University of Massachusetts Memorial Medical Center, Inc. v. Christodoulou

823 A.2d 51, 360 N.J. Super. 313, 2003 N.J. Super. LEXIS 140
CourtNew Jersey Superior Court Appellate Division
DecidedApril 16, 2003
StatusPublished
Cited by5 cases

This text of 823 A.2d 51 (University of Massachusetts Memorial Medical Center, Inc. v. Christodoulou) 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
University of Massachusetts Memorial Medical Center, Inc. v. Christodoulou, 823 A.2d 51, 360 N.J. Super. 313, 2003 N.J. Super. LEXIS 140 (N.J. Ct. App. 2003).

Opinion

The opinion of the court was delivered by

COBURN, J.A.D.

This is a common law action by medical providers for the reasonable value of medical services that were at issue in a workers’ compensation case. It also includes a cross-claim by the [316]*316compensation petitioner against the compensation respondent for indemnification with respect to the medical bills and for counsel fees in defending against the medical providers’ action.

The primary issue is whether the petitioner in a workers’ compensation action, which was settled without providing for the payment of medical bills, may be held accountable thereafter at common law by medical providers who failed to intervene in the workers’ compensation action despite having received timely notice of its pendency. The other substantive issues are: whether the respondent in that compensation action may be held liable to the unpaid medical providers based on respondent’s agreement to hold petitioner harmless from liability for the medical bills; and whether the hold-harmless agreement requires the respondent to reimburse petitioner for his legal fees in defending against the common law action. These issues were presented to the trial court on defense motions for summary judgment. The trial court denied the motions, and we granted the unsuccessful parties leave to appeal. We conclude that the common law action against the workers’ compensation petitioner is barred because of the medical providers’ failure to intervene, or file their own claim, in a timely manner in the compensation action; that the hold-harmless agreement provides no basis for the medical provider’s action against the compensation respondent and its insurance representatives; and that the petitioner is entitled to reimbursement from the compensation respondent for his legal fees in defending this action.

I

Plaintiffs, University of Massachusetts Memorial Medical Center, Inc., and University of Massachusetts Group Practice, provided over $700,000 in medical services to Mario S. Christodoulou (“Mario”) for injuries he sustained in a motor vehicle accident. After Mario died as a result of those injuries, his father, defendant Steve Christodoulou (“Steve”) filed two petitions with the Division of Workers’ Compensation (the “Division”). One petition sought [317]*317benefits for Mario’s estate, and the other sought benefits for Steve and his wife, Despina, as Mario’s dependents. Mario was an unmarried adult, had no children or other possible dependents, and lived with his parents. Plaintiffs received timely notice of the petitions, but failed to intervene in the proceedings or file their own claim petition. The respondent in both cases was Mario’s employer, defendant Auto Auction Land, Inc. (“Auto Auction”). Defendant Granite State Insurance Company (“Granite State”) was Auto Auction’s compensation insurer, and defendant AIG Claim Services, Inc. (“AIG”), was Granite State’s claims administrator.

Faced with difficult issues respecting the viability of both compensation claims, the parties resolved their dispute by a settlement that made no provision for payment of plaintiffs’ medical bills. Pursuant to the agreement, which was approved by the judge of compensation under N.J.S.A. 34:15-20, respondent agreed to pay $50,000 in a lump sum payment and to indemnify petitioner with respect to any future claim for the medical bills. The terms of the indemnity agreement were set out in the following manner in the settlement proceeding. Petitioner’s attorney asked petitioner this question: “As part of the settlement I’ve told you that should any doctor or hospital come against you or as a result of any of the injuries sustained by your son, the insurance company will protect you, do you understand that?” (Emphasis added). He replied, “I understand.” Respondent’s attorney then engaged in the following examination of Steve.

Q. Do yon understand that by accepting this settlement that the ease is closed forever and neither you nor anyone else from your family can come back into court to try to seek additional monies from Auto Auction Land?
A. Yes, I understand.
Q. You also understand that in the event that there is a claim against you for hospital bills, the insurance company will protect you in this matter?
A. Yes I understand.
[Emphasis added.]

This agreement was reflected in the order approving the settlement in the following manner: “Respondent will hold petitioner harmless for any medical or hospital bill arising out of the [318]*318accident____” Although Despina did not actively participate in the compensation proceedings, it was obviously intended that she benefit from the settlement to the same extent as Steve.

The settlement of the compensation ease occurred on May 10, 1999. Over a year later, plaintiffs filed pleadings in the Division attempting to vacate the settlement and obtain payment of their bills. The judge of compensation denied them relief, and they appealed. In an unreported opinion, we affirmed. Christodoulou v. Auto Auction Land Inc., No. A-2860-00T2 (App. Div. April 10, 2002), certif. denied, 174 N.J. 191, 803 A.2d 1163 (2002). Among other things, we held that these medical providers were barred from obtaining payment in the Division because of their failure to file a timely petition, and were not entitled to be relieved of the effect of that failure under Rule 4:50-1.1 This common law action was filed while that appeal was pending.

II

We consider first the compensation parties’ demand for dismissal of this common law action on the ground that it violates the Workers’ Compensation Act, N.J.S.A. 34:15-1 to -128 (the “Act”). As a preliminary matter, we observe as a matter of law that there were actually three petitioners in the compensation action: Steve, Despina, and, in essence, Mario’s estate. Although Steve signed the dependency action, he clearly did so on behalf of his wife as well as himself, an informality apparently permitted by the Division. See 3 Larson, Workers’ Compensation, §§ 124.03-124.04 (Desk Ed.2000), discussing the procedural informality in such matters with respect to the form and substance of pleadings. Steve filed the employee’s claim petition for his deceased son in a representative capacity, namely as “such person as would be appointed administrator of the estate of the decedent____” [319]*319N.J.S.A. 34:15-21. We so conclude because there is no evidence of the formal appointment of an administrator or executor of such estate as Mario might have had.

A medical provider may not sue petitioners or respondents at common law while a compensation case is pending. Medical Diagnostic Assoc. v. Hawryluk, 317 N.J.Super. 338, 347, 722 A.2d 122 (App.Div.1998), certif. denied, 160 N.J. 89, 733 A.2d 494 (1999). However, they may file a timely claim petition for the value of services rendered in the Division. Id. at 348, 722 A.2d 122; N.J.S.A. 34:15-15. If the Division rejects the petitioner’s claim, or the medical provider’s claim, on the merits, the medical provider can then sue the petitioner at common law.

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Bluebook (online)
823 A.2d 51, 360 N.J. Super. 313, 2003 N.J. Super. LEXIS 140, Counsel Stack Legal Research, https://law.counselstack.com/opinion/university-of-massachusetts-memorial-medical-center-inc-v-christodoulou-njsuperctappdiv-2003.