Not a Lexis Advance subscriber? Try it out for free.

Small v. Blue Cross Blue Shield of Mich.

Superior Court of New Jersey, Law Division, Bergen County

March 15, 2019, Argued; March 20, 2019, Decided

DOCKET NO. BER-L-4141-18

Opinion

Civil Action

FACTUAL BACKGROUND

THIS MATTER arises from a dispute concerning payment of a medical bill by a healthcare insurance company to a healthcare provider. Plaintiff Tsvi Small, M.D. ("Plaintiff") is an out-of-network provider that rendered preauthorized, medically-necessary surgical services to an unnamed patient ("Patient"). At all relevant times, Patient lived in Bergen County, New Jersey and received health benefits through TTI Global, Inc. ("TTI"). These healthcare benefits were administered by defendant Blue Cross Blue Shield of Michigan ("BCBS Michigan").

Patient suffered from *** cancer, and determined that the best course of treatment was to undergo a double mastectomy. Patient sought Plaintiff to perform a *** reconstruction immediately following the mastectomy procedure.

Prior to performing Patient's *** reconstruction surgery, Plaintiff's office in New Jersey contacted [*2]  BCBS Michigan to request prior authorization for the surgery, which BCBS Michigan approved via letter from Michigan on November 2, 2016. The reconstruction surgery occurred sometime thereafter. Plaintiff then submitted a bill to BCBS Michigan in the amount of $51,400. The allowed benefit under the TTI insurance plan (the "TTI Plan") for the subject procedure was $4,413.32. Plaintiff then filed a complaint in New Jersey Superior Court alleging causes of action for: (1) breach of implied contract; (2) estoppel; (3) account stated; and (4) fraudulent inducement (the "Complaint").

BCBS Michigan is not incorporated in New Jersey, is not headquartered in New Jersey, does not insure risk in New Jersey, and is not licensed to do business in New Jersey. Furthermore, BCBS Michigan does not solicit insurance in New Jersey, maintain offices or own property in the state, or maintain any bank accounts in the state. Similarly, TTI is not incorporated in New Jersey, nor is its headquarters in New Jersey. Like BCBS Michigan, TTI is incorporated and headquartered in Michigan.

Defendants now move for dismissal of Plaintiff's Complaint in its entirety, alleging that the State of New Jersey lacks personal [*3]  jurisdiction over Defendants. Specifically, Defendants argue that New Jersey is not the correct forum to litigate this matter, because neither defendant is "at home" in New Jersey to confer general jurisdiction, nor are there "sufficient minimum contacts" with New Jersey to confer specific jurisdiction. Plaintiff opposes the motion, arguing that both general and specific jurisdiction are applicable, and therefore, New Jersey is the proper forum for this litigation.

Read The Full CaseNot a Lexis Advance subscriber? Try it out for free.

Full case includes Shepard's, Headnotes, Legal Analytics from Lex Machina, and more.

2019 N.J. Super. Unpub. LEXIS 661 *

TSVI SMALL, M.D., Plaintiff, v. BLUE CROSS BLUE SHIELD OF MICHIGAN, as administrators; TTI GLOBAL, INC.; JOHN AND JANE DOES 1-10; and ABC CORPORATIONS 1-10, Defendants.

Notice: NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE COMMITTEE ON OPINIONS.

PLEASE CONSULT NEW JERSEY RULE 1:36-3 FOR CITATION OF UNPUBLISHED OPINIONS.

Prior History: Small v. Blue Cross Blue Shield of Mich., 2018 U.S. Dist. LEXIS 192415 (D.N.J., Oct. 16, 2018)

CORE TERMS

personal jurisdiction, contacts, forum state, purposefully, Patient, availed, cause of action, coverage, principal place of business, motion to dismiss, contractual, headquarters, healthcare, employees, benefits, prong