Citizens United Reciprocal Exchange v. Hackensack Umc A/S/O A.R. ( 2024 )

NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the
internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-3330-21
CITIZENS UNITED
RECIPROCAL EXCHANGE,
Plaintiff-Respondent,
v.
HACKENSACK UMC a/s/o
A.R.,
Defendant-Appellant.
Argued December 18, 2023 – Decided July 8, 2024
Before Judges Mawla, Marczyk, and Chase.
On appeal from the Superior Court of New Jersey, Law
Division, Mercer County, Docket No. L-1866-21.
Lynne A. Goldman argued the cause for appellant
(Callagy Law, PC, attorneys; Lynne A. Goldman, of
counsel and on the briefs).
Damian A. Scialabba argued the cause for respondent
(Brennan & Sponder, attorneys; Stewart M. Martinez,
of counsel and on the brief).
PER CURIAM
Defendant Hackensack UMC a/s/o A.R. ("HUMC") appeals from the June
7, 2022 trial court order entered in favor of plaintiff Citizens United Reciprocal
Exchange ("CURE") vacating the Forthright arbitration award and Forthright
appellate award. Based on our review of the record and applicable legal
principles, we affirm.
I.
On October 8, 2018, CURE-insured A.R. sustained life-threatening
injuries in a car accident. Because of the severity of his injuries, he was taken
to HUMC, a state-designated Level II Trauma Center, where he underwent
emergency surgery and other extensive treatment over the course of eleven days
until his discharge on October 19, 2018.
On October 25, 2018, HUMC billed CURE $204,963.75 for A.R.'s
medical services pursuant to A.R.'s personal injury protection ("PIP") benefits
under his policy. On March 21, 2019, CURE sent a letter to HUMC's billing
and business addresses 1 that rejected the amount billed by HUMC and asserted
the proper payment to be that which was determined by CURE's auditor:
CURE has received your bill in the amount of
$204,963.75 for the above claimant on October 29,
2018. Please be advised that CURE disputes the billed
amount. Please provide support for your usual and
1
As discussed below, checks sent to HUMC's lock box (billing address) are
automatically deposited. CURE emphasizes it also sent the same
correspondence to HUMC's business address.
2 A-3330-21
customary fee for the services billed in the form of
exemplary EOBs [explanation of benefits].
....
CURE has allowed $44,454.06 for payment of
services rendered for the above[-]mentioned bill per
independent audit. A copy of this audit is attached. A
payment and/or [EOB] will be issued shortly.
Also on March 21, 2019, CURE issued an EOB, which approved the allowed
amount of $44,454.06 and contained a reference that "payment, if applicable,
[would] be processed and mailed separately." The EOB also contained an
explanation of CURE's PIP appeal process under CURE's Decision Point
Review Plan ("DPRP")—a plan approved by the New Jersey Department of
Banking and Insurance ("DOBI"). 2
Seven days later, on March 28, 2019, CURE sent to HUMC's post office
lock box an offer of settlement accompanied with a check for $45,479.04. The
payment description was: EOB ($44,454.07) with interest ($24.97) and
2
CURE's EOB stated the process as follows:
IN ACCORDANCE WITH N.J.A.C 11:3-4.7B AND
THE PRE-CERTIFICATION/[DPRP] APPROVED
BY THE NJ DOBI . . . ALL APPEALS (PRE-
SERVICE AND POST-SERVICE) SHALL BE
INITIATED USING THE FORMS ESTABLISHED
BY THE DEPARTMENT BEFORE MAKING A
REQUEST FOR ALTERNATE DISPUTE
RESOLUTION.
3 A-3330-21
consideration ($1,000). The top part of the check stub stated, "CURE is offering
the attached check as full and final settlement of the dispute regarding amounts
owed for these services . . . [including] consideration for the settlement of this
dispute." It further stated that "depositing of the attached check constitutes
[HUMC's] acknowledgement that [it has] notice of this dispute and that [it
accepts] this check as a complete settlement of [its] claim with regards to these
services." The letter then provided an address for the check to be returned within
ninety days if HUMC did not accept the offer.
On April 5, 2019, HUMC deposited the check into the hospital's account.
On May 28, 2019, CURE sent a follow-up letter directly to HUMC's billing
address and principal place of business and advised:
CURE wishes to acknowledge that check #1852
in the amount of $45,479.04 was deposited by your
office. Your deposit of the check constitutes your
acceptance and acknowledgement of full and final
settlement of the dispute regarding amounts owed for
these services.
