Author: Jones Jones

Welcome to Part One of the  Jones Jones LLC’s Loss Transfer Series! The purpose of this three part series is to educate and inform our readers on the importance of this application of the law.  Understanding and utilizing loss transfer will make a major impact on your mitigation recovery – which will equate to large savings to your clients.  You may have already read about Jones Jones LLC’s major success with our Loss Transfer Department—with over a 96% recovery rate on amounts sought via loss transfer.   Now, this three part series will take you through the basics of loss transfer under NY Insurance Law Section 5105(a) so that you can find opportunities in your own caseload to begin your journey towards loss transfer success.

WHAT IS LOSS TRANSFER?

Loss transfer is a carrier or self-insured’s right under NY Insurance Law Section 5105(a) to seek reimbursement  from another carrier or self-insured for benefits paid on certain claims arising from motor vehicle accidents.

WHO CAN SEEK REIMBURSEMENT VIA LOSS TRANSFER?

No-Fault carriers, as well as Workers’ Compensation carriers and any other carrier who provides benefits that could be considered to be “in lieu of No-Fault”.

WHO DO YOU SEEK LOSS TRANSFER REIMBURSEMENT FROM?

The carrier or self-insured owner responsible for providing No-Fault benefits for the vehicle responsible for the underlying motor vehicle accident.

WHEN DOES LOSS TRANSFER APPLY?

Loss transfer applies when ALL of the following criteria are met:

1. The underlying claim arose from a motor vehicle accident that was caused by a “covered person” as defined under NY Insurance Law Section 5104;
2. The motor vehicle accident occurred in New York State; and
3. At least one of the vehicles involved in the loss meets one of the following criteria:
   1. 1. 1. 1. Weighs 6,500 lbs unloaded; OR
            2. Is a Livery vehicle

WHO IS A COVERED PERSON?

A covered person is an operator of a motor vehicle that was either:

• An authorized self-insured company in New York;
• Insured by a companies authorized to issue No-Fault policies in New York (note: almost all major auto insurance companies fall under this category); OR
• Insured by an out-of-state company which has filed with the NY Commissioner of Motor Vehicles authorizing the commissioner to accept service of process on their behalf and stating that their policies will be varied to meet NY insurance requirements.

Stay tuned for Part Two of the Jones Jones LLC’s Loss Transfer Series to learn about what kind of benefits can be recovered under loss transfer! As always, the attorneys of Jones Jones LLC are beside you every step of the way and welcome any questions or thoughts you may have on this most important topic.  Contact our team today at clientservices@jonesjonesllc.com.

Have an idea for an education series? Would you like to learn more about a certain are of subrogation, New Jersey & New York Workers’ Compensation defense, or No-Fault? Contact us with what you want to hear more about today at clientservices@jonesjonesllc.com!

Jones Jones LLC Partner Kathleen (Kassy) Ginnane provided her expert opinion as part of a panel discussion at the New Jersey Self Insurer’s Association (NJSIA) Conference May 13th, 2022 in Atlantic City, New Jersey. Kassy provided the New York perspective as part of a panel discussion entitled, “What Really Happens when you Presume: Presumption Laws and their Impact”

Kassy is often asked to provide her legal analysis to clients and conferences alike on a variety of workers’ compensation issues. At Jones Jones LLC she is a Supervising Partner, meaning she leads a team of attorneys to tailor their practice to the needs of our clients. Kassy counsels clients and attorneys on the intricacies of workers’ compensation and insurance defense law. Kassy began her legal career at Jones Jones LLC as an associate, handling thousands of New York State claims from inception through closure. As a Supervising Partner, Kassy has spearheaded many successful settlement initiatives, often hosting bulk settlement days at our firm’s office. Kassy enjoys educating employer and carrier clients on various aspects of worker’s compensation law, most recently on issues including electronic claims filing and reporting, settlement strategies, and updates to the New York State Workers’ Compensation Board internal processes. Kassy earned her LL.M. in International Legal Studies from New York University School of Law, and her LL.B. from Queen’s University, Belfast, Northern Ireland.

The May 13, 2022 panel discussion at the NJSIA was a lively one! Kathleen educated the attendees on the current state of presumptions in the NYS Workers’ Compensation system; specifically as it relates to World Trade Center and Covid-19 claims. Kassy also provided an insight in to the possible future of presumptions – with a particular focus on what the legal future might hold for Covid-19 claims.

Kassy is happy to discuss presumptions and how they affect your claims in New York State—reach out to the firm today at clientservices@jonesjonesllc.com to schedule a time and talk tailored for you and your claims team!

We are excited to announce a major win secured by Jones Jones LLC Attorney Ian Leaderman. This win highlights:

• The jurisdictional complexities that may arise while representing national or worldwide employer entities;
• The success that can come with a detailed review of the facts surrounding a claimant’s contacts with New York State versus their home state;
• The need to review a claim for an aggressive defense, despite possible filing issues with pre-hearing conference forms.

Attorney Ian Leaderman recently successfully litigated a claim before the New York State Workers’ Compensation Board for an airline client on the issue of proper state jurisdiction. The flight attendant claimant sustained injury to her neck, left shoulder, back and bilateral wrists as she pushed a drink cart during a flight between Greece and JFK. The claimant was a Georgia state resident at the time of injury and immediately begun to start treating in her home state. Thereafter, a claim was initiated with the Georgia State Board of Workers’ Compensation on September 6, 2019, just two days after the subject accident. Several “WC-2, Notice of Payment” forms were filed by the Georgia Board documenting indemnity payments made to the claimant. Eventually, the claimant’s Georgia doctors found that the claimant had reached maximum medical improvement and was 0% disabled.

Six months after the date of accident, and after receiving Georgia workers’ compensation benefits, the claimant’s New York attorney filed an initial notice of claim with the New York State Workers’ Compensation Board. In April 2021, a hearing was scheduled and evidence regarding the Georgia claim was submitted for review by the New York State Law Judge. Ultimately, Attorney Leaderman argued that there were simply insufficient ties to New York State to establish a New York claim; advising the Law Judge that the record demonstrated that the claimant resided in Georgia and chose to pursue all medical treatment in Georgia. Further, had the need for litigation, testimony, etc. arose, particularly with regard to any medical disputes, the witnesses, including the claimant’s physicians, all resided in Georgia as well.

The New York State Law Judge issued a Reserved Decision finding in favor of all of Attorney Leaderman’s points, concluding that there was a lack of sufficient contacts to established a New York State claim. The claimant’s attorney appealed this decision, heavily relying on the fact that the carrier for the airline did not timely file a pre-hearing conference form outlining the defense of jurisdiction. On appeal, Attorney Leaderman argued that the issue of jurisdiction can be raised at any stage of a workers’ compensation claim . The Board Panel agreed, and upon review, held that the carrier’s failure to file a pre-hearing conference statement is not a waiver of the issue of subject matter jurisdiction (see Hermann Transportation, 2018 NY Wrk Comp G1069461), while also noting that the New York Law Judge properly found that there is no subject matter jurisdiction in New York. The Board upheld the disallowance of the claim. Attorney Leaderman’s excellent litigation of this claim allowed for the case to remain closed with the finding of a 0% disability at maximum medical improvement.

Jones Jones LLC attorneys are ready to navigate you and your team through the complexities of jurisdictional defenses. Our attorneys will apply the necessary detailed review and aggressive approach to ensure success.

Contact us today at clientservices@jonesjonesllc.com to connect with an attorney today!