Fort Lee Surgery Center Inc. v. Proformance Ins. Co., A-1192-08T2; (N.J. Super. Ct. App. Div. Feb. 22, 2010 (Fisher, J.)

Appellate courts lack jurisdictional appellate review of trial court's correction of arbitration award when trial court rationally explains its reasoning and reasoning is grounds for correction under Alternative Procedure for Dispute Resolution Act.

Brent Keys underwent a series of spinal treatments as a result of injuries sustained in a motor vehicle accident at the plaintiff's, Fort Lee Surgery Center, facilities. The defendant, Proformance Insurance Company, claimed that this treatment was not medically necessary and declined payment. Fort Lee demanded arbitration pursuant to the Alternative Procedure For Dispute Resolution Act (APDRA). The arbitrator denied the plaintiff's claim, finding the procedures unecessary under NJ.S.A. §§ 39:6A-2(m) and 11:3-4.2. The plaintiff appealled the arbitrator's decision to the trial court, which held that the arbitrator "prejudicially erred" by failing to apply the doctrine of collateral estoppel to bar further consideration of whether the treatment was medically necessary and, also, by misapprehending the meaning of medical necessity as applied to the facts. In correcting these errors, the judge made her own determination, as permitted by N.J.S.A. § 2A:23A-13(f), that the treatment was medically necessary. On appeal, this court held that appellate courts lack jurisdictional appellate review of a trial court's correction of an arbitration award when the trial court rationally explains its reasoning and the reasoning is grounds for correction under the APDRA.

Case Law Alert - 2nd Qtr 2010