If this check was deposited in error, please be
advised you have [ninety] days from the date on the
check to refund CURE the amount paid or return the
original check to: Mr. Greg Osborn, CURE, 214
Carnegie Center, Suite 101, Princeton, NJ 08540.
HUMC did not return the original check issued by CURE prior to June 28, 2019.
On May 28, 2019, HUMC filed for PIP arbitration, pursuant to the
Alternate Procedure for Dispute Resolution Act ("APDRA"), N.J.S.A.
4 A-3330-21
2A:23A-1 to -30, seeking payment for the amount it billed less the amount of
the check. The arbitration was assigned to a Dispute Resolution Professional
("DRP").
CURE initially filed an application for dismissal asserting a lack of
subject matter jurisdiction based on accord and satisfaction. HUMC opposed
the motion, relying on Zeller v. Markson Rosenthal & Co., 299 N.J. Super. 461,
463 (App. Div. 1977) (delineating the elements of accord and satisfaction), and
Loizeaux Builders Supply Co. v. Donald B. Ludwig Co., 144 N.J. Super. 556,
564-65 (Law Div. 1976) (also outlining the elements of accord and satisfaction),
to argue there was no accord and satisfaction. The DRP determined in his
August 20, 2019 order CURE did not establish the elements of accord and
satisfaction and denied CURE's application. The DRP also noted the "legal
issue[s] simply [could not] be determined on an [a]pplication for [d]ismissal, as
there are genuine issues of fact in dispute."
The parties proceeded to a Forthright3 arbitration in March 2021. During
the hearing for the Forthright award, CURE again raised the accord and
satisfaction defense and also argued: (1) HUMC had not proven its usual,
3
The Commissioner of Banking and Insurance has been authorized by the
Legislature to designate an organization to serve as an arbitration forum for PIP
disputes. N.J.S.A. 39:6A-5.1(b). Forthright currently serves in that capacity.
Kimba Medical Supply v. Allstate Ins. Co., 431 N.J. Super. 463 (2013).
5 A-3330-21
customary, and reasonable ("UCR") charges; (2) CURE's payment was proper;
and (3) that N.J.A.C. 11:3-29.4(e)(1) applies to inpatient hospitals like HUMC
such that HUMC was mandated to submit exemplar EOBs to support its UCR
charges. The DRP found in favor of HUMC reasoning that, pursuant to accord
and satisfaction principles, HUMC did not manifest its intent to accept the offer
by depositing the check. In his Forthright award, the DRP explained:
Here, there was simply a partial payment sent in
response to [HUMC]'s bill. [CURE] had not contested
the billing prior to the time the check was submitted
and, therefore, no bona fide dispute existed when the
check was presented to the provider for payment. The
simple act of depositing a check cannot constitute an
accord and satisfaction where no dispute existed at the
time the check was remitted. When [CURE] offered the
check, it was paying part of an amount which it never
previously disputed was owed to [HUMC]. When
[HUMC] accepted the check, it was merely accepting a
part of the payment that was rightfully due to it.
[CURE] unilaterally and arbitrarily issued a check and
demanded that [HUMC] accept it and forego the rest of
its lawful claim. Accordingly, there is no way the
cashing of the check can rise to the level of accord and
satisfaction. . . . That [CURE]'s actions simultaneously
create and resolve its own controversy, reveals that
accord and satisfaction does not apply in this case.
....
[HUMC] never signed a release. [HUMC]
appealed the underpayment, evidencing that [HUMC]
had never intended to accept a settlement offer.
[HUMC] did not even come into contact with [CURE]'s
check prior to deposit. As mentioned, [HUMC] is a
Trauma Facility. Given [HUMC]'s size, it utilizes a
6 A-3330-21
"lock box" service to receive payments from insurance
carriers. The process is as follows: [HUMC] sends out
a UB-04 [form] to the insurance carrier. The UB-04
designates a P.O. Box 48027, Newark, New Jersey for
checks to be sent. Thousands of checks per day are
deposited by a clerk of TD Bank, contracted with
[HUMC] to deposit the checks received. The clerk who
opens the mail and deposits checks has no authority to
negotiate for or enter into settlements on behalf of
[HUMC]. The check sent by [CURE] here was
processed as described. Under these circumstances, it
simply cannot be established that [HUMC] had the
intent to accept and be bound by [CURE]'s [o]ffer of
[s]ettlement. Under the well settled case law, absent
the element of intent, there is no accord and
satisfaction.
