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James H. Cole

Director, Professional Liability Department

Chair, First Party Property Practice

Co-Chair, Fraud/Special Investigation Practice

Portrait of James H. Cole

James is the Director of the firm’s Professional Liability Department and serves on the firm’s Board of Directors. In his role as Director of the Professional Liability Department, James manages key administrative processes and leads strategic department initiatives for over 140 lawyers among 19 offices. As a member of the firm’s Board of Directors, James oversees the firm’s daily operations spanning four departments and 50 practice areas.

James, in addition to serving as Director, continues to focus his practice on representing insurance companies, whether in pre-litigation consultation or the defense of first-party or bad faith lawsuits. He has had a particular interest in Special Investigative Unit and Property Damage claims, including arson, burglaries, public adjuster represented claims, mold/ pollution and automobile thefts. Within his areas of practice, he is experienced in the bad faith and coverage issues inherent in first party/SIU investigations and litigation. Throughout his career, James has assisted with hundreds of SIU investigations, coverage consultations and litigated hundreds of first party lawsuits; and consulted on hundreds of property coverage issues.

James is frequently asked by clients and industry organizations to lecture on a variety of topics concerning property damage, insurance fraud and bad faith. For the past five years, he has been a featured speaker at the annual Pennsylvania Insurance Fraud conferences, and he has spoken several times at PLRB conferences, among others. James is an active member of the Claims & Litigation Management Alliance (CLM). He formerly served on the Executive Council for the CLM's Claims College, School of Property, where he helped to develop curriculum surrounding good faith claims handling and insurance coverage topics.

James is a 1990 graduate of the Indiana University of Pennsylvania. Immediately following graduation, he worked as a claims representative with a large insurance carrier, where for eight years he was involved in the investigation and resolution of property and casualty claims. In 1995, he entered Temple University School of Law while continuing to work full time. James graduated from Temple University in 1999 with a degree of juris doctor. Thereafter, he joined Marshall Dennehey and is currently chair of the firm's SIU Litigation and First Party Property Practice Groups.   His firsthand property background, insurance industry knowledge and familiarity with property policies allows him to effectively, efficiently and practically counsel clients on Property and SIU issues, and when necessary, provide a vigorous and common-sense defense tailored to the needs of a particular carrier.

