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Jeffrey G. Rapattoni

Assistant Director, Casualty Department

Chair, Personal Injury Protection (PIP) Litigation Practice

Co-Chair, Fraud/Special Investigation Practice

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Portrait of Jeffrey G. Rapattoni

Jeffrey is the Assistant Director of the Casualty Department and with the Director, is responsible for administrative oversight of more than 250 lawyers among 19 offices. Jeffrey is also a past member of the firm's Board of Directors, having served the maximum two term limit. 

Jeffrey joined Marshall Dennehey in 2008 and serves as the chair of the firm’s PIP Litigation Practice, co-chair of the firm's Fraud/Special Investigation Practice Group. He focuses his practice on insurance fraud, bad faith and SIU related matters working with carriers both in the US and internationally.

For over 20 years Jeffrey has litigated insurance fraud and fraud-related matters on a national level. He acts as coordinating counsel to several insurance companies and helps clients develop strategies for defending complex litigation related to medical provider fraud, PIP and other emerging insurance issues. In addition, Jeffrey frequently consults with insurance carriers across the country to help integrate internal analytical platforms, create risk management protocol and conduct fraud-related investigations.

He has extensive training and background in provider-based investigations, underwriting fraud, policy voidance, and staged accidents. Other practice areas include large loss property claims, coverage, general civil litigation, and appellate practice. He is an experienced mediator and coordinates investigations for companies in the healthcare, insurance, gaming, hospitality and other industries. As part of his practice, Jeffrey has worked with experts in the fields of cause and origin and bad faith as well as local and federal authorities.

Jeffrey serves as Counsel to the Board of Directors of the International Association of Special Investigation Units (IASIU), the largest global organization devoted to fighting insurance fraud by connecting the insurance, investigatory and legal communities. He also is a member of the Advisory Board of the BigData@Rutgers certificate program, where he provides input on curriculum development to improve the program's offerings and value to the business community.

He frequently lectures on insurance fraud, bad faith and data analytics topics for a number of local and national insurance organizations. He also provides legal education seminars for clients and organizations across the country.

After graduating with a Bachelor of Arts degree from Villanova University in 1997, Jeffrey served as a legislative correspondent for United States Senator Arlen Specter in Philadelphia and Washington D.C., where he assisted in drafting legislation and conducting legal investigations. While attending Rutgers Law School, he served as a judicial extern to the Honorable Judge John A. Almeida, J.S.C. Burlington County-Civil Division, where he drafted tentative dispositions of the court and assisted in court-ordered mediation sessions. 

