Five Boro Medical Equipment, Inc., v. Praetorian Ins. Co., Slip Copy, 2016 WL 6106195 (Table), 2016 N.Y. Slip Op. 51481(U) Insurer sough to dismiss the claim based upon 2 IME no shows. The Court found insurer’s proof to be defective, saying: The conclusory affidavits of defendant’s IME
Bronx Acupuncture Therapy, P.C., v. Hereford Ins. Co., Slip Copy, 2016 WL 6106132 (Table), 2016 N.Y. Slip Op. 51479(U) Defendant moved to dismiss the claim based upon the assignor’s failure to appear at the IME’s. The Court ruled that Defendant’s IME notices were not timely,
Bob Acupuncture, P.C., v. New York Central Mutual Fire Insurance Company, 2016 N.Y. Slip Op. 51434(U) plaintiff established the submission of the claim forms to defendant by virtue of the defendant, insurer’s denial. The Court said as follows: As plaintiff argues, the submission of the cl
Here is one with potential wide ranging implications. In Compas Medical, P.C., v. Travelers Insurance Company, 2016 N.Y. Slip Op. 51441(U), Plaintiff complied partially with the insurer’s verification request. The Court said as follows: Contrary to plaintiff’s contention, defen
Island Life Chiropractic, P.C., v. Travelers Insurance Company, 2016 N.Y. Slip Op. 51413(U) An affidavit by Plaintiff saying it had submitted the requested verification was sufficient to raise a triable issue of fact that it had complied with the requested verification and thereby was enough to d
Liberty Chiropractic, P.C., v. 21st Century Insurance Company, 2016 N.Y. Slip Op. 51409(U) Is this the standard of proof for a carrier when invoking the 8 unit defense? The Court said: Plaintiff properly argues on appeal that defendant failed to establish its defense, that the fees charged exce
High Quality Medical Supplies, Inc., v. Mercury Ins. Group, 2016 N.Y. Slip Op. 51444(U) It appears that the Plaintiff medical supply company billed for something not specifically set forth in the fee schedule the Court said as follows in a short decision: In this action by a provider to recover ass
KEW GARDENS MED AND REHAB, P.C., v. COUNTRY–WIDE INSURANCE COMPANY, 52 Misc. 3d 143 Plaintiff commenced a PIP action in April 2002. In 2014, the Civil Court granted plaintiff’s motion for summary judgment and directed that the judgment for $5,255.74 in principal and $15,457.93 in statutory i
Looks like DFS is attempting to limit reimbursement for services being performed outside of NY. Here is the proposed rule change: http://www.dfs.ny.gov/insurance/r_prop/rp83text.pdf
In Liberty Mutual Ins. Co v. Branch Med., P.C., 2016 NY Slip Op 31706(U), http://www.leagle.com/decision/In%20NYCO%2020160916409/LIBERTY%20MUT.%20INS.%20CO.%20v.%20BRANCH%20MED.,%20P.C. Defendants are licensed physicians sued by the insurer based on Mallela allegations stemming from their alleged