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Procedural Issues (203)

Coverage (160)

EUO issues (207)

Evidence (137)

Fee Schedule (127)

Medical Necessity (184)

Additional Verification (95)

IME issues (161)

What happened Mr. Rookie?

January 3, 2015 No Comments

Healthway Med. Care, P.C. v Travelers Ins. Co., 2014 NY Slip Op 51870(U)(App. Term 2d Dept. 2014) “On its cross motion for summary judgment, the burden was

From the eyes of the insured has its limits

December 25, 2014 5 Comments

Nationwide Gen. Ins. Co. v Pontoon, 2014 NY Slip Op 09001 (2d Dept. 2014) “The referee incorrectly concluded that GEICO was required to submit evidence that Pontoon

A good causation case

December 25, 2014 No Comments

Jones v MTA Bus Co., 2014 NY Slip Op 08915 (1st Dept. 2014) As for plaintiff’s other claimed injuries, defendants met their burden by relying on

MVAIC trouble

December 23, 2014 No Comments

Central Radiology Servs., P.C. v MVAIC, 2014 NY Slip Op 24402 (App. Term 2d Dept. 2014) “Insofar as is relevant to this appeal, Insurance Law § 5202

Contemporaneous medical records sufficient

December 11, 2014 No Comments

Sanchez v Draper, 2014 NY Slip Op 08584 (1st Dept,. 2014) “Plaintiff also submitted certified medical records of the physical therapy and chiropractic treatment he started receiving

Triable issue of causation established

December 11, 2014 No Comments

Vargas v Marte, 2014 NY Slip Op 08561 (2d Dept. 2014) Triable issue of fact on causation “In particular, plaintiff’s surgeon, recognizing that plaintiff had sustained a

It did not work the second time around

December 4, 2014 1 Comment

Perhaps the only thing worse than leaving your fate in the hands of the Civil Court is to leave your fate at the mercy of the

Break in the chain of causation

December 4, 2014 No Comments

Kester v Sendoya, 2014 NY Slip Op 08379 (1st Dept. 2014) “While plaintiff’s certified medical records may be referenced to show her complaints and the doctor’s referral

Insurable interest

November 14, 2014 No Comments

Matter of Progressive Specialty Ins. Co. v Alexis, 2014 NY Slip Op 07668 (2d Dept. 2014) The term insurable interest is always interesting. What is it really?

Permanent consequential v. Significant limitaton – the value of early surgery

November 14, 2014 No Comments

Sutliff v Qadar, 2014 NY Slip Op 07769 (1st Dept. 2014) This case really discusses the danger on the personal injury side of the “significant limitation prong”

An Application of Langan

October 28, 2014 No Comments

Matter of Utica Mut. Ins. Co. v Burrous, 2014 NY Slip Op 06986 “From the eyes of the decedent” “Contrary to the Supreme Court’s determination, Utica

Supplemental affirmation on a DJ case acceptable and res judicata mandates dismissal of complaint

August 29, 2014 No Comments

Great Health Care Chiropractic, P.C. v American Tr. Ins. Co., 2014 NY Slip Op 51324(U)(App. Term 2d Dept. 2014) This was proudly mine and another example of

Back when DJ’s roamed the earth

August 29, 2014 No Comments

Ultimate Health Prods., Inc. v American Tr. Ins. Co., 2014 NY Slip Op 51321(U)(App. Term 2d Dept. 2014) Good job to my colleague and friend James Sullivan

A case better left unappealed

August 29, 2014 No Comments

Optimal Well-Being Chiropractic, P.C. v General Motors Assur. Co., 2014 NY Slip Op 51323(U)(App. Term 2d Dept. 2014) “In support of its motion, defendant’s investigator stated that,

There is no policy of insurance in effect – the standard is set forth below

August 20, 2014 1 Comment

Delta Diagnostic Radiology, P.C. v American Tr. Ins. Co., 2014 NY Slip Op 51240(U)(App. Term 2d Dept. 2014) “Despite plaintiff’s contention to the contrary, defendant was not

Wrong carrier (again)

August 20, 2014 No Comments

Flatbush Chiropractic, P.C. v Omni Indem. Co., 2014 NY Slip Op 51235(U)(App. Term 2d Dept. 2014) “In support of its motion, defendant submitted affidavits by its litigation

Reargument granted and complaint dismissed under PA law

August 13, 2014 No Comments

Optimal Well-Being Chiropractic, P.C. v Infinity Ins. Co., 2014 NY Slip Op 51203(U)(App. Term 2d Dept. 2014) This fact pattern asked if under PA law, the injured

Walking out of an EUO leads to a disclaimer and a whole lot more

July 17, 2014 5 Comments

American States Ins. Co. v Huff, 2014 NY Slip Op 05366 (1st Dept. 2014) (1) “[p]laintiff’s motion for summary judgment as sought a declaration that plaintiff properly

Verdict sustaining that the loss was intentional sustained

April 19, 2014