Pennsauken, NJ (Law Firm Newswire) October 20, 2016 – In a published ruling, the appeals court stated that the Workers’ Compensation Act has control over claims against third-party tortfeasors who suffer injuries in motor vehicle accidents while they are engaged in employment.
In the case of Lambert v. Travelers Indemnity Company of America, three judges resolved disagreements between the workers’ compensation law and the Automobile Insurance Cost Reduction Act, both of which concern the way in which medical liens should be satisfied. The decision was released in August 2016, in three separate cases that were consolidated because they dealt with similar issues.
Prominent South Jersey workers’ compensation attorneys Petrillo & Goldberg stated, “These cases highlight the importance of focusing on the medical expenses paid by Workers’ Compensation at the time of settlement negotiations. Failure to address this issue could adversely affect the amount of recovery from the tortfeasor.”
As reported in the New Jersey Law Journal, plaintiff, Jennifer Lambert, worked as a school bus aide for the Howell Township Board of Education. She sustained an injury when the bus she was riding was struck by a vehicle operated by Kaitlin Antonaccio. Ms. Lambert filed a workers’ compensation claim, which resulted in a payment by Travelers in the amount of $94,705 to cover her medical expenses, and $54,695 for compensation benefits.
Ms. Lambert filed a lawsuit against Ms. Antonaccio, culminating in a settlement of $300,000. Ms. Lambert’s attorney made an offer of reimbursement to Travelers in the amount of $35,713. This was two-thirds of the workers’ compensation benefit she obtained, minus $750 in statutory costs. However, Ms. Lambert would not reimburse Travelers for medical expenses. When Travelers refused to accept the offer, Ms. Lambert filed a claim to abate Travelers’ medical lien.
In the second case, the plaintiff, Paul Reed, worked as a police officer in Marlboro, and was directing traffic when he was hit by a car operated by Vladlen Futernik. Mr. Reed received $60,430 from the Monmouth County Municipal Joint Insurance Fund to cover his medical bills, and $44,578 as compensation benefits. Mr. Reed filed a lawsuit against Mr. Futernik, resulting in a settlement of $100,000. Mr. Reed also filed an uninsured motorist claim against New Jersey Manufacturers Insurance, and reached a settlement in the amount of $199,000, making his total compensation $299,000.
The third case involved plaintiff, William Agar, a police officer from Hazlett, who was seated in his police car when it was rear-ended by Ethel McCaffrey. The Monmouth County JIF paid him $4,331 in medical benefits and $15,693 in workers’ compensation benefits. Mr. Agar also filed a lawsuit against Ms. McCaffrey that resulted in a settlement of $60,000. The JIF then filed a claim against Mr. Agar’s receipt of compensation benefits and payment to cover his medical bills. When the parties were unable to resolve the issue, Mr. Agar filed a lawsuit to annul the JIF lien on his medical recovery.
Upon hearing the three cases, Superior Court Judge Joseph Quinn of Monmouth County permitted plaintiffs to eliminate the liens for medical expenses. In support of his decision, he cited Dever v. New Jersey Manufacturers Insurance Company, an unpublished 2013 case from the Appellate Division. In Dever, the court held that an insurance company does not have a legal claim on the medical part of a third-party lien. Judge Quinn said that since the workers suffered injuries during the course of employment, they should receive the same treatment as no-fault insureds. Thus, any payments received from the tortfeasor must exclude medical expenses that were paid by an insurer. In addition, because the injured worker was unable to recover medical expenses from the tortfeasor, the workers’ compensation insurer could not obtain repayment of medical expenses under the Workers’ Compensation Act.
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