The DRP awarded HUMC reimbursement of $158,484.71 (HUMC's total bill
less the check previously deposited).
In May 2021, CURE filed a request for an appeal to an internal Forthright
panel arguing the DRP failed to give proper deference to Zeller by requiring
additional elements that are not required under that case to establish an accord
and satisfaction. In June 2021, HUMC opposed CURE's request for a Forthright
appeal, arguing that CURE failed to meet the narrow grounds for vacating an
arbitration award set forth in N.J.S.A. 2A:23A-13, emphasizing review of
arbitration awards is limited.
On August 5, 2021, the Forthright panel affirmed the DRP's finding that
HUMC never accepted CURE's payment, and there was no intent by "both
7 A-3330-21
parties" that the amount CURE paid represented the full and complete payment
of the disputed bill. The panel specifically stated:
the [c]ourt in Zeller indicated that "[a]n accord and
satisfaction requires a clear manifestation that both the
debtor and the creditor intend the payment to be in full
satisfaction of the entire indebtedness."
In the case of Schlesinger v. Kresge, 388 F. 2d
208 (3d Cir. 1968), the [c]ourt noted that "[i]t is the
universal rule in this country, including Michigan and
New Jersey, that an accord and satisfaction arises only
where both parties intend the payment to terminate a
then existing controversy."
The panel further noted that "although disputed by [HUMC], there may have
been a bona fide dispute between [HUMC] and [CURE] as to the amount owed;
and, [CURE]'s intent that the payment of $45,479.04 made in conjunction with
an [o]ffer of [s]ettlement was in full satisfaction of the disputed amount."
However, "[HUMC] never accepted CURE's payment in full payment" as
evidenced by "[HUMC]'s filing of a post-service appeal request regarding . . .
the underpayment for the services provided to [A.R.]" In short, the panel noted,
"[HUMC] did not intend its acceptance to serve as full satisfaction of its bill for
that date of service." Accordingly, the panel found no intent by both parties and
therefore no accord and satisfaction and affirmed the award entered by the DRP.
On September 10, 2021, CURE filed a verified complaint and order to
show cause seeking to vacate the DRP award and the Forthright panel award
8 A-3330-21
affirming the DRP. CURE alleged the DRP committed prejudicial error by
erroneously applying the law of accord and satisfaction to the issues and facts
presented and "so imperfectly executed his powers so that a final and definitive
award was not made." HUMC opposed, arguing that CURE failed to satisfy the
standards for vacating an arbitration award as mandated in N.J.S.A. 2A:23A-13.
On June 7, 2022, the trial court rendered an oral decision and entered an
order vacating the APDRA awards on the following grounds: the DRP and
Forthright panel "committed prejudicial error by erroneously applying law to
the issues and facts presented at the hearing" and that they "exceeded their power
or so imperfectly executed their power so that a final and definitive award was
not made."
Specifically, the court further stated:
I find that – both under Zeller, that the cashing of the
check imputes an agreement . . . .
....
I place the greatest weight upon the letter sent on March
28th, 2019[,] and the follow-up letter . . . in which
CURE is clearly invoking – following with provisions
putting the hospital on notice, . . . if it was not already
on notice, that there was a bona fide dispute and the
cashing of the check was to be an accord and
satisfaction and, . . . if . . . the check [was deposited]
mechanically, inadvertently, [or] mistakenly, you have
[ninety] days to return the check. The check was not
returned here and there was no other response.
9 A-3330-21
Accordingly, I find that the arbitrator erred in
finding . . . that there was no accord and satisfaction in
this matter, and so I will vacate the award and the
Forthright Appellate Award in this case.
The court found it "most significant" that CURE sent the letter to both the lock
box and to the hospital itself. Moreover, the court noted the statute, N.J.S.A.
12A:3-311(c)(1), has an escape clause and the "prospective fix" is for the
hospital to designate a specific individual under the statute for CURE to send
such legal correspondence to avoid the situation that occurred here.
II.
HUMC argues we have jurisdiction to review this appeal because this
matter raises public policy issues and the trial court failed to follow the APDRA.
It further contends the trial court erred in vacating the APDRA award on the
issue of accord and satisfaction.
