Manual muscle testing from the 4th DCA
4th DCA ruling on manual muscle testing CPT codes in no-fault insurance - provider failed to justify unbundling evaluation codes with required documentation
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June 2021 Articles
12 articles published in June 2021
Not at 200% in Florida- what happens?
Florida court rules on no-fault insurance payment calculations when provider bills less than 80% of 200% Medicare rates in Geico v. Muransky case.
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“Equitable estoppel” – Domotor light
Florida court affirms equitable estoppel doctrine when insurer wrongly denied PIP coverage then changed tactics after discovering their error in no-fault case.
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Bad faith averted for another year
New York bad faith insurance claims face legislative challenges despite progressive majority. Analysis of third-party vs first-party bad faith standards and actionable carrier behaviors.
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Verification – MRI
Court ruling on MRI verification requirements in no-fault cases, addressing provider demands for reproduction costs and insurer verification rights.
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When many new Court of Appeals Judge is a former prosecutor
New York Court of Appeals judges with prosecutor backgrounds handling civil insurance and personal injury cases - analysis of impact on consumer protection and legal decisions.
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Interesting discussion on NF-10s
Court ruling clarifies that insurance companies can use substantially similar NF-10 denial forms and must prove proper mailing in no-fault cases.
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The Cuomo Toll
Court decision on COVID-19 executive order tolling periods for legal actions in New York, covering March 2020 to November 2020 statute of limitations suspensions.
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205 toll
Analysis of U.S. Bank N.A. v Jalas ruling on CPLR 3215(c) dismissals and seven-year delays in default judgment motions under New York law.
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Intention act on default
Court ruling on intentional acts and default judgments in New York no-fault insurance staged accident cases, with claims representative affidavits as evidence.
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NJ Transit is estopped from relying on Hyatt
NY appellate court rules NJ Transit waived Eleventh Amendment immunity defense in no-fault insurance case, preventing federal sovereign immunity claims.
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Another Mailing Again
New York court ruling shows evolution in no-fault insurance mailing requirements, moving away from strict "duty to ensure compliance" standard for claims examiners.
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