Tuesday, May 31, 2016

Fight against the clock for lawyer losing his eyesight

By Myles Ma | NJ Advance Media for NJ.com
Email the author | Follow on Twitter

on May 30, 2016 at 8:15 AM, updated May 30, 2016 at 12:00 PM

Stay connected to NJ.com




PARAMUS —€” Sean Callagy started to notice his vision problems as center fielder for Emerson High School and later for the Columbia University baseball team.


He was fast, he hit well, and he was normally a good fielder.


But he started to lose fly balls in the light.


Callagy has a condition called retinitis pigmentosa. The 46-year-old has been slowly losing his vision since those days in center field and is now legally blind.


He’s known about the disease his whole life. It’s hereditary: His grandfather and brother both had it.


The loss of his eyesight has accelerated in recent years. He recently stopped being able to play catch with his son, also a baseball player at Emerson High.


“My whole life has been fighting the clock,” Callagy said.


Callagy has fast-tracked his life as a result. The River Vale resident formed his own law firm in 1999, when he was 29, winning two verdicts of more than $27 million each in the past two years.


Callagy still has some vision: He can walk around his office in Paramus with little trouble. But he can’t drive, and he can only see a letter at a time while reading, in a profession that requires him to parse through piles of documents.


While trying a case in Arizona representing a Phoenix businessman who claimed his former business partner assaulted him, committed fraud and stole his company, Callagy relied on law partner Michael Smikun to read documents for him in court. Outside of court, Callagy uses iPad apps to read documents out loud and listens to the audio of videotaped depositions. His assistant, Taylor Gallo, takes care of driving.


Smikun said Callagy’s vision has slipped significantly over the past two years. In that time, he’s come to rely more on Smikun.


“We have a form of mind-meld where I just understand what he wants to accomplish,” he said.


While Callagy can’t always read people’s body language when he’s cross-examining them, and sometimes misses seeing an extended handshake, he “still has a great legal mind,” Smikun said.


“He’s found a way to be extraordinarily effective as a litigator despite the fact that he can’t read documents or emails,” he said.


Callagy has a Blackberry because he can feel the keys and uses it to take copious notes. He said he’s honed his memory and speaking ability to compensate for his loss of vision.


It’s clear Callagy loves talking about law: He goes into animated explanations when describing the case in Arizona.


Since he started his firm, his office has grown to employ 100 people and opened a satellite location in Arizona. His goal is to keep growing.


“I would love to have offices all over the country,” he said.


He has moments of fear and frustration at the prospect of losing his vision. He gets emotional speaking about losing sight of his daughter at her soccer games.


But Callagy, who is Christian, said he believes he won’t lose his sight completely. He believes science, whether through gene therapy or retinal cameras or some other advancement, will restore his vision.


“I believe whole-heartedly that this is not going to happen,” he said. “I remain 100 percent in my belief that I will be seeing better when I am 50 or 60 than I do today.”


Myles Ma may be reached at mma@njadvancemedia.com. Follow him on Twitter@MylesMaNJ. Find NJ.com on Facebook.




Fight against the clock for lawyer losing his eyesight

Friday, May 27, 2016

Keeping Insurance Payments Flowing | Callagy Law

The purpose of this post is to help assist those with questions they have concerning their business or medical practice. The Callagy Law team is knowledgeable in many law practice areas and will frequently post topics ranging from Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance. We hope to have this blog shed a light on many common questions.



Billing insurance companies and collecting what you are entitled to collect can be a difficult process for medical providers. There are inevitably coverage issues, difficulties with navigating the ambiguities of policies, correct coding problems, and carriers will look for any discrepancy as a way to avoid payment.  Below are a few tips to help overcome or at least alleviate some of these issues.


Let’s begin with coding.  Employing a certified coder is a start.  It is best these days to hire a professional, who will stay educated on the latest coding practices and information, rather than simply someone who has general knowledge.  Coding has grown and continues to grow more and more complicated.  A certified coder reviewing the National Correct Coding Initiative (NCCI) tables will ensure that bundling errors do not hold up payments. A professional coder can navigate the labyrinth of codes so as to limit the carriers’ ability to delay payments for coding deficiencies.


Insurance policies too can be problematic.  Whenever possible a medical provider should obtain as much information about the insurance policy relevant to the treatment as possible.  This might mean the declaration page of an automobile policy or the health benefit plan description for a commercial insurance patient.  Knowledge of the policies and plans will help reduce, if not, eliminate unknown coverage pitfalls, and provide a better knowledge base of likely reimbursement levels.  Too often providers render services having little or no real knowledge as to what the reimbursement levels will be or whether or not they are even likely to be reimbursed.


