Allstate New Jersey Insurance Company v. Gregorio Lajara

77 A.3d 491, 433 N.J. Super. 20
CourtNew Jersey Superior Court Appellate Division
DecidedOctober 9, 2013
DocketA-5684-11T4
StatusPublished
Cited by1 cases

This text of 77 A.3d 491 (Allstate New Jersey Insurance Company v. Gregorio Lajara) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Allstate New Jersey Insurance Company v. Gregorio Lajara, 77 A.3d 491, 433 N.J. Super. 20 (N.J. Ct. App. 2013).

Opinion

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION

SUPERIOR COURT OF NEW JERSEY APPELLATE DIVISION DOCKET NO. A-5684-11T4

ALLSTATE NEW JERSEY INSURANCE COMPANY, ALLSTATE INSURANCE COMPANY, ALLSTATE INDEMNITY COMPANY, ALLSTATE PROPERTY APPROVED FOR PUBLICATION AND CASUALTY INSURANCE COMPANY, ALLSTATE NEW JERSEY PROPERTY October 9, 2013 AND CASUALTY INSURANCE COMPANY and ENCOMPASS INSURANCE, f/k/a APPELLATE DIVISION CONTINENTAL INSURANCE COMPANY, and COMMERCIAL INSURANCE COMPANY OF NEWARK, NJ,

Plaintiffs-Respondents,

v.

GREGORIO LAJARA; PEDRO GONZALEZ; MILEYDIS T. DIAZ a/k/a MILLY DIAZ; AWILDA D. RODRIGUEZ a/k/a AWILDA D. GONZALEZ; KENNETH J. VIAFORA; JOSE ORLANDO HERNANDEZ; FRANCISCA HERNANDEZ; FRANCISCO CABA; AQUALINA RAMOS; ASHRAF Y. AZIR; MUHAMMAD A. SHAMSHAIR; MICHAEL C. GOLOWSKI; ELVIA BEDOYA; NYDIA MARTINEZ; NEREDA ZUNIGA; ALEXANDRA GALLEGOS; BIBARS KAGHDOU, D.C.; STEPHEN LOMANTO, D.C.; DAVID STEPHENS, D.C.; THOMAS J. BONACUSO, D.C.; MICHAEL CARLESIMO, D.C.; BRYAN SIEGEL, D.C.; KEITH LEWANDOWSKI, D.C.; WEI JU; LUCY LIU; JIANMIN LI, a/k/a JIAN MIN LI; SHAN S. NAGENDRA, M.D.; ALEKSANDR LEVIN, M.D.; MANOJ D. PATHARKAR, M.D.; ALFRED REZK TAWADROUS, M.D.; HOWARD KESSLER, M.D.; NATALIO DAMIEN, M.D.; DAVID WALKER, ESQ.; MEDICO MANAGEMENT CO., INC.; UNION COLLECTIONS, LLC; PLAINFIELD MEDICAL MANAGEMENT, INC.; SPINAL ADJUSTMENT CENTER, P.C. f/k/a SPINAL ADJUSTMENT CENTER, INC.; RAHWAY SPINAL INJURY P.C. f/k/a RAHWAY SPINAL CENTER CORP; ADVANCED SPINAL CARE, P.C.; MILLENNIUM TOTAL HEALTH, P.C.; ALEVE CHIROPRACTIC, P.C.; IN-LINE CHIROPRACTIC, P.C.; BAYVIEW HEALTH, P.C. a/k/a BAYVIEW HEALTH SERVICE, P.C.; BOUND BROOK CHIROPRACTIC, P.C.; NEW WAVE CHIROPRACTIC, P.C.; ABSOLUTE CHIROPRACTIC, P.C.; BACK PAIN P.C.; AM PAIN CARE, P.C.; ACUPUNCTURE ACADEMY P.C.; TCM ACUPUNCTURE, P.C.; AMERICAN ACUPUNCTURE ACADEMY, P.C.; CONVERY MEDICAL GROUP, P.C.; RARITAN PAIN MANAGEMENT AND REHAB CENTER, P.C.; ASBURY MEDICAL AND REHABILITATION P.C.; PAIN MANAGEMENT ASSOCIATES OF CENTRAL JERSEY, P.A.; BEST HEALTH MEDICAL, P.C.; PERTH AMBOY HEALTH CARE, LLC d/b/a "PERTH AMBOY DIAGNOSTIC IMAGING"; LIBERTY SUPPLIES, L.L.C.; K-MED SERVICES, INC.; PRESTIGE MEDICAL SUPPLIES, LLC; THERAPEUTIC DEVICES, INC.,

Defendants-Respondents,

and

A.P. DIAGNOSTIC IMAGING, INC. and DR. HARSHAD PATEL,

Defendants-Appellants. ___________________________________

Argued April 30, 2013 – Decided October 9, 2013

Before Judges Messano, Lihotz and Ostrer.