CURE, as a New Jersey-based auto insurer, is required to provide PIP
benefits under its policies. The New Jersey Automobile Reparation Reform Act,
N.J.S.A. 39:6A-1 to -35, mandates that automobile liability insurance policies
provide PIP coverage, including payment of "reasonable medical expenses,"
N.J.S.A. 39:6A-4(a). Cobo v. Mkt. Transition Facility, 293 N.J. Super. 374, 384
(App. Div. 1996). Disputes regarding the appropriateness and amount of PIP
coverage are determined in "dispute resolution." N.J.S.A. 39:6A-5.1(a); see
Citizens United Reciprocal Exch. v. N. N.J. Orthopedic Specialists, 445 N.J.
10 A-3330-21
Super. 371, 376-77 (App. Div. 2016) (stating disputes between health care
providers and insurers over billing covered by PIP insurance provisions are
typically settled through arbitration).
The forum for PIP arbitration is the APDRA, N.J.S.A. 2A:23A-1 to -30.
Although proceedings under the APDRA are frequently referred to as
"arbitrations," and are indeed similar in style and substance to arbitrations, the
APDRA is distinct from the Arbitration Act, N.J.S.A. 2A:23B-1 to -36. An
APDRA decision is binding, subject to "vacation, modification[,] or correction"
by the Superior Court in limited instances. N.J.S.A. 2A:23A-13(a). In matters
where jurisdiction exists, an award may only be vacated if the rights of a party
were prejudiced by:
(1) Corruption, fraud[,] or misconduct in procuring the
award;
(2) Partiality of an umpire appointed as a neutral;
(3) In making the award, the umpire's exceeding their
power or so imperfectly executing that power that a
final and definite award was not made;
(4) Failure to follow the procedures set forth in [this
Act], unless the party applying to vacate the award
continued with the proceeding with notice of the defect
and without objection; or
(5) The umpire's committing prejudicial error by
erroneously applying law to the issues and facts
presented for alternative resolution.
11 A-3330-21
[Selective Ins. Co. of Am. v. Rothman, 414 N.J. Super.
331, 341 (App. Div. 2010) (quoting N.J.S.A.
2A:23A-13).]
N.J.S.A. 2A:23A-18(b) makes clear, once the trial court, sitting as an
appellate court, has issued an order "confirming, modifying[,] or correcting" a
decision, "[t]here shall be no further appeal or review of the judgment or
decree." Our Supreme Court upheld the constitutionality of N.J.S.A.
2A:23A-18(b) in Mt. Hope Development Associates v. Mt. Hope Waterpower
Project, L.P., 154 N.J. 141, 148-52 (1998). The Court ruled that "the language
of [the] APDRA unmistakably informs parties that by utilizing its procedures
they are waiving [their] right" to appeal beyond the trial court, and that such a
waiver generally must be enforced. Id. at 148.
While there are exceptions to the appellate bar set by N.J.S.A.
2A:23A-18(b), they are limited. There are exceptions when it is "necessary for
[the Court] to carry out its 'supervisory function over the [trial] courts.'" Morel
v. State Farm Ins. Co., 396 N.J. Super. 472, 475-76 (App. Div. 2010) (quoting
Mt. Hope Dev. Assoc., 154 N.J. at 152). This "supervisory function" permits us
to exercise appellate jurisdiction when a trial court has exceeded its jurisdiction
under the APDRA. See Morel, 396 N.J. Super. at 476. As the Supreme Court
instructed in Mt. Hope, although arbitration can be a favored procedure, there
may be "'rare circumstances' grounded in public policy" that may warrant
12 A-3330-21
"limited appellate review" over trial court decisions in APDRA matters. 154
N.J. at 152. Appellate review is thus allowed "where public policy would
require" it. Ibid. One example identified by the Court is a child support order,
ibid.; another example is an award of attorney's fees. Allstate Ins. Co. v. Sabato,
380 N.J. Super. 463, 472-76 (App. Div. 2005).
However, "when the trial judge adheres to the statutory grounds in
reversing, modifying[,] or correcting an arbitration award, we have no
jurisdiction to tamper with the judge's decision or do anything other than
recognize that the judge has acted within his jurisdiction." N.J. Citizens
Underwriting Reciprocal Exch. v. Kieran Collins, D.C., LLC, 399 N.J. Super.
40, 48 (App. Div 2008). Thus, "we review the decision of the trial judge here
for the limited purpose of determining whether he exceeded the authority
granted to him by [the] APDRA." Ibid.A.
