Case 3:21-cv-17221 Document 1-1 Filed 09/20/21 Page 1 of 16 PageID: 8
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`Case 3:21-cv-17221 Document 1-1 Filed 09/20/21 Page 2 of 16 PageID: 9
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`Service of Process
`Transmittal
`08/19/2021
`CT Log Number 540106222
`
`TO:
`
`RE:
`
`FOR:
`
`Rebecca Thompson
`UnitedHealth Group Incorporated (111504190770700600)
`9900 Bren Rd E Ste 300W, MN008-T502
`Minnetonka, MN 55343-9693
`
`Process Served in New Jersey
`
`Oxford Health Insurance, Inc. (Domestic State: NY)
`
`ENCLOSED ARE COPIES OF LEGAL PROCESS RECEIVED BY THE STATUTORY AGENT OF THE ABOVE COMPANY AS FOLLOWS:
`
`TITLE OF ACTION:
`
`ADVANCED ORTHOPEDICS AND SPORTS MEDICINE INSTITUTE, P.C., PLTF. vs. OXFORD
`HEALTH INSURANCE, INC., DFT.
`
`DOCUMENT(S) SERVED:
`
`--
`
`COURT/AGENCY:
`
`NATURE OF ACTION:
`
`None Specified
`Case # MONL00284121
`
`Insurance Litigation
`
`ON WHOM PROCESS WAS SERVED:
`
`C T Corporation System, West Trenton, NJ
`
`DATE AND HOUR OF SERVICE:
`
`By Process Server on 08/19/2021 at 14:31
`
`JURISDICTION SERVED :
`
`APPEARANCE OR ANSWER DUE:
`
`ATTORNEY(S) / SENDER(S):
`
`ACTION ITEMS:
`
`New Jersey
`
`None Specified
`
`None Specified
`
`CT has retained the current log, Retain Date: 08/19/2021, Expected Purge Date:
`09/18/2021
`
`Image SOP
`
`Email Notification, Administrative Assistant legalmail@uhg.com
`
`REGISTERED AGENT ADDRESS:
`
`C T Corporation System
`820 Bear Tavern Road
`West Trenton, NJ 08628
`877-564-7529
`MajorAccountTeam2@wolterskluwer.com
`The information contained in this Transmittal is provided by CT for quick reference only. It does not constitute a legal opinion, and should not otherwise be
`relied on, as to the nature of action, the amount of damages, the answer date, or any other information contained in the included documents. The recipient(s)
`of this form is responsible for reviewing and interpreting the included documents and taking appropriate action, including consulting with its legal and other
`advisors as necessary. CT disclaims all liability for the information contained in this form, including for any omissions or inaccuracies that may be contained
`therein.
`
`Page 1 of 1 / RT
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`
`
`Wolters Kluwer
`
`PROCESS SERVER DELIVERY DETAILS
`
`Date:
`
`Thu, Aug 19, 2021
`
`Server Name:
`
`Drop Service
`
`Entity Served
`
`Case Number
`
`J urisdiction
`
`Oxford Health Insurance, Inc.
`
`M0NL00284121
`
`NJ
`
`
`
`John W. Leardi (NJ Bar No. 040542004)
`Frank X. Wukovits (NJ Bar ID 321362020)
`BUTTACI LEARDI & WERNER LLC
`212 Carnegie Center, Suite 202
`Princeton, New Jersey 08540
`609-799-5150
`
`Leslie S. Howard (NJ Bar No. 021551992)
`COHEN HOWARD, LLP
`766 Shrewsbury Ave., Suite 200
`Tinton Falls, NJ 07724
`732-747-5202
`
`Attorneys for Plaintiff Advanced
`Orthopedics and Sports Medicine Institute, P. C.
`
`ADVANCED ORTHOPEDICS AND
`SPORTS MEDICINE INSTITUTE, P.C., •
`
`: SUPERIOR COURT OF NEW JERSEY
`: LAW DIVISION: MONMOUTH COUNTY
`
`Plaintiff
`
`: Docket No. MON-L-002841-21
`
`- V. -
`
`OXFORD HEALTH INSURANCE, INC.,
`
`Defendant.