    • Rutgers Law School (J.D., 2001)
    • Villanova University (B.A., 1997)
    • New Jersey, 2002
    • U.S. District Court District of New Jersey, 2002
    • U.S. Court of Appeals 3rd Circuit, 2004
    • Michigan, 2016
    • Pennsylvania, 2026
    • Counsel, International Association of Special Investigation Units (IASIU) (2025)
    • Ohio Chapter of International Association of Special Investigators (IASIU) Service Award (2020)
    • New Jersey Special Investigators Association (NJSIA) President's Award (2018)
    • Advisory Board Member, BigData@Rutgers Certificate Program (2017)
    • National Insurance Crime Bureau, Certificate of Appreciation (2010)
    • New Jersey Special Investigators Association President's Award (2009)
    • Counsel, Ohio Chapter of International Association of Special Investigators (IASIU)
    • Burlington County Bar Association
    • Camden County Bar Association
    • Claims and Litigation Management Alliance, Board Member and Secretary, South Jersey Chapter
    • Claims and Litigation Management Alliance, Insurance Fraud Committee Member
    • International Association of Special Investigators (IASIU)
    • National Society of Professional Insurance Investigators (NSPII)
    • New Jersey Insurance Defense Committee
    • New Jersey Special Investigators Association (NJSIA)
    • New Jersey State Bar Association
    • South Jersey Claims Association
    • Legal Affairs Committee of the Coalition Against Insurance Fraud, Member
    • The Lawyers Club of Philadelphia
    • "Crash & Con: Navigating Staged Accident Fraud," AM Best Insurance Law Podcast, May 22, 2025
    • Getting Caught With Your Hand in the Proverbial Cookie Jar, ClaimsXchange Annual Conference, Philadelphia, PA, October 12, 2023
    • Top Cases Impacting Fraud Fighting, Marshall Dennehey Client Webinar, June 28, 2023
    • The CAT's Out of the Bag: Insurance Fraud in Catastrophic Losses, CLM Annual Conference, Palm Desert, CA, March 24, 2022
    • PI’s in the Field – Pre, During & Post COVID & New Manned/Unmanned Surveillance, Illinois Chapter of IASIU, March 18, 2022
    • Charting the Course of Telehealth in the Post-COVID Landscape, ASHRM Webinar Series, April 27, 2021
    • Rising Risk and Economic Hardship: Insights on Fighting Fraud in Uncertain Times, CLM Webinar, November 5, 2020
    • Fraud Leadership Series: P&C Claims During Covid 19, FRISS Webinar, November 3, 2020
    • The Civil and Criminal State of the SIU in 2020, The Ohio Chapter of IASIU, October 27, 2020
    • All Hands Meeting- The Criminal State of the SIU in 2020, OIFP | NICB Webinar, October 7, 2020
    • National Perspective, Local Impact; New Case Law Impacting the SIU IASIU Webinar, September 14, 2020
    • SIU Litigation Trends Panel Discussion, IFM Webinar, May 12, 2020
    • CLM COVID-19 Webinar Series: "Stop the Spread...Don't Let COVID-19 Infect You With Insurance Fraud," April 23, 2020
    • Medical Investigator's Guide to the Modern SIU Claim, Speaker, New Jersey Special Investigators Association (NJSIA) Annual Conference, Atlantic City, NJ, October 2019
    • How the Market is Falling Short on CAT Claims, CLM Southeast Conference, Orlando FL, October 2019
    • How to Use Data in Your Advantage – Speaker, FRAUDTalks Conference, Amsterdam, Netherlands, September 24, 2019
    • Secrets to Maintaining a Successful Major Case Unit , IASIU, Phoenix, AZ, September 2019
    • Clamping Down On Fraud – Panelist, Casualty Actuarial Society Spring Meeting, New Orleans, Louisiana, May, 2019
    • SIU’s Management of Brand Protection – Concerns and Consequences, IFM, Coronado, CA, March 2019
    • Major Case From A-Z, IASIU 2018 Seminar & Expo on Insurance Fraud, Baltimore, MD, September, 2018
    • Major Case From A-Z, Marshall Dennehey Insurance Fraud 360 Seminar, Lafayette Hill, PA, June, 2018
    • The Evolving Partnership of Data Analytics and Claims, A.M. Best Webinar, May 3, 2018 (registration is required but no cost to view webinar)
    • How Smart Data is Remaking Insurance Claims, A.M. Best Webinar, February 22, 2018 (registration is required but no cost to view webinar)
    • Strategic SIU Management and Risk Avoidance – Moderator, 2017 Insurance Fraud Management Conference, Phoenix, AZ, March, 2017
    • Insurance Fraud - Staged Accidents: The New Frontier - panel, 2017 CLM Southeast Conference, Atlanta, GA, November, 2017
    • Trends and the Future State of SIU – Moderator, 27th Annual NJSIA Anti-Fraud Insurance Training Seminar, Atlantic City, NJ, October, 2017
    • Major Case From A-Z, IASIU 2017 Seminar & Expo on Insurance Fraud, New Orleans, LA, September, 2017
    • Ethics Roundtable, HB Litigation Northeast Corporate Counsel Forum, Atlantic City, NJ April, 2017
    • SIU Management Panel, New Jersey Special Investigators Association (NJSIA) Annual Conference, Atlantic City, NJ, October 2016
