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Legal Updates for Insurance Services

Supreme Court of New Jersey Strikes Down “Step Down” Provision In Policy Issued to Automobile Dealership

Legal Updates for Insurance Services - April 21, 2021

April 21, 2021

by Todd J. Leon

This morning, the Supreme Court of New Jersey handed down its decision in Huggins v. Aquilar, (A-78-19). The case involved the twin questions of (1) whether the insurance company that issued a Garage policy to an automobile dealership owed liability coverage to a customer who was involved in an accident while driving a loaner vehicle provided by the dealership, and (2) if so, how much coverage the insurer owed. After examining the issues presented, the court concluded that the provision in the Garage policy purportedly limiting coverage to customers constituted an illegal escape clause, but that, at least with respect to the policy at issue, the amount of coverage available was to be reformed from the policy limits to the compulsory requirement set forth by the Motor Vehicles Commission (MVC).

The accident at issue involved a car driven by Mary Aquilar, which was loaned to her by a car dealership, Trend Motors, while the dealership serviced Aquilar’s personal vehicle. At the time of the accident, Aquilar was insured under a personal auto policy issued by GEICO, which included limits of $15,000 per person and $30,000 per accident. Trend was insured under a Garage policy issued by Federal Insurance Company, which included $1,000,000 in liability coverage.

While driving the car loaned to her by Trend, Aquilar struck a pedestrian, Tyrone Huggins. At the time of the crash, Huggins was insured under a personal auto policy issued by NJM Insurance Company, which included $100,000 in UIM benefits.

After Huggins filed a complaint against Aquilar, GEICO deposited its $15,000 policy limits into court. Huggins then sought UIM coverage from his personal auto insurer, NJM, which asserted that it did not owe UIM coverage because Huggins was entitled to $1,000,000 in liability coverage under the Garage policy issued by Federal to Trend.

The dispute between NJM and Federal focused upon a provision of Federal’s policy, which, in short, provided that Trend’s customers were only entitled to coverage from Federal for their use of Trend’s vehicles if the customer lacked the minimum insurance coverage required by law. In that instance, the Federal policy would provide coverage, but only up to the statutorily required amount.

NJM contended that the provision of the Federal policy constituted an “illegal escape” clause. For its part, Federal countered that the provision was permissible under the applicable New Jersey statutes since Aquilar carried the statutorily-required minimum amount of liability coverage.

The Supreme Court of New Jersey, in an opinion written by Justice LaVecchia and joined in by all of the other six Justices, held that Federal’s “customer” provision violated the statutory requirement that all owners of motor vehicles provide compulsory liability insurance for accidents in which their cars are involved. As such, the court determined that the provision was an invalid escape clause since it attempted to exclude from coverage cars that Trend owned but were driven by customers that had personal automobile insurance of at least the statutory minimum of $15,000. In so holding, the court also acknowledged the requirement set forth by the MVC that, as a condition of obtaining a dealership license, automobile dealers are required to secure $100,000 in coverage for all owned vehicles.

That said, the court did not end its inquiry by simply concluding that the “customer” provision was an invalid step-down clause. Rather, the court moved to the next step of the analysis, which was the question of “how much” coverage Federal owed. In this regard, NJM and Huggins contended that the full policy limits ($1,000,000) should be available, while Federal argued that its coverage was limited to the amount of coverage mandated by the MVC ($100,000).

Examining two previous decisions with similar issues, the court concluded that Federal should be obligated to provide coverage up to the $100,000 requirement and reformed the limits accordingly. In so holding, the court focused upon the fact that Federal had no reason to expect that its provision would be deemed to be invalid. However, the court also cautioned, future insurers would not have the benefit of the argument that they were unaware that the provision would be considered to be an illegal step-down clause, and implied that reformation would not be an available remedy in the future.

 

Legal Updates for Insurance Services - April 21, 2021, has been prepared for our readers by Marshall Dennehey Warner Coleman & Goggin. It is solely intended to provide information on recent legal developments, and is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. We welcome the opportunity to provide such legal assistance as you require on this and other subjects. If you receive the alerts in error, please send a note to tamontemuro@mdwcg.com ATTORNEY ADVERTISING pursuant to New York RPC 7.1. © 2021 Marshall Dennehey Warner Coleman & Goggin. All Rights Reserved.