The medical documentation also can raise issues.  A medical provider must make sure the supporting documentation matches the diagnosis codes, and should be very specific.  It is self defeating to be cavalier about explaining the need for and the medical necessity of all aspects of the treatment.  It is important to be aware of codes that need specific explanations for payment and ensure your documentation has the necessary explanations.


Finally, confronting denials as and when they happen, as well as having a competent and aggressive legal time at your disposal, will pay big dividends. You need collection personnel with tenacity and organization skills to pursue relentlessly the frequent follow up calls that are necessary.  Knowing payer systems and rules and asking the right questions of claims adjusters is also important.


These are some simple suggestions to combat the revenue roller coaster many providers face.  As a liaison for Callagy Law, I have seen some of my providers struggle with insurance payments, and these basic steps can help alleviate that struggle.



We hope you found the information provided in this article helpful to various questions you may have had concerning the healthcare industry. For information pertaining to our services for medical providers, please click here. Please note, Callagy Law has recovered over $200,000,000 for medical providers, and that number grows daily. Our team of knowledgeable PIP Arbitration attorneys are ready to help you. Please free to reach out to Sean Callagy of Callagy Law at any time for questions you may have concerning personal and business matters. Callagy Law offices are located conveniently in Paramus, NJ. Beyond the scope of information, Sean Callagy has developed multiple areas of our healthcare legal practice and business coaching. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.



Learn More About Callagy Law Here:


Avvo


Blog


Facebook


YouTube


Pinterest


Indeed


Yelp


LawNearMe


Wikipedia


Website



Keeping Insurance Payments Flowing | Callagy Law

Thursday, May 26, 2016

Imputing Income For Support | Callagy Family Law Blog

The following article was written by Callagy Law’s Legal Team, and will focus on many common questions and concerns surrounding new developments, legal matters, and other procedures within the practice area of Family Law, which include, but are not limited to, divorce law, child custody, child support, and prenuptial agreements. Our family law team members are also Certified Matrimonial Attorneys in the State of New Jersey.  Our mission is to answer any questions and give knowledge to many different aspects of these matters.



An issue that often comes in the divorce context, particularly when attempting to establish child support and/or alimony obligations, is the accurate determination of a parent’s/spouse’s income.  If a party is voluntarily underemployed or unemployed, then an income is appropriately imputed to that party.  The question then becomes what level of income should be imputed to that party?


There are certain priorities that attorneys and judges will look to for imputing income to a litigant.  First, the party’s work history, occupational qualifications, educational background and prevailing job opportunities in the region will be reviewed, evaluated and considered.  A court may impute income based upon the party’s former income at that person’s usual or former occupation or the average earnings of such an occupation as reported by the New Jersey Department of Labor.  The New Jersey Department of Labor categorizes employment fields and breaks down earnings in geographical segments.  For example, Bergen, Passaic and Hudson Counties are grouped together for wage and employment statistics.


If potential earnings cannot be determined, income can be imputed based on the party’s most recent wage or benefit record.  Finally, if a wage or benefit record is not available, income may be imputed based upon full-time employment at the New Jersey minimum wage rate.


In addition, in high income cases or where a party has an advanced degree, but has been out of the workforce for a period of time, an employability expert may be retained to provide greater detail and input as to a party’s employability and potential earnings.  This almost becomes a job placement search and various market statistics and research tools are utilized to canvas the region for potential and available job opportunities based upon the person’s educational and employment background.


It is also noteworthy that, when young children are involved, the costs of work-related day care necessary for a person to work outside of the home or obtain full-time employment will be deducted from the imputed income for child support purposes.  This is important when dealing with an imputed income that is marginally more or even less than the costs of child-care.  If it will cost more in child-care then the person can earn, other alternatives need to be considered.



The Team at Callagy Law hopes the information in this article was helpful in either your personal or professional life.. Callagy Law, is a multidisciplinary law firm, headquartered in Paramus, NJ owned and operated by Sean Callagy. We are committed to providing legal representation and advice to our clients at additional law offices located across the United States. Please note that the information posted here should not be used as a legal argument of defense. If you find yourself needing legal advice pertaining to your unique situation, you can contact us at here. Feel free to search us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.



Learn More About Callagy Law Here:


Avvo


Blog


Facebook


YouTube


Pinterest


Indeed


Yelp


LawNearMe


Wikipedia


Website



Imputing Income For Support | Callagy Family Law Blog

Monday, May 23, 2016

Navigating The “Health Care Primary” Option in PIP Claims

The purpose of this post is to help assist those with questions they have concerning their business or medical practice. The Callagy Law team is knowledgeable in many law practice areas and will frequently post topics ranging from Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance. We hope to have this blog shed a light on many common questions.