    • Temple University Beasley School of Law (J.D., cum laude, 1999)
    • Indiana University of Pennsylvania (B.S., cum laude, 1990)
    • New Jersey, 1999
    • Pennsylvania, 1999
    • AV® Preeminent™ by Martindale-Hubbell®
    • The Best Lawyers in America©, Insurance Law (2024-2026)
    • National Insurance Crime Bureau, Certificate of Appreciation, 2010
    • Claims & Litigation Management Alliance
    • CLM Claims College, School of Property, Instructor
    • International Association of Special Investigation Units (IASIU)
    • Philadelphia Bar Association
    • Condominium Conundrum (Acts, Liability, & HO6 and HOA master policies), Pennsylvania Association of Mutual Insurance Companies (PAMIC), Lancaster, PA, April 7-8, 2026
    • Liar, Liar, Your House is on Fire, Annual PLRB Claims Conference, National Harbor, MD, March 24-25, 2026
    • Unfair Claims Practices: This is Jeopardy!, Annual PLRB Claims Conference, National Harbor, MD, March 23-24, 2026
    • Untying Tangled Titles – How Property Deed Fraud Drives Costs and Indemnity, International Association of Special Investigation Units (IASIU) 2025 Fraud Conference, Denver, CO, August 27, 2025
    • Unfair Claims Practices: This is Jeopardy!, PLRB Claims Conference & Insurance Services Expo, Indianapolis, IN, April 1-2, 2025
    • Untying Tangled Titles – How Property Insurance Drives Fraud, 2024 Pennsylvania Insurance Fraud Prevention Authority (IFPA) Conference, Hershey, PA, April 12, 2024
    • Unfair Claims Practices: This is Jeopardy!, PLRB Claims Conference & Insurance Services Expo, Boston, MA, March 18-19, 2024
    • Untying Tangled Titles – How Property Insurance Drives Fraud, Pennsylvania Insurance Fraud Prevention Authority (IFPA) Conference, Pocono Manor, PA, April 27, 2023
    • Unfair Claims Practices: This is Jeopardy!, PLRB Claims Conference & Insurance Services Expo, Orlando, FL, March 21-22, 2023
    • Managing the Fire Claim from Notice of Loss to the Courtroom – Are you Prepared for Trial?, International Association of Arson Investigators, Virtual, March 9,2023
    • Untying Tangled Titles – How To Recognize How Property Title Issues Drive Fraud, Marshall Dennehey Insurance Fraud 360 Seminar, Lafayette Hill, PA, June, 2022 
    • What You Need to Know After you Go – Parts 1 and 2, CLM Claims College School of Property - Level 2 – Coverage, Virtual, 2021
    • Claims/SIU/Legal – COVID & Post-COVID Impact, 2021 Insurance Fraud Management Conference, July 8, 2021
    • Civil Litigation Updates in COVID-19 Litigation– Where Do We Stand One Year Later? Marshall Dennehey Webinar , May, 2021
    • COVID-19 Business Interruption Claims: Where Are We Now?, ILG Virtual Conference, March 23, 2021
    • New Techniques - Old Fraud - Staying One Step Ahead of Fraudulent Contractors, Speaker, New Jersey Special Investigators Association (NJSIA) Annual Conference, Atlantic City, NJ, October 2019
    • This is Jeopardy! The Pennsylvania Unfair Claims Practices Act, Pennsylvania Association of Mutual Insurance Companies (PAMIC) Annual Claims Summit, Gettysburg, PA, April 10, 2019
    • Mock Examination Under Oath: Theft Loss, PLRB Claims Conference & Insurance Services Expo, Indianapolis, IN March 2019
    • Good Faith Claims Handling, CLM Claims College School of Property – Coverage Level 2, Baltimore, MD, 2018
    • Property Insurance Fraud Update: Real Housewives Edition, Marshall Dennehey Insurance Fraud 360 Seminar, Lafayette Hill, PA, June, 2018
    • Unfair Insurance Practices Act and Strategies for Claims Handling, PLRB Claims Conference & Insurance Services Expo, Orlando, FL, April, 2018, Co-presenter
    • Cooperative Investigations: The Necessities and Pitfalls of Information Sharing,  Pennsylvania's 2018 Insurance Fraud Conference, Hershey, PA, April, 2018
    • Bad Faith in Property Litigation: The Good, The Bad and the Ugly, 2017 NAIIA National Conference, St. Thomas, June 2017 
    • Cooperative Investigations: The Necessities and Pitfalls of Information Sharing, Pennsylvania's 2017 Insurance Fraud Conference, Hershey, PA, April, 2017
    • Dealing with Jokers? How and When to Play the Rescission Card, Pennsylvania's 2017 Insurance Fraud Conference, Hershey, PA, April, 2017
    • It's Jeopardy! An In-depth Look At The Unfair Claims Act, PLRB Claims Conference & Insurance Services Expo, Boston, MA, March 2017, Co-presenter
    • "#Water Is The New Arson", Marshall Dennehey Insurance Fraud 360 Seminar, Lafayette Hill, PA, June, 2016
    • Mock Examination Under Oath: Theft Loss, PLRB Claims Conference & Insurance Services Expo, San Antonio, TX, April 2016
    • Managing the Irrational Claimant - a Psychological & Legal Perspective, Pennsylvania's 2016 Insurance Fraud Conference, Hershey, PA, April, 2016
    • It's Jeopardy! An In-depth Look At The Unfair Claims Act, Client Presentation, Omaha, NE, March , 2016
    • Cooperation with Law Enforcement, ICAC Webinar, November 2015
    • Appraisal and Recent Trends in Bad Faith Law, Marshall Dennehey Client Seminar, April, 2015
    • Property Overview: 3Ms - Marring, Matching, Misrepresentation, New Jersey Special Investigators Association (NJSIA) Annual Conference, Atlantic City, NJ, October 2014
