Gotkin v. Allstate Insurance Co., 2014-01403 This is an interesting scenario but more from the perspective of the individual who feels wronged that an insurer cancels or changes coverage and increases the premium without notice. Insurance Law §3425 imposes restrictions on a liability insurer̵
Throgs Neck Multicare, P.C. v. Mercury Cas. Co., 2016 wl 3748667, 2016 Slip Op. 51081 The insurer in it summary judgment motion attached as proof a record downloaded from the New York State Dept of State with respect to the medical providers corporate status and name of the owner. The Court ruled
Aetna Health Plans v. Hanover Insurance Company, 2016 NY SLIP OP 04658 https://www.nycourts.gov/ctapps/Decisions/2016/Jun16/97opn16-Decision.pdf The issue presented in this appeal is whether a health insurer who pays for medical treatment that should have been covered by the insured’s no-fau
Avalon Radiology, PC. v Ameriprise Ins. Co., 2016 NY Slip Op 26182 http://www.nycourts.gov/reporter/3dseries/2016/2016_26182.htm Defendant issued denial based upon the failure of plaintiff’s assignor, Avalon Radiology P.C., to appear for two Examinations Under Oath (EUOs). Defendant’
MB Advanced Equip., Inc. v New York Cent. Mut. Fire Ins. Co., 2016 NY Slip Op 50863(U) http://www.nycourts.gov/reporter/3dseries/2016/2016_50863.htm The IME doctors swore they were in a different location, other than the location of the alleged no show. The Court said: In support of its motion,
Great Health Care Chiropractic, P.C. v Hereford Ins. Co., 2016 NY Slip Op 50858(U) http://www.nycourts.gov/reporter/3dseries/2016/2016_50858.htm After Defendant established established that it had timely mailed its verification request and follow-up verification request (see St. Vincent’s Ho
AAA 991410007677 I have not posted any AAA arbitration decisions yet but decided to post this decision since lately it has become somewhat of a trend for the losing party to file an appeal to a Master Arbitrator solely on the basis of the lower arbitrator failing to decide or mention an issue in his
Maxim Tyorkin, M.D. v. Garrison Property & Casualty Ins. Co., 2016 N.Y. Slip Op. 50846(U) This was a case of first impression, whether an insurer, when receiving a bill from a medical provider, who rendered services in New Jersey and is making a claim for New York no-fault benefits, is requi
Allstate Property and Casualty Insurance Company v. Northeast Anesthesia and Pain Management, 2016 N.Y. Slip Op. 50828(U) The Appellate Term ruled that: An arbitrator’s award directing payment in excess of the monetary limit of a no-fault insurance policy exceeds the arbitrator’s power and co
BIG APPLE ORTHO PRODUCTS, INC. v. STATE FARM MUTUAL AUTOMOBILE INS. CO., No. CV–037717–13/KI. Another example of a motion lacking proper evidence. In this case insurer denied provider’s claim because the accident occurred in Georgia. The Court stated as follows: According to the Affidavi