Why insurance carriers’ DPRPs should be specific as to what claims/actions are and are not arbitrable to protect themselves against motions to dismiss.

GEICO filed a complaint against a series of medical providers asserting claims under the New Jersey Insurance Fraud Prevention Act (IFPA), violations of RICO, common law fraud and unjust enrichment. Some of the medical providers filed a motion to compel arbitration on all claims because the claims are subject to arbitration under both New Jersey No-Fault Law and GEICO’s Decision Point Review Plan (DPRP). The court found that because GEICO’s DPRP provided that any claims “arising out of” and “in connection with any claim for PIP benefits” were required to be heard via arbitration and because GEICO’s RICO, common law fraud and unjust enrichment claims arose out of the payment of PIP benefits, these claims were dismissed as arbitrable under GEICO’s DPRP’s arbitration clause. The court further found that, pursuant to current case law, IFPA claims are not arbitrable. While there have been recent cases that provided differing opinions on whether violations of RICO, common law fraud and unjust enrichment are arbitrable or not, insurance carriers’ DPRPs should be specific as to what claims/actions are and are not arbitrable to protect themselves against motions to dismiss.

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