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When insanity is more persuasive than reason

Atlantic Radiology Imaging, P.C. v Interboro Mut. Ins. Co., 2016 NY Slip Op 51031(U)(App. Term 2d Dept. 2016) I admittedly find the extent that the judges

July 13, 2016 7 Comments

Fraudulent procurement defense looks more like a 3105 defense

Compas Med., P.C. v Praetorian Ins. Co., 2016 NY Slip Op 51000(U)(App. Term 2d Dept. 2016) “Moreover, defendant failed to establish as a matter of law

July 10, 2016 No Comments

Trial de novos and exhausting administrative remedies

AutoOne Ins. Co. v Eastern Is. Med. Care, P.C., 2016 NY Slip Op 05354 (2d Dept. 2016) This case is interesting on a few levels since

July 7, 2016 No Comments

The EUO bust statement as a business record

Charles Deng Acupuncture, P.C. v Titan Ins. Co., 2016 NY Slip Op 26211 (Civ. Ct. Kings Co. 2016) The Court here stated the following: (1) “The

July 7, 2016 5 Comments

A sighting of “interboard” in action

TC Acupuncture, P.C. v Tri-State Consumer Ins. Co., 2016 NY Slip Op 50978(U)(App. Term 1st Dept. 2016) (1)”Defendant made a prima facie showing of entitlement to

June 30, 2016 2 Comments

Reversal of Supreme Court’s vacatur on a First Department 75

Country-Wide Ins. Co. v TC Acupuncture, P.C., 2016 NY Slip Op 05104 (1st Dept. 2016) Respondent commenced an arbitration against petitioner insurance company for reimbursement of

June 30, 2016 1 Comment

Default – First Department reverses vacatur of the judgment

ALFA Med. Supplies, Inc. v Allstate Ins. Co., 2016 NY Slip Op 50942(U)(App. Term 1st Dept. 2016) (1) “Defendant-insurer failed to offer a reasonable excuse to

June 27, 2016 No Comments

The Civil Kings briefing schedule

Brand Med. Supply, Inc. v Praetorian Ins. Co., 2016 NY Slip Op 50961(U)(App. Term 2d Dept. 2016) “Although the stipulation required that plaintiff’s opposition was to

June 27, 2016 5 Comments

Expansion of Mallela

Liberty Mut. Ins. Co. v Raia Med. Health, P.C., 2016 NY Slip Op 04916 (2d Dept. 2016) As I wait every week for the results of

June 23, 2016 2 Comments

5102(d) baseline under an aggravation and exacervbation

Boroszko v Zylinski, 2016 NY Slip Op 04830 (4th Dept, 2016) In the realm of a complaint seeking to breach the serious injury threshold where significant

June 21, 2016 No Comments

Equitable subrogation takes the backseat to the wording of the regualtion

(1) “Article 51 of the New York Insurance Law, enacted as the Comprehensive Motor [*3]Vehicle Insurance Reparations Act (see L 1973, ch 13), governs payments

June 20, 2016 No Comments

Late notice defense sustained

Sunrise Acupuncture PC v ELRAC, Inc., 2016 NY Slip Op 50905(U)(App. Term 1st Dept. 2016) (1) “Defendant made a prima facie showing of entitlement to

June 20, 2016 No Comments

IME/EUO no-show substantiated (First Department).

Urban Well Acupuncture, P.C. v Nationwide Gen. Ins. Co., 2016 NY Slip Op 50906(U)(App. Term 1st Dept. 2016) “Contrary to plaintiff’s contention, defendant submitted competent

June 20, 2016 No Comments

EUO sustained – failure to challenge EUO requests is fatal to provider’s position

Vladenn Med. Supply Corp. v State Farm Mut. Auto. Ins. Co., 2016 NY Slip Op 50928(U)(App. Term 2d Dept. 2016) “With respect to plaintiff’s contention

June 20, 2016 No Comments

The verification affidavits again

Great Health Care Chiropractic, P.C. v Hereford Ins. Co., 2016 NY Slip Op 50910(U)(App. Term 2d Dept. 2016) “In support of the cross motion, defendant

June 20, 2016 No Comments

EBT’s of medical necessity cases.

New York Community Hosp. of Brooklyn v Mercury Cas. Co., 2016 NY Slip Op 50900(U)(App. Term 2d Dept. 2016) “Defendant’s contention that the branch of

June 20, 2016 No Comments

Prestigious EUO firm seems to have partners who lack personal knowledge

IMA Acupuncture, P.C. v Allstate Ins. Co., 2016 NY Slip Op 50926(U)(App. Term 2d Dept. 2016) Contrary to defendant’s contention, the affirmation submitted in support

June 20, 2016 8 Comments

EUO no-show from the First Department – lucky win by Mapfre?

Mapfre Ins. Co. of N.Y. v Manoo, 2016 NY Slip Op 04446 (1st Dept. 2016 This is an interesting one. I believe (see below) the

June 14, 2016 5 Comments

EUO no show – what’s the reason?

Avalon Radiology, PC. v Ameriprise Ins. Co., 2016 NY Slip Op 26182 (Dis. Ct. Suffolk Co. 2016) “Avalon responded to the first EUO request with a

June 11, 2016 6 Comments

Medical necessity

Ji Sung Kim Acupuncture, P.C. v American Tr. Ins. Co., 2016 NY Slip Op 50873(U)(App. Term 2d Dept. 2016) “The IME report set forth a factual

June 11, 2016 No Comments

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