Firm Highlights

Thought Leadership

Featured Conversations... Key Takeaways from A.M. Best’s Webinar on the Misuse Defense in Product Liability Claims, Featuring Michael Salvati

Michael Salvati, shareholder in our Philadelphia office, was a panelist for the April A.M. Best webinar, “The Misuse Defense: Strategic Approaches to Defending Product Liability Claims for Insurers.” During the program, Michael and his fellow panelists offered practical, jurisdiction‑specific guidance on how misuse and failure‑to‑warn theories intersect in modern product liability litigation. Michael emphasized the unique challenges these claims present—particularly in states like Pennsylvania, where evidentiary rules diverge sharply from those applied in many other jurisdictions. Failure to Warn as the “Flip Side” of Misuse Salvati explained that failure‑to‑warn allegations often arise as a direct counter to a misuse defense. As he noted, “If our misuse defense is that the plaintiff didn't use a product properly or safely, then the failure to warn claim is that we didn't tell them how to use it properly.” He emphasized that these claims can stem from either the absence of warnings or criticisms of existing warnings, such as insufficient specificity or lack of clarity about risks. Pennsylvania’s Unique Evidentiary Landscape One of Salvati’s most notable points was the stark difference in how Pennsylvania treats evidence of compliance with industry standards. He highlighted that Pennsylvania is “one of the only states…where that evidence is not admissible” in strict liability cases. Manufacturers cannot rely on compliance with ANSI, UL, ISO, or even federal safety standards to defend the product against a strict liability claim—because the focus is solely on the product itself, not the manufacturer’s conduct. Salvati acknowledged the challenge this creates for defense counsel and clients who expect such compliance to carry weight. Understanding the Three Defect Theories Salvati also walked through the three primary defect theories recognized in many jurisdictions: - Design defect – a flaw in the product’s intended design - Manufacturing defect – a deviation affecting a specific unit - Failure to warn – inadequate instructions or warnings He noted that warnings claims are increasingly significant and sometimes stand alone when design or manufacturing theories are weak. As he put it, plaintiffs often default to warnings claims because “the default position seems to be, ‘If I got hurt, there must be something wrong.’” Warranties and State‑by‑State Variations Salvati addressed how breach‑of‑warranty claims fit into the broader framework, explaining that implied warranties—such as merchantability—often overlap with strict liability in Pennsylvania. He emphasized the importance of understanding local nuances, as warranty law and admissibility rules vary widely across states. Looking Ahead: The Growing Importance of Warnings In his closing remarks, Salvati stressed that warnings should never be treated as an afterthought in product liability defense. He observed that warnings‑only claims are becoming more common and urged manufacturers and insurers to continually evaluate the clarity and completeness of their instructions and warnings. His takeaway: “We should always be talking about what are the instructions that come with our products…to bolster a misuse defense.” Listen to the complete webinar here: https://www3.ambest.com/conferences/events/eventregister.aspx?event_id=WEB1074.