    • Deposing the Adjuster; Social Media and Big Data, IASIU Annual Seminar and Expo on Insurance Fraud, Red Rock, Nevada, September 2016
    • Managing the Risk in SIU Investigations, Panel Moderator, Marshall Dennehey Insurance Fraud 360 Seminar, Lafayette Hill, PA, June, 2016
    • Risk Management in SIU,  IFM/ISO- Insurance Fraud Management Conference, Savannah, Georgia, March 2016
    • NAMIC Webinar: Contemporary Solutions to Provider and Claimant Medical Fraud, October 27, 2015
    • NAMIC Webinar: Provider Fraud Investigations in Personal Injury Protection Claims, October 13, 2015
    • NAMIC Webinar: Medical Provider Fraud in Uninsured Motorist/Bodily Injury Claims, October 6, 2015
    • Building a Better Medical Major Case, New Jersey Special Investigators Association (NJSIA) Annual Conference, Atlantic City, NJ, October 2015
    • SIU Data Analytics: A Sword and Shield for Florida Law, Florida Insurance Fraud Education Committee (FIFEC) 23rd Annual Conference, June 11, 2015
    • Avoiding Risk in Managing the Anti-Fraud Function and Tracking the Value-Add of SIU, 2015 Insurance Fraud Management Conference, Coronado, California, March , 2015.
    • Dissecting The Staged Loss Claim, Speaker, New Jersey Special Investigators Association (NJSIA) Annual Conference, Atlantic City, NJ, October 2014
    • "The Burden of Medical Provider Fraud on the Insurance Industry," A.M. Best PODCAST, September 2014
    • SIU Management Panel - Contemporary SIU Issues, Marshall Dennehey Insurance Fraud 360 Seminar, Lafayette Hill, PA, June 2014
    • Managing and Investigating Billing Misrepresentations Under the New PIP Statute, Florida Insurance Fraud Education Committee (FIFEC) 22nd Annual Conference, June 12, 2014.
    • Effectively Managing Contemporary Insurance Fraud Issues, National Society of Professional Insurance Investigators’ 2013 Advanced Insurance Fraud Seminar, St. Louis, MO, November, 2013
    • Effectively Managing Major Case Investigations of Fraudulent Medical Providers, Speaker, New Jersey Special Investigators Association (NJSIA) Annual Conference, Atlantic City, NJ, October 2013
    • Trending Contemporary Medical Fraud, IASIU's 28th Annual Seminar and Expo on Insurance Fraud, Atlanta, GA, September 2013
    • Contemporary Medical Fraud Issues, Marshall Dennehey Insurance Fraud Perspectives Seminar, Cleveland, OH, November 2012
    • Effectively Managing Complex and Emerging Issues, NJSIA 22nd Annual Fraud Seminar, Atlantic City, NJ, October 2012
    • Discussions of Recent Florida Case Law Developments Regarding EUO Methodology and Limitations, FIFEC - Florida Insurance Fraud Education Committee, Orlando, FL, June 2012
    • Effectively Managing Contemporary Provider Fraud Issues, Marshall Dennehey Fraud Seminar - Insurance Fraud Perspectives, Lafayette Hill, PA, June 2012
    • Proper Interaction and the Role of the Public Adjuster During an Arson Investigation, ICAC - National Arson Training Seminar, Las Vegas, NV, February, 2012
    • Managing Public Adjuster Issues, IFM - Insurance Fraud Management Conference, Phoenix, AZ, March, 2012
    • NJSIA – Anti-Fraud Training Seminar, Acupuncture Fraud and Abuse, October 2011
    • 2010 NJSIA Auto Theft Investigations; Hail Fraud Claims; Public Adjuster and Homeowner's Fraud, Presenter 
    • 2010 IASIU Property Loss Fraud, Presenter 
    • National Insurance Crime Bureau - 2010 - Hail Storm and Large LossProperty Claims
    • Multi-State Auto Theft Investigation Review, 2010 - Combating Insurance Fraud Seminar, Conshohocken, PA 
    • 2010 IFM General Convention, Point of Sale Fraud, Co-Presenter 
    • 2010 IAA & ACFE Fraud Convention, Insurance Fraud, Presenter 
    • 2009 NJSIA SIU Investigations of the Future, Presenter 
    • 2009 NSPII Medical Provider Fraud, Presenter 
    • 2009 IASIU Public Adjuster Fraud, Presenter
    • 2008 IASIU Medical Provider Fraud, Presenter 
    • 2008 NJSIA Preferred SIU Strategies, Presenter 
    • 2008 NSPII Point of Sale and Underwriting Fraud, Presenter 
    • 2007 NJSIA Innocent Third Party Seminar, Presenter 
    • 2006 NJSIA Policy Voidance Seminar, Presenter 
    • 2005 NJSIA Public Adjuster Fraud Seminar, Co-Presenter 
    • 2004 NJSIA Underwriting Fraud Seminar, Co-Presenter 
    • Defeated a bad faith action where plaintiffs sought treble and punitive damages based upon coverage denials.
    • Secured a voluntary dismissal regarding a $750,000 fraudulently submitted homeowner's claim.
    • Secured a voluntary dismissal with respect to a $375,000 homeowners/bad faith matter in which the insured submitted a fraudulent contents inventory.
    • Through the use of medical and forensic accounting experts, Jeffrey has also been successful in collecting on behalf of insurance carrier clients large sums of money improperly paid to fraudulent medical providers.