`
`Civil Action
`
`SUMMONS
`
`From the State of New Jersey to the Defendant(s) Named Above:
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`The Plaintiff(s), named above, filed a lawsuit against you in the Superior Court of New
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`Jersey. The complaint attached to this summons states the basis for this lawsuit. If you dispute this
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`complaint, you or your attorney must file a written answer or motion and proof of service with the
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`deputy clerk of the Superior Court in the county listed above within 35 days from the date you
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`received this summons, not counting the date you received it. (A directory of the addresses of each
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`deputy clerk of the Superior Court is available in the Civil Division Management Office in the
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`county listed above and online at http://www.njcourts.gov/forms/10153 deptyclerklawref.pdf.) If
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`the complaint is one in foreclosure, then you must file your written answer or motion and proof of
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`service with the Clerk of the Superior Court, Hughes Justice Complex, P.O. Box 971, Trenton, NJ
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`08625-0971. A filing fee payable to the Treasurer, State of New Jersey and a completed Case
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`Information Statement (available from the deputy clerk of the Superior Court) must accompany
`
`
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`your answer or motion when it is filed. You must also send a copy of your answer or motion to
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`plaintiffs attorney whose name and address appear above, or to plaintiff, if no attorney is named
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`above. A telephone call will not protect your rights; you must file and serve a written answer or
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`motion (with fee of $175.00 and completed Case Information Statement) if you want the court to
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`hear your defense. If you do not file and serve a written answer or motion within 35 days, the court
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`may enter a judgment against you for the relief plaintiff demands, plus interest and costs of suit. If
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`judgment is entered against you, the Sheriff may seize your money, wages or property to pay all
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`or part of the judgment. If you cannot afford an attorney, you may call the Legal Services office
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`in the county where you live or the Legal Services of New Jersey Statewide Hotline at 1-888-
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`LSNJ-LAW (1-888-576-5529). If you do not have an attorney and are not eligible for free legal
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`assistance, you may obtain a referral to an attorney by calling one of the Lawyer Referral Services.
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`A directory with contact information for local Legal Services Offices and Lawyer Referral
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`Services is available in the Civil Division Management Office in the county listed above and online
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`at http ://www.nj courts. gov/forms/10153 deptyclerklawref.pdf.
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`DATED: August 16, 2021
`
`Michelle M. Smith
`
`Clerk of the Superior Court
`
`Name of Defendant to be Served:
`
`OXFORD HEALTH INSURANCE, INC.
`
`Address of Defendant to be Served:
`
`820 Bear Tavern Road, West Trenton, NJ 08628
`
`2
`
`
`
`John W. Leardi (NJ Bar No. 040542004)
`Frank X. Wukovits (NJ Bar ID 321362020)
`BUTTACI LEARDI & WERNER LLC
`212 Carnegie Center, Suite 202
`Princeton, New Jersey 08540
`609-799-5150
`
`Leslie S. Howard (NJ Bar No. 021551992)
`COHEN HOWARD, LLP
`766 Shrewsbury Ave., Suite 200
`Tinton Falls, NJ 07724
`732-747-5202
`
`Attorneys for Plaintiff Advanced
`Orthopedics and Sports Medicine Institute, P.C.
`
`ADVANCED ORTHOPEDICS AND
`SPORTS MEDICINE INSTITUTE, P.C.,
`
`: SUPERIOR COURT OF NEW JERSEY
`: LAW DIVISION: MONMOUTH COUNTY
`
`Plaintiff
`
`: Docket No. MON-L-002841-21
`
`- V. -
`
`Civil Action
`
`OXFORD HEALTH INSURANCE, INC.,
`
`: COMPLAINT AND JURY DEMAND
`
`Defendant.