Thought Leadership

Legal Update for Special Education Law: Recent Positive Outcomes From the Group

Hearing Officer Confirms District Acted Appropriately Under IDEA and Section 504 William J. McPartland (Scranton) obtained a finding in favor of our client, a school district, on all issues following a due process hearing. The parent had filed a due process complaint alleging that the school district had breached its child find duty under the IDEA and Section 504, that the school district had discriminated against the student on the basis of disability in violation of Section 504, and that the school district had denied a free and appropriate public education to the student both by developing inadequate IEPs and via an actionable procedural violation.  Specifically, the student had received a Section 504 evaluation in October 2023, after a number of behavioral infractions culminating in a fight in September 2023, was identified as having anxiety and a sleep disorder, and received appropriate Section 504 accommodations. The student had never previously demonstrated signs of a learning disability, and the parent denied the school district permission to evaluate the student for special education needs in November 2023, and January 2024. The parent granted the district permission to evaluate the student in October 2024, after a private psychologist diagnosed the student with Attention Deficit Hyperactivity Disorder, possible Oppositional Defiance Disorder, a learning disorder, and anxiety. The school district issued a special education evaluation report in December 2024, finding that the student had an emotional disturbance and other health impairment, and an IEP providing an itinerant level of emotional support, as well as instruction in academics and social skills, was issued in January 2025, and amended in February, March, and April 2025. The student withdrew from the school district in April 2025, to attend a cyber charter school. The hearing officer determined that the school district had not violated its child find duty to the student in violation of either the IDEA or Section 504 where the district developed a Section 504 plan for the student within a month and a half of the parent’s first request for a Section 504 evaluation and where the parent repeatedly denied consent to conduct an IDEA evaluation of the student. The hearing officer noted that the student’s sporadic record of behavioral infractions prior to September 2023, did not suggest that the student had a disability prior to the parent’s initial request for an evaluation. The hearing officer further determined that no evidence had been produced to suggest that the student was discriminated against on the basis of disability in violation of Section 504. Additionally, the hearing officer determined that the IEP offered to the student was substantively adequate and that, to the extent the social and emotional programming offered by the school district was not received by the student, this resulted from the parent’s refusal to accept the same. The hearing officer finally determined that the school district did not commit an actionable procedural violation by delaying development of an IEP for the student where the parent repeatedly denied consent to evaluate the student. Court Dismisses Three of Four Claims Against School District Christopher J. Conrad and Daniel P. McGannon (Harrisburg) achieved a significant early victory on behalf of a school district client in. The team successfully obtained dismissal of three of the four claims asserted in the plaintiff’s amended complaint. The former district superintendent brought multiple claims arising out of his alleged “forced resignation,” including age discrimination under the ADEA, a Section 1983 Equal Protection claim, a Pennsylvania Whistleblower claim, and breach of contract. On behalf of the district, the defense team moved to dismiss the complaint in part, arguing: The plaintiff failed to plead sufficient facts to support a prima facie case of age discrimination. The equal protection claim was barred because the ADEA provides the exclusive federal remedy for age-based employment claims. The breach of contract claim could not stand because the underlying employment agreement had expired prior to the alleged breach. The court agreed, dismissing the ADEA, equal protection, and breach of contract claims in their entirety. As a result, only a single claim under the Pennsylvania Whistleblower Law remains pending. This outcome substantially narrows the scope of the litigation and positions the client for a more efficient defense moving forward.

Result

No-Cause Jury Verdict Secured in Wrongful Death Trial

We successfully obtained a no-cause jury verdict in a 13-day wrongful death trial. The decedent, a 59-year-old man, was admitted to the emergency room on February 15, 2019, with complaints of abdominal pain, decreased appetite, and constipation, despite the use of laxatives. The patient did not complain of any nausea, vomiting, or diarrhea. He had a significant medical history including diabetes, hypertension, prior coronary artery stenting, morbid obesity (with past gastric bypass surgery), longstanding ventral hernia, and back pain. A CT scan revealed multiple hernias and a potential closed-loop bowel obstruction, leading to a surgery consultation. Our client, an emergency general surgeon, interpreted that the patient did not have a closed loop or any significant obstruction and recommended non-surgical management. The patient was approved to have clear liquids, and had a vomiting incident shortly after, but our client was not notified. The patient was returned to NPO status, and after improving overnight, he was returned to “clears” and additional medical and renal consults were ordered. Our client did not receive any communications from the residents/nurses of any changes in the patient’s condition. On February 18, 2019, two rapid responses were called due to increased heart rate and vomiting. It is believed that the vomiting resulted in aspiration, causing sepsis, ultimately leading to the patient’s death. During the trial, the plaintiff’s sole medical expert highlighted imaging on the wrong hernia, which called into question all of his opinions in the case. We made key objections related to the expert testimony, limiting what the allegations were, and preventing new allegations from being made. After approximately two and a half hours of deliberating, the jury returned a no-cause verdict.