Thought Leadership

Events

Firm Highlights

Thought Leadership

Florida Supreme Court Adopts Traditionally More Expansive Concept of Occupational Causation

The Florida Supreme Court issued a significant decision rebuking the First District Court of Appeal (1st DCA) in the high-profile case of Bouayad v. Normandy Insurance Co., a case addressing the compensability of workplace injuries resulting from assaults by third-party tortfeasors. The Judge of Compensation Claims (JCC) found the claimant was entitled to workers' compensation benefits, relying in part on the Florida Supreme Court's earlier decision in Strother v. Morrison Cafeteria from 1980. In Strother, the Court upheld an award of benefits to a cashier who was assaulted and robbed by individuals who followed her home from work under the mistaken belief that she was carrying restaurant cash deposits. In Bouayad, the 1st DCA concluded that the claimant's injuries were not compensable because they did not arise out of his employment. The Florida Supreme Court disagreed, holding that the 1st DCA applied too narrow an interpretation of the "arising out of employment" requirement. In doing so, the Court reaffirmed a broader and more traditional view of occupational causation than that recently adopted by the 1st DCA. The claimant in Bouayad was the general manager of a car rental business operating from a hotel near an airport. Around midnight, while walking along a covered outdoor walkway from the hotel's atrium, where the rental kiosk was located, to an office near the pool, he was shot multiple times by an unidentified assailant. As part of his regular duties, the claimant carried rental agreements and cash receipts from the kiosk to the office at the end of each shift. After the shooting, the claimant managed to return to the hotel atrium, where he stated that he believed "Robert" had shot him, referring to an individual who had threatened the claimant's son the previous day. The assailant, however, was never identified. Consequently, the Supreme Court analyzed the case as involving an unknown third party while the claimant was acting within the course and scope of his employment. The central issue therefore was whether the injury "arose out of" the claimant’s employment. At the final hearing, the claimant presented evidence regarding the risks and hazards associated with his employment, including the nature of his duties, his late-night work schedule, and the location of the business in a high-turnover hotel near a major airport. His expert opined that these factors exposed him to an increased risk of becoming the victim of a crime while at work. In contrast, the employer/carrier's expert characterized the shooting as a targeted attack rather than a robbery and asserted that the risk of violent crime was actually higher near the claimant's residence than at the hotel. Based on that analysis, the expert concluded that the claimant was not exposed to an increased workplace risk. The 1st DCA focused narrowly on the specific activity the claimant was performing at the moment of injury. According to the court, the claimant's “work performed” at the time of the shooting was simply "walking" between two employer-operated locations, and that act of walking did not itself cause the injury. The Florida Supreme Court found this analysis far too myopic and inconsistent with decades of workers' compensation precedent. Reaffirming longstanding principles of workplace causation, the Court explained that the proper inquiry is not whether the precise physical task being performed at the moment of injury directly caused the harm. Rather, the relevant question is whether the employment, viewed as a whole, exposed the worker to risks and hazards that contributed to the injury. The decision is significant because it reinforces a broader conception of work-relatedness in the “arising out of” compensability analysis. Instead of limiting the causation analysis to the employee's discrete physical activity at the time of injury, courts must consider the totality of the employment circumstances, including the employee's duties, work environment, hours, and occupational risks. Under that framework, an injury may arise out of employment when the employment places the employee in a position of increased hazard, even if the specific task being performed at the moment of injury is not itself the direct cause of the harm.