As a PIP litigation attorney, I frequently find myself explaining what PIP is to individuals who are not familiar with this area of practice. I generally explain it by stating that injuries sustained in auto accidents are covered by auto insurance in the state of New Jersey and I represent health care providers in cases where the auto carrier denies payment. A follow-up question I sometimes receive is, “why aren’t those injuries covered by health insurance?”


The answer to this question is simple, except when it isn’t. (I kid.) New Jersey mandates that all auto insurance policies cover a minimum of $15,000 of PIP coverage. Typically, the auto insurer is the primary payor of injuries sustained in an auto accident under this PIP requirement. Thus, in such cases, it is the auto insurer that is primarily liable and not the patient’s health insurer.


However, there is an exception to the default system which is called “health care primary.” This refers to instances where the insured, in selecting her auto coverage, opts for the “health care primary” option. Essentially, in selecting this option, the insured is committing to utilize health insurance as the primary payor of injuries sustained in auto accidents in exchange for a lower auto insurance premium. In such cases, the patient’s auto insurance serves as a secondary payor rather than as the primary payor.


Health care primary policies can put a wrinkle in health care providers’ standard billing practices for PIP cases and it is worthwhile to understand how to navigate this situation. If a provider treats a car accident victim with a “health care primary” auto policy, the provider should first bill the patient’s health insurer. (If the provider mistakenly bills the auto insurer first, the auto insurer will likely deny the claim and the provider can simply bill the health insurer thereafter.)


The question then becomes, what happens if the patient’s health insurer denies the claim?  The good news here is that the provider can often bill the patient’s auto policy following such a denial since the PIP provision of the policy continues to act as secondary coverage.


While there is some ambiguity on this issue, many interpret the law in a way that requires the patient’s health insurer to issue a substantive denial in order for PIP to be triggered as secondary coverage.


For example, if the health insurer denies the claim because the treatment is not covered under the patient’s policy, this would serve as a substantive denial and the provider would then be free to bill the patient’s auto insurer. However, if the health insurer denies the claim stating that more documentation is needed to process the claim, this will likely not be regarded as a substantive denial and the provider would be wise to resubmit the claim to the health insurer with the requested documentation prior to attempting to bill the patient’s auto carrier.


One final note to be mindful of is, when billing the auto carrier following a health insurance denial, be sure to include the health insurance EOBs. This will signal to the auto carrier that, even though the claim involves a health care primary policy, the patient’s health insurer was already billed but the claim was denied.



We hope you found the information provided in this article helpful to various questions you may have had concerning the healthcare industry. For information pertaining to our services for medical providers, please click here. Please note, Callagy Law has recovered over $200,000,000 for medical providers, and that number grows daily. Our team of knowledgeable PIP Arbitration attorneys are ready to help you. Please free to reach out to Sean Callagy of Callagy Law at any time for questions you may have concerning personal and business matters. Callagy Law offices are located conveniently in Paramus, NJ. Beyond the scope of information, Sean Callagy has developed multiple areas of our healthcare legal practice and business coaching. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.



Learn More About Callagy Law Here:


Avvo


Blog


Facebook


YouTube


Pinterest


Indeed


Yelp


LawNearMe


Wikipedia


Website



Navigating The “Health Care Primary” Option in PIP Claims

Friday, May 20, 2016

What’s In A Word? | The Importance of Marital Settlement Agreements

The following article was written by Callagy Law’s Legal Team, and will focus on many common questions and concerns surrounding new developments, legal matters, and other procedures within the practice area of Family Law. Our mission is to answer any questions and give knowledge to many different aspects of these matters.



The recent unpublished Appellate Division decision Fleming v. Fleming decided May 16, 2016 reminds us of the critical importance in careful and clear drafting of Marital Settlement Agreements.  In Fleming the Appellate Court was tasked with interpreting the parties’ agreement regarding college expenses and the meaning of the term “bonuses “for alimony purposes.  The parties’ agreement provided that “student loan programs” would be sought and applied to college costs before either parent was required to make an out of pocket contribution for the expenses.  Mr. Fleming argued that the phrase “student loan programs” included, or should include, loans from private financial institutions.  The trial court disagreed and held that “student loan programs” was limited to financial aid awarded through the Free Application for Federal Student Aid (FAFSA).  The trial court reasoned that including private loans within the meaning of “student loan programs” would effectively relieve either parent of contributing to a child’s college costs contrary to their stated intent to do so in the agreement.  The Appellate Court agreed.


Further, the parties agreed that Ms. Fleming would receive 30% of any gross “bonuses” received by Mr. Fleming as supplemental alimony.  Mr. Fleming subsequently received a number of payments other than his salary which his former spouse claimed she was entitled to receive 30% of as supplement alimony.  These payments were identified in various and separate categories (visionary award, shining performance, etc.).  The Appellate Court held that the term “bonuses” was not defined in the parties’ agreement and there were questions as to why these payments were made (as bonuses or severance or part of his salary).  The issue was remanded to the trial court for an evidentiary hearing to resolve the ambiguity.