2 A-5684-11T4 On appeal from the Superior Court of New Jersey, Law Division, Union County, Docket No. L-4091-08.

Carl A. Salisbury (Kilpatrick Townsend & Stockton, LLP) argued the cause for appellants.

Thomas O. Mulvihill argued the cause for respondents Allstate New Jersey Insurance Company, Allstate Insurance Company, Allstate Indemnity Company, Allstate Property and Casualty Insurance Company, Allstate New Jersey Property and Casualty Insurance Company and Encompass Insurance, f/k/a Continental Insurance Company, and Commercial Insurance Company of Newark, NJ (Pringle Quinn Anzano, P.C., attorneys; Mr. Mulvihill, on the brief).

The Law Office of Jeffrey Randolph, LLC, attorneys for respondents Plainfield Medical Management, Pedro Gonzalez and Awilda D. Rodriguez a/k/a Awilda D. Gonzalez, join in the briefs of appellants.

Bubb Grogan & Cocca, LLP, attorneys for respondents Shan Nagendra, M.D., Convery Medical Group, P.C., and Raritan Pain Management and Rehab Center, P.C., join in the briefs of appellants.

Archer & Greiner, P.C., attorneys for respondents Dr. Manoj Patharkar and Pain Management Associates of Central Jersey, P.A., join in the briefs of appellants.

The opinion of the court was delivered by

OSTRER, J.A.D.

On leave granted, defendants appeal from the trial court's

order (1) granting plaintiffs' motion to withdraw their jury

3 A-5684-11T4 demand in their action under the Insurance Fraud Prevention Act

(Act), N.J.S.A. 17:33A-1 to -30; and (2) striking defendants'

jury demand. The Act is silent on the right to trial by jury.

We therefore must determine whether the Act implied that right,

or whether the Constitution's right to trial by jury, N.J.

Const. art. I, par. 9, encompasses a private action under the

Act.

After considering the Act's plain language, its legislative

history, and the legislative intent, and applying well-settled

principles of statutory construction, we conclude the Act does

not create a right to a jury trial. Also, as the equitable

nature of the statutorily created right to relief was unknown at

common law before adoption of the State Constitution, we

conclude the Constitution does not guarantee a right to a trial

by jury. We therefore affirm the trial court's order.

I.

Given the purely legal nature of the question before us,

the pertinent facts may be briefly stated. Plaintiffs alleged

they paid $8.2 million in personal injury protection (PIP)

benefits under the Unsatisfied Claim and Judgment Fund Law

(UCJFL), N.J.S.A. 39:6A-1 to -91, as a result of violations of

the Act. The forty-two count complaint included as defendants

individual physicians and chiropractors; medical and

4 A-5684-11T4 chiropractic practices; management companies of medical

practices; medical equipment companies; attorneys; and

unlicensed individuals.

Among their allegations, plaintiffs asserted that Gregorio

Lajara, who was neither a licensed physician nor a chiropractor,

directed a scheme to defraud plaintiffs. He allegedly did so,

in part, by controlling and effectively owning chiropractic

facilities, which plaintiffs alleged violated the law.

Plaintiffs alleged various defendants performed services in

violation of professional regulations; billed for various

services performed by unlicensed persons; engaged in unlawful

fee-splitting; knowingly and intentionally concealed facts

concerning services provided; billed for services and equipment

not actually provided, or medically unreasonable or unnecessary;

failed to charge co-pays; paid persons who intentionally caused

accidents in order to generate fraudulent bills; and paid

kickbacks to attorneys who referred clients.

The complaint sought a declaratory judgment that plaintiffs

were not obligated to pay PIP benefits to defendants;

disgorgement of sums already paid to defendants; imposition of a

constructive trust and equitable lien on defendants' assets

until they disgorged the sums sought; and damages allowed under

the Act.

5 A-5684-11T4 Plaintiffs initially demanded a jury trial. However, after

answers were filed, plaintiffs moved for leave to withdraw their

prior demand. Defendants opposed the motion and demanded a jury

trial, some of them for the first time, having omitted the

demand from their answers. The Commissioner of Banking and

Insurance, who had earlier intervened in the suit, moved to

strike the jury demand as it related to the Commissioner's

claims. See N.J.S.A. 17:33A-7d (authorizing the Commissioner to

join in an insurance company's private action, in order to

recover civil penalties authorized by N.J.S.A. 17:33A-5).

Judge Kenneth J. Grispin granted plaintiffs' motion, and

struck defendants' jury demand. Defendants sought leave to

appeal, which another panel granted.

Renewing arguments they presented to the trial court,

plaintiffs urge us to find an implied jury trial right under the

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Related

Allstate New Jersey Ins. Co. v. Gregorio Lajara (073511)
117 A.3d 1221 (Supreme Court of New Jersey, 2015)

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