PQA attorneys helped win an important procedural victory on May 10, 2011, when the New Jersey Supreme Court granted the petition for certification in the matter of Selective Insurance Co. of America v. Hudson East Pain Management Osteopathic Medicine and Physical Therapy. In granting the petition, the Court agreed to hear an appeal from a decision in which an Appellate Division panel had severely limited the ability of insurers to investigate insurance claims involving healthcare providers.
PQA attorneys had filed a motion with the Supreme Court on behalf of the Insurance Council of New Jersey (“ICNJ”) and the Property Casualty Insurers Association of America (“PCI”) seeking leave to appear jointly as amicus curiae and submitted a brief on behalf of the insurance industry urging the Court to grant the petition for certification. ICNJ is a nonprofit, insurance, research, information and advocacy organization representing twenty-two New Jersey licensed property casualty insurance companies that collectively write 93 percent of the automobile insurance policies in New Jersey. ICNJ member companies underwrote the great majority of the nearly $17 billion in direct premiums written in New Jersey in 2009. PCI is a trade group representing more than 1,000 property casualty insurance companies domiciled and transacting business throughout the United States. Its member companies write nearly 49.5 percent of the nation’s auto insurance business.
PQA’s brief on behalf of ICNJ and PCI outlined the ways in which New Jersey automobile insurers’ long-standing ability to investigate personal injury protection (“PIP”) fraud schemes, including unlawful self-referral schemes, kickback arrangements, fee-splitting schemes, and unlawful practice structure schemes, would be crippled if the Appellate Division decision were allowed to stand. In urging the Supreme Court to hear the appeal, PQA’s brief further explained why the unfortunate but inevitable effects of allowing the Appellate Division decision to stand would be an increase in insurance fraud and abuse, and rising premium costs that will be borne by New Jersey private passenger automobile policy holders .
ICNJ and PCI’s application and brief in support of the petition for certification was prepared and submitted by PQA attorneys Kenneth E. Pringle and Denise O’Hara of PQA’s Belmar office, and Lisa R. Levine, of PQA’s Trenton office.