THIRD PARTY ADMINISTRATORS & INSURANCE CARRIERS

Pietras Saracino Smith & Meeks, LLP’s workers’ compensation third-party administrator and insurance carrier practice is a recognized leader in its field, among the true elite of law firms representing New Jersey insurers in complex workers’ compensation litigation for over 15 years.

We handle the full range of workers’ compensation insurance matters, from the routine to the most complex, and have a depth of experience in the field that is unsurpassed in New Jersey. Led by a core practice representing third-party administrators, workers’ compensation insurers, municipal joint insurance funds, and excess carriers we vigorously represent clients before the New Jersey Division of Workers’ Compensation, Superior Court of New Jersey, Appellate Division and the New Jersey Supreme Court.

Pietras Saracino Smith & Meeks represents third-party administrators and insurance carriers in each stage of a workers’ compensation claim from investigation, discovery, and medical and temporary disability issues through trial, and in obtaining contribution from other sources such as the New Jersey Second Injury Fund.  The firm has established niches in efficiently and successfully managing claims short of trial.

Pietras Saracino Smith & Meeks, LLP’s workers’ compensation third party administrator and insurance defense practice provides legal counsel and litigation services to third-party administrators, insurance companies and their clients. We represent regional and national insurers, insureds and self-insureds to defend against insurance claims including:

• Formal Claim Petitions for traumatic accidents filed pursuant to N.J.S.A. 34:15-7
• Formal Claim Petitions for occupational disease claims filed pursuant to N.J.S.A. 34:15-31
• Motions for Medical and Temporary Benefits pursuant to N.J.A.C. 12:235-3.2
• Dependency Claims filed pursuant to N.J.S.A. 34:15-13
• Motions to Dismiss for Workers’ Compensation Fraud pursuant to N.J.S.A. 34:15-57.4
• Third-Party Liens pursuant to N.J.S.A. 34:15-40
• Medicare Claims pursuant to the Medicare Secondary Payer 42 U.S.C. Sec. 1395y(b)
• Verified Petitions for Second Injury Fund Benefits pursuant to N.J.S.A. 34:15-95 and N.J.A.C. 12:235-5.1 to 5.3.
• Claims Barred by the Statute of Limitations at N.J.S.A. 34:15-51 & N.J.S.A. 34:15-34
• PIP Subrogation Claims filed pursuant to N.J.S.A. 34:15-51.1
• Applications for Review or Modification of an Award pursuant to N.J.S.A 34:15-27
• Motions to Implead filed pursuant to N.J.A.C. 12:235-3.6
• Accidental and Ordinary Disability Pension Offsets in Public Employment filed pursuant to N.J.S.A. 34:15-43 & N.J.S.A. 34:15-29
• Medical Provider Applications for Payment or Reimbursement of Medical Payment
• Bad Faith Claims filed pursuant to N.J.S.A. 34:15-28.1
• Bona Fide Offers pursuant to N.J.S.A. 34:15-64
• Order Approving Settlement with Dismissal pursuant to N.J.S.A. 34:15-20
• Intentional Injury Claims and N.J.S.A. 34:15-8
• Appeals to the New Jersey Superior Court, Appellate Division and New Jersey Supreme Court

Our workers’ compensation attorneys draft workers’ compensation policies, investigate and file responses to formal claims on behalf of clients, locate expert witnesses, prepare oral and written discovery, negotiate settlements, and bring cases to trial when necessary.

We work with our clients’ claims representatives, nurse case managers, and the insureds to determine the best strategy for our defense. Our philosophy uniquely prepares our team to counsel and assist our clients when it is time to make the strategic decisions as to how a case will be handled. Understanding and avoiding the costs of court involvements, as well as the risks associated with a trial before a judge of compensation, can make settling a case attractive.

On the other hand, there are times when the issues strike at the heart of a company’s character or mission — and settling becomes the last choice. Our attorneys, who have a combined 140 years of workers’ compensation trial experience, and are often hired by TPAs and insurance carriers on behalf of insureds because of the results we have achieved.  We have successfully navigated our TPA and insurance clients through all types of claims from minor slip and falls to multi-respondent occupational disease claims for total disability involving the New Jersey Second Injury Fund.

One of the fastest growing areas of litigation is occupational disease claims.  We have defended thousands of employment based claims where the allegation is that an injury or condition was not due to a traumatic accident, but rather due to exposures at work.  These include all sorts of claims from orthopedic injuries such as carpal tunnel syndrome to claims for psychiatric, pulmonary, and/or cardiac disabilities.  Our attorneys have also handled thousands of “plant closing” claims filed only after a business has closed its doors for good.

From the basic slip-and-fall claims to catastrophic injury claims, we have the necessary experience to successfully represent insurers and their insureds in all types of workers’ compensation claims.

Some of our TPA and Insurance Clients:

ACE USA

AMERIHEALTH CASUALTY, INC.

AMTRUST NORTH AMERICA, INC.

ATLANTIC COUNTY MUNICIPAL JOINT INSURANCE FUND

BURLINGTON COUNTY MUNICIPAL JOINT INSURANCE FUND

CAMDEN COUNTY INSURANCE COMMISSION

CAMDEN COUNTY MUNICIPAL JOINT INSURANCE FUND

CCMSI, INC.

CONNOR STRONG

CORVEL

COTTINGHAM & BUTLER CLAIMS SERVICES

GALLAGHER BASSETT SERVICES, INC.

QUAL-LYNX

SCHOOL POOL FOR EXCESS LIABILITY LIMITS (SPELLIF)

SEDGWICK

SPECIALTY RISK SERVICES

TRISTAR INSURANCE GROUP

ZURICH NORTH AMERICA