`
`[Filed via NJ eCourts]
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`Plaintiff Advanced Orthopedics and Sports Medicine Institute, P.C. ("AOSMI"), by way
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`of Complaint against Oxford Health Insurance, Inc. ("OHI"), hereby alleges upon personal
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`knowledge as to itself and its own acts, and upon information and belief as to all other matters,
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`based upon, inter alia, the investigation made by and through its attorneys, as follows:
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`PARTIES
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`1.
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`AOSMI is a New Jersey professional corporation, engaged in the practice of
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`orthopedics and sports medicine through its duly-licensed clinical staff, with a primary office
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`located at 301 Professional View Drive, Building 300, Freehold, NJ 07728.
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`2.
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`Established in 2007, AOSMI is the result of a merger between two of Monmouth
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`County's preeminent orthopedic groups: Western Monmouth Orthopedic Associates and New
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`Jersey Orthopedic Associates. Over the last 25 years, the physicians at AOSMI have earned a
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`stellar reputation throughout Central New Jersey as a true leader in the practice of orthopedics and
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`
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`sports medicine.
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`3.
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`Grigory Goldberg, M.D., formerly of AOSMI, is a fellowship-trained orthopedic
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`surgeon specializing in spinal surgery. Dr. Goldberg attended medical school at Downstate
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`Medical Center, State University of New York, and completed his orthopedic residency at Thomas
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`Jefferson University Hospital in Philadelphia. Dr. Goldberg has over 12 years of experience in the
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`treatment of spinal disorders including sciatica, arm and leg pain, neck and back pain, neurological
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`deficits, trauma, and cancer.
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`4.
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`OHI is a New York corporation authorized to transact business as a health insurance
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`company in New Jersey pursuant to N.J.S.A. 17B:23-1 to -11. Its corporate office is located at 4
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`Research Drive, Shelton, CT 06484, but it may be served with legal process through the New
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`Jersey Department of Banking and Insurance. Moreover, OHI maintains a registered office in New
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`Jersey at 820 Bear Tavern Road, West Trenton, NJ 08628.
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`JURISDICTION AND VENUE
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`5.
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`AOSMI's primary office is in Monmouth County, and the surgical services
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`underlying this action were performed at CentraState Medical Center ("CentraState"), which is in
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`Freehold, NJ, also in Monmouth County.
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`6.
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`Patient "K.G.," herein identified only by the last four digits of her OHI Member ID
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`-1701, received professional medical and surgical services from AOSMI's professional staff at
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`CentraState, including Dr. Goldberg.
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`7.
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`K.G. lives in Monroe, NJ, in Middlesex County. At the time she received
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`professional medical and surgical services from AOSMI's professional staff at CentraState, she
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`was enrolled in OHI's PPO Flex Liberty Network through her employer.
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`8.
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`AOSMI is asserting its own individual common-law claims against OHI with
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`respect to the services its professional staff rendered to K.G., as opposed to derivatively asserting
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`2
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`claims as an assignee or authorized representative of K.G. seeking plan benefits under the fully-
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`insured insurance policy underwritten by OHI through which K.G. was covered.
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`9.
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`The Court has personal jurisdiction over OHI because OHI: (i) is authorized to
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`transact business in New Jersey; (ii) is licensed to conduct business as an insurance company in
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`New Jersey by the Department of Banking and Insurance; (iii) conducts business in New Jersey,
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`including but not limited to underwriting and administering health insurance plans that permit their
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`members to obtain medical services from providers licensed in New Jersey.
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`10.
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`Venue is appropriate in Monmouth under R. 4:3-2 based on AOSMI's primary
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`place of business, as well as the situs of the surgical services in question at CentraState.
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`FACTS COMMON TO ALL COUNTS
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`1 1.
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`This dispute arises out of OHI's refusal to pay AOSMI a reasonable fee for the
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`services provided to K.G., and OHI insured, for services rendered by AOSMI's clinical staff,
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`including Dr. Goldberg, at CentraState in August 2016.
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`12. AOSMI and its clinical staff are non-participating or out-of-network providers with
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`OHI, meaning neither OHI nor its clinical staff members have provider agreements with OHI to
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`discount their usual and customary fees when providing care to OHI insureds.
