Mercury Cas. Co. v Encare, Inc., etc., 2012 NY Slip Op 69137 (2012)
Congratulations to my able adversary Howard Stern, Esq., who prevailed on this case, all the way from arbitration to my leave application to the Court of Appeals. We shall say he earned every dollar he obtained for his client and begrudgingly I salute him.
I will dream up my next battle. Any ideas?
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6 Responses
How about a late denial for a medical necessity case? That might be “coverage.” Throw anything against the wall these days in the first…it may stick?
I want to congratulate the Court on a well written, clear and cogent decision.
How about a staged loss defense based upon the following two discrepancies:
1. two unrelated people
2. late model vehicle
3. late night accident
Just kidding. An way, nice try.
It appears that no fault is possibly the only health insurance coverage where the provider has not even the mininal assurance of getting paid. Each claim is either medically unnecessary or fraud. And when all else fails lets just throw in a coverage defense – after all, its all about coverage anyway.
As you know Mitch, two unrelated people never ride in a late model vehicle late at night unless they are looking to stage an accident. The only people that should be on the road at that hour should be related people in new cars.
Thanks for the kind words. You are a worthy adversary. Regards.
Kurt has hit the nail on its head, in no-fault it is harder to get paid then in any other medical field. Especially when carrier hire such astute experts like Dr. Sposta or many other hacks who have not touched a patient in years and simply make their living by electronically signing their name to coockie-cutter peer review and IME reports drafted by third-party peer and IME vendors owned by lay people. These same third-party lay people owned companies split fees with the crooked peer review and IME doctors. Where is the Mallela there?