While the meaning of “student loan programs” and “bonuses” may seem self-evident and certainly no fault can be placed on the drafters of the agreement, the Fleming opinion should serve as a reminder to err on the side of more specificity and detail rather than less when drafting settlement agreements.  While every family law attorney, including myself, may think to themselves that statement is a “given,” the simple word “bonuses” has surely cost the Flemings significant professional fees at the trial level, appellate level and now facing an hearing for further fees and distress to define this single word.  The client must have a clear understanding of the meaning of the terms of the Agreement and what is intended to avoid future litigation.  Both the attorney and client have an obligation to make sure there is a complete understanding of exactly what is being agreed to before the agreement is signed.  Terms of an agreement that are susceptible to at least two reasonable alternative interpretations can lead the attorney and client back into court.



Sean Callagy, the owner and President of Callagy Law is an attorney, business coach, public speaker, and entrepreneur; and is dedicated to the personal and business growth. Please reach out to us here with any questions or comments regarding personal or business matters. We will to continue to provide daily updates with helpful information on our website and social media. Please feel free to contact Callagy Law at anytime. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube by clicking here.



Learn More About Callagy Law Here:


Avvo


Blog


Facebook


YouTube


Pinterest


Indeed


Yelp


LawNearMe


Wikipedia


Website



What’s In A Word? | The Importance of Marital Settlement Agreements

Wednesday, May 18, 2016

To Start Up a Start-up | Callagy Law - Business Law Blog

In this blog post, Callagy Law will focus on topics to help people better their businesses. Clients often come to Sean Callagy’s team with questions about their businesses, ranging from contracts, disputes, and other common legal issues in the business world. We hope to answer some common questions with business owners their teams. Our mission is to answer any litigation and business law questions. Our goal is to help you avoid litigation and give you the necessary tools to run a successful business.



Approximately  90% of start-up companies fail.   With such a high failure rate, it is no surprise that the relatively few businesses that succeed tend to thrive—at least for awhile.  So, is there a secret to success?  Success is probably simpler than the statistics might suggest, but, as with anything, an entrepreneur must pay attention to what works and what does not.  There are about twenty-eight million small businesses in the United States.  Most will not succeed much longer, but a small percentage will thrive and continue to thrive.


 


One trait of a successful business—and it might seem obvious–is to create a product that fits the current market.  The most common reason new companies fail is that they make a product no one actually wants.  The owner/businessman might think he or she is offering a desirable product or service, but in reality it is a product or service he thought the public wanted.  In other words, it was a product or service he or she wanted and then they assumed the rest of the buying public thought the same way.


 


It is also important for the owner to work on the business, rather than in the business. Successful entrepreneurs understand that doing everything themselves might be necessary at the very beginning of a start-up, but business growth comes with proper staffing. An entrepreneur/owner acts as the captain of the ship and steers it in the right direction.  If the business owner works too much in the business, he or she will not be working on the business, that is, they will fail to ready the business for future success.


 


With a team of determined personnel, with a leader setting the direction and steering the company toward the goals set, a new business has a much greater of chance success. Versatility among the personnel is also important, because versatility involves mindset. Startup teams that are ready to change products, adjust plans, market differently, study other industries, or even start from scratch, are the ones that will make it.



We hope you found the information provided in this article helpful to your everyday life and business. Please free to reach out to Sean Callagy or the Callagy Law team at any time for questions you may have concerning personal and business matters. Callagy Law’s headquarters is located conveniently in Paramus, NJ. Beyond the scope of information, Sean Callagy has developed multiple areas of business legal practice and business coaching, if you need help with anything, please reach out to us by calling 201-261-1700 or by emailing us here. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube by clicking here.



Learn More About Callagy Law Here:


Avvo


Blog


Facebook


YouTube


Pinterest


Indeed


Yelp


LawNearMe


Wikipedia


Website


 


 



To Start Up a Start-up | Callagy Law - Business Law Blog

Tuesday, May 17, 2016

On Mother’s Day and Motherhood | Callagy Law"s Blog

This past Sunday my wife and I attended Mass in New York City prior to visiting my wife’s elderly mother.  We would be spending the day visiting with my mother-in-law and my wife’s family.  As you would expect, the priest gave special recognition to all of the mothers in attendance, and asked that they stand up and be recognized.  I say “as expected” not only because it was Mother’s Day, but also because Catholicism is particularly reverential toward motherhood, given the church’s veneration of Mary, the Mother of Jesus.  At Mass they also distributed a Happy Mother’s Day card that contained a short piece of verse called “A Mother’s Love.”  The first two lines read


Of all the gifts that God has given both here on earth and up above.