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`13. On August 8, 2016, K.G. presented at the CentraState emergency room with severe
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`pain in her left leg, which left her unable to walk. Dr. Goldberg, the on-call orthopedic specialist
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`at the time, examined K.G., and found severe weakness of the left tibialis interior and EHL,
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`positive SLR on the left side, and decreased sensation in the left dermatomal distribution. Due to
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`the severity of her condition, K.G. was admitted as an inpatient at CentraState.
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`14.
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`Upon her admission to CentraState, Dr. Goldberg ordered MRIs of the lumbar spine
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`and thoracic spine, which indicated L4-5 disk herniation with a foraminal component at level L5.
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`At that time, Dr. Goldberg discussed care options with K.G.
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`3
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`15.
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`K.G. had been in excruciating pain for almost ,18 months. She had undergone
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`multiple courses of physical therapy and anti-inflammatory medications. She had also been under
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`the care of a pain management doctor, who had provided epidural injections. All of these
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`treatments had failed, and K.G. opted for immediate surgical intervention.
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`16.
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`Prior to scheduling the procedure, Dr. Goldberg explained to K.G. that because of
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`the foraminal component of her disk herniation, surgery would require a complete facetectomy
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`and stabilization with a complete diskectomy. K.G. understood and signed a consent for DR.
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`Goldberg to proceed with the surgery as described to her.
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`17.
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`Prior to surgery, CentraState contacted OHI and obtained pre-authorization for Dr.
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`Goldberg, with Timothy Dowse, P.A. Timothy Dowse, PA-C, to perform a L4 and L5
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`laminectomy, pedical instrumentation right and left L4 and left L5, posterolateral fusion of the
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`right fact of L5, transforaminal facetectomy and diskectomy of left L4-L5, transforaminal lumbar
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`interbody fusion, and placement of PEEK cage, autograft, and allograft. OHI's pre-authorization
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`was tendered under confirmation number 108221092.
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`18.
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`"Pre-authorization" refers to the health industry practice of a medical provider
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`contacting a payor, plan, administrator or an agent thereof, and being provided approval or
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`confirmation that services related to a medical incident will be reimbursed or being advised that
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`pre-authorization is unnecessary, which in turn induces the provider to render services to that
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`patient. Under New Jersey law, pre-authorization cannot be withdrawn unless the provider made
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`material misrepresentations to obtain the pre-authorization.
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`19. AOSMI then reasonably relied upon OHI's pre-authorization, as OHI reasonably
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`expected in the ordinary course of business in the healthcare industry, with the understanding that
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`AOSMI would receive a reasonable payment from OHI for performing the services in question.
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`4
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`20.
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`Moreover, OHI knew or should have known that, under New Jersey law, K.G. must
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`be held harmless for all charges over and above any applicable in-network cost-sharing amounts,
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`i.e., deductibles, co-payments, and co-insurance, for: (i) emergency services, regardless of whether
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`by participating or non-participating providers, N.J.A.0 11:4-37.3(b)(2); and (ii) services rendered
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`in a network hospital like CentraState, even when the admitting physician is out-of-network,
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`N.J.A.C. 11:22-5.8.
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`21.
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`Ergo, based on well-known state law coverage mandates as well as its prior course
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`of dealing with OHI over several decades, AOSMI reasonably understood OHI's pre-authorization
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`of services to be rendered to K.G. to contemplate payment of 100% of AOSMI's usual, customary,
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`and reasonable ("UCR") charges. The UCR fee is defined as, or is reasonably interpreted to mean,
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`the amount that out-of-network providers, like plaintiff, normally charge to patients in the free
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`market, i.e., without an agreement with an insurance company or other payor to reduce such a
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`charge in exchange for obtaining access to the defendants' members and beneficiaries. The UCR
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`fee means the reasonable charge for a particular service by providers in the same geographic area
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`with similar training and experience (i.e., central New Jersey surgical practice).
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`22.