News

106 Marshall Dennehey Attorneys Recognized in the 2027 Editions of The Best Lawyers in America® and the Best Lawyers: Ones to Watch® in America

Marshall Dennehey is proud to highlight the firm’s 106 attorneys who have been recognized in the 2027 editions of The Best Lawyers in America® and the Best Lawyers: Ones to Watch® in America. Less than 6% of all practicing lawyers in the U.S. were selected by their peers for this recognition. Additionally, four of the firm’s attorneys received the Best Lawyers® 2027 “Lawyer of the Year” awards in their respective practice areas and demographic regions. Since it was first published in 1983, Best Lawyers® has become universally regarded as the definitive guide to legal excellence. Best Lawyers lists are compiled based on an exhaustive peer-review evaluation. For more information, please visit https://www.bestlawyers.com/. OUR 2027 LAWYERS OF THE YEAR Harrisburg, PA Christopher Reeser, Personal Injury Litigation - Defendants Kacey Wiedt, Workers Compensation Law - Employers Roseland, NJ Justin F. Johnson, Medical Malpractice Law - Defendants Leonard Leicht, Personal Injury Litigation - Defendants   OUR 2026 BEST LAWYERS IN AMERICA Philadelphia, PA Nicholas D. Bowers, Personal Injury Litigation - Defendants Josh J. T. Byrne, Professional Malpractice Law - Defendants Jefferey J. Chomko, Insurance Law James H. Cole, Insurance Law John J. Delany III, Personal Injury Litigation - Defendants Laurianne Falcone, Personal Injury Litigation - Defendants John P. Gonzales, Employment Law - Management John Hare, Appellate Practice Daniel D. Krebbs, Personal Injury Litigation - Defendants Michele Punturi, Workers' Compensation Law - Employers Bradley D. Remick, Product Liability Litigation - Defendants Andrea Cicero Rock, Workers' Compensation Law - Employers Robin M. Romano, Workers' Compensation Law - Employers Daniel J. Ryan, Jr., Personal Injury Litigation - Defendants Gary M. Samms, Professional Malpractice Law - Defendants Christopher N. Santoro, Personal Injury Litigation – Defendants; Product Liability Litigation -Defendants Josh D. Scheets, Personal Injury Litigation - Defendants Robert P. Schenk, Workers' Compensation Law - Employers Robert E. Smith, Insurance Law Robin Snyder, Litigation - Health Care Michael L. Turner, Commercial Litigation; Criminal Defense: White-Collar; Mass Tort Litigation / Class Actions - Defendants Claire Breaux Ventola, Product Liability Litigation - Defendants Pittsburgh, PA Melissa Devich Cochran, Commercial Litigation; Mass Tort Litigation / Class Actions – Defendants; Product Liability Litigation - Defendants  John F. Deasy, Personal Injury Litigation – Defendants; Product Liability Litigation - Defendants Daniel W. Deitrick, Workers' Compensation Law - Employers Douglas C. LaSota, Litigation - Construction; Mass Tort Litigation / Class Actions - Defendants Joseph V. Lesinski, Product Liability Litigation – Defendants   Christian D. Marquis, Personal Injury Litigation - Defendants Patricia A. Monahan, Insurance Law; Litigation - Insurance Patrick T. Reilly, Commercial Litigation; Mass Tort Litigation / Class Actions – Defendants; Product Liability Litigation - Defendants Brett C. Shear, Medical Malpractice Law - Defendants Teresa O. Sirianni, Education Law; Employment Law – Management; Litigation - Labor and Employment Stuart Sostmann, Product Liability Litigation – Defendants Danielle M. Vugrinovich, Mass Tort Litigation / Class Actions - Defendants Scranton, PA Sarah E. Argo, Litigation - Insurance Michael J. Connolly, Personal Injury Litigation – Defendants; Professional Malpractice Law - Defendants Matthew Keris, Litigation - Health Care; Medical Malpractice Law - Defendants John T. McGrath, Jr., Insurance Law; Medical Malpractice Law – Defendants; Product Liability Litigation - Defendants William J. McPartland, Insurance Law John R. Nealon, Product Liability Litigation - Defendants Victoria Scanlon, Health Care Law; Litigation - Health Care; Medical Malpractice Law - Defendants Michael A. Sebastian, Workers' Compensation Law - Employers Thomas