The gift more precious and dear is the gift of a mother’s love.


The sentiment expressed, of course, is a beautiful one and you would think is beyond reproach, but there are those who might scoff at, or worse, be offended by this type of veneration.


Putting aside the religious aspect of motherhood, without a doubt the most cherished possession in Nature is the Mother.  Even before this past Sunday, I was struck watching a National Geographic special about mothers of innumerable species and the importance of them.  All of nature is about survival of the species–the mother always choosing a mate in a way meant to ensure, or at least improve the likelihood, that her cubs will grow strong and survive.  Reptiles, mammals, birds, amphibians—it is all about mothers and them doing what they can to guarantee the survival of their offspring so that the species lives on.  Nature has no greater treasure than Motherhood and what it does for life.  It is Life—its start and its continuation.


So, whether you are religious or not, whether you are a naturalist or not, know this: Motherhood is at the heart of all of it.



Learn More About Callagy Law Here:


Avvo


Blog


Facebook


YouTube


Pinterest


Indeed


Yelp


LawNearMe


Wikipedia


Website



On Mother’s Day and Motherhood | Callagy Law"s Blog

Monday, May 16, 2016

Callagy Law - The Record Reporter - Arizona

Callagy — Record Reporter



Callagy Law - The Record Reporter - Arizona

Callagy Law"s 27.6 Million Dollar Jury Verdict - NOT BAD!



Dear Client and Friend,


I hope this Monday Morning finds you doing well.  This is the first in what will be an ongoing communication from me to our client and other friend base.


One of my goals has been, for a long time, to build a sense of community around Callagy Law. The idea is to find likeminded people of integrity, empathy, caring, urgency, aggression and a desire to grow and live a life of passion and positive energy. We want this in the people with whom we work as both clients and business teammates.


As you may know, we post videos on our callagylaw.com website, our Facebook page, our LinkedIn page and throughout our social media. Please join us there to receive our videos and other content that is designed to foster that sense of community, fun, adventure and growth for you and your career.


Today’s Why Not message was about one of my favorite quotes: “The unexamined life is not worth living.” The challenge is to examine our lives and really determine in which areas we want growth and change.


The key though, is to focus as much on the feelings we want as the “things” we want. Peace, for example, is a critically important feeling for our life. Joy, fulfillment, adventure and many other feelings are also critically important for most of us. If we only focus on “things” or tangible outcomes (e.g., winning a trial), then we can miss many of the critical feelings we NEED in our life.


So, the quick message for today: examine your life and set your goals. I did this on Thursday, and it led to me on Friday ending up a half mile off shore in 50 feet of water free diving by myself in another country. While that’s a story for a different day, it was the result of this process, and a tremendous boost to my energy level and mind set!


By the way, for those that don’t know, we just obtained an over 27 million dollar jury verdict for our client Marc Wichansky. It has been a five year odyssey, which will be the subject of other videos and articles, but I want to thank our entire team for once again putting Callagy Law, and me personally, in America’s top 100 verdicts, as well as putting us in the running for Arizona’s highest verdict of 2016. The American jury system is the great equalizer and human lie detector. I am so appreciative for the work of Michael Smikun, Chris Miller, Robert Solomon, Sam Saltman, Taylor Gallo, Dally Shala and everyone at Callagy Law and outside the firm, who helped make this result a reality.


By the way, I think we are America’s only trial team to have two verdicts in excess of 27 million dollars within the past two years.  Not a bad team to have helping you with your legal challenges….


Also, we have added a Family Law team to our world of Callagy Law. Chris Cavalli and Brian McCann have joined the firm as partners and hold the special designation of Certified Matrimonial Attorneys. If you have any divorce, child custody or other family law issues, please call us, we are here to help.


Please also be on the lookout for live events we will be doing at the firm to help educate, inspire and even network as we continue to grow the Callagy Law community with awesome like-minded people.


I am so thankful to work with you, and I look forward to seeing you soon.


In your service,


Sean Callagy


Please subscribe on YouTube and spread the word.


You can see all of our WHY NOT – HUDDLE videos by clicking here and subscribing! If you have questions about any of the content you see or to have your questions answered on an upcoming show by Sean, please email your questions directly to him by clicking here.


The Daily Why Not Huddle is for you if you want to exponentially increase your money, time, or fulfillment. The Why Not Huddle with business coaching expert, successful entrepreneur, and attorney Sean Callagy provide the essential daily ingredients for you to create and achieve your destiny.



Callagy Law"s 27.6 Million Dollar Jury Verdict - NOT BAD!

Monday, May 9, 2016

What is No-Fault Auto Insurance and How does the Arbitration Process Relate?

