Coverage Trial - Right to Jury
No Right to Jury Trial in Action Brought under Insurance Fraud Prevention Act
Allstate N.J. Ins. Co. v. Lajara, 2013 N.J. Super. LEXIS 147 (App. Div. Oct. 9, 2013)
The Insurance Fraud Prevention Act does not include a statutory right to a trial by jury. The New Jersey Constitution does not guarantee a right to trial by jury for private actions under the Act.
Plaintiff insurers brought a fraud claim under the Act against various defendants, including individual physicians and chiropractors, medical and chiropractic practices, and unlicensed individuals. The insurers alleged that the defendants participated in a scheme to coax insurers into paying unwarranted PIP benefits. Among the defendants' alleged tactics were paying kickbacks to attorneys who referred clients, paying persons to intentionally cause accidents in order to generate fraudulent bills, and billing for various services performed by unlicensed persons. The insurers sought a declaration that they were not obligated to pay PIP benefits to defendants, disgorgement of sums already paid and damages allowed under the Act.