Key Takeaway
New precedent protects NYC & Long Island medical providers from post-payment independent contractor challenges in no-fault insurance cases. Call 516-750-0595.
Understanding the Independent Contractor Defense in New York No-Fault Insurance Cases
If you’re a medical provider or healthcare practice in Long Island or New York City, understanding the nuances of no-fault insurance law is crucial to your financial stability. One of the most significant recent developments in this area involves the independent contractor defense—a legal strategy that insurance companies have increasingly attempted to use to deny claims from medical providers.
The landscape changed dramatically with new precedent that requires insurance carriers to properly preserve this defense in their initial denial forms, or risk being precluded from raising it later in litigation. This development has major implications for healthcare providers throughout Nassau, Suffolk, Queens, Brooklyn, Manhattan, and the Bronx.
The Landmark W & Z Acupuncture Case
W & Z Acupuncture, P.C. v Unitrin Auto & Home Ins. Co., 2012 NY Slip Op 52400(U)(2d Dept. 2012)
Insurance carrier sought an EBT of the medical provider based upon the “independent contractor” defense. Until three months ago, this defense escaped preservation. Not so anymore. The Court was therefore constrained to reverse the Civil Court:
“In an affirmation in support of defendant’s motion to compel, defendant’s attorney argued that the treating acupuncturists were not plaintiff’s employees; rather, they were independent[*2]contractors and, therefore, plaintiff was ineligible to recover the assigned no-fault benefits at issue. However, defendant’s denial of claim forms did not deny plaintiff’s claims on the ground that the treatment at issue had been rendered by independent contractors. Therefore, defendant is precluded from asserting that ground for denial of coverage as a defense in this litigation (A.M. Med. Servs., P.C. v Progressive Cas. Ins. Co., ___ AD3d ___, 2012 NY Slip Op 06902 ). Consequently, the branch of defendant’s motion seeking to compel plaintiff to appear for an EBT in support of this defense should have been denied, as this discovery demand is palpably improper.”
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