoned that neither the employer nor the workers' compensation carrier should have to absorb the cost of reimbursing the PIP carrier for unauthorized medical treatment, while facing the possibility of a substantial award in the personal injury action against the employer. Thus, the Judge concluded that permitting a PIP carrier to recover costs in the workers' compensation system "undermines the financial soundness of the ... system ... that results from control of the provision for treatment by employers and their carriers." Accordingly, the Judge concluded that he lacked jurisdiction over the petition. We disagree and reverse.
Although we afford substantial deference to an administrative agency's interpretation of a statute, we are not bound by that interpretation or the agency's determination of a strictly legal issue, which we conclude this case presents. Goodman v. Board of Review, 245 N.J. Super. 551, 556 (App. Div. 1991) (citing Mayflower Securities v. Bureau of Securities, 64 N.J. 85, 312 A.2d 497 (1973)). Construction of a statute is a judicial, not an executive function. Service Armament Co. v. Hyland, 70 N.J. 550, 561, 362 A.2d 13 (1976). And when the interpretation is clearly contrary to the plain meaning of the statute, we must override it. Philadelphia Outdoor v. New Jersey Expressway Authority, 221 N.J. Super. 207, 534 A.2d 77, appeal dismissed, 114 N.J. 470, 555 A.2d 598 (1987).
An insurer must make
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