Selective Insurance Co. of America v. Rothman
208 N.J. 580
| N.J. | 2012Background
- Selective Insurance challenged medical claims arising from treatment of an auto-accident victim and PIP subrogation by Rothman, M.D.
- Disputes centered on whether a licensed Physician Assistant could perform needle EMG tests and bill insurers for them.
- Rothman prevailed in an arbitration challenging insurer's denial of EMG-related claims.
- A consolidated trial led to a judgment confirming the arbitration award and a declaration that PAs are not authorized to perform EMGs.
- The Appellate Division reversed, addressing the PA EMG issue and denying Rothman’s request to limit the judgment to prospective effect.
- The Supreme Court granted certification and ultimately affirmed the Appellate Division’s decision on the EMG issue and declined retroactivity, concluding the judgment should not be limited to prospective application.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether PAs may perform needle EMG tests | Rothman argues PAs can perform EMGs under PA authorization. | Selective Ins. contends EMG requires physician license only, excluding PAs. | PAs may not perform needle EMGs. |
| Whether the appellate judgment should have prospective-only effect | Defendant argues retroactivity would cause reliance-based inequities and ongoing litigation issues. | N/A in this synthesis; (defendant argued for prospective-only application). | Judgment affirmed with retroactivity; no prospective-only restriction. |
Key Cases Cited
- Nieder v. Royal Indem. Ins. Co., 62 N.J. 229 (1973) (questions not properly presented generally not reviewed)
- Alloway v. Gen. Marine Indus., 149 N.J. 620 (1997) (Nieder guiding principle on appeal arguments)
- Malinowski v. Jacobs, 189 N.J. 345 (2007) (prospective application when fairness/justice require)
- Montells v. Haynes, 133 N.J. 282 (1993) (prospective relief when first-impression or murky area)
- SASCO 1997 NI, LLC v. Zudkewich, 166 N.J. 579 (2001) (reliance considerations in retroactivity analysis)
- Reuter v. Ft. Lee Borough Council, 167 N.J. 38 (2001) (retroactivity generally applied to civil decisions with exceptions)
- Velez v. City of Jersey City, 180 N.J. 284 (2004) (principles for prospective application of rulings)