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Patricia A. Lee

Chair, ERISA and Benefit Plan Litigation

Overview

With a focus on healthcare and construction law, Patricia Lee litigates matters ranging from minor disputes to complex cases involving millions of dollars. She takes a collaborative approach with her clients to understand their needs, identify their objectives and develop an efficient legal strategy that meets their business goals. An aggressive advocate, Patti honed her legal skills and strong attention to detail early in her career as a criminal defense lawyer.  

As chair of Connell Foley’s ERISA and Benefit Plan Litigation Practice Group, Patti devotes a substantial portion of her work to defending lawsuits that seek benefits under health plans, changes to policies or other contractual remedies. She has obtained numerous dismissals on the basis that claims were preempted by the Employee Retirement Income Security Act of 1974 (ERISA). She also successfully defends claims on the grounds of lack of standing, failure to exhaust administrative remedies, accord and satisfaction and fraud. Patti represents insurers in actions seeking relief against health care providers, including recovery of overpayments, and has obtained favorable settlements on behalf of insurer clients on claims of violation of the New Jersey Insurance Fraud Prevention Act, common law fraud and/or negligent misrepresentation. 

In addition to her health care work, Patti represents clients in complex construction litigations arising out of delay and defective workmanship claims, lien claims, architectural and engineering liability, fraud claims and builder’s risk insurance coverage disputes. She also handles transactions such as access agreements for new construction projects.

Patti has tried several cases to verdict and handled numerous appeals from trial court orders and jury verdicts. She appears regularly in federal and state courts, as well as arbitration, mediation and administrative tribunals. 

Experience

Representative Experience

Healthcare/ERISA

  • Obtained a voluntary dismissal for an insurer -- prediscovery and pending ruling on a motion to dismiss -- of a putative class action seeking coverage for medical tattooing under the Women's Health and Cancer Rights Act of 1998
  • Defended against a subscriber-brought putative class action challenging coverage policies for eating disorder treatments brought under ERISA and state parity laws, resulting in a favorable and groundbreaking settlement for a limited class of New Jersey insureds
  • Prosecuted an overpayment recovery from providers that received double payments both from the insurer and from a hospital system with capitated rates for anesthesiology services
  • Defended a provider pain specialist’s request for payments under a network agreement and pursued overpayment counterclaims based upon overbilling, overutilization, unbundling and upcoding
  • Succeeded in opposing an order to show cause for emergent nursing care coverage
  • Prosecuted a claim for emergent relief against an ambulance transportation provider seeking to enjoin balance billing following a defective termination of a network services agreement, resulting in a favorable settlement
  • Part of defense team for national putative class actions brought by individual health care providers and chiropractic associations asserting challenges to health insurance company overpayment recovery procedures; pursuit of counterclaims to recover overpayments from certain plaintiff providers investigated by the insurer’s Special Investigations Unit. Many of plaintiffs’ claims, including all RICO claims and the individual claims of several providers, were successfully dismissed by way of initial motions
  • Part of defense team for a national, multi-district putative class action brought by subscribers, providers, and medical associations alleging ERISA, RICO and Sherman Act violations relating to the use of industry databases to determine usual and customary rates for out-of-network services. Majority of the claims were dismissed, including RICO and antitrust
  • Obtained dismissal of an associational action seeking to enjoin the inclusion of provisions in network agreements setting maximum fees to be charged for services that, because of deductibles, frequency limitations, benefit maximums and plan exclusions, do not result in a payment from the insurer. Dismissal was granted based upon defense motions; dismissal upheld on appeal
  • Defended a health care provider in an unfair competition action alleging violations of health care regulations and interference with a restrictive covenant agreement
  • Prevailed in regulatory appeals relating to the New Jersey Individual Health Coverage Program Act, serving as amicus for interested insurance company
  • Defended a wrongful death action brought against numerous health care providers, pharmacies and hospitals relating to overutilization of prescription medications

Construction

  • Represented a large shopping center developer in a substantial multi-party dispute involving defective workmanship, professional negligence, insurance coverage and delay claims; won dismissal of contractor’s fraud claim and contract defenses re: alleged failure of developer to disclose groundwater and soil conditions and developer’s claim under the Consumer Fraud Act against contractor for substitution of inferior materials
  • Defended a wind engineering company in a property damage action involving a snow and ice study performed for a new building at Baruch College in New York City
  • Represented a horizontal directional drilling contractor in a substantial multi-party arbitration action involving affirmative delay and change order damages as well as defective workmanship claims
  • Represented a retail shopping chain in an order to show cause seeking emergent C.O. approval, as well as in resolving outstanding construction disputes and bonding issues
  • Represented a real estate owner-developer in negotiation of construction access agreements
  • Represented a real estate owner-developer on an order to show cause to allocate funds to lienholders
  • Represented a real estate owner-developer in a partnership dispute involving breach and fraud claims against a construction contractor-partner; prevailed in an appeal of an order compelling the parties to arbitrate and won remand of the matter for full discovery on the breach and fraud claim
  • Defended an engineering firm in two complex professional malpractice actions arising from the design and construction of a major wastewater treatment facility
  • Defended substantial personal injury litigations involving alleged architectural and engineering errors in major New Jersey construction projects, including the Tropicana parking garage collapse

