LM Insurance Corporation v. Favor Services Inc. and Novie Pramudita

CourtDistrict Court, D. New Jersey
DecidedDecember 1, 2025
Docket1:24-cv-05932
StatusUnknown

This text of LM Insurance Corporation v. Favor Services Inc. and Novie Pramudita (LM Insurance Corporation v. Favor Services Inc. and Novie Pramudita) is published on Counsel Stack Legal Research, covering District Court, D. New Jersey primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
LM Insurance Corporation v. Favor Services Inc. and Novie Pramudita, (D.N.J. 2025).

Opinion

NOT FOR PUBLICATION

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF NEW JERSEY CAMDEN VICINAGE HONORABLE KAREN M. WILLIAMS LM INSURANCE CORPORATION, Plaintcff, Civil Action v. No, 24-05932 (KMW-EAP) FAVOR SERVICES INC, and NOVIE PRAMUDITA, OPINION Defendants.

APPEARANCES: Sean P. Hvisdas, Esq. Anthony J. Golowski II, Esq. GOLDBERG SEGALLA LLP 1700 Market Street, Ste. 3232 Philadelphia, PA 19103 . Counsel for Plaintiff LM Insurance Corporation

Roger J. Harrington, Esq. ELLIOTT GREENLEAR & SIEDZIKOWSKI 925 Harvest Drive, Suite 300 Blue Bell, PA 19422, Counsel for Defendants Favor Services Inc. and Novie Pramudita

WILLIAMS, District Judge: L INTRODUCTION Before the Court is Defendants Favor Services Inc. (“Favor”) and Novie Pramudita’s (“Pramudita,” collectively, “Defendants’”) Motion to Dismiss (““MTD,” Dkt. No. 27) Plaintiff LM Insurance Corporation’s (“Plainiff’?) Amended Complaint (Dkt. No. 25), Plaintiff opposes the motion. (Dkt. No. 28.) Defendants replied. (Dkt. No. 29.) The Court, having considered the Parties’ submissions without oral argument pursuant to L.Civ.R. 78.1(b), GRANTS in part and DENIES in part Defendants’ MTD. The Court further GRANTS Plaintiff’s request for leave to amend to correct the deficiencies identified herein. Il, FACTUAL BACKGROUND! a. The 2019 Application and Initial Representations. In December 2019, Favor submitted an application (“Application”) for workers’ compensation insurance through New Jersey’s Involuntary Market for Worker’s Compensation Insurance Plan (the “Plan’’). (Amended Complaint (‘AC’) J 24, Ex. C, Dkt. No, 25.) The Application included a certification which states: THEREBY ACKNOWLEDGE THAT I HAVE FULLY READ THE INSTRUCTIONS RELATED TO THE COMPLETION OF THIS APPLICATION AS WELL AS ABOVE STATEMENTS AND CERTIFY THAT THE FOREGOING STATEMENTS AND INFORMATION CONTAINED HEREIN ARE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE AND, THAT I, AS AN OWNER/OFFICER, AM FULLY AUTHORIZED TO SIGN THIS FORM ON BEHALF OF THE INSURED, AND TO BIND THE INSURED. I UNDERSTAND THAT UNDER NEW JERSEY CRIMINAL LAW, INSURANCE FRAUD IS PUNISHABLE BY UP TO TEN (10) YEARS IMPRISONMENT AND FINES UP TO $150,000, AS WELL AS CIVIL PRNALTIES

1 When considering a motion to dismiss under Rule 12(b)(6), the Court is obligated to accept as true allegations in the complaint and all reasonable inferences that can be drawn therefrom. See Rocks v. City of Phila., 868 R2d 644, 645 (3d Cir. 1989). The facts are taken from Plaintiffs’ Amended Complaint and the exhibits attached thereto.

