At times, it has been a struggle to have legal precedent followed in the No-Fault field. As in, actually abiding by Court of Appeals cases. I have occasionally left comments on other No-Fault blogs discussing the inconsistency in interpreting the No-Fault Regulations and how it affects No-Fault healthcare providers. [...]
The no-fault regulations are in derogation of common law and must be strictly construed (Presbyt. Hosp. of New York v Maryland Cas. Co., 226 AD2d 613, 614 [2d Dept]. [...]
Hey insurance carriers, if there is one thing the No-Fault Regulations have been clear on, it’s this: you have 30 days from receipt of the bill to pay or deny the claim; failure to do so waives any defenses the carrier may have. In this world of No Fault confusion, providers and their attorneys were relieved that at least this was something they could rest their hats on; or so they thought. Yet insurance carriers continue to surprise & amaze medical providers, claimants, and their attorneys every chance they get, and here should be no different. There are still some carriers arguing that an untimely denial does not waive their right to a fee schedule defense. [...]
I am sure through the overzealous media, or your social media connections, or if you’re anything like me, your addiction to television, you have seen or heard of medical malpractice. I am sure you have developed your own definition as to what you believe medical malpractice to be with the information you have been provided. Unfortunately, much of this information is not always accurate. [...]
You don't have to be from New York to have heard about the infamous Taconic Parkway crash that took the lives of eight people, half of which were children. If for some reason you haven't heard, here is a brief synopsis:Diane Schuler was driving a minivan with her three [...]
There are three very important reasons I felt the need to blog this week about pedestrians injured in a car accident and where they get their first party benefits. First, according to Newsday, there has been a recent epidemic of pedestrians being struck by motor vehicles. [...]
During one of my ever exciting jury verdict searches, I recently read about the First Department affirming a slip and fall verdict of $4,700,000 for neck and back injuries. My inner nerd immediately compelled me to read more. Throughout my entire reading of the case, the old phrase, which is mentioned above (and edited, for any of you who actually know the real saying), ran through my head. The hilarity of the old saying, coupled with the outstanding job done by Plaintiff's attorney, compelled me to share this with you. [...]
Since my first day of school, I was taught about the well known dangers of DUI, driving under the influence/while intoxicated. I was told: "DO NOT DRINK & DRIVE, it is bad & you will die." Ok, maybe not that harsh, but the point was: if you drink and drive, you could end up killing yourself, someone else or both. Although I was bored to tears during every drinking & driving lecture, to this day I have not driven while intoxicated. Drunk driving can also have a significant effect on a personal injury case. [...]
Since the beginning of time (or at least since I began my work in Personal Injury), a rear end collision was as straight forward as liability can be; when car #1 hits car #2 in the rear, car #1 is always to blame. Having a client come in and tell you they were rear ended puts a smile on any personal injury attorney’s face. [...]
Insurance carriers have continuously attempted to put forth an argument that a non Article 28 facility cannot bill Worker's Compensation or Medicare and therefore cannot bill No-Fault either. When I attempt to wrap my head around this argument, I can't help but picture a family situation. Imagine this: No-Fault insurance being the "little brother", and Worker’s Compensation and Medicare being the two "older brothers"..."Little brother" No-Fault wants to be able to do or not do everything both "older brothers" can/can't. I picture No-Fault carriers yelling "Me too! If they don’t have to pay me either!" However, "Mom", the No Fault Regulations, make the rules and the rules do not derive from mimicking other types of insurance coverage. This analogy helps to lighten my mood when this ever frustrating issue is continuously and adamantly argued by the carriers. [...]
That’s right, this is a blog focused on acupuncture, the fee schedule & the big bad Great Wall Decision. For the less informed, a brief background is in order. Basically, there is no fee schedule for licensed acupuncturists; therefore there is no mandated amount acupuncturists may bill for their services. Most acupuncturists bill at either the chiropractic or physicians rate for acupuncture services. There wasn’t much of a problem with this, “until one bad grape ruined it for the bunch” and the Great Wall decision was handed down. [...]
Ever since the Workers Compensation Guidelines were released, becoming effective on December 1, 2010, providers & their attorneys alike took a deep breath, as they knew exactly what would happen next; arguments with the insurance carriers on the applicability of the guidelines. [...]
Ever since the Workers Compensation Guidelines were released, becoming effective on December 1, 2010, providers & their attorneys alike took a deep breath, as they knew exactly what would happen next; arguments with the insurance carriers on the applicability of the guidelines. [...]
One too many times a client has come to the firm with a personal injury settlement they are unhappy with. For some reason, they signed a release settling their claim for much less than it is worth; maybe they really were short changed in the deal, maybe their previous representation did a bad job [...]
Recently, a client of mine brought this issue to my attention, and I thought it was worth blogging about. I know that it's an issue that has been decided & slightly over blogged, but I figured what's one more informative blog if it helps answer at least one person's question [...]
