Denial and EOB is sufficient to preserve fee schedule defense

If you were injured due to someone else’s careless actions, we understand the challenges you may be facing. As a victim or a surviving family member, you could be dealing with the life-altering consequences of a serious accident.

W.H.O. Acupuncture, P.C. v AIG Auto Ins., 2012 NY Slip Op 50755(U)(App. Term 2d Dept. 2012)

“Contrary to plaintiff’s sole contention, defendant’s denial of claim forms and the accompanying explanation of benefit forms were sufficient to apprise plaintiff that defendant was partially paying and partially denying its bills on the ground that the unpaid portion exceeded the amount permitted by the workers’ compensation fee schedule. Accordingly, the order is affirmed”

I have to wonder if a “you failed to explicitly ask for judicial notice” argument would have worked?  It seems to be the flavor of the year at this Court.

Facebook
Twitter
Email
Print

Latest Article

DON'T ACCEPT LESS THAN WHAT YOU'RE OWED!

Choosing the right legal representation is one of the most critical decisions you can make after an accident.

Partnering with a skilled, experienced, and dedicated personal injury attorney can bolster your case and position you to secure the full financial compensation you’re entitled to.

Our firm is ready to manage every aspect of your case, including negotiations with insurance companies. We reject inadequate settlement offers and relentlessly fight for the maximum compensation you rightfully deserve.

Contact Us – We’re Here to Help


    5-Star Rating on Google