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`Based on OHI's pre-authorization, as well as its prior course of dealings with OHI
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`and other payers providing pre-authorization to its non-participating clinical staff for services to
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`be rendered in a network facility, AOSMI had Dr. Goldberg and Mr. Dowse perform the pre-
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`authorized services on August 10, 2016, just 2 days after K.G. was admitted.
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`23.
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`In or around September 2016, AOSMI submitted bills to OHI totaling $269,859.50
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`and was paid only $4,671.36, representing less than 2% of AOSMI's UCR fee, and purportedly
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`leaving K.G. with out-of-pocket responsibility of $265,188.14 pursuant to the Explanation of
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`Benefits (E0Bs) OHI sent to K.G.
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`5
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`24. AOSMI initially sought to appeal this underpayment on behalf of K.G., first
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`telephonically in or around October and November 2016, and later in writing, through counsel, on
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`October 3,2017, October 4,2017, December 11, 2017, and February 15, 2018. In each instance
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`(five appeal letters in total), AOSMI advanced multiple arguments as to why it was entitled to
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`additional payments on K.G.'s behalf Notably, in each such appeal, AOSMI expressly noted its
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`right to assert direct common law claims against OHI notwithstanding its attempted pursuit of
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`administrative appeals on behalf of K.G.
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`25.
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`While OHI acknowledged most of these appeals, it refused to consider the
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`substance of them, incorrectly casting them as "untimely" and deeming AOSMI (and specifically,
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`it counsel) as not being properly authorized to appeal on behalf of K.G.
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`26.
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`As such, AOSMI exhausted whatever administrative remedies made available to it
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`by OHI and/or OHI's provider and/or member appeal processes were futile. See R. 4:5-8(b).
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`27. By and through this lawsuit, therefore, AOSMI seeks damages due to OHI's
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`conduct, as opposed to policy benefits payable to K.G. under her insurance policy.
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`FIRST COUNT
`(Breach of Implied Contract)
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`28. AOSMI repeats and re-alleges each allegation contained in Paragraphs 1 to 27 of
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`this complaint as if set forth at length herein.
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`29. OHI indicated, by a course of conduct, prior dealings, and the circumstances
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`underlying K.G.'s treatment at CentraState, to AOSMI that it would pay for the pre-authorized
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`surgical services provided by Dr. Goldberg and Mr. Dowse to K.G. in August 2016 at AOSMI's
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`UCR fee.
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`30.
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`AOSMI's clinical staff, namely Dr. Goldberg and Mr. Dowse, provided said
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`surgical services to K.G., and in doing so reasonably expected OHI to properly compensate
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`
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`AOSMI.
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`31. A reasonable person in the position of OHI would know or should have known that
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`AOSMI was having its clinical staff perform surgical services to K.G. expecting that OHI would
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`pay for those services appropriately.
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`32.
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`Despite indicating to AOSMI, by a course of conduct, prior dealings, and the
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`circumstances underlying K.G.'s treatment at CentraState, that it would pay for the pre-authorized
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`surgical services provided by Dr. Goldberg and Mr. Dowse to K.G. in August 2016 at AOSMI's
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`UCR fee, OHI failed to do so.
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`33.
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`OHI's failure to pay for the pre-authorized surgical services provided by Dr.
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`Goldberg and Mr. Dowse to K.G. in August 2016 at AOSMI's UCR fee constitutes a breach of the
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`implied contract between OHI and AOSMI.
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`34.
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`As a direct and proximate result of this breach by OHI, ASMI has been damaged.
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`WHEREFORE, AOSMI demands judgment against OHI on the first count of its
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`complaint for: (i) compensatory damages; (ii) pre-judgment interest; (iii) costs of suit; (iv)
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`attorneys' fees; and (v) such other relief as the Court deems equitable and just.
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`SECOND COUNT
`(Breach of the Warranty of Good Faith and Fair Dealing)
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`35. AOSMI repeats and re-alleges each allegation contained in Paragraphs 1 to 34 of
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`this complaint as if set forth at length herein.
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`36.
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`The law implies in every contractual relationship, including that between AOSMI
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`and OHI here, a warranty of good faith and fair dealing, which requires each party to the agreement
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`to act in a manner that is consistent with the other party's reasonable expectations.