    • Property Overview: 3Ms - Marring, Matching, Misrepresentation, Marshall Dennehey Insurance Fraud 360 Seminar, Lafayette Hill, PA, June, 2014
    • Coverage "C": Tools to Ensure Payment of Legitimate Content Claims, Marshall Dennehey Client Seminar, May, 2014
    • Cooperative Investigations-The Necessity and Pitfalls of Information Sharing, 2014 Pennsylvania Fraud Insurance Fraud Conference, Hershey, PA, April, 2014
    • Streamlining the Process and Controlling the Cost of Large-Scale Ring Cases, IFM – 2014 Insurance Fraud Management Conference, Amelia Island, FL, March 2014
    • Auto Repair Fraud, Moderator, New Jersey Special Investigators Association (NJSIA) Annual Conference, Atlantic City, NJ, October 2013
    • Towing and Auto Body Fraud, IASIU's 28th Annual Seminar and Expo on Insurance Fraud, Atlanta, GA, September 2013
    • Investigating Suspicious Wind and Hail Claims, Pennsylvania Association of Mutual Insurance Companies (PAMIC) Annual Claims Summit, Gettysburg, PA, April 3, 2013
    • Body Shop and Towing Fraud, Pennsylvania Insurance Fraud Prevention Authority Annual Conference, Hershey, PA, April 1-2, 2013
    • Effectively Managing Complex and Emerging Issues, 2012 NJSIA 22nd Annual Fraud Seminar, Atlantic City, NJ
    • The Importance of a Complete and Thorough Investigation, 2012 Marshall Dennehey Insurance Fraud Perspectives Seminar, Cleveland, OH
    • Recent Trends in Auto Body & Towing Fraud - Enhanced Damage and Reconstructed Titles, 2012 Marshall Dennehey Insurance Fraud Perspectives Seminar, Lafayette Hill, PA
    • Managing Public Adjuster Issues, 2012 IFMC - Insurance Fraud Management Conference, Phoenix, AZ
    • Proper Interaction and the Role of the Public Adjuster During an Arson Investigation, 2012 ICAC - National Arson Training Seminar, Las Vegas, NV
    • Insurance Fraud, 2011 ACFE Conference, San Diego, CA
    • Litigation Strategies for Combating Fraudulent Hail Claims, 2011 Pennsylvania Fraud Conference, Hershey, PA
    • Managing the Public Adjuster Process, 2011 IFM Conference, Amelia Island, FL
    • Homeowner Fraud, 2010 NJSIA Conference, Atlantic City, NJ
    • Civil Litigation Strategies for Combating Fraudulent Hail Claims, 2010 NICB Hail Fraud Awareness Conference, West Deptford, NJ
    • The Importance of a Complete Investigation, 2010 Combating Insurance Fraud Conference, Conshohocken, PA
    • Public Adjusters an SIU Perspective, 2010 IASIU Conference, Orlando, FL
    • Public Adjusters An SIU Perspective, 2010 Pennsylvania Fraud Conference, Gettysburg, PA
    • SIU and the Public Adjuster Represented, 2009 IASIU Conference, Palm Desert, CA
    • Cooperative Arson Investigations, 2009 PLRB Conference, Seattle, WA
    • Property Claims Overview, 2008 PAMIC Conference, Harrisburg, PA
    • Investigating Fraudulent Claims and Reporting Requirements, 2006 IASIU Conference, La Quinta, CA
    • Application Fraud; PIP Fraud; Automobile Theft Fraud; Medical Fraud; Special Disaster Fraud; Arson Investigations and Bad Faith, local and national presentations to clients
    • “A Royal Assignment [of Benefits]: Ramifications for Insurers in the First Party Property Context,” Defense Digest, Vol. 28, No. 12, December 2022
    • "Much Ado About Marring," co-written with Hillary Dean, Litigation Management, Winter 2014
    • "Game, Set, Match: the Pennsylvania Superior Court Clarifies Whether an Insurance Company Owes to Match," Defense Digest, Vol. 14, No. 1, March 2008
    • "When an Insured Fires a Public Adjuster: The Sequel," Defense Digest, Vol. 12, No. 4, December 2006
    • 'Direct Physical Loss Does Not Equal Direct Physical Damage: The Third Circuit Expands the Scope of Property Insurance Coverage," Defense Digest, Vol. 11, No. 4, December 2005
    • "When The Insured Fires A Public Adjuster," Defense Digest, Vol. 11, No. 1, March 2005
    • "Pennsylvania Superior Court Clarifies Application of Depreciation in Homeowners Policies," Defense Digest, Vol. 10, No. 1, June 2004
    • Obtained a Breach of Contract/Bad Faith/ Unfair Trade Practices defense verdict after a four week jury trial.  The Plaintiffs refused to move off of a $9 million demand prior to and during trial.  The plaintiff family claimed that their house was contaminated by a common disinfectant solution that was applied during a water mitigation by a contractor referred by their homeowners' insurance company.  The family not only claimed the house had to be razed and all the personal property disposed of; they also claimed a myriad of personal injuries. Ultimately, the jury returned a unanimous defense verdict on the breach of contract claim and the judge entered a verdict in favor of the defense on the bad faith and UTPCPL claims.
    • Obtained a Defense jury verdict in a Breach of Contract claim involving matching continuous tile and paint.
    • Obtained a $4.1 million judgment against a contractor who was suspected and later proven to be fraudulently fabricating hail damage to thousands of area homes and convincing the unwitting homeowner to file claims with their insurance carrier.
    • Certified Claims Professional in Property Claims, CLM
    • Associate in Claims (AIC), The Insurance Institute of America
    • Litigation Management Institute, Graduate 2014 (CLMP) 

