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Category Archives: Featured Case

PQA Wins Appellate Division Decision Confirming No Right to Jury Trial Under the Insurance Fraud Prevention Act

PQA Wins Appellate Division Decision Confirming No Right to Jury Trial Under the Insurance Fraud Prevention Act

In a 3-0 decision handed down on October 9, 2013, in the case of Allstate v. Lajara, an Appellate Division panel upheld Judge Kenneth Grispin’s interlocutory ruling that there is no statutory or constitutional right to a jury trial in cases brought under the New Jersey Insurance Fraud Prevention Act, N.J.S.A. 17:33A-1, et. seq. (the “IFPA”).

The Court’s decision relied in part upon its finding that the IFPA provides equitable remedies, and a requires fewer elements of proof of a violation than common law claims of fraud.  The Court also looked to the “Act’s general purpose to combat fraud and control insurance rates,” and stated that this purpose further supported its “conclusion that defendants have no constitutional right to a jury trial.”   The Court also relied upon the Legislature’s failure to include a right a jury trial in the IFPA.  “Although the Legislature’s silence is not dispositive, it is a significant factor weighing against the finding of a statutorily implied right,” the court stated. “[W]e should be reluctant to infer statutory provisions of law when the Legislature has not seen fit to expressly include them.”

This decision is an important victory for Allstate and other insurance companies fighting complex insurance fraud schemes in New Jersey.   The nature of these cases, which require extensive and often complex testimony and evidence, require many weeks, if not months to try.  This decision will enable these kinds of cases to be tried to a judge, who can hear these cases in segments tried over a period of weeks or months,  and requiring the parties where appropriate to supplement their respective positions with briefs, proposed findings of facts and other submissions designed to narrow and define the issues in dispute, and thereby assisting the court in reaching a verdict.

PQA partner Tom Mulvihill briefed and argued the appeal on behalf of Allstate.

 

 

PQA Files $5 Million Suit Against Owner of Ambulatory Surgery Center

PQA Files $5 Million Suit Against Owner of Ambulatory Surgery Center

On August 7, 2013, PQA filed a 15-count, $5.6 million lawsuit against the owner of a licensed ambulatory surgery center (“ASC”) on behalf of a Fortune 100 insurance company.   The suit alleges that the owner of the ASC paid more than $450,000 in kickbacks to an individual who acted as a “patient broker,” and who… Continue Reading

PQA Wins $3.9 Million Verdict Against Chiropractor and Lawyer for “Doc-in-a-Box” Scheme

On September 11, 2012, the Honorable Stephan C. Hansbury, a New Jersey Superior Court Judge, entered an Order of Judgment pursuant to the New Jersey Insurance Fraud Prevention Act in the amount of $3,961,240 in favor of PQA’s client, a Fortune 100 insurance company, against a California chiropractor and a New York attorney.  The case… Continue Reading

PQA Partner George McGill Wins Site Plan Approval for Flagship Location of Investors Savings Bank

On January 11, 2012, PQA Partner George D. McGill, Esquire successfully concluded an application before the Brick Township Planning Board on behalf of Investors Savings Bank.   The application sought preliminary and final site plan approval with variance relief to enable Investors Savings to construct a 6,418-square- foot state-of-the-art banking facility at the busy intersection… Continue Reading

PQA Wins $9.7 Million Judgment Against Chiropractor and Ten Fraudulent Medical Offices

On March 30, 2011, PQA obtained final summary judgment on behalf of Allstate Insurance Company against a New Jersey chiropractor and a network of ten fraudulent medical offices he created and secretly controlled.  The chiropractor created these sham medical corporations in response to the New Jersey Legislature’s adoption of the Automobile Insurance Cost Reduction Act… Continue Reading

PQA’s Waldron wins judgment against defendant under the Uniform Fraudulent Transfer Act

On August 25, 2010, the Honorable Mary C. Jacobson, Presiding Judge of the Superior Court for Mercer County, entered an order finding that the transfer of a home by a chiropractor to his mother, constituted a fraudulent transaction under the Uniform Fraudulent Transfer Act, N.J.S.A. 25:2-20, et seq (the “UFTA”). The Court also ordered that PQA may file a new application for relief under the UFTA, and may apply for a final judgment up to the $525,000 amount of the value of the home that the defendant unlawfully conveyed, as well as its attorneys’ fees and costs, once the amount of the damages the defendant owes to PQA’s client is established at the conclusion of parallel proceedings that are pending in another court pursuant to the New Jersey Insurance Fraud Prevention Act, N.J.S.A. 17:33A-1, et seq. Continue Reading

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