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Major medical provider does not have standing to bring action against no-fault carrierJanuary 6, 2014

AETNA Health Plans v Hanover Ins. Co., 2013 NY Slip Op 33221(U)(Sup. Ct. Bronx Co. 2013)

In this case, Defendant provided no-fault services to Plaintiff’s Assignor.  Defendant cut-off Plaintiff’s Assignor, who then sought to have medical benefits paid for by Aetna.  When all was said and done, Aetna paid over $42,000 in benefits.  Plaintiff asserted a lien on its assignor’s personal injury case and its assignor sought arbitration with AAA.  The arbitrator found that since major medical paid for the benefits, the assignor could not maintain an case against no-fault carrier.  The master arbitrator affirmed.

Now, Plaintiff assigns whatever rights it has to the Assignee major medical carrier.  This does not go anywhere as is discussed in this opinion.

Just note that the lower arbitrator’s and master arbitrator’s decisions were wrong based upon Todaro v. Geico.

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