Thought Leadership

Defense Digest

On the Pulse…Insurance Fraud & Special Investigations Practice Group

March 1, 2025

Insurance fraud is, understandably, intolerable, and its impact on insurers and insureds alike can be devastating. We work very closely with our clients in furtherance of that philosophy through relentless investigation, aggressive defense, and prosecution in response to false and inflated insurance claims.  The attorneys in this practice group supplement their litigation experience with up-to-date knowledge of the current trends in insurance fraud detection and prosecution areas by regularly attending and participating in seminars given by such educational agencies as the National Insurance Crime Bureau (NICB), International Association of Special Investigation Units (IASIU), and The Coalition Against Insurance Fraud. In addition, they also attend and present at numerous local and national conferences and association meetings throughout Pennsylvania, New Jersey, Delaware, Ohio, Florida, and New York. As part of our fraud practice, we regularly handle PIP matters for our clients. Our team of attorneys are familiar with all local PIP regulations and have significant experience handling all facets of PIP litigation, including IME cut-offs, opinions on absences of injury, and EUO investigations of prior medical history. Other PIP practice areas include UCR litigation, medical necessity defense, and provider and claimant regulatory compliance. We routinely partner with our clients to help create PIP protocol and manage the defense of PIP litigation. Our attorneys are knowledgeable and focused on an array of contemporary medical procedures and codes that often flood the PIP industry.  The increase in auto glass claims have changed the industry’s perception. Our attorneys are focused on glass litigation in both the defensive and affirmative ligation recovery model against fraudulent actors. Our team has national experience in defending and civilly prosecuting these claims. Aggressive Fraud Defense As a part of an overall aggressive fraud defense, the Insurance Fraud & Special Investigations Practice Group members believe that the “best defense is a good offense.” Our trial attorneys are experienced in the investigation, defense, and affirmative prosecution of fraudulent claims. The scope of their practice is not only focused on the individual claimant, but also on organized groups or “rings.” We routinely file suits and collect judgments against perpetrators of insurance fraud, including both insureds and medical providers. Our team works with local and federal agencies to make sure our clients’ interests are protected and made whole.  We have considerable experience with cases involving:   •    Medical Provider Fraud •    New York Labor Law •    Staged Accidents – Trucking & Transportation; Auto; Slip and Fall •    RICO •    Arson •    Vehicle “Give Ups” & Fraudulent Theft Claims •    Application/Rate Evasion Fraud We maintain a centralized Fraud Library that catalogs fraud schemes, investigations, and known perpetrators. By sharing this information with our team and fostering ongoing dialogue among our attorneys, we ensure that emerging legal developments and industry trends are swiftly integrated into our defense strategies. In turn, we keep our clients informed with timely updates on fraud-related developments, empowering them to enhance their own investigative efforts. Our collaborative approach is highly valued by our clients as it allows us to align strategies, coordinate efforts, and effectively combat fraud together. Stay tuned for new insights from our fraud practice on staged accidents in commercial auto and trucking and transportation. As fraud schemes grow more sophisticated, criminals are increasingly targeting commercial vehicles with carefully orchestrated collisions designed to exploit insurers and businesses. Our team is at the forefront of uncovering these fraudulent claims, leveraging cutting-edge investigative techniques and legal strategies to protect our clients. Our attorneys will be featured in a podcast discussing staged accidents this May —more details to come! *Jeff Rapattoni and Jim Cole are co-chairs of our Fraud/Special Investigation Practice Group. Jeff works in our Mount Laurel, New Jersey, office, and Jim works in our Philadelphia, Pennsylvania, office.    Defense Digest, Vol. 31, No. 1, March 2025, is prepared by Marshall Dennehey to provide information on recent legal developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. ATTORNEY ADVERTISING pursuant to New York RPC 7.1. © 2025 Marshall Dennehey. All Rights Reserved. This article may not be reprinted without the express written permission of our firm. For reprints, contact tamontemuro@mdwcg.com.

Defense Digest

A Royal Assignment [of Benefits]: Ramifications for Insurers in the First-Party Property Context

