ATLANTIC AMBULANCE CORPORATION VS. JOHN G. CULLUMÂ ATLANTIC AMBULANCE CORPORATION VS. HALA HITTI(L-264-12 AND L-2097-12, MORRIS COUNTY AND STATEWIDE)(RECORD IMPOUNDED)
166 A.3d 260
| N.J. Super. Ct. App. Div. | 2017Background
- Atlantic Ambulance sued Cullum and Hitti in Special Civil Part for unpaid ambulance bills; defendants counterclaimed alleging overbilling and sought class certification for ~36,000 putative class members. Cases were consolidated and transferred to Law Division; class-cert motion followed extensive discovery.
- Disputed facts: both appellants received ambulance care but challenged the reasonableness/structure of Atlantic’s flat/bundled Advanced Life Support (ALS) fees ($1500 ALS-Assessment, $1750 ALS-1, $2300 ALS-2 plus mileage); Cullum transported and billed $1750 (insurance paid part; balance unpaid); Hitti not transported but billed $1500 plus $14 mileage (insurer rejected payment).
- Appellants asserted Consumer Fraud Act (CFA) and breach-of-(quasi-)contract claims on behalf of two subclasses: the “Cullum class” (transported, challenged bundled ALS rates) and the “Hitti class” (non-transported, challenged $14 mileage charge).
- Trial judge denied class certification, finding lack of typicality/commonality and that appellants hadn’t suffered an "ascertainable loss" under the CFA because they hadn’t paid Atlantic’s bills; appellants appealed.
- Appellate Division affirmed in part and remanded in part: held ambulance providers are exempt from CFA under the learned-professional/comprehensively-regulated exception; held courts are unsuited to adjudicate policy questions about reasonableness of health-care rates (affirming denial of class cert for Cullum class breach claim); remanded to consider class certification on the Hitti quasi-contract claim limited to the admitted-improper $14 mileage charge.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether appellants had to pay Atlantic’s bill to show an "ascertainable loss" under the CFA | Relying on Thiedemann/Cox: an estimate of damages suffices; nonpayment does not defeat ascertainable loss | Atlantic argued nonpayment foreclosed ascertainable loss and class standing under CFA | Court: appellants need not have paid to show ascertainable loss, but CFA claim still fails on other grounds (learned-professional exception) |
| Whether ambulance services fall within the CFA or are excluded as "learned professional"/comprehensively regulated services | Appellants argued CFA applies to Atlantic’s alleged overbilling | Atlantic argued ambulance services are comprehensively regulated by Dept. of Health and thus fall within the learned-professional/semi-professional exception to CFA | Held: ambulance providers are regulated by statute/regulation and excluded from CFA; CFA claim cannot proceed |
| Whether class certification was appropriate for breach-of-contract challenge to reasonableness of bundled ALS rates (Cullum class) | Appellants: common questions (rate reasonableness) predominate; individual suits would be impractical | Atlantic: ALS services vary by patient; reasonableness requires individualized adjudication; rate-setting is a policy/regulatory matter | Held: denial of class certification affirmed — courts are ill-suited to resolve rate-reasonableness policy questions better addressed by Legislature/administrative agencies |
| Whether class certification is appropriate for a quasi-contract claim to recover the $14 mileage fee mistakenly charged to non-transported patients (Hitti class) | Appellants: Atlantic conceded the $14 fee was improper; class treatment is appropriate to recover small per-person amounts | Atlantic: (implicit) challenges to typicality/maintainability | Held: remanded — certification for the limited quasi-contract claim (refund of admitted improper $14 charge) should be reconsidered by trial court |
Key Cases Cited
- Macedo v. Dello Russo, 178 N.J. 340 (N.J. 2004) (recognizes that learned professionals, when comprehensively regulated, are generally insulated from CFA claims)
- Cox v. Sears Roebuck & Co., 138 N.J. 2 (N.J. 1994) (an ascertainable loss under the CFA may be shown by a reasonable estimate; actual out‑of‑pocket expenditure is not required)
- Thiedemann v. Mercedes-Benz USA, LLC, 183 N.J. 234 (N.J. 2005) (clarifies that an "ascertainable" loss means quantifiable or measurable; estimates within reasonable certainty suffice)
- DiCarlo v. St. Mary's Hosp., 530 F.3d 255 (3d Cir. 2008) (federal appellate view that courts are poorly equipped to set or second-guess reasonable hospital/healthcare rates; policy matters for legislature/administrative agencies)
- Hampton Hosp. v. Bresan, 288 N.J. Super. 372 (App. Div. 1996) (hospital services regulated by Dept. of Health are outside the CFA's purview)
- Manahawkin Convalescent v. O'Neill, 217 N.J. 99 (N.J. 2014) (discusses scope of CFA and regulatory oversight for long-term care providers)