More MUA – this one is over the top
Court case analysis examining chiropractor MUA billing disputes under NY no-fault fee schedules, including rate limitations and multiple procedure rules.
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March 2012 Articles
29 articles published in March 2012
Knowledge is quite a broad term
New York Court of Appeals clarifies that property owners need only notice of conditions, not that they knew those conditions were dangerous for negligence claims.
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5520 applies to reargument orders that were never appealed
Court applies CPLR 5520 to treat defective appeal as valid when appellant failed to appeal reargument order that superseded original order.
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Major medical carrier taken to the mat for unscrupulous conduct
Get expert legal analysis on Major medical carrier taken to the mat for unscrupulous conduct from Law Office of Jason Tenenbaum | Personal Injury Lawyers
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Another no-fault physician commits insurance fraud
Doctor convicted of insurance fraud for falsifying no-fault C-4 forms, showing patient as disabled when they were working. Court upheld conviction based on consistent witness testimony.
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They call her crash
Court analysis of four accidents determining which qualify for serious injury under 5102(d), examining significant limitation vs permanent consequential categories.
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When can you "change the caption"?
Fourth Department ruling on CPLR 305(c) caption amendments in no-fault cases - when substitution fails and proper procedural requirements for changing party names.
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What are objective signs of continuing disability?
Court case examines objective medical tests for proving continuing disability in personal injury cases, including EMG tests, straight leg tests, and muscle spasm documentation.
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Renewal granted and Plaintiff loses.
Court grants renewal motion after law office failure, defendant wins summary judgment in no-fault insurance case when plaintiff fails to raise triable issues of fact.
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Civil Court overturns Appellate Term precedent
Civil Court overturns Appellate Term precedent on no-fault peer review expert testimony, ruling original peer reviewer must testify at trial
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A bad day for Mr. Pearson
Pearson v Miles demonstrates how failing to properly allege the 90/180 day injury category in a bill of particulars can doom a no-fault threshold case.
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Mailing discrepencies and the way to prove non-receipt
Court case demonstrates how mailing discrepancies can undermine no-fault insurance claims when dates don't align with alleged service dates.
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Would you go to this psychologist?
Burns v Kaplan case analysis: psychotherapist sues patient for missed appointment fee, patient claims medical emergency defense in small claims court dispute.
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Letter of medical necessity sufficient to raise an issue of fact
Court ruling demonstrates that a treating physician's letter of medical necessity can create sufficient factual disputes to defeat summary judgment in no-fault insurance cases.
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No coverage due to lack of proof regarding Claimant's status as resident relative
Rally Chiropractic v Nationwide case ruling on no-fault coverage denial due to assignor not regularly residing with insured under NY regulations.
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Another motion to dismiss an initial acupuncture session is denied
New York Appellate Term denies insurer's motion to dismiss acupuncture provider's claim for initial session, reinforcing provider rights under no-fault law.
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Business record rule applies to hospitals also
Court ruling shows hospitals must prove their records qualify as business records for summary judgment in no-fault cases, adding procedural hurdle.
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A signature placed at the direction of the signor
Court ruling clarifies that electronic signatures placed at the direction of the signor are legally valid, even when appearing as facsimile stamps on peer review reports.
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Acupuncture fee schedule (again)
New York appellate court reinforces requirement for insurance carriers to properly submit fee schedules as evidence in acupuncture reimbursement disputes under no-fault law.
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Objected to inadmissible proof spells doom
Court dismisses no-fault case after plaintiff objects to inadmissible proof, highlighting importance of sworn medical reports and hearsay rules in New York.
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Some evidentiary issues –
New York appellate court addresses key evidentiary issues including hearsay exceptions, interrogatory use for impeachment, and harmless error doctrine in civil litigation.
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Another substitute peer case finds it way back on remand – but the dissent is potent
Appellate Term reverses trial court's exclusion of substitute expert testimony in no-fault medical necessity case, with strong dissent on expert testimony scope.
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A lesson on why the failure to attempt a DJ on an EUO no-show can spell doom
A 2012 case highlights how insurance companies must properly establish EUO scheduling to avoid losing their right to deny claims based on no-shows.
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Lack of causation proven prima facie through a biomechanical study
Court grants summary judgment based on biomechanical engineer's conclusion that claimed injuries could not have resulted from the accident, shifting burden to plaintiff.
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A Mallela defense does not have to be pleaded
Appellate Term rules Mallela defense doesn't require formal pleading - adequate allegations of fraudulent incorporation sufficient for discovery rights
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Abusive summation and cross-examination causes this case to go back to trial
Court reverses personal injury verdict due to attorney's abusive summation and improper cross-examination tactics that denigrated medical experts and witnesses.
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3212(b) motion – affidavit from movant necessary
CPLR 3212(b) motion requirements: when affidavit from movant is necessary for summary judgment in New York courts, based on Maragos v Sakurai case analysis.
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3101(d) gone awry?
Court strikes expert affidavit when plaintiff failed to identify expert during discovery phase, emphasizing importance of timely disclosure under CPLR 3101(d).
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Use and Operation
Cividanes v City of New York case analysis examining "use and operation" requirements for no-fault coverage when plaintiff injured exiting bus into pothole.
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