AUTHORIZED BY THE NEW JERSEY INSURANCE FRAUD PREVENTION ACT. I UNDERSTAND THAT THE INFORMATION PROVIDED HEREIN IS MATERIAL AND WILL BE RELIED UPON BY THE COMPENSATION RATING & INSPECTION BUREAU, AS WELLAS BY THE DESIGNATED INSURANCE COMPANY, TO PROVIDE THE REQUESTED INSURANCE AND WILL BE USED TO CALCULATE MY PRELIMINARY WORKERS’ COMPENSATION PREMIUM. I ALSO UNDERSTAND THAT I HAVE A CONTINUING OBLIGATION TO PROMPTLY NOTIFY THE DESIGNATED CARRIER OF CHANGES IN: * THE KIND OF WORK CONDUCTED BY THE BUSINESS * THE SIZE OF AND/OR CLASSIFICATION OF OUR WORKFORCE * THE AMOUNT OF REMUNERATION * THE BUSINESS OWNERSHIP OR BUSINESS STRUCTURE * CHANGE OF MAILING ADDRESS AND/OR PRINCIPAL PHYSICAL LOCATION. TAGREE TO MAKE AVAILABLE ALL RECORDS NECESSARY FOR A CARRIER OR RATING BUREAU AUDIT AND TO PERMIT THE AUDITOR OR OTHER REPRESENTATIVE TO MAKE PHYSICAL INSPECTION OF OUR PREMISES/OPERATIONS. I UNDERSTAND THAT FAILURE TO DO THIS MAY RESULT IN TERMINATION OF THE COVERAGE PROVIDED, CIVIL PENALTIES AND/OR CRIMINAL PROSECUTION. IT IS FURTHER UNDERSTOOD THAT IF THERE IS WORKERS’ COMPENSATION LIABILITY UNDER THE LAW(G) OF ANY OTHER STATEG), OTHER ARRANGEMENTS MUST BE MADE, IN ACCORDANCE WITH NEW JERSEY LAW, IF I/WE INTENTIONALLY UNDERSTATE OR CONCEAL, REMUNERATION, OR MISREPRESENT OR CONCEAL EMPLOYEE DUTIES, SO AS TO AVOID PROPER CLASSIFICATION FOR PREMIUM CALCULATIONS, OR MISREPRESENT OR CONCEAL INFORMATION PERTINENT TO THE COMPUTATION AND APPLICATION OF AN EXPERIENCE RATING MODIFICATION FACTOR, I/WE SHALL BE SUBJECT TO

CIVIL PENALTIES AUTHORIZED BY THE NEW JERSEY INSURANCE FRAUD PREVENTION ACT, AS WELL AS PROSECUTION UNDER THE CRIMINAL LAWS OF THIS STATE. Ud., Ex. C at 4, Dkt. No. 25 at 78.) Beneath the Certification are two fields, labeled “Print Name and Title,” and “Signature,” which both contain the typed name “Novie Pramudita.” □□□□□ Plaintiff alleges that this reflects that Pramudita executed, certified, and signed the application electronically with this typed signature. Ud., Jf 24, 26.) The Application represented, among other things, that Favor did not use subcontractors. (/d., Ex. C, Dkt. No, 25 at 76.) Plaintiff alleges that if an imsured uses subcontractors who are not adequately insured during the insurer’s policy period, the Plan entitles insurers, such as Plaintiff, to charge premiums based on the amounts insured, like Favor, paid to those underinsured or uninsured subcontractors. (/d., J 76.) The Application also contained payroll information for Favor’s employees and classified Favor’s business operations within certain premium-bearing class codes. (/d., Ex. C, Dkt. No. 25 at 77.) Plaintiff alleges these representations were material because, under the Plan and the New Jersey Workers’ Compensation Manual (“Manual”), insureds must fully disclose business operations, employee remuneration, and subcontractor exposure, both at inception and on a continuing basis. Ud., □□ 206-209; see Ex. A, Dkt. No. 25 at 49.) The Plan also requires insureds to cooperate in all audits and to provide complete records reflecting payroll, payments to subcontractors, and certificates of insurance for subcontractors who maintain their own coverage. Ud., JJ 206-209; see Ex. C, Dkt. No. 25 at 78.) b. The 2020-2022 Audits and Alleged Incomplete Disclosures. Plaintiff alleges that during several audits conducted between 2020 and 2022, Favor— principally through Pramudita—-failed to disclose accurate payroll, failed to disclose or produce documentation identifying subcontractors, and repeatedly denied paying cash wages. (d., J 43-

117.) Specifically, Plaintiff alleges that it conducted: (1) a preliminary audit of the 019 Policy (O19 Preliminary Audit”) on March 10, 2020, (d., | 44); (2) an audit of the 019 Policy (“019 Audit’) on March 22, 2021, (id., § 63); (3) an audit of the 010 Policy (010 Audit”) between January 14, 2022 and February 17, 2022, (id., J 79); and an audit of the 011 Policy on April 5, 2022, (id., J 111). Plaintiff alleges that throughout these audits, it made multiple requests for payroll journals, job-cost records, 1099s, cancelled checks, contracts, and Certificates of Insurance (“COIs”) for subcontractors, but Defendants did not produce complete records. Ud., [| 43-117.) Aithough the audits revealed some information suggesting that Defendant utilized subcontractors during Plaintiff’s early review of Defendant’s tax submissions—such as Profit & Loss (“P&L”) statements and 1099 information—Plaintiff asserts these disclosures were incomplete and inconsistent with Favor’s repeated statements during audits that subcontractor usage was limited and that any subcontractors used were adequately insured. For example, Plaintiff alleges that despite its request for subcontractor COIs during the 019 Preliminary Audit, Defendants did not inform Plaintiff’s auditors that Favor used subcontractors, Ud., JY 46, 56.) Plaintiff alleges that it was not until the 019 Policy Audit that Favor informed Plaintiff’s auditor that it utilized one subcontractor to transport its workers.

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LM Insurance Corporation v. Favor Services Inc. and Novie Pramudita, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lm-insurance-corporation-v-favor-services-inc-and-novie-pramudita-njd-2025.