A. Specht, Insurance Law; Litigation - Insurance Suzanne Tighe, Litigation Insurance Harrisburg , PA Casey Alan Coyle, Administrative/Regulatory Law; Appellate Practice; Commercial Litigation Brittany E. Bakshi, Personal Injury Litigation - Defendants Shannon P. Fellin, Workers' Compensation Law - Employers Allison Krupp, Insurance Law John R. Ninosky, Litigation – Insurance; Personal Injury Litigation - Defendants Christopher Reeser, Personal Injury Litigation - Defendants Kacey Wiedt, Workers' Compensation Law – Employers King of Prussia, PA  Michael L. Detweiler, Construction Law Joseph L. Hoynoski III, Medical Malpractice Law - Defendants Gregory J. Kelley, Construction Law, Litigation - Construction Anthony Natale III, Workers' Compensation Law - Employers Francis X. Wickersham, Workers' Compensation Law - Employers A. Judd Woytek, Workers' Compensation Law – Employers Erie, PA Patrick M. Carey, Personal Injury Litigation - Defendants Joel M. Snavely, Health Care Law; Insurance Law New Haven, CT Michael Wrona, Commercial Litigation, Litigation - Bankruptcy  Mount Laurel, NJ David D. Blake, Litigation - Insurance Barbara Davis, Personal Injury Litigation - Defendants Lynne Nahmani, Litigation - Health Care John H. Osorio, Personal Injury Litigation - Defendants John L. Slimm, Legal Malpractice Law – Defendants; Professional Malpractice Law – Defendants Roseland, NJ Robert T. Evers, Medical Malpractice Law - Defendants Justin F. Johnson, Medical Malpractice Law - Defendants Julia Klubenspies, Medical Malpractice Law - Defendants Leonard C. Leicht, Personal Injury Litigation - Defendants Patricia M. McDonagh, Appellate Practice Sunny Sparano, Litigation - Construction Randall S. Watts, Health Care Law New York, NY Tonya M. Lindsey, Medical Malpractice Law - Defendants Tampa, FL Michael Archibald, Personal Injury Litigation - Defendants Lindsay G. McCormick, Litigation – Construction Orlando, FL Thomas F. Brown, Personal Injury Litigation - Defendants Dante C. Rohr, Commercial Litigation Fort Lauderdale, FL Kimberly Kanoff Berman, Appellate Practice Patrick M. Delong, Personal Injury Litigation – Defendants Jacksonville, FL  Heather Byrer Carbone, Workers' Compensation Law - Employers Linda Wagner Farrell, Workers' Compensation Law - Employers Elizabeth B. Ferguson, Litigation - Construction James P. Hanratty, Personal Injury Litigation – Defendants Wilmington, DE Sarah B. Cole, Litigation - Insurance Benjamin K. Durstein, Workers' Compensation Law - Employers Maria R. Granaudo, Medical Malpractice Law - Defendants  Keri L. Morris-Johnston, Workers' Compensation Law - Employers Cincinnati, OH Timothy B. Schenkel, Personal Injury Litigation - Defendants David E. Williamson, Personal Injury Litigation - Defendants Cleveland, OH Vincent E. Cononico, Litigation – Insurance, Personal Injury Litigation - Defendants Jillian L. Dinehart, Personal Injury Litigation - Defendants David J. Fagnilli, Insurance Law Jason P. Ferrante, Health Care Law, Litigation - Health Care Andrew H. Isakoff, Transportation Law Leslie M. Jenny, Litigation - Health Care; Medical Malpractice Law – Defendant OUR 2026 BEST LAWYERS: ONES TO WATCH Jacksonville, FL Sean J. Reeves, Personal Injury Litigation – Defendants; Product Liability Litigation - Defendants Orlando, FL Carolin A. Pacheco, Insurance Law Mount Laurel Stacey Gorin, Insurance Law Melville, NY Kimberly Gitlin, Personal Injury Litigation – Defendants Matthew A. Gray, Insurance Law; Personal Injury Litigation - Defendants Philadelphia, PA Holli K. Archer, Health Care Law; Medical Malpractice Law – Defendants; Professional Malpractice Law Emily Pritchyk, Commercial Litigation; Product Liability Litigation – Defendants Pittsburgh, PA Taylor E. Kosko, Mass Tort Litigation / Class Actions – Defendants; Personal Injury Litigation - Defendants Alana Staniszewski, Workers' Compensation Law - Employers Michael D. Winsko, Product Liability Litigation – Defendants; Transportation Law King of Prussia, PA Richard Lechette, Commercial Litigation; Insurance Law, Personal Injury Litigation – Defendants

