eNotes: Workers’ Compensation – November 2023 – New Jersey

SIGNIFICANT CASE SUMMARIES

New Jersey Case Summary

Pozadas v. Capital Iron Associates, LLC.
Superior Court of New Jersey
No. A-0162-22

Decided: October 30, 2023

Courts strictly decide coverage issues under N.J.S.A. 34:15-81, and an accident may be compensable where a petitioner deviates from a job route on an out-of-state motorcycle ride before returning to the job route on the way to a customer in New Jersey.

Background

On October 14, 2016, the Petitioner took a personal detour into Pennsylvania from New Jersey while on the way to a work-related meeting in New Jersey. While on his way back to New Jersey to meet with the client, the Petitioner was injured in a motor vehicle accident while still in Pennsylvania. The Respondent denied the claim, citing the expiration of the Respondent’s policy as well as the Petitioner’s deviation from employment by driving away from the intended destination. The Respondent filed a Motion to Dismiss on the basis of non-coverage. The Petitioner opposed the motion, arguing that the Respondent’s nonrenewal did not comply with the statutory requirements of N.J.S.A. 34:15-81. The Respondent alleged that on August 19, 2016 it had sent a renewal notice to the Petitioner, who was also the owner of the company. The Petitioner denied receipt of the notice. The accepted facts were that the Respondent contacted the Petitioner by e-mail on September 16, 2016 to advise of the pending policy expiration. The Petitioner in his capacity as the owner of the company replied on September 29, 2016 that he would like to exclude coverage for himself as an individual for the upcoming policy period. The policy expired on October 13, 2016 before the broker finalized the changes. At a bifurcated hearing on the coverage issue, the insurance carrier failed to produce any witnesses to testify about the nonrenewal.

Holding

The Court held that coverage was in effect on October 14, 2016 even though the policy period expired on October 13, 2016 since the Respondent could not prove that they complied with the statutory provisions on non-renewal and cancellation set forth at N.J.S.A. 34:15-81. The Court also held that the accident occurred in the course of employment once the Petitioner took the jug handle to travel back in the direction of the client meeting.

Takeaway

If coverage is raised as a defense, the insurance carrier must establish compliance with N.J.S.A. 34:15-81, which the Court strictly construes. Secondly, an out-of-state accident may be compensable under N.J.S.A. 34:15-36 if a petitioner has resumed a mission to engage in the performance of duties assigned or directed by the employer.

Questions about this case can be directed to Theresa Garvin-Keyser at (856) 334-0437 or tgarvin@tthlaw.com.