December 1, 2022

Key Points: This summer, a federal court in Pennsylvania, on two separate occasions, permitted an insured to assign a bad faith claim to a vendor seeking payment for services on their property. Until now, Pennsylvania courts had not previously permitted the assignment of extra-contractual tort claims, such as bad faith, in the first-party property context. These recent decisions may have costly ramifications for insurers and have the potential to profoundly change the first-party property landscape in Pennsylvania. With recent decisions in the U.S. District Court for the Eastern District of Pennsylvania, insurers must be braced for bad faith claims brought by their insured’s vendors. For the past 25 years, with the enactment of 42 Pa. C.S. § 8371, Pennsylvania’s bad faith statute has allowed insureds to bring lawsuits against their insurance companies for improper first-party claims handling, with the primary purpose being to hold insurers accountable for good faith and fair dealing towards their insureds. See, generally, 42 Pa. C.S. § 8371; see also Charter Oak Insurance Co. v. Maglio Fresh Food, 45 F.Supp.3d 461 (E.D. Pa. 2014). Prior to the enactment of 42 Pa. C.S. § 8371, bad faith actions existed only under common law, and only in the third-party context, wherein an insured could sue their liability carrier for a bad faith refusal to settle a lawsuit against the insured within the policy limits, exposing him to an excess verdict. In the third-party/excess verdict context, courts have held assignments of bad faith claims, post-judgment, to be valid. See, e.g., Gray v. Nationwide Mutual Insurance Co., 223 A.2d 8 (Pa. 1966); Allstate Property & Casualty Insurance Co. v. Wolfe, 105 A.3d 1181, 1188 (Pa. 2014) (carving out scenarios in which bad faith claims may be assigned by insureds). A concept rooted in contract law, an assignment is the signing over of a claim by one party to the contract to a non-party. This has been found acceptable in the first-party insurance context when an insured assigns benefits for services rendered, such as to a physician in a PIP claim or to a mitigation vendor in a property claim, but courts stopped short of extending this concept to the assignment of extra-contractual tort claims such as bad faith. Some states, such as Florida, have allowed vendors to secure post-loss assignments, not only for services rendered, but for extra-contractual damages such as attorney’s fees and bad faith in the first-party context, leading to what may be described as an insurance crisis. It has been widely reasoned that lawsuits involving the assignment of benefits have increased between 2004–2018. See Bethan Moorcraft, AOB Abuse in Florida Rises 70% in 15 Years, Insurance Business Mag., Mar. 28, 2019, https://www.insurancebusinessmag.com/us/news/breaking-news/aob-abuse-in-florida-rises-70-in-15-years-163448.asp. Mostly due to the assignment of benefits, Florida is responsible for 76% of lawsuits filed against insurance companies in the United States, although the state itself only accounts for 8% of the population. David Altmaier, Florida OIR Report, Insurance Journal, Apr. 2, 2021, https://www.insurancejournal.com/app/ uploads/2021/04/Florida-OIR-Report.pdf. In Pennsylvania, however, courts had not allowed the assignment of a bad faith claim outside the narrow third-party/excess verdict context. For example, in a case in which a disbarred attorney sought assignment of his client’s underinsured motorist-turned-bad faith claim, the Third Circuit specifically held that under 42 Pa. C.S. § 8371, bad faith claims can only be assigned to an injured plaintiff and judgment creditor. See Feingold v. Palmer & Barr, 831 F. App'x 608, 609 (3d Cir. 2020) (holding that bad faith claims may be assigned by statutory permission, but are not “freely assignable”). Feingold reaffirmed Wolfe’s interpretation that, in the first-party property context, an insured may assign his bad faith claim only to a judgment creditor who has been injured. On June 29, 2022, the U.S. District Court for the Eastern District of Pennsylvania issued an opinion which royally changes the Commonwealth’s interpretation of first-party property bad faith claims. In Royal Water Damage Restoration, Inc. a/a/o 1133 Columbia LLC v. State Farm Fire & Casualty Co., WL 2345740 (E.D. Pa. June 29, 2022), the court decided that an insured’s water mitigation vendor has standing to bring a bad faith claim against the insurer—not on behalf of the insured, but directly as an injured party. Simply stated, the court has ruled, contrary to the precedent set in Wolfe and reconfirmed in Feingold, that an insured’s vendor—who is not a party to the insurance contract between the carrier and its insured—may pursue an extra-contractual claim under the Pennsylvania bad faith statute against the carrier. On July 28, 2022, in another case involving Royal Water Damage Restoration, the Eastern District of Pennsylvania again permitted a third party’s standing to pursue a bad faith claim against an insurer. See Royal Water Damage Restoration, Inc. a/a/o Janet Thorn v. Allstate Vehicle and Property Insurance Co., WL 2985637 (E.D. Pa. July 28, 2022). More pointedly, in this case, the court based its finding on the mere potential that a vendor “could potentially be” a judgment creditor, even if the property owner/named insured is the only party actually injured. It can be argued, however, that the Federal Rules of Civil Procedure, which govern who is permitted to bring a lawsuit, have not and were not meant to be bent for the sake of convenience. A plethora of case law since the enactment of the Federal Rules has held that a plaintiff must establish standing in order to bring any claim in suit, bad faith or otherwise. Allowing a party who has not sustained any actual injury to bring a claim for bad faith may circumvent the purpose of the federal rule on standing. More concernedly, allowing insureds to assign their bad faith claims to vendors seeking payment for services on their property could open a floodgate of litigation directly against carriers who issue insurance policies with the specific understanding that the named insureds are the only parties to whom they owe any duties or obligations. A vendor that performs repair work on the insured property is neither an injured party nor a judgment creditor, particularly if no judgment has been rendered by a court. Widening the class of first-party bad faith plaintiffs to include vendors of insureds has the potential to significantly increase premiums. Allowing any repair contractor—who is not a party to the contract and who was not considered in the underwriting process—to pursue a bad faith claim has the potential to profoundly change the first party property landscape in Pennsylvania. With the recent Royal Water decisions contorting Pennsylvania’s understanding of the bad faith statute, insurers should wait with bated breath for a case to reach the Third Circuit or Pennsylvania appellate courts to decide whether Pennsylvania will follow Florida down the assignment-of-benefits rabbit hole.