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`37. OHI violated the implied warranty of good faith and fair dealing with respect to its
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`implied contract with AOSMI through acts of commission and omission that were wrongful and
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`7
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`without justification.
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`38.
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`As a direct and proximate result of this breach by OHI, ASMI has been damaged.
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`WHEREFORE, AOSMI demands judgment against OHI on the second count of its
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`complaint for: (i) compensatory damages; (ii) pre-judgment interest; (iii) costs of suit; (iv)
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`attorneys' fees; and (v) such other relief as the Court deems equitable and just.
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`THIRD COUNT
`(Promissory Estoppel)
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`39. AOSMI repeats and re-alleges each allegation contained in Paragraphs 1 to 38 of
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`this complaint as if set forth at length herein.
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`40. OHI indication to AOSMI, by a course of conduct, prior dealings, and the
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`circumstances underlying K.G.'s treatment at CentraState, that it would pay for the pre-authorized
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`surgical services provided by Dr. Goldberg and Mr. Dowse to K.G. in August 2016 at AOSMI's
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`UCR fee represented a promise to AOSMI.
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`41.
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`OHI knew or should have known that AOSMI would rely upon OHI's promise to
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`would pay for the pre-authorized surgical services provided by Dr. Goldberg and Mr. Dowse to
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`K.G. in August 2016 at AOSMI's UCR fee.
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`42. AOSMI substantially relied upon the promises made by OHI that it would pay for
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`the pre-authorized surgical services provided by Dr. Goldberg and Mr. Dowse to K.G. in August
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`2016 at AOSMI's UCR fee.
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`43.
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`OHI's actions therefore caused AOSMI to suffer a detriment of definite and
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`substantial nature in reliance on the promises made by OHI that it would pay for the pre-authorized
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`surgical services provided by Dr. Goldberg and Mr. Dowse to K.G. in August 2016 at AOSMI's
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`UCR fee.
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`44.
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`As a direct and proximate result of OHI's failure to fulfill its promise to pay for the
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`8
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`pre-authorized 'surgical services provided by Dr. Goldberg and Mr. Dowse to K.G. in August 2016
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`at AOSMI's UCR fee, AOSMI has been damaged.
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`WHEREFORE, AOSMI demands judgment against OHI on the third count of its
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`complaint for: (i) compensatory damages; (ii) pre-judgment interest; (iii) costs of suit; (iv)
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`attorneys' fees; and (v) such other relief as the Court deems equitable and just.
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`FOURTH COUNT
`(Unjust Enrichment)
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`45. AOSMI repeats and re-alleges each allegation contained in Paragraphs 1 to 44 of
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`this complaint as if set forth at length herein
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`46. OHI has enriched itself unjustly at the expense of AOSMI.
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`47.
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`To satisfy its coverage obligations under New Jersey law, OHI required the services
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`of AOSMI to render services to K.G. in August 2016.
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`48. By pre-authorizing the surgical services provided by Dr. Goldberg and Mr. Dowse
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`to K.G. in August 2016, OHI agreed to pay the UCR fee.
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`49. AOSMI provided pre-authorized surgical services provided by Dr. Goldberg and
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`Mr. Dowse to K.G. in August 2016.
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`50. OHI refused to pay AOSMI for the pre-authorized surgical services provided by
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`Dr. Goldberg and Mr. Dowse to K.G. in August 2016 at AOSMI's UCR fee.
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`51.
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`At a minimum, AOSMI was entitled to the fair and reasonable value of the services
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`Dr. Goldberg and Mr. Dowse provided to K.G. in August 2016.
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`52. OHI has, therefore, received and retained a benefit because of AOSMI rendering
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`services that remain underpaid. OHI has thus been unjustly enriched.
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`53.
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`As a direct and proximate result of this breach by OHI, ASMI has been damaged.
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`WHEREFORE, AOSMI demands judgment against OHI on the fourth count of its
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`9
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`complaint for: (i) compensatory damages; (ii) pre-judgment interest; (iii) costs of suit; (iv)
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`attorneys' fees; and (v) such other relief as the Court deems equitable and just.
