Search Rutgers Law Library N.J. Court Opinions

31 LIBERTY MUTUAL INSURANCE COMPANY v. BRUNSWICK SURGICAL CENTER, PC -- rank: 595

... resolution at the request of any party to the dispute. N.J.S.A. 39:6A-5.1a. The Commissioner of Banking and Insurance is authorized to ... dispute resolution proceedings regarding medical expense benefits under PIP coverage. N.J.S.A. 39:6A-5.1b. Regulations codified at N.J.A.C. 11:3 ... authority. All decisions of the dispute resolution professional are binding, N.J.S.A. 39:6A-5.1c, but are reviewable by the Superior Court in an ... on its insureds and their assignees. As permitted by statute, N.J.S.A. 39:6A-5.1, Liberty Mutual elected to submit PIP coverage disputes to ...

docket:	a4083-06
court:	njappellate
decided:	2008-07-18
status:	unpublished
citation:	*CITE_PENDING*
Document Size:	55590

32 VINCENT GRIECO v. TRAVELERS OF NEW JERSEY INSURANCE COMPANY -- rank: 595

... which was presented to a DRP pursuant to APDRA. See N.J.S.A . 39:6A-5.1; N.J.A.C. 11:3-5.6. Before ... by a physician from a medical review organization (MRO), see N.J.S.A. 39:6A-5.1(d), who compared an MRI study of the lumbar ... that the MRO's physician's determination was correct, see N.J.S.A. 39:6A-5.1(d). Because of these two failures in his proofs ... opinion unless rebutted by a preponderance of the evidence, see N.J.S.A. 39:6A-5.1(d), because such decision is "akin to [an] arbitrator ...

docket:	a6157-12
court:	NJ Superior Court Appellate Division
decided:	2015-02-26
status:	unpublished
citation:
Document Size:	24006

33 JACOB BOYD v. PLYMOUTH ROCK ASSURANCE CORPORATION -- rank: 587

... initiative of any party to the dispute, as hereinafter provided. [ N.J.S.A. 39:6A-5.1(a); see also N.J.A.C. 11:3 ... resolution on the initiative of any party to the dispute." N.J.S.A. 39:6A-5.1(a) (emphasis added). We interpreted that section in a ... that historical backdrop, we concluded that the word "may" in N.J.S.A. 39:6A-5.1(a) was intended to give either party an absolute ... to the trial court's interpretation, the word "may" in N.J.S.A. 39:6A-5.1(a) does not imply that either party can require ...

docket:	a1379-12
court:	NJ Superior Court Appellate Division
decided:	2013-05-28
status:	unpublished
citation:
Document Size:	26830

34 /usr/local/share/www/libweb/collections/courts/appellate/a2236-20.opn.html -- rank: 587

... claims for the wrongful denial of PIP benefits and that N.J.S.A. 39:6A-5(h) limited the remedies on a successful claim for a ... insurer fails to issue payments in a timely manner. See N.J.S.A. 39:6A-5(g). The No-Fault Act's statutory scheme provides an ... context of uninsured or underinsured motorist claims). The text of N.J.S.A. 39:6A-5 addresses the payment of PIP benefits but not authorization or ... the need for additio nal time to investigate the claim. N.J.S.A. 39:6A-5(g). In addition, the statute references situations where a treating ... written notice to an insurer 'following the commencement of treatment.' N.J.S.A. 39:6A-5(a). Failure to give written notice within twenty-one days ... may allow the insurer to deny payment of the claim. N.J.S.A. 39:6A-5(c). Health care providers have an incentive to comply ...

docket:
court:	NJ Superior Court Law/Chancery Division
decided:
status:
citation:
Document Size:	18873

35 ESTATE OF CAREY LEEMAN VS EAGLE INSURANCE COMPANY -- rank: 577

... without merit. R. 2:11-3(e)(1)(E).     Under N.J.S.A. 39:6A-5(c), See footnote 1 reasonable attorney's fees and costs ... attorney's fees, is reversed and remanded.      Footnote: 1 Now N.J.S.A. 39:6A-5(h), applicable only to accidents occurring after January 10, 1996 ...

docket:	a5477-96
court:	njappellate
decided:	1998-03-09
status:	published
citation:	309 N.J.Super. 525
Document Size:	27444

36 /usr/local/share/www/libweb/collections/courts/appellate/a1931-20.opn.html -- rank: 567

... PIP benefits is an award of the interest mandated by N.J.S.A. 39:6A-5(h).' 391 N.J. Super. at 594. Further, '[that conclusion ... PIP benefits to the alternative dispute resolution procedures provided by N.J.S.A. 39:6A-5.1.' Ibid.4 In Endo Surgi Center, we noted the ... in the highly- regulated area of personal injury protection, see N.J.S.A. 39:6A-5, that wrongful failure to pay benefits, wrongful withholding of benefits ... of the statutorily mandated alternative dispute resolution procedure provided by N.J.S.A. 39:6A-5.1.' 391 N.J. Super. at 594- 95. A-1931 ...