Thought Leadership

Appellate Division Affirmed Trial Judge’s Orders Granting Summary Judgement for Defendants on COVID-19 Case

In Dunne v. Advanced Subacute Rehab Servs. at Sewell, LLC, et al., the plaintiffs appealed from two Law Division orders. By way of background, Louis Doto, Sr. (Doto) worked for BP & SC Services, Inc. (BP). BP leased Doto to Advanced Subacute Rehabilitation Center at Sewell, LLC (Advanced Subacute) and it had control of his work, paid wages, and had the power to hire or fire him. A BP employee was assigned to the facility to train and supervise him and BP was responsible for securing workers’ compensation coverage. Doto worked as an aide in the laundry department. Linen from COVID-19 residents were delivered in clearly marked bags and he had no direct contact with residents. A co-worker, Sheila Smith, was also an aide and she never contracted COVID-19 at the facility. Advanced Subacute did not require Doto to wear an N-95 mask, but instead a surgical mask, though N-95 masks were available to all employees. He was also required to attend period mandatory meetings with other high-risk employees, the last of which he attended was in November 2020. All employees were required to test for COVID-19 and there were no reported cases from June to October 2020. On December 23, 2020, Doto tested positive for COVID-19 and passed away on January 18, 2021. The last member of housekeeping that Doto may have encountered tested positive 22 days earlier. After his death, OSHA found two “serious” violations concerning the N-95 masks worn by housekeepers. In response, Advanced Subacute fit tested all non-clinical staff. Doto’s estate filed a workers’ compensation claim and named both BP and Advanced Subacute as his employer. The estate received an award. In July 2022, the plaintiffs filed a complaint in the Law Division, alleging wrongful death and survivor causes of action. In October 2024, the defendants moved for summary judgment, arguing: 1) immunity pursuant to the Emergency Health Powers Act: 2) the exclusive remedy provision of the Workers’ Compensation Act; 3) Doto’s inability to establish infection at the facility; 4) net expert opinions by the plaintiffs’ expert; and 5) inadmissibility of the OSHA report. The plaintiffs opposed and filed a cross-motion for summary judgment, arguing: 1) no immunity as Advanced Subacute engaged in gross negligent or willful misconduct; 2) no preclusion by the Workers’ Compensation Act as Doto was not Advanced Subacute’s employee; and 3) no net expert opinions. In February 2025, the judge issued a written decision granting the defendants’ motion. Specifically, he found Advanced Subacute’s COVID-19 immunity precluded the plaintiffs’ claim as no reasonable jury could find any gross negligence or utter disregard for Doto’s safety. He also addressed the other defenses for completeness. The plaintiffs moved for reconsideration and the judge issued another written decision denying the plaintiffs’ motion in April 2025. The plaintiffs then appealed both decision. The Appellate Division affirmed the orders for reasons stated by the judge in his written decisions. The Appellate Division only added: 1) Advanced Subacute acted consistently with the legislative grant of immunity; 2) there was no doubt Doto was an employee of both BP and Advanced Subacute and the latter may have inadvertently failed to follow some precautions; and 3) confirmed the plaintiffs’ experts did not identify a basis for their opinions. Ultimately, the Appellate Division found no reason to disturb the judge’s well-reasoned decisions and affirmed the judge’s orders.