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`DEMAND FOR JURY TRIAL
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`AOSMI hereby demands a trial by jury as to all issues so triable.
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`DESIGNATION OF TRIAL COUNSEL
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`Pursuant to R. 4:25-4, John W. Leardi, Esq., is designated as trial counsel by AOSMI.
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`CERTIFICATION UNDER RULE 4:5-1
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`The undersigned hereby certifies that (1) the matter in controversy is not the subject of any
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`other action pending in any court, or of a pending arbitration proceeding, and that no such court
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`action or arbitration proceeding is contemplated; and (2) it is unknown at this time whether any
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`other parties should be joined in this action.
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`RULE 1:38-7(B) CERTIFICATION
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`The undersigned hereby certifies that confidential personal identifiers have been redacted
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`from documents now submitted and will be redacted from all documents submitted in the future.
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`Dated: August 16, 2021
`
`Respectfully submitted,
`
`/s/ Frank X Wukovits
`John W. Leardi (NJ Bar No. 040542004)
`Frank X. Wukovits (NJ Bar ID 321362020)
`BUTTACI LEARDI & WERNER LLC
`212 Carnegie Center, Suite 202
`Princeton, NJ 08540
`609-799-5150
`
`Leslie S. Howard (NJ Bar No. 021551992)
`COHEN HOWARD, LLP
`766 Shrewsbury Ave., Suite 200
`Tinton Falls, NJ 07724
`732-747-5202
`
`Attorneys for PlaintiffAdvanced
`Orthopedics and Sports Medicine Institute, P.C.
`
`10
`
`
`
`Civil Case Information Statement
`
`[ease Details: MONMOUTH I Civil Part Docket# L-002841-21
`
`Case Caption: ADV. ORTHO. AND SPOR T MED. IN VS
`
`Case Type: CONTRACT/COMMERCIAL TRANSACTION
`
`OXFORD HEALTH
`
`Case Initiation Date: 08/16/2021
`
`Document Type: Complaint with Jury Demand
`
`Jury Demand: YES - 6 JURORS
`
`Attorney Name: FRANK XAVIER WUKOVITS
`
`Is this a professional malpractice case? NO
`
`Firm Name: BUTTACI LEARDI & WERNER, LLC
`
`Address: 212 CARNEGIE CTR STE 202
`
`Related cases pending: NO
`
`If yes, list docket numbers:
`
`PRINCETON NJ 08540
`
`Phone: 6097995150
`
`Do you anticipate adding any parties (arising out of same
`
`transaction or occurrence)? NO
`
`Name of Party: PLAINTIFF : Adv. Ortho. and Sport Med. Int
`
`Name of Defendant's Primary Insurance Company
`
`Of known): Unknown
`
`Are sexual abuse claims alleged by: Adv. Ortho. and Sport Med.
`Int? NO
`
`THE INFORMATION PROVIDED ON THIS FORM CANNOT BE INTRODUCED INTO EVIDENCE
`CASE CHARACTERISTICS FOR PURPOSES OF DETERMINING IF CASE IS APPROPRIATE FOR MEDIATION
`
`Do parties have a current, past, or recurrent relationship? YES
`
`If yes, is that relationship: Business
`
`Does the statute governing this case provide for payment of fees by the losing party? NO
`
`Use this space to alert the court to any special case characteristics that may warrant individual
`management or accelerated disposition:
`
`Do you or your client need any disability accommodations? NO
`If yes, please identify the requested accommodation:
`
`Will an interpreter be needed? NO
`If yes, for what language:
`
`Please check off each applicable category: Putative Class Action? NO Title 59? NO Consumer Fraud? NO
`
`I certify that confidential personal identifiers have been redacted from documents now submitted to the
`court, and will be redacted from all documents submitted in the future in accordance with Rule 1:38-7(b)
`
`08/16/2021
`Dated
`
`/s/ FRANK XAVIER WUKOVITS
`Signed
`
`
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