Allstate New Jersey Ins. Co. v. Gregorio Lajara (073511)

117 A.3d 1221, 222 N.J. 129, 2015 N.J. LEXIS 797
CourtSupreme Court of New Jersey
DecidedJuly 16, 2015
DocketA-70-13
StatusPublished
Cited by80 cases

This text of 117 A.3d 1221 (Allstate New Jersey Ins. Co. v. Gregorio Lajara (073511)) is published on Counsel Stack Legal Research, covering Supreme Court of New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Allstate New Jersey Ins. Co. v. Gregorio Lajara (073511), 117 A.3d 1221, 222 N.J. 129, 2015 N.J. LEXIS 797 (N.J. 2015).

Opinion

*134 Justice ALBIN

delivered the opinion of the Court.

In this appeal, we must decide whether a civil defendant sued by an insurance company for violating the Insurance Fraud Prevention Act (IFPA), N.J.S.A. 17:33A-1 to -30, has a right to trial by jury. The trial court determined that, in an action arising under the IFPA, neither the statutory scheme nor the New Jersey Constitution grants a civil defendant the right to a jury trial. The Appellate Division affirmed. Allstate N.J. Ins. Co. v. Lajara, 433 N.J.Super. 20, 44, 77 A.3d 491 (App.Div.2013).

We now reverse. The right to a civil jury trial is one of the oldest and most fundamental of rights. It predates the founding of our Republic, is enshrined in the Federal Bill of Rights, and is part of the fabric of all three of New Jersey’s Constitutions. A jury trial is self-government at work in our constitutional system, and a verdict rendered by one’s peers is the ultimate validation in a democratic society.

In determining whether the jury-trial right applies to a statutory cause of action, we assess whether the grant of a jury trial is consistent with our common-law tradition. An IFPA claim meets that standard because compensatory and punitive damages are legal — not equitable — in nature and because the elements necessary to prove an IFPA claim are similar to common-law fraud.

By this measure, we conclude that the right to a civil jury trial provided by Article I, Paragraph 9 of the New Jersey Constitution applies to private-action claims seeking compensatory and punitive damages under the IFPA. We also presume that the Legislature, in passing the IFPA, intended the statutory scheme to conform to the Constitution. We therefore remand to the trial court to allow defendants in this case to exercise their right to a jury trial.

I.

A.

In December 2008, plaintiffs Allstate New Jersey Insurance Company and affiliated companies, Encompass Insurance, and *135 Commercial Insurance Company of Newark, New Jersey, filed a 604-paragraph complaint alleging that sixty-three defendants violated the IFPA. 1 The sixty-three defendants include physicians and chiropractors; medical, imaging, and pain-management practices; medical equipment and billing companies; employees, owners, and shareholders of those practices and companies; and an attorney and unlicensed individuals.

The complaint alleges that defendants engaged in a “broad, multi-faceted scheme to defraud” plaintiffs of $8.14 million in personal injury protection benefits under the New Jersey Automobile Reparation Reform Act, N.J.S.A. 39-.6A-1 to -35. According to the complaint, defendants played different roles and engaged in singular and multiple fraudulent acts in this far-reaching scheme. Unlicensed defendants provided “purported healthcare services” through companies that concealed their true status. Defendants provided unnecessary care and prescribed unnecessary medical equipment, engaged in fraudulent testing of patients, misrepresented test results and patients’ symptoms, and unlawfully split fees and concealed prohibited self-referrals — all for the purpose of wrongly securing or enhancing recoveries for claimants or price gouging. The complaint also contends that some defendants paid fees to individuals who staged accidents, created fraudulent medical records and bills, and recruited persons involved in accidents who suffered either minor or no injuries.

Plaintiffs sought various forms of relief: payment of compensatory damages, treble damages, and attorneys’ fees under the IFPA; a declaration that allegedly fraudulent benefits do not have to be paid; disgorgement of benefits paid; and constructive trusts and equitable liens on defendants’ assets.

Although plaintiffs demanded a jury trial in the complaint, they later moved to withdraw that demand. That motion was opposed *136 by defendants A.P. Diagnostic Imaging, Inc. and Dr. Harshad Patel, who are parties to this appeal, as well as by other defendants. 2

B.

The trial court granted plaintiffs’ motion to withdraw their jury-trial demand and denied defendants’ request for trial by jury. The court determined that State v. Sailor, 355 N.J.Super. 315, 810 A.2d 564 (App.Div.2001), was “the controlling precedent.” In that case, the State brought an action under the IFPA against an individual defendant for giving false information to an insurance carrier regarding an automobile accident. Id. at 318-19, 810 A.2d 564. The State sought restitution on the claim paid to the defendant. Id. at 318, 810 A.2d 564. The Appellate Division determined that the plaintiff was not entitled to a jury trial because the Act did not expressly provide such a right and because the remedy at issue was equitable in nature. Id. at 322-23, 810 A.2d 564. The trial court ruled that “Sailor makes clear that the issue turns on the fact that the remedies available under the [IFPA] are in the form of restitution, an equitable form of relief,” and therefore at common law plaintiffs would not have been entitled to a jury trial.

Defendants filed a motion for leave to appeal.

C.

The Appellate Division granted leave to appeal and affirmed the trial court’s denial of defendants’ demand of a jury trial. Allstate, supra, 433 N.J.Super. at 27, 44, 77 A.3d 491. The panel held that, *137 in an insurer’s action under N.J.S.A. 17:33A-7, the IFPA contains no express right to a jury. Id. at 38,77 A.3d 491. It also declined to find an implied right from the statute’s silence. Ibid.

Additionally, the panel found that defendants did not possess a constitutional jury-trial right. Id. at 42, 77 A.3d 491. The panel acknowledged that, “ ‘[generally, the New Jersey Constitution protects the right of trial by jury in legal, but not equitable, actions.’ ” Id. at 41, 77 A.3d 491 (quoting Ins. Co. of N. Am. v.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Fairkings Partners, LLC, Etc. v. Essence L. Daniels
New Jersey Superior Court App Division, 2025
James Park v. Lisa A. Clemmons
New Jersey Superior Court App Division, 2025
Khongsana Soumphonphakdy v. Englewood Hospital and Medical Center
New Jersey Superior Court App Division, 2025
J.H. v. Warren Hills Board of Education
New Jersey Superior Court App Division, 2025
Carla Wilson v. the Housing Authority of the City of Newark
New Jersey Superior Court App Division, 2025
In the Matter of Thomas R. Tomei Trust
New Jersey Superior Court App Division, 2025
Jennifer Weinmeier v. Joseph Garzone
New Jersey Superior Court App Division, 2025
Adrian Evans and Kenneth Hicks v. City of Paterson, Etc.
New Jersey Superior Court App Division, 2025
Robert Smith v. North Jersey Truck Center, Inc.
New Jersey Superior Court App Division, 2024
LEE v. ELECTRIFAI, LLC
D. New Jersey, 2024
McLeod v. Pershing LLC
N.D. Texas, 2024
Sanford v. Pershing LLC
N.D. Texas, 2024

Cite This Page — Counsel Stack

Bluebook (online)
117 A.3d 1221, 222 N.J. 129, 2015 N.J. LEXIS 797, Counsel Stack Legal Research, https://law.counselstack.com/opinion/allstate-new-jersey-ins-co-v-gregorio-lajara-073511-nj-2015.