Courtside by Larry Rogak brings to the fore cases and decisions of relevance to doing insurance business. Some of the results are, in a word, “unbelievable”.
Natural Therapy Acupuncture, P.C. v Omni Indem. Co. Plaintiff medical provider brought suit against Omni Indemnity. Omni was granted summary judgment after it proved that it did not issue a policy for the subject accident, but that a different insurer did. Plaintiff appealed. The Appellate Term affirmed the dismissal of the suit, and ordered both […]
Pavlova a/a/o Cosby Reavis v Allstate Ins. Co. In this no-fault suit, plaintiff medical provider billed for services under CPT code 20999, which is a “by report” code. The insurer denied the claim on the grounds that the provider did not supply documentation backing up the need for the services. The Appellate Term held that […]
First Am. Alliance, Inc. v Ameriprise Ins. Co. In this no-fault suit, plaintiff medical provider billed for services under CPT code 20999, which is a “by report” code. The insurer denied the claim on the grounds that the provider did not supply documentation backing up the need for the services. The Appellate Term held that […]
Pavlova a/a/o Cosby Reavis v Allstate Ins. Co. In this no-fault suit, plaintiff medical provider billed for services under CPT code 20999, which is a “by report” code. The insurer denied the claim on the grounds that the provider did not supply documentation backing up the need for the services. The Appellate Term held that […]
Sunrise Acupuncture, P.C. a/a/o Sharise Davis v Kemper Independence Ins. Co. Both named insureds under an auto policy died in June 2007. Raquel Davis was named as executor of the estate. In May 2008, Raquel’s daughter, Sharise, got into an accident while driving the insured vehicle and applied for no fault benefits, which were denied […]
Monaghan v Roman Catholic Diocese of Rockville Ctr. This lawsuit arose out of the alleged sexual abuse of a child by a Catholic priest. The Diocese moved to dismiss some of the causes of action, and Supreme Court denied the motion. But the Appellate Division reversed, and held that there is no legal duty for […]
Rickard v New York Cent. Mut. Fire Ins. Co. Breaking with precedent, the Appellate Division holds here that an insurer’s SUM claims file is subject to discovery by plaintiff—even those portions created after litigation was commenced—limited only by a court’s in-camera inspection of those portions claimed to be privileged.—LNR υFollowing a motor vehicle accident in […]
In the Matter of the Arbitration between: Kazu Acupucture, PC and Metropolitan Property and Casualty Insurance Company This New York PIP arbitration was dismissed without prejudice because the arbitrator found that the claimant was a New Jersey resident with a New Jersey insurance policy, and therefore the claim was governed by New Jersey law. —LNR The claim for […]
In the Matter of the Arbitration between: Nu Age Medical Solutions, Inc. and American Transit Insurance Company Edited by Lawrence N. Rogak In this No-Fault arbitration, the claimant was a pedestrian standing on the sidewalk saying goodbye to the occupant of a car. When the occupant opened the car door to step out to speak […]
Matter of Global Liberty Ins. Co. v ISurply, LLC Edited by Lawrence N. Rogak A No-Fault arbitrator ruled that this auto insurer, Global Liberty, must reimburse a medical provider for rental of a CPM and a Cold Therapy Unit at the monthly rental charge to the general public. The Master Arbitrator affirmed. Global Liberty moved […]
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