The purpose of this post is to help assist those with questions they have concerning their business or medical practice. The Callagy Law team is knowledgeable in many law practice areas and will frequently post topics ranging from Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance. We hope to have this blog shed a light on many common questions.



One of the primary functions of Callagy Law, P.C. is the representation of New Jersey medical providers for collection of unpaid medical bills incurred as the result of motor vehicle accidents, which operates within the construct of what is called “Personal Injury Protection.”


To understand the relationships at play, the first thing to understand is that under New Jersey Law, all operators of Motor Vehicles must carry automobile insurance.  This insurance can be obtained in two forms, “liability only,” or “liability plus collision.”  The difference between the two is that the former is limited to payment of vehicular damage of another party’s vehicle – should it be determined that the accident was your fault.  The latter includes coverage for damage to your own car in addition to damage caused to another person’s.


However, what many people do not realize is that, if you are injured as a result of a motor vehicle accident, the primary payor (i.e. insurance company) will typically default to your automobile insurance, not any personal health insurance that you may have. This is termed as the PIP coverage portion of your automobile insurance.


If a party is injured in an accident, their default payor will be their own car insurance company, not the other party involved in the accident, even if you feel the accident was caused by them.  This is because New Jersey is one (1) of twelve (12) “No-Fault” states.


Specifically, the term “no-fault” auto insurance generally refers to any auto insurance plan that allows policyholders to recover reimbursement from their own insurance company, regardless of fault.  However, the State of New Jersey utilizes the strictest definition of no-fault coverage, which provide for the payment of no-fault first-party benefits and restrict the right to sue any third parties with regard to the accident. As noted above, this “policyholder benefit coverage” is known as personal injury protection (PIP). [See: Insurance Information Institute, “No Fault Auto Insurance”- http://www.iii.org/issue-update/no-fault-auto-insurance]

Currently 12 states and Puerto Rico have no-fault auto insurance laws. Florida, Michigan, New Jersey, New York and Pennsylvania have verbal thresholds of PIP coverage. However, in New Jersey, Pennsylvania and Kentucky only, motorists may reject the lawsuit threshold and retain the right to sue for any auto-related injury. [Id.]

Therefore, in the most typical situation, when a patient is injured, and requires medical treatment, their personal car insurance company is responsible for making the appropriate covered payments.  However, in many cases, the insurance companies’ unjustly deny payment based on purely procedural or theoretical grounds, or based upon differences in medical opinions between the patient’s doctors’ and the insurance companies’ hired “physician experts.”


Therefore, to take the burden of establishing the medical necessity of post-accident treatment, most patients “Assign” their right to payment to the physicians, who must then seek to recover any underpayments on their own accord, as subrogee of the insured patient.  In order to protect their right to payment, the matters of PIP disputes are contractually stipulated to take place within an authorized New Jersey Arbitration Forum, rather than the more costly State Judicial System (ie Court).


At present, a company called “Forthright” administers New Jersey No-Fault Arbitrations, wherein its sole focus is management of No-Fault PIP Arbitrations under the State’s Automobile Insurance Cost Reduction Act. [See http://www.nj-no-fault.com/]


Callagy Law, P.C. represents all facets of medical providers from all stages of the arbitration process.  We pick up your unpaid files, file the Demand for Arbitration, and send one of our highly skilled PIP-Litigation Specialized Attorneys to the scheduled hearing, where the provider’s argument for payment is presented to a Forthright Dispute Resolution Professional, who will subsequently render a decision, awarding the unpaid medical provider the fees to which they feel it is entitled.  To date, almost $135,000,000.00 has been recovered for our PIP clients, a result of our 90% Claim Success Rate in the 44,000 cases that have been handled to date.



Learn More About Callagy Law Here:


Avvo


Blog


Facebook


YouTube


Pinterest


Indeed


Yelp


LawNearMe


Wikipedia


Website



What is No-Fault Auto Insurance and How does the Arbitration Process Relate?

Friday, May 6, 2016

Success Is Easy—All It Takes Is Hard(er) Work | Callagy Law

Cael Sanderson is currently the head wrestling coach at Penn State.  Since he began coaching there, Penn State has won 5 National Team Championships in the past 6 years.  After winning 4 National Championships his first 4 years there as head coach, Penn State lost the year before last, and re-gained the title this past season.