Thought Leadership

Commonwealth Court Deemed Worker an Employee Despite Independent Contractor Agreement; Insurer Estopped from Denying Coverage

In this case, the claimant filed a Claim Petition for injuries sustained on October 28, 2019, naming J&S as his Employer, and alleging that the injuries occurred when he fell from a ladder while installing a satellite dish for Dish Network. Dish Network contracted with J&S to install satellite dishes. Subsequently J&S filed a Petition to Join Brickstreet Insurance Company and the claimant filed a Claim Petition against the Uninsured Employer Guaranty Fund. The Fund then joined Dish Network as another employer.  Before the Workers’ Compensation Judge (WCJ), the claimant testified that he was hired in 2015 by J&S and at the time signed an Independent Contractor Agreement (IC Agreement). J&S defended the case on the basis that the claimant was not an employee, but was an independent contractor, even after the IC Agreement expired. Additional evidence showed that, at the time of the October 28, 2019, work injury, J&S’ workers’ compensation insurance with Brickstreet had lapsed, even though a Brickstreet agent had been working to renew J&S’ policy and had a Certificate for coverage from September 25, 2019 to September 25, 2020 issued, with Dish Network listed as the Certificate Holder. A renewal policy was not in effect at the time the Certificate was issued and the agent learned on October 25, 2019 that Brickstreet was not going to renew their policy with J&S, due to an unpaid premium.    Ultimately, the WCJ found that the claimant was an employee of J&S at the time of the work injury and that J&S did not have a workers’ compensation policy in place at the time, due to their failure to pay the renewal premium to Brickstreet. The WCJ also found Dish Network was a Statutory Employer under Section 302(a) of the Act. The Claim Petition and the Guaranty Fund Claim Petition were both granted, as was the Guaranty Fund’s Petition to Join Dish Network. The WCJ also denied J&S’ Petition to Join Brickstreet, finding that neither J&S or Dish Network showed that Brickstreet was estopped from denying coverage. J&S and Dish Network appealed to the Workers’ Compensation Appeal Board (Board) and the Board affirmed. J&S and Dish Network appealed to the Commonwealth Court. The Commonwealth Court rejected J&S' argument that the claimant was an independent contractor. In doing so, the court noted that the claimant credibly testified that he worked for J&S full time, could not work for another company, and that J&S, scheduled his jobs, tracked him, and scheduled additional installations, if he finished early. Additionally, the court noted the claimant lacked discretion in the manner he performed his job, because all questions had to be referred to J&S.  As for Dish Network’s appeal, the court held that the WCJ erred in holding that Brickstreet was not estopped from denying coverage as to Dish Network. According to the court, the insurance agent was an authorized representative of Brickstreet and, at the direction of J&S, issued the Certificate of Insurance that he knew was not accurate at the time, and was aware would be presented as proof of coverage for J&S. Dish Network relied upon that information and continued to use J&S, ultimately leading to Dish Network being named as the Statutory Employer liable for payment of benefits because of J&S’ uninsured status. The court held that the Board erred in affirming the WCJ ’s conclusion that Dish Network did not establish that Brickstreet was equitably estopped from denying coverage, reversed the decision below, and remanded the case to the WCJ.