Experience

• Successfully defended a claim before the Appellate Division on a question of insurance coverage and whether the policy was in effect at the time of injury. The policy at issue was provided to a subcontractor hired by our insured. The claim was initially filed in Pennsylvania where the injured worker lived, and his employer was located. Based on Pennsylvania law, it appeared that the carrier canceled the workers' compensation insurance coverage for non-payment. The injured worker then chose to pursue his claim in New Jersey, where the injury occurred. He also received medical treatment in New Jersey totaling over $1.3 million for an extended hospital stay due to his severe burns. The insurance carrier for the subcontractor attempted to argue that there was no coverage in place in New Jersey at the time of the accident as the insurance carrier did not operate nor write policies in New Jersey. The insurance carrier claimed cancellation of the Pennsylvania policy was transferable to New Jersey and, therefore, there was no need to show proper cancellation in New Jersey. However, the insurance carrier did not deny that New Jersey was not excluded under the policy. After briefs were submitted, and without oral argument, the Appellate Division denied the Motion for Leave to Appeal and dismissed the Notice of Motion for Appeal.

• Successfully defended a motion for medical treatment involving a claim where the petitioner had two work-related accidents within months of each other with alleged injury to the hip in both claims, among other injuries. The petitioner filed a Motion for Medical and Temporary Disability Benefits seeking hip surgery recommended by her expert for a labral tear. This contrasted with the respondent’s expert who found no discrete tear from an accident and no need for treatment. After testimony by the petitioner and both experts, all conducted using Zoom, the Judge entered an Order denying the Motion for failure to sustain the burden of proof. While the Judge noted the petitioner was a credible individual, the issue turned on causation to which the Judge looked to the experts. The Judge found the respondent’s expert to be more thorough in his explanations of his conclusions during testimony and in his ability to explain his review of the MRI study as well as being able to show the MRI during testimony.

• Successfully obtained a voluntary dismissal of a medical provider application where the provider was seeking additional payment for services rendered to the injured worker.  The medical provider rendered medical services to the petitioner for a New York workers’ compensation claim.  They were seeking additional payments pursuant to the New Jersey compensation statute.  The insured was located in NY, the injured worker was employed in NY and worked in NY.  As the medical provider had no jurisdiction to seek additional payments pursuant to the New Jersey compensation statute, they agreed to voluntary dismissal of the medical provider application.