I had heard stories about Cael Sanderson over the years—how he trained incessantly year after year–and was struck by one story my son told me when he was wrestling in high school.  My son’s high school coach, in an attempt to inspire his wrestlers at St. Joseph’s Regional High School in Montvale, New Jersey, showed a video about Cael Sanderson.  Cael Sanderson was undefeated in college, with a record of 159-0 and won 4 National Championships.  In the video the St. Joseph’s coach showed his wrestlers, Cael Sanderson, shortly after winning one of his National Championships, apparently had a bite to eat—well-deserved of course—and then immediately started training for the next season.  I thought to myself, “Relax a little.  Go see a movie.  Play some video games.”  But then I realized, it was no accident or coincidence, nor was it fate or destiny, nor luck, serendipity, or any other name for good fortune that brought him the success he achieved, and continues to achieve.  It is pure, unmitigated hard work and dedication, always beyond even the most dedicated wrestlers around him.  He took nothing for granted.  He believed he had room for improvement, no matter how successful he had been, and simply worked, and worked, and worked some more, and continues to do so, knowing there is always more room for more improvement.


So, what are we to make of this?  Okay, Cael Sanderson was a great wrestler and now a great wrestling coach, and he achieved his success through a great deal of hard work.  We are not all as dedicated as he is or perhaps as crazy to be so obsessed with something as to dedicate our entire being to it the way did and does.  Tell me something that is not obvious!


Well, you might come away from this with the moral that hard work and dedication pay off or are important to success.  You might think it is necessary to always strive to improve.  And both of those are noble lessons to have learned from the example of Cael Sanderson.


I have a slightly different take.  I come away from his example not thinking that success is hard, but that success is easy!  But by easy I am not suggesting you can be lazy and succeed.  Success is easy because, for the most part, all you need to do is work harder than everybody else, and, in most instances, that is not difficult to do.  I understand that Cael Sanderson had more going for him with wrestling than simple hard work.  So many things go into the level of success he enjoyed—the very highest level, a level that Sports Illustrated regarded as the second greatest college athletic achievement in history, behind Jesse Owens who set four world records in one afternoon.  But for the great majority of us, achieving success among our peers requires simply an increment over and above their performance.  It need not be a very great increment either.  It only needs to be enough to enable us to stand out.  We stand out by performing beyond those around us.  Perform over and above and you will succeed over and above.  It really is that simple.


Too often, people follow the pack, falling in line with the expectations of their peers, and succumbing to the pressures not to do too much.  That is fine if you do not want to succeed.  In fact, that is a sure-fire formula for not succeeding.  But if you do want to succeed and, indeed, excel, just raise the bar above the expectations of your peers and colleagues, not even necessarily by much, and success will come swifter than you can imagine, perhaps not in the form of 4 National Championships and an undefeated record, but at least enough to earn a raise or a promotion or your supervisor’s recognition.


Success is easy—all it takes is hard(er) work.  After re-capturing the National Championship for Penn State this past season, Cael Sanderson was quoted as saying, “We’re happy, but we leave here ready to improve, and build . . . .  We’re happy we won, but we are excited about the future also.”  I wonder how many other coaches at his level say that. My guess is that virtually any other coach would savor the moment, enjoy the high note he was on, and pay no mind to the next season for awhile.  Not Cael Sanderson.



The team at Callagy Law hopes the information in this article was helpful in either your personal or professional life. Businesses and people are multi-dimensional and at times may need a guiding light. The legal world pertains to all walks of life and businesses, therefore, we aim to provide information which will help you navigate through your life. Callagy Law, is a multidisciplinary law firm, headquartered in Paramus, NJ owned and operated by Sean Callagy. We are committed to providing legal representation and advice to our clients at our law offices located in New York, New Jersey and Arizona. Please note that the information posted here should not be used as a legal argument of defense. If you find yourself needing legal advice pertaining to your unique situation, you can contact us at by writing us here. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.



Learn More About Callagy Law Here:


Avvo


Blog


Facebook


YouTube


Pinterest


Indeed


Yelp


LawNearMe


Wikipedia


Website



Success Is Easy—All It Takes Is Hard(er) Work | Callagy Law

Thursday, May 5, 2016

Uninsured Employer’s Fund for New Jersey Workers’ Compensation Claims

The purpose of this post is to help assist those with questions they have concerning their business or medical practice. The Callagy Law team is knowledgeable in many law practice areas and will frequently post topics ranging from Medical Revenue Recovery, PIP, Workers Compensation, and Commercial Insurance. We hope to have this blog shed a light on many common questions.



The New Jersey Workers’ Compensation Law established the Uninsured Employer’s Fund (UEF) in order to provide benefits for any employee injured while working for an employer who did not have the required workers’ compensation insurance coverage.  Benefits from the Uninsured Employer’s Fund also paid to an injured employee when an uninsured employer does not pay the benefit payments awarded by the Division of Workers’ Compensation.  The benefits provided by the Uninsured Employer’s Fund include payment of medical expenses and temporary disability benefits.  These benefits are administered by The Office of Special Compensation Funds (OSCF).


