James G. Lowe, M.D. v. Bernard Audet

New Jersey Superior Court Appellate Division·Decided June 24, 2025·No. A-4093-23·Unpublished

Opinion

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.

SUPERIOR COURT OF NEW JERSEY APPELLATE DIVISION

DOCKET NO. A-4093-23

JAMES G. LOWE, M.D., Plaintiff-Appellant,

v.

BERNARD AUDET, RICHARD LAVER, and THE CREATIVE FINANCIAL GROUP, LTD.,

Defendants-Respondents.

Argued February 4, 2025 – Decided June 24, 2025 Before Judges Gooden Brown and Vanek.

On appeal from an interlocutory order of the Superior Court of New Jersey, Law Division, Camden County, Docket No. L-0633-24.

Stephen J. DeFeo argued the cause for appellant (Brown & Connery, LLP, attorneys; Stephen J. DeFeo, Kathleen E. Dohn, and Taylor L. Johnson, on the briefs).

Jared K. Levy argued the cause for respondent Richard Laver (Wood, Smith, Henning & Berman, LLP, attorneys; Jared K. Levy, on the brief).

Barry R. Temkin argued the cause for respondents Bernard Audet and The Creative Financial Group, Ltd.

(Mound Cotton Wollan & Greengrass LLP, attorneys;

Katharine Anne Lechleitner, Barry R. Temkin, and Kate E. DiGeronimo, on the brief).

Robert H. Solomon argued the cause for amicus curiae New Jersey Association for Justice (Nagel Rice, LLP, attorneys; Bruce H. Nagel, on the brief).

PER CURIAM By leave granted, plaintiff James G. Lowe, M.D., appeals from Law Division orders entered on July 19, 2024, granting motions to dismiss his claims under the Consumer Fraud Act (CFA), N.J.S.A. 56:8-1 to -210, against defendant insurance brokers Richard Laver and Bernard Audet and defendant The Creative Financial Group, Ltd. (CFG) (collectively defendants). We granted the New Jersey Association for Justice's (NJAJ) application to participate as amicus in support of plaintiff's position. Having considered the record and the governing principles, we affirm the dismissal of plaintiff's CFA claims.

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I.

We glean these facts from plaintiff's complaint, accepting as true the facts alleged therein. Lemelledo v. Beneficial Mgmt. Corp. of Am., 150 N.J. 255, 263 (1997). Through defendants, plaintiff, a neurosurgeon, procured four MetLife insurance policies: (1) an individual disability income (IDI) policy providing a $10,000 monthly benefit until age sixty-five, effective December 1, 2003; (2) another IDI policy providing a $10,000 monthly benefit until age sixty-seven, effective June 1, 2016; (3) a business overhead expense (BOE) policy with a $30,000 monthly benefit and a twenty-four-month maximum benefit period, effective February 17, 2009; and (4) another BOE policy with a $20,000 monthly benefit and a twelve-month maximum benefit period, also effective February 17, 2009.

The IDI policies covered plaintiff individually, while the BOE policies covered his surgical practice, Lowe Greenwood Zerbo Spinal Associates, P.A. (LGZ), of which he was a fifty-percent co-owner. Plaintiff alleged all four policies "contain[ed] a waiver of premiums benefit, which states 'we will waive any premium that becomes due while you remain disabled' and 'your policy and its benefits will continue as if the premium had been paid.'"1

1 The insurance policies are not part of the record.

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In purchasing the policies, plaintiff alleged that he relied on his two-

decades-long "special relationship" with defendants. Plaintiff's business relationship with CFG commenced in 2002. Audet and Laver, described as "a disability insurance expert," worked at CFG as insurance brokers, producers, and agents. Over the years, defendants marketed, sold, and procured insurance and financial products for plaintiff and his practice, including the four policies at issue in this case.

Specifically, plaintiff alleged that from 2003 to 2021, he met with Audet "at least [fifty-one] times" and provided him and Laver with "comprehensive information" regarding plaintiff's individual and business needs. In particular, plaintiff discussed his "need for insurance coverage" to cover "LGZ business expenses" and "to replace his income in the event he suffered a disability that prevented him from performing neurosurgery." In response, Audet represented that plaintiff would receive "maximum benefits for the maximum policy periods[] and premium payments would be waived" under the policies "regardless of any other factors." Plaintiff alleged that although Audet was aware of plaintiff's "medical-legal consulting business, which dated back to 2011," at "no time did Audet explain to [plaintiff] that MetLife would consider

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income or expenses from any business interest unrelated to LGZ in reviewing a claim for benefits."

In addition, prior to procuring the IDI policies, Audet allegedly reviewed plaintiff's "existing disability policy, which was an 'own occupation' policy that provided coverage if [plaintiff] became injured and was unable to perform neurosurgery but would allow him to earn income in other vocations while still receiving disability benefits." After reviewing the policy, Audet advised plaintiff that the 2003 MetLife IDI policy "'compared favorably' to [plaintiff's] existing own occupation disability policy."

Plaintiff subsequently developed bilateral maculopathy, a progressive condition affecting the retina. As a result, plaintiff was unable to perform surgery and did not operate after September 14, 2021. He was also forced to "divest his ownership interests in and involvement with LGZ." On November 6, 2021, plaintiff had a teleconference with Laver. This was the "first time" he "dealt directly with Laver." During the conversation, Laver allegedly informed plaintiff that "Audet's statements about the coverage provided under the IDI [p]olicies were false," and that plaintiff "would probably only be covered under the residual disability benefit provision of the IDI [p]olicies."

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In December of 2021, plaintiff filed claims with MetLife under all four policies. MetLife denied the claims under the BOE policies and only paid partial benefits under the IDI policies, "claiming benefits are only payable . . . pursuant to the residual disability provision." Although "MetLife has acknowledged that [plaintiff] is permanently unable to perform neurosurgery," it claims plaintiff's "medical-legal consulting business prevents him from being considered totally disabled under the terms of the IDI . . . and BOE [p]olicies" because "its definition of [plaintiff's] 'regular occupation' includes revenues and expenses from his medical-legal consulting business."

Plaintiff alleged that "[t]he first time anyone raised [his] medical-legal consulting business . . . and related income or expenses as a potential bar to receiving maximum benefits" under the policies was during his conversation with Laver "after he suffered his disability and made claims for benefits from MetLife." Plaintiff continued to talk with Audet and Laver about "advocat[ing] on his behalf to support his claims for benefits." However, after MetLife denied his claims for "maximum benefits," Audet and Laver became "less responsive" and "ceased all communication by the summer of 2023."

On February 27, 2024, plaintiff filed a nine-count complaint seeking damages and asserting, among other things, that defendants committed fraud and

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professional negligence, breached their fiduciary duties, and violated the CFA. Contemporaneously, pursuant to N.J.S.A. 2A:53A-27 and N.J.S.A. 2A:53A- 26(o), plaintiff filed an affidavit of merit prepared by a licensed New Jersey insurance producer averring that based on his review of the complaint, defendants' conduct "deviated from the acceptable professional standards . . . of the insurance industry."

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