Author Archives: Leon Kucherovsky
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
Does this case show that a party can invoke the arbitration clause in a contract and stay litigation? In ST. Chiropractic, P.C. v. Geico General Ins. Co., NYLJ 1202766695437 http://law.justia.com/cases/new-york/appellate-term-second-department/2016/2016-ny-slip-op-26271.html. Plaintiff assignor
Metro Health Products, Inc. v. Nationwide Ins, 2014-2609KC, NYLJ 1202765281225 Provider sued to collect on its No Fault bills. Nationwide commenced a DJ Action in Supreme Court on the basis that Provider failed to appear for EUO’s. Provider never answered and d default judgment was granted
Hu-Nam-Nam, M.D., v. New York Central Mutual Fire Insurance Company, — N.Y.S.3d —-, 2016 WL 4020542 (N.Y.Sup.App.Term), 2016 N.Y. Slip Op. 26237 Insurer moved for summary judgment dismissing the complaint on the basis that it had timely and properly denied plaintiff’s claim based on