HUMC argues this matter raises an important public policy concern
because application of accord and satisfaction in a PIP dispute undermines
medical providers' right to accept partial payments and commence a claim for
the balance as is permitted under New Jersey's PIP laws. Further, HUMC argues
appellate review is required to "provide needed precedent" because this is a
recurring issue, and there are conflicting interpretations of accord and
13 A-3330-21
satisfaction. In essence, HUMC asserts CURE's accord and satisfaction defense
is a "manufactured end-run around" the New Jersey PIP statutory scheme.
HUMC further contends CURE's DPRP provides a mechanism for resolving
"all" reimbursement disputes, and CURE's "accord and satisfaction scheme"
undermines the Legislature's intent in enacting the PIP regulations. The use of
accord and satisfaction also forecloses a medical provider's right to file an
internal appeal, and the utilization of accord and satisfaction in this context
should be "extinguished."4
HUMC further argues that the trial court judge did not properly apply the
standards of review under N.J.S.A. 2A:23A-13(b), (c), and (f), and therefore, we
have jurisdiction to review under our supervisory function. HUMC argues the
trial court did not give proper deference to the factual findings in the Forthright
awards. Specifically, it contends that de novo review of the facts before the
DRP is appropriate only when vacating an award under N.J.S.A.
4
HUMC asserts CURE sent the check with the settlement language to a lock
box "well aware that no human representative of the hospital would rea[d]" the
notation above the check and that it would be "automatically and electronically
deposited." HUMC does not squarely address that CURE's May 28, 2019 letter
was sent to both HUMC's billing and business address advising HUMC that
HUMC had deposited the check previously sent by CURE, which operated as a
final settlement of the parties' dispute, and advised that if it was deposited in
error, it should be returned within ninety days. Rather, HUMC asserts that by
filing its appeal twelve days after CURE sent the settlement check, it
demonstrated that it did not intend to accept CURE's settlement offer.
14 A-3330-21
2A:23A-13(c)(1) through (4) and that the court's "de novo" review was not
permitted under N.J.S.A. 2A:23A-13(c)(5).
We first address HUMC's second argument. Although the court's order
stated it conducted a de novo review, the court adhered to the standard in
N.J.S.A. 2A:23A-13(c)(5). The court did not fail to give deference to the DRP's
factual findings, which were essentially undisputed, but instead came to a
different legal conclusion under N.J.S.A. 2A:23A-13(c)(5). The court found the
DRP committed prejudicial error by erroneously applying the law to the issues
and facts presented at the hearing. In doing so, the court largely relied on
CURE's May 28, 2019 correspondence to HUMC, which was not squarely
addressed by the DRP and the Forthright panel. The court made specific
conclusions of law that were rationally explained and supported by the record.5
Accordingly, we find no error on this issue.
5
In Fort Lee Surgery Center, Inc. v. Proformance Insurance Co., we noted:
when a trial judge is able to provide a rational
explanation for how the arbitrator committed
prejudicial error, N.J.S.A. 2A:23A-18(b) requires a
dismissal of an appeal of that determination regardless
of whether we may think the trial judge exercised that
jurisdiction imperfectly. Any broader view of appellate
jurisdiction would conflict with the Legislature's
expressed desire in enacting [the] APDRA to eliminate
appellate review in these matters.
15 A-3330-21
B.
Turning to HUMC's primary argument, we engage in limited appellate
review of whether the principles of accord and satisfaction can be utilized in the
context of a PIP dispute of this nature. Public policy supports us addressing this
legal issue.
The "essential elements of accord and satisfaction" are: (1) "a bona fide
dispute as to the amount owed;" (2) "a clear manifestation of intent by the debtor
to the creditor that payment is in satisfaction of the disputed amount "; and (3)
"acceptance of satisfaction by the creditor." Loizeaux Builders, 144 N.J. Super.
at 564-65. "[A]n accord and satisfaction requires a clear manifestation that both
the debtor and the creditor intend the payment to be in full satisfaction of the
entire indebtedness." Zeller, 299 N.J. Super. at 463.
Although the APDRA sets forth a detailed process whereby parties can
resolve PIP disputes through arbitration, there is no indication the Legislature
intended to preclude parties from resolving PIP matters through conventional
settlements. In fact, parties routinely resolve disputes through settlements
related to complex areas of the law even where there are clearly defined formal
procedures to resolving the litigation. Moreover, it is well-settled that "public
[412 N.J. Super. 99, 104 (App. Div. 2010).]
