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N.J. worker can't sue ACE USA over unpaid medical bills: Court


TRENTON—Exclusive remedy provisions prevent a New Jersey man from suing his workers compensation insurer over pain and suffering caused by its failure to pay his medical bills, the New Jersey Supreme Court has ruled.

In a 4-1 ruling last week, the court said that New Jersey workers comp law prevents most tort cases against insurers, even if they "intentionally delay making payments that the... court has ordered."

The plaintiff in Wade Stancil vs. ACE USA argued that tort cases should be allowed against "recalcitrant" insurers. But the state Supreme Court said that such companies are held accountable under a 2008 amendment to the workers comp law, which allows courts to find insurers in contempt for failure to comply with orders.

Mr. Stancil injured his neck, back and shoulder while working for textile manufacturer Orient Originals Inc. in 1995, court records show. A New Jersey workers comp court ruled in 2006 that Mr. Stancil was totally disabled by his work accident.

In 2007, a workers comp judge ordered ACE USA to pay Mr. Stancil's medical bills. The judge in that case said ACE USA had a history of failing to make medical payments in workers comp cases and warned the insurer against further violations, court records show.

After ACE USA failed to pay the medical bills by October 2007, the workers comp judge advised Mr. Stancil that he could sue the insurer in New Jersey Superior Court. At that time, the court noted that it had limited authority to force ACE USA to pay Mr. Stancil's costs.


Mr. Stancil sued ACE USA for pain and suffering in 2009 after undergoing surgery and psychiatric treatment the prior year. His physician attributed the treatments to delays in Mr. Stancil's medical payments, which prevented earlier care for Mr. Stancil.

Mr. Stancil's lawsuit was dismissed by the state Superior Court based on exclusive remedy provisions, and a state appellate court upheld that ruling.

The Supreme Court upheld the earlier rulings on Wednesday. In its majority opinion, the court said amendments to the workers comp law in 2008 removed employees' ability to sue "recalcitrant insurers" in court and authorized courts to find such insurers in contempt.

“In light of the clear legislative command, we deem it both unnecessary and inappropriate to create an alternate avenue of redress through a common law cause of action,” the majority opinion reads.

In a dissenting opinion, Justice Barry T. Albin said New Jersey's workers comp law falls "woefully short of making the worker whole for the damages he has suffered."

"In this case, ACE USA breached the social compact by its willful refusal to pay court-ordered benefits, rendering a nullity the whole purpose of the Workers' Compensation Act,” the dissent reads. “As a direct consequence, Stancil suffered aggravation of his original work-related injuries and additional emotional and mental harm.”