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Allstate New Jersey Insurance Company v. Neurology Pain Associates A/S/O Marianne Tubelis

January 31, 2011

ALLSTATE NEW JERSEY INSURANCE COMPANY, PLAINTIFF-RESPONDENT,
v.
NEUROLOGY PAIN ASSOCIATES A/S/O MARIANNE TUBELIS, DEFENDANT-RESPONDENT.
NATIONAL ARBITRATION FORUM, APPELLANT.



On appeal from Superior Court of New Jersey, Chancery Division, Camden County, Docket No. C-124-09.

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION

APPROVED FOR PUBLICATION

Argued November 30, 2010

Before Judges Skillman, Parrillo and Espinosa.

The opinion of the court was delivered by SKILLMAN, P.J.A.D.

The Automobile Insurance Cost Reduction Act (AICRA), enacted in 1998, L. 1998, c. 21, substantially revised the prior system for arbitration of disputes concerning the payment of personal injury protection (PIP) benefits under the Automobile Reparation Reform Act (No Fault Act), N.J.S.A. 39:6A-1 to -35. AICRA added a new section, N.J.S.A. 39:6A-5.1(b), which requires the Commissioner of Banking and Insurance to designate an organization for the purpose of administering dispute resolution proceedings regarding PIP benefits and to adopt rules and regulations for the conduct of those dispute resolution proceedings. In accordance with this statutory directive, the Commissioner designated appellant, the National Arbitration Forum (NAF), as the organization responsible for administering PIP dispute resolution proceedings and adopted rules and regulations the NAF is required to follow in conducting such proceedings.

The primary issue presented by this appeal is whether those rules and regulations authorize an appeal to the courts from an interlocutory order or other interim action by the NAF relating to a dispute resolution proceeding. We conclude that the rules and regulations governing PIP dispute resolution proceedings do not authorize judicial review of an interlocutory order or other interim action taken by the NAF during an ongoing proceeding relating to the payment of PIP benefits. Therefore, we reverse an order of the Chancery Division that directed the NAF to refer the issue of the timeliness of submission of a brief a NAF administrator had accepted as timely to a panel of NAF arbitrators and also established detailed procedures and schedules the NAF is required to follow in a pending PIP dispute resolution proceeding.

I.

Marianne Tubelis was insured under an automobile liability policy issued by plaintiff Allstate New Jersey Insurance Company (Allstate). Tubelis suffered injuries in an automobile accident, for which she received medical care from defendant Neurology Pain Associates (Neurology). Tubelis subsequently assigned her claim for PIP benefits under the Allstate policy to Neurology. After a dispute arose between Allstate and Neurology regarding those benefits, Neurology filed a demand for arbitration before the NAF.

The NAF appointed an arbitrator to hear the dispute, who ruled in favor of Allstate. Neurology filed a request for an internal appeal of the arbitrator's award to a three-person panel of dispute resolution professionals (DRP), as provided by a NAF rule. Such an appeal is decided based solely on documentary submissions and legal argument. The NAF rules establish deadlines for filing these papers.

In accordance with those rules, the NAF set a deadline of August 14, 2009 for the submission of Allstate's response to Neurology's appeal. After Allstate filed its response on August 14, 2009, Neurology submitted a reply to that response on August 16, 2009. Allstate objected to the submission of Neurology's reply by a faxed letter dated August 18, 2009, which argued that Neurology's submission made "numerous assertions relative to issues that were never raised below and should not be raised for the first time in a reply brief." The NAF case coordinator for the appeal decided in a letter dated August 19, 2009 that Neurology's August 16, 2009 reply brief had been timely, and therefore would be sent to the DRP panel, but that Allstate's August 18, 2009 objection to the reply was untimely and therefore would not be sent to the panel.

After a further exchange of correspondence that resulted in the NAF case coordinator adhering to his position regarding the timeliness of the parties' submissions, Allstate filed this action in the Chancery Division challenging the case coordinator's decision. Allstate sought a court order precluding the submission of Neurology's reply brief to the DRP panel. Allstate's complaint named only Neurology as a defendant, without joining the NAF as a party. The case was brought before the trial court by an order to show cause.

Before the return date, the NAF filed a motion to intervene. The NAF's supporting papers asserted, among other things, that the court lacked jurisdiction to review the NAF case coordinator's decision regarding the timeliness of Neurology's reply brief and that Allstate's Chancery Division action was improperly seeking "to interject the [c]court into the system and procedures for the ongoing administration of PIP arbitrations."

The trial court denied the NAF's motion to intervene. The court also granted Allstate relief from the NAF case coordinator's decision regarding the timeliness of the parties' August 16 and 18, 2009 submissions relating to Neurology's appeal of the arbitrator's award, concluding that this decision had resulted in a "manifest denial of justice." Based on this conclusion, the court ...


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