Events

Firm Highlights

Thought Leadership

NJ Workers' Compensation Legislation Update

A couple more bills were introduced for the 2026-27 session. Any updates since February have been highlighted in bold. A1023 | S3984 Medical use of cannabis under certain circumstances This requires workers’ compensation, PIP, and health insurance coverage for the medical use of cannabis under certain circumstances. It was introduced on January 13, 2026 and referred to the Assembly Financial Institutions and Insurance Committee. It was also introduced on March 19, 2026 and referred to the Senate Commerce Committee. A1045 Certain injuries to volunteer and professional public safety and law enforcement personnel This revises workers’ compensation coverage for certain injuries to volunteer and professional public safety and law enforcement personnel. It was introduced on January 13, 2026 and referred to the Assembly Labor Committee. A3724 Personal liability to employer officers for failure to pay for coverage This provides personal liability for owner, executive officer, or executive director of employer for failure to pay for workers' compensation coverage. It was introduced on January 13, 2026 and referred to the Assembly Labor Committee. On May 7, 2026, it was reported and referred to Assembly Judiciary Committee. A4617 Certain workers' compensation supplemental benefits and funding method This concerns certain workers' compensation supplemental benefits and funding method. For a permanently and totally disabled worker or surviving dependents after December 31, 1979, with some exceptions, this bill provides for an annual cost of living adjustment in the weekly workers’ compensation benefit rate. It was introduced on March 10, 2026, and referred to the Assembly Labor Committee. S241 Inclusion in database of appointed officials This requires that workers’ compensation judges and administrative law judges be included in database of appointed officials. It was introduced on January 13, 2026 to the Senate, Referred to Senate State Government, Wagering, Tourism & Historic Preservation Committee. A1870 | S1379 Workers' compensation benefits for certain workers due to September 11, 2001, terrorist attacks This provides workers’ compensation benefits for certain public safety workers who developed illness or injury as result of responding to September 11, 2001 terrorist attacks. It was introduced on January 13, 2026 and referred to the Assembly Labor Committee. It was also introduced on the same day and referred to the Senate Labor Committee. On February 5, 2026, it was reported from the Senate Committee, 2nd Reading, and referred to the Senate Budget and Appropriations Committee. A2779 | S1521 Excludes Certain Illegal Aliens This excludes certain illegal aliens from workers’ compensation and temporary disability benefits. It was introduced on January 13, 2026 and referred to the Senate Labor Committee. It was also introduced on the same day and referred to the Assembly Labor Committee. A2792 | S1555 Prevent Intoxicated Employees from Workers’ Compensation This prevents intoxicated employees from receiving workers’ compensation. It was introduced on January 13, 2026 and referred to the Senate Labor Committee. It was also introduced on the same day and referred to the Assembly Labor Committee. S2290 Increase Mandatory Retirement Age This increases statutory mandatory retirement age for Supreme Court Justices, Superior Court Judges, Tax Court Judges, Administrative Law Judges, and Workers’ Compensation Judges from 70 to 72. It was introduced on January 13, 2026, and referred to the Senate Judiciary Committee. A3167 | S2372 Workers’ compensation insurance requirements for certain corporations and partnerships. This concerns workers’ compensation insurance requirements for certain corporations and partnerships. It was introduced on January 13, 2026 and referred to the Senate Labor Committee. It was also introduced on the same day and referred to the Assembly Labor Committee. A1384 | S2757 Reduce Statute of Limitations in Medical Fee Disputes This reduces statute of limitations from six years to two years in medical fee disputes in workers’ compensation matters. It was introduced on January 13, 2026 and referred to the Senate Labor Committee. It was also introduced on the same day and referred to the Assembly Labor Committee. S3144 Testimony in Workers’ Compensation This concerns submission of testimony in workers’ compensation claims. It was introduced on January 13, 2026, and referred to the Senate Labor Committee. S3342 Increase Mandatory Retirement Age This increases statutory mandatory retirement age for Supreme Court Justices, Superior Court Judges, Tax Court Judges, Administrative Law Judges, and Workers’ Compensation Judges from 70 to 75. It was introduced on February 5, 2026, and referred to the Senate Judiciary Committee. A3548 | S3571 Maximum benefits for certain volunteers This provides certain volunteer and other workers with maximum compensation benefit for workers' compensation claim regardless of outside employment.. It was introduced on January 13, 2026 and referred to the Senate Labor Committee. On March 2, 2026, it was reported from the Senate Committee, 2nd Reading, and referred to the Senate Budget and Appropriations Committee. It was also introduced on the same day and referred to the Assembly Labor Committee. On May 7, 2026, it was reported and referred to Assembly State and Local Government Committee.