When a Petitioner files a Claim Petition, the insurance carrier or the approved self insurance of the employer is indicated on the application.  If none is provided, then a search is performed with the Compensation Rating & Inspection Bureau to identify the whether the employer is uninsured.  In the employer is determined to have no workers’ compensation coverage, then an attorney for the Uninsured Employer’s Fund will be assigned to the claim and will appear at the scheduled court proceedings.



We hope you found the information provided in this article helpful to various questions you may have had concerning the healthcare industry. For information pertaining to our services for medical providers, please click here. Please note, Callagy Law has recovered over $200,000,000 for medical providers, and that number grows daily. Please free to reach out to Sean Callagy of Callagy Law at any time for questions you may have concerning personal and business matters. Callagy Law offices are located conveniently in Paramus, NJ. Beyond the scope of information, Sean Callagy has developed multiple areas of our healthcare legal practice and business coaching. Feel free to connect with us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.



Learn More About Callagy Law Here:


Avvo


Blog


Facebook


YouTube


Pinterest


Indeed


Yelp


LawNearMe


Wikipedia


Website



Uninsured Employer’s Fund for New Jersey Workers’ Compensation Claims

Wednesday, May 4, 2016

Supreme Court upholds Agreement terminating alimony upon showing of cohabitation



The following article was written by Callagy Law’s Legal Team, and will focus on many common questions and concerns surrounding new developments, legal matters, and other procedures within the practice area of Family Law. Our mission is to answer any questions and give knowledge to many different aspects of these matters.



In the recently published opinion Quinn v. Quinn (A-5-14, decided May 3, 2016), the Supreme Court upheld the parties’ divorce settlement agreement which provided for a termination of alimony upon cohabitation.  The majority’s decision is not surprising given the strong public policy favoring agreements and, absent a showing of fraud, coercion or overreaching, agreements will be enforced as written.  The wrinkle in the dispute was that, absent the parties’ agreement calling for an outright termination of alimony upon cohabitation, cohabitation may not have resulted in a termination of the obligation and the court would have had the discretion to modify or suspend the obligation.  In fact, the trial court in Quinn v. Quinn did suspend the alimony obligation for the period of cohabitation, rather than terminating the obligation in total, reinstating the obligation as of the date the cohabitation ended.  The trial court’s decision was affirmed on appeal, but the Supreme Court reversed, finding that the trial court was bound to enforce the parties’ agreement, which was entered freely, voluntarily and with the advice of independent counsel.  By failing to enforce the terms of the agreement, the trial court effectively created a different agreement not contemplated or intended by either party.


Two (2) of the Supreme Court Justices dissented noting the severe financial consequences to Ms. Quinn as a result of the termination of the alimony obligation.  The dissent believed that the provision of the parties’ agreement mandating a termination of alimony upon cohabitation is contrary to public policy and would effectively “pauperize” the ex-wife.  The dissent cites a lack of evidence of any financial or economic benefit received by the ex-wife as a result of the cohabitation.  The dissent viewed the anti-cohabitation provision in the parties’ agreement “as a means to oppress an ex-spouse,” viewing the provision as requiring the ex-wife to choose between her right to alimony and her “desire to enter into a loving relationship.”


The majority opinion, in addressing the dissents concern regarding the economic consequences, acknowledged the “serious” financial consequences to the ex-wife resulting from the termination of alimony.  However, the majority clearly felt that the ex-wife understood without doubt that her conduct could result in a termination of the alimony obligation, yet she proceeded to cohabit anyway.  Interestingly, Ms. Quinn stopped cohabitating just after her ex-husband sought to terminate the alimony obligation.  Yet, the majority found that the cessation of cohabitation was of no moment and irrelevant.  Will this open the door for similar applications to terminate or modify alimony obligations based upon cohabitation that existed months or maybe even years earlier, but subsequently ended?


The Quinn v. Quinn decision exemplifies the clash of equities often experienced in family law disputes.  Certainly Mr. Quinn believes that enforcement of the bargained for agreement was equitable and the majority of the Supreme Court agreed.  If nothing else, the Quinn decision should serve as a reminder that notions of equity and fairness are subject to judicial interpretation.



The Team at Callagy Law hopes the information in this article was helpful in either your personal or professional life.. Callagy Law, is a multidisciplinary law firm, headquartered in Paramus, NJ owned and operated by Sean Callagy. We are committed to providing legal representation and advice to our clients at additional law offices located across the United States. Please note that the information posted here should not be used as a legal argument of defense. If you find yourself needing legal advice pertaining to your unique situation, you can contact us at here. Feel free to search us on Facebook, Twitter or LinkedIn! Additionally you can subscribe to our daily videos on YouTube.



Learn More About Callagy Law Here:


Avvo


Blog


Facebook


YouTube


Pinterest


Indeed


Yelp


LawNearMe


Wikipedia


Website