16 A-3330-21
policy wisely encourages settlements . . . ." McDermott v. AmClyde, 511 U.S.
202, 215 (1994); see also Jannarone v. W.T. Co., 65 N.J. Super. 472, 476 (App.
Div. 1961) ("The settlement of litigation ranks high in our public policy").
Settlement agreements are encouraged as a matter of public policy "because they
promote the amicable resolution of disputes and lighten the increasing load of
litigation faced by . . . courts." Ehrheart v. Verizon Wireless, 609 F.3d 590, 595
(3d Cir. 2010).
Accord and satisfaction is a defense to a claim, predicated on a settlement
agreement in which parties had agreed to resolve a dispute or debt. See Rule
4:5-4 (setting forth affirmative defenses including accord and satisfaction).
HUMC has not cited to any authority that supports the proposition that the
principles of accord and satisfaction cannot be utilized by parties in the context
of a PIP dispute, and we conclude there is no basis to carve out an exception.
Accordingly, parties are free to resolve disputes by accord and satisfaction in
PIP-related matters, provided they satisfy the elements set forth in Zeller.
We decline, however, HUMC's invitation for us to make the more nuanced
and substantive determination as to whether the trial court correctly applied the
elements of accord and satisfaction to the underlying facts in this matter.
N.J.S.A. 2A:23A-18(b) provides: "Upon the granting of an order confirming,
modifying[,] or correcting an award, a judgment or decree shall be entered by
17 A-3330-21
the court in conformity therewith and be enforced as any other judgment or
decree." More importantly after the trial court renders its decision, essentially
sitting as an appellate court, "[t]here shall be no further appeal or review of the
judgment or decree." Ibid. That is, where the trial court "navigated within [the]
APDRA's parameters," the appeal should be dismissed. Fort Lee, 412 N.J.
Super. at 104.
The trial court noted there are several cases with similar fact patterns
involving multiple hospitals where CURE has prevailed utilizing the principles
of accord and satisfaction, although HUMC notes there are several cases where
CURE's defense of accord and satisfaction has been rejected. It is generally not
our role under N.J.S.A. 2A:23A-18(b) to revisit the decisions rendered by the
trial court subject to the exceptions discussed above, which are not present here.
Indeed, although we addressed the fundamental issue of whether accord and
satisfaction can be utilized in the context of PIP matters, the court's application
of accord and satisfaction to the specific facts in this case does not warrant our
intervention under N.J.S.A. 2A:23A-18(b). By resorting to the principles of
accord and satisfaction, the court here did not "commit any glaring errors that
would frustrate the Legislature's purpose in enacting the APDRA." Riverside
Chiropractic Grp. v. Mercury Ins. Co., 404 N.J. Super. 228, 240 (App. Div.
2008). Without determining here the specific merits of the accord and
18 A-3330-21
satisfaction analysis, we conclude the court acted within the authority granted
to it by the APDRA, and, therefore, we have "no jurisdiction to tamper with the
[court's] decision." N.J. Citizens Underwriting Reciprocal Exch., 399 N.J.
Super. at 48.6
To the extent we have not specifically addressed any of defendant's
remaining arguments, we conclude they lack sufficient merit to warrant
discussion in a written opinion. R. 2:11-3(e)(1)(E).
Affirmed.
6
HUMC argues CURE engaged in deceptive practices and "lure[d] hospitals
into an 'accord and satisfaction' trap." Although HUMC questions the settlement
tactics of CURE, HUMC is not without a remedy in future matters. We observe
that New Jersey has codified the doctrine of accord and satisfaction under
N.J.S.A. 12A:3-311. Notably, N.J.S.A. 12A:3-311(c)(1) provides an "escape
hatch," stating a claim is not discharged if:
The claimant, if an organization, proves that within a
reasonable time before the tender, the claimant sent a
conspicuous statement to the person against whom the
claim is asserted that communications concerning
disputed debts, including an instrument tendered as full
satisfaction of a debt, are to be sent to a designated
person, office, or place, and the instrument or
accompanying communication was not received by that
designated person, office, or place.
HUMC made no such designation here, despite its ongoing litigation with CURE
in other cases. It would appear many of these disputes could be avoided by
HUMC and other hospitals designating a particular individual or office to field
communications regarding disputed debts.
19 A-3330-21