Other Complex Litigation Results

  • Secured orders of the Commonwealth Court of Pennsylvania granting cut-through to reinsurance policies for two airlines insured by the bankrupt Legion Insurance Company
  • Won acquittal after a jury trial on air piracy criminal charges arising from allegations that the defendant had released stink bombs on two overseas TWA flights within days of one another (United States v. Botnick, E.D.N.Y.)
  • Tried to verdict a white collar criminal defense matter based upon allegations of mail and wire fraud through a mortgage refinancing scheme; bail pending appeal to the Third Circuit granted (United States v. Ragbir, D.N.J.)
  • Secured dismissal of all claims against an engineering company acting in its capacity as municipal zoning officer, including §1983 claims
  • Handled a white-collar criminal jury trial involving allegations that the defendant, a former political figure, committed fraud against his hospital system employer (United States v. Botnick, D.N.J.)
  • Prosecuted claims of a property owner alleging constitutional due process and equal protection violations caused by a blight designation
  • Won acquittal after a bench trial on several counts of sexual misconduct brought against an educator in a multi-complainant case
  • Successfully defended a contamination action against an oil tank removal contractor by establishing commingled contamination sources, false damages, and net expert opinions

Decisions

  • In re Aetna UCR Litig., MDL 2020, 2015 U.S. Dist. LEXIS 84600 (D.N.J. June 30, 2015)
  • Montvale Surgical Ctr., LLC v. Aetna Ins. Co. 2013 U.S. Dist. LEXIS 72927 (D.N.J. May 22, 2013)
  • MHA, LLC v. Aetna Health Inc., 2013 U.S. Dist. LEXIS 25743 (Feb. 25, 2013)
  • New Jersey Dental Association v. Metropolitan Life Insurance Company and Aetna Life Insurance Company, Docket No. A-2916-10T2, 424 N.J. Super. 160, 36 A.2d 1066 (App. Div. Feb. 15, 2012), cert. denied, Supreme Court Docket No. 070235 (May 21, 2012)
  • Surgical Ctr. of N. Brunswick v. Aetna Health Inc., 2012 U.S. Dist. LEXIS 133924 (D.N.J. Sept. 19, 2012)
  • Association of New Jersey Chiropractors, et al. v. Aetna, Inc., 2012 U.S. Dist. LEXIS 64413 (D.N.J. May 8, 2012); 2011 U.S. Dist. LEXIS 67718 (D.N.J. June 17, 2011)
  • In re Chubb Colonial Life Ins. Co. of America, 2009 N.J. Super. Unpub. LEXIS 907 (App. Div. Apr. 3, 2009)
  • DeVito v. Aetna, Inc., 536 F. Supp. 2d 523 (D.N.J. Feb. 25, 2008)
  • Frompovicz v. Twp. Of S. Manheim, 2007 U.S. Dist. LEXIS 74361 (M.D. Pa Oct.4, 2007)
  • State v. Romero, 191 N.J. 59, 922 A.2d 693 (2007) (appearing amicus curiae on behalf of the ACDL of NJ)
  • O'Connell v. Konner, ESX-L-4705-03, A-0968-03T1 (N.J. Super. App. Div. 2004)

Activities

Professional and Community Affiliations

  • Co-Chair, Connell Foley Hiring Committee
  • Co-Chair, Connell Foley Diversity Committee
  • Member, Connell Foley Website Committee
  • Member, American Bar Association
    • ABA Litigation Section
  • Member, New Jersey State Bar Association
    • NJSBA Class Action Subcommittee
  • Member, Essex County Bar Association
  • Member, Association of Criminal Defense Lawyers of New Jersey
  • Member, New Jersey Women Lawyers Association
  • Member, USLAW, Construction Practice Group
  • Participant, IADC Trial Academy (2007)
  • Certified Mediator, State of New Jersey

News & Insights

Honors

New Jersey Super Lawyers Rising Stars (2013)

New Jersey New Leaders of the Bar (2012)

Clerkships

  • Honorable R. Benjamin Cohen, Chancery Division−General Equity Part, New Jersey Superior Court, Essex County

Education

American University - Washington College of Law (J.D., magna cum laude, 1998)

Rider University (B.A., Political Science and English Literature, summa cum laude, 1995)

Admissions

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