docket:
court:	NJ Superior Court Law/Chancery Division
decided:
status:
citation:
Document Size:	31007

37 AMBULATORY SURGICAL CENTER OF SOMERSET v. ALLSTATE FIRE CASUALTY INSURANCE COMPANY -- rank: 562

... proceedings in the class action lawsuit pending arbitration pursuant to N.J.S.A. 39:6A-5.1 of plaintiffs' challenge to defendant's denial of their reimbursement request.3 3 N.J.S.A. 39:6A-5.1 provides for the arbitration of disputes 'regarding the recovery ... medical expense benefits or other benefits provided under [PIP] coverage.' N.J.S.A. 39:6A-5.1(a). A-1998-19T3 4 Plaintiffs filed a demand ...

docket:	a1998-19
court:	NJ Superior Court Appellate Division
decided:	2020-11-12
status:	Unpublished
citation:
Document Size:	26500

38 ALLSTATE NEW JERSEY INSURANCE COMPANY v. HARRIS C. LEGOME -- rank: 560

... non-payment of a claim. The judge stated: Pursuant to N.J.S.A. 39:6A-5.2(g), the costs of the proceedings shall be apportioned ... of insurance, and therefore the IFPA cannot apply. [see also N.J.S.A. 39:6A-5.2(g).] As the judge aptly found, the payments were ... reasonable fee based on the statutory factors set forth in N.J.S.A. 39:6A-5.2(g). Allstate does not contend the arbitrators failed to ...

docket:	a1886-20
court:	NJ Superior Court Appellate Division
decided:	2022-07-26
status:	Unpublished
citation:
Document Size:	32994

39 HACKENSACK SURGERY CENTER v. ALLSTATE INSURANCE COMPANY -- rank: 558

... also awarded attorney's fees and costs totaling $1325 under N.J.S.A. 39:6A-5(h). On August 28, 2015, seven days after receipt of ...

docket:	a3896-15
court:	NJ Superior Court Appellate Division
decided:	2017-09-05
status:	unpublished
citation:
Document Size:	22816

40 CITIZENS UNITED RECIPROCAL EXCHANGE v. NORTHERN NJ ORTHO SPECIALISTS -- rank: 555

... ourt failed to properly apply the standards as established by N.J.S.A. 39:6A-5.1 when considering the rebuttable presumption and the submission of ... and amount of PIP coverage is determined in 'dispute resolution.' N.J.S.A. 39:6A- 5.1(a); see Citizens United Reciprocal Exch., supra, 445 N ... fair and independent review process, including the use of MROs. N.J.S.A. 39:6A-5.1(d). Specifically, N.J.S.A. 39:6A- 5.1(d) states '[t]he determination of the medical review ...

docket:	a1669-15
court:	NJ Superior Court Appellate Division
decided:	2017-06-01
status:	unpublished
citation:
Document Size:	20581

41 /usr/local/share/www/libweb/collections/courts/supreme/a5810-13.opn.html -- rank: 553

... Yoo demanded arbitration with the National Arbitration Forum pursuant to N.J.S.A. 39:6A-5.1(a) and N.J.A.C. 11:3-5 ... injury protection ("PIP") benefits may be submitted to dispute resolution. N.J.S.A. 39:6A-5.1. A PIP dispute can involve the application of, or ...

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court:	NJ Superior Court Law/Chancery Division
decided:
status:
citation:
Document Size:	17524

42 STATE FARM GUARANTY INSURANCE COMPANY v. HEREFORD INSURANCE COMPANY -- rank: 548

... with respect to the conduct of the dispute resolution proceedings.' N.J.S.A. 39:6A- 5.1(b). In exercising that authority, the Commissioner enacted regulations ...

docket:	a3749-16
court:	NJ Superior Court Appellate Division
decided:	2018-03-14
status:	published
citation:	454 N.J.Super. 1 183 A.3d 946
Document Size:	41265

43 THE BACK INSTITUTE v. HIGH POINT INSURANCE -- rank: 540

... 2011, plaintiff filed a demand for arbitration 2 pursuant to N.J.S.A. 39:6A-5.1. Both parties submitted extensive medical records and reports and ...

docket:	a2721-12
court:	NJ Superior Court Appellate Division
decided:	2014-04-25
status:	unpublished
citation:
Document Size:	31059

44 Christina DiProspero v. Barbara J. Penn, et al. -- rank: 540

... new dispute resolution procedure concerning personal injury protection (PIP) benefits, N.J.S.A. 39:6A-5.1, and a new “basic automobile insurance policy” that limited ...

docket:	a-66-03
court:	New Jersey Supreme Court
decided:	2004-11-29
status:
citation:
Document Size:	73117

45 HEATHER ADCOX v. ENCOMPASS INSURANCE COMPANY -- rank: 530

... in lieu of filing an action in the Superior Court. N.J.S.A. 39:6A-5.1. Under AICRA, the Commissioner of Banking and Insurance is ...

docket:	A1863-05
court:	NJ Superior Court Appellate Division
decided:	2006-10-18
status:	unpublished
citation:
Document Size:	42842