I came across a recent decision regarding the disclosure of mental health records, which got me thinking about disclosure in general. Many clients tell me that one of the reasons they didn't know if they should start a personal injury lawsuit even though they are seriously injured is because they are afraid of what the other side will find out about them. [...]
There is an old saying “a man who represents himself has a fool for a client." Here’s the scenario: You’ve been in an auto accident where you are in no way at fault [...]
You have gone through all the initial steps, you found a skilled lawyer to take your case, and now that million dollar question runs through your head “How Long will my case take to settle?” [...]
To ease the burden on courts, in 1973 the New York State legislature passed what we now call the No-Fault law for automobile drivers. It was also passed to ensure New Yorkers injured in automobile accidents were promptly paid regardless of their fault to ensure full recovery [...]
When you’ve been injured in a car accident and it becomes time to retain a lawyer, many questions may cross your mind. Typically, many of our clients have same questions and concerns regarding our fee. We felt it was important to take this time out to answer some of those reoccurring questions so that you may know the answers before deciding to retain us. [...]
Good old Regulation 68, enacted in 1974, in order to ensure that all reasonable and necessary medical treatment following a motor vehicle accident was paid for, which was revised in 2002, is once again up for revision. The original proposed revisions were released in November 2009 [...]
Insurance carriers are constantly trying to delay payment of claims by sending verification requests. This is a clever tactic because until a provider complies with these requests, an action to recover payment on the claims [...]
Here at Rubin & Licatesi, P.C., we do our best to promptly come to a resolution with the insurance company that fully compensates our client for their injuries. But let’s face it, this isn’t always a possibility. If settlement negotiations fail [...]
Whether it is due to the repetitive nature of the practice or just plain confusion in this area of law, the purpose behind the No Fault Regulations seems to have gotten lost in the shuffle. The spirit and purpose of the No-Fault Regulations is to promote [...]
Here at Rubin & Licatesi, P.C. we see many incidents where a pedestrian is injured when they are hit by a car. It is imperative we stay abreast of all the proposed changes in our areas of practice. Since we handle so many cases involving pedestrians, when I came across this recent New York Times Article , I felt compelled to comment on it [...]
Recently, our firm has seen a rise in No Fault arbitrations circulating around a procedure known as Manipulation under Anesthesia. One would assume that any advance in medicine is always a positive thing, but they would be wrong [...]
After the winter New York has been having, coupled with the drama surrounding the care and removal of snow and ice, it should come as no surprise that our office has been flooded with injured clients who have slipped on the ice or snow [...]
Like it or not the No-Fault Regulations (11 N.Y.C.R.R. § 65-3.8) require insurers to either deny or pay a claim for benefits within 30 days from the date the applicant submits proof of claim. If the insurer fails to respond [...]
If you have ever read the No-Fault Regulations, or any statute for that matter, you know there is a lot of terminology which can make your head spin. For whatever reason, us lawyers seem to get a kick out of using such complex phraseology [...]
As has been discussed ad nauseum in the industry, automobile insurance fraud is a major problem in New York. Some estimates state more than one in five claims submitted to auto insurers are fraudulent [...]
Numbers are an excellent way to compare things. But like anything else, they can be twisted to show things in your favor. Maybe in ways more with more persuasion [...]
I do not profess to be a math whiz, but when it comes to simple mathematics, I think I can hold my own. An article published February 3, 2010 noted that insurance lobbyists were headed to Albany to discuss inflating no-fault costs in the state since 2005 [...]
As you probably know, in order to drive in New York, you must purchase No Fault Insurance. By purchasing this insurance, you “make a trade off”; you give up your right to sue the other driver unless you have a serious injury, yet you gain the benefit of your insurance company paying for reasonable and necessary medical care resulting from the accident [...]
If you have ever been injured in a motor vehicle accident in New York and required treatment, your insurance company may have required you to attend an examination—infamously known as an Independent Medical Examination (IME) [...]
Insurance companies are relentless trying to deprive health care providers the money they have earned treating their No-Fault patients. Throughout the state, many providers are wondering what they have to do get paid [...]
It’s winter again, and it seems as if this year promises to bring one of the colder seasons we’ve had in New York in quite some time. Inevitably, clients come to our office after sustaining injuries from a slip and fall on an icy or snowy surface [...]
Yesterday was a big day for us here. Anthony Licatesi, a partner for our firm, argued for our health care provider, United Diagnostic Imaging, P.C. (United) in front of the Appellate Division, Second Department [...]
I read an interesting blog the other day detailing the results of No-Fault arbitrations (click here for article). More specifically, the blog discussed how insurers and applicants fared on a particular day in cases regarding denials due to negative Independent Medical Examinations [...]