Thought Leadership

What’s Hot in Workers’ Comp - News and Results*

RESULTS* Ben Durstein (Wilmington) obtained a favorable decision involving a claimant who fractured his patella in a work accident requiring two surgeries. The IAB rejected the claimant’s medical expert’s opinion that he sustained a 25% permanent impairment to the right lower extremity. Instead, the board accepted the opinion of the employer’s medical expert that the appropriate permanency was 13% utilizing the 6th Edition of the AMA Guides to the Evaluation of Permanent Impairment. Tony Natale III (King of Prussia) successfully had a claim petition alleging new injuries and periods of disability dismissed based on full recovery. The claimant was injured when his skid loader was struck by another loader in the process of baling hay. Original injuries were accepted and the claimant returned to work. Thereafter, the claimant abandoned work and filed a claim petition to assert new injuries and extended disability. Cross examination of the claimant’s medical expert stunningly revealed his failure to review claimant testimony, his lack of awareness of a social security disability decision detailing the existence of claimant’s alleged work-related conditions prior to the date of work injury, and his failure to understand that the claimant admitted to full recovery of injuries for which he was continuing to treat. Tony Natale III (King of Prussia) successfully obtained a defense verdict in a Medicare conditional payment lien third level appeal. The United States government alleged a Medicare conditional lien payment was due and owing in the upper six-figure range based on an auto accident and PIP policy for which the government conditionally became the primary carrier. The government argued that our client, the PIP carrier, was the primary payer and, under federal law, must reimburse the government for its conditional lien payment. At the third-level appeal hearing, the government’s position was refuted by the revelation that the date of injury tied to the medical bills associated with the lien was glaringly and chronologically prior to the insurer’s PIP policy date. The court held that based on this evidence and argument, the government could not meet its requirements to assert a lien against our client. A. Judd Woytek (King of Prussia) and John Abda (Scranton) successfully had a workers’ compensation claim petition granted for medical benefits only for a closed period with no wage loss awarded. The claimant alleged multiple injuries as the result of a very minor motor vehicle incident where a co-worker’s delivery van rolled down an incline of approximately six feet, and bumped into the rear of the claimant’s delivery van. He claimed he was thrown forward and suffered head and neck injuries, along with aggravating a pre-existing ankle injury. The claimant was also terminated following the accident for having a large hunting knife in his van, which was against the employer’s workplace violence policy. The judge granted the claim for a mild concussion and an ankle contusion, but terminated medical benefits as of the date of our IME’s. The judge found that no wage loss benefits were payable as the claimant was terminated for cause and work remained available to him. The judge found our medical experts to be more credible than the claimant’s, along with finding our four employer witnesses to all be credible. The trial team was assisted by paralegal Bonnie Zemek (King of Prussia). Eric Scott Thompson (Wilmington) was successful in a workers’ compensation matter in Delaware. On October 15, 2024, the claimant was injured while performing fire training in a multistory building when he tripped over a fire line, injuring his right knee. The claimant received regular and consistent treatment for the right knee through August 29, 2025, when he presented with left knee complaints for the first time. His treating orthopedist diagnosed a hamstring strain. The claimant was next seen October 15, 2025, with continued left knee complaints, and was referred to a total knee doctor within the practice. He was then diagnosed with a posterior root tear of the medial meniscus. Our expert testified that it was not plausible for a lateral hamstring strain to progress to a meniscal tear in two months. The claimant required a total knee replacement that was ultimately performed in February 2026. In the six months between the time of initial presentation with left knee complaints and the total knee replacement, conservative care consisted of a single injection. Our expert testified that posterior root media meniscal tears can respond to conservative care, and it was not known if it would with the claimant because it was not adequately explored. The Industrial Accident Board agreed with our expert and determined that the claimant failed to meet the burden of establishing more likely than not that the left knee complaints were caused by overloading/overuse as a result of the compensable injury to the right knee. They also agreed that the claimant was able to return to work in a sedentary capacity as opined by his physicians and our expert prior to the left total knee replacement and that there were employment opportunities available within his restrictions and capabilities as presented by the vocational expert. As a result, the claimant was no longer entitled to total disability benefits and will receive partial disability benefits for which he is limited to 300 weeks. Michele Punturi (Philadelphia) and Alana Staniszewski (Pittsburgh) had a termination petition granted in a Pennsylvania workers’ compensation case. The petition involved an echocardiography technologist with long-term employment at a local hospital who sustained a right shoulder injury resulting in surgery in January 2024. Following surgery, the claimant was diagnosed with a frozen shoulder and underwent additional surgery in June 2024, with a recommendation for a third surgery. The opinions of the defense medical expert, a Board-certified orthopedic surgeon, were found credible, persuasive, and competent based upon the extensive history he obtained from the claimant, analysis of the mechanism of injury, and review of records, along with comparison of MRIs from October 2023, February 11, 2024, and January 6, 2025, which failed to reveal any causal relationship other than a strain/sprain of the right shoulder. This evidence supported that the claimant had fully recovered, and was not in need of any ongoing medical treatment and/or restrictions. In particular, despite allegations of injuries beyond a sprain/strain, the defense medical expert identified that those allegations were not consistent with what was found at the time of surgery, and elements of the surgery were to treat a chronic and degenerative condition. Additionally there were no ongoing issues or problems with the subscapularis, which was intact, consistent with the follow-up MRI of February 11, 2024, and the claimant did not have evidence of a frozen shoulder. In fact, the MRIs and mechanism of injury, he opined, did not support any injury causing tendonitis or inflammatory conditions within the bicep tendon. Furthermore, multiple days of surveillance footage demonstrated the claimant’s normal use, with the ability to sweep and shovel snow, operate her vehicle, raise her arms above shoulder level, and use a broom – all without any observable difficulty, which challenged the claimant’s credibility of a disability and further established a lack of causation. As a result of this favorable decision, supersedeas fund reimbursement will be obtained for both wage loss and medical benefits through the supersedeas fund recovery process. *Prior Results Do Not Guarantee a Similar Outcome NEWS Heather Carbone (Jacksonville) was a panelist for a webinar hosted by The Workers’ Compensation Claims Professionals (WCCP) Association. As part of the “Meet the Experts” Series, the speakers addressed “Afterthoughts that Undermine a Successful Mediation,” highlighting the pitfalls and challenges of underprepared or unprepared mediation participants. The discussion included appropriate pre-mediation communications, setting of expectations, management of expectations, and working through the unexpected or unprepared. Attendees gained ideas about how and when to prepare, best practices, and the potential for non-parties (spouse, significant other, risk owners-insurers) to have differing perspectives or concerns than the actual employee and employer. On May 21-22, 2026, A. Judd Woytek, (King of Prussia) joined a panel at the CLM Alliance (Claims and Litigation Management Alliance) Work Comp Conference in Nashville to present "We See You: How Employee Engagement Enhances Work Comp Outcomes." Judd and his fellow panelists discussed the positive impact of employee engagement on claim outcomes, return-to-work timelines, and overall claim costs.

Result

No-Cause Jury Verdict Secured in Wrongful Death Trial

We successfully obtained a no-cause jury verdict in a 13-day wrongful death trial. The decedent, a 59-year-old man, was admitted to the emergency room on February 15, 2019, with complaints of abdominal pain, decreased appetite, and constipation, despite the use of laxatives. The patient did not complain of any nausea, vomiting, or diarrhea. He had a significant medical history including diabetes, hypertension, prior coronary artery stenting, morbid obesity (with past gastric bypass surgery), longstanding ventral hernia, and back pain. A CT scan revealed multiple hernias and a potential closed-loop bowel obstruction, leading to a surgery consultation. Our client, an emergency general surgeon, interpreted that the patient did not have a closed loop or any significant obstruction and recommended non-surgical management. The patient was approved to have clear liquids, and had a vomiting incident shortly after, but our client was not notified. The patient was returned to NPO status, and after improving overnight, he was returned to “clears” and additional medical and renal consults were ordered. Our client did not receive any communications from the residents/nurses of any changes in the patient’s condition. On February 18, 2019, two rapid responses were called due to increased heart rate and vomiting. It is believed that the vomiting resulted in aspiration, causing sepsis, ultimately leading to the patient’s death. During the trial, the plaintiff’s sole medical expert highlighted imaging on the wrong hernia, which called into question all of his opinions in the case. We made key objections related to the expert testimony, limiting what the allegations were, and preventing new allegations from being made. After approximately two and a half hours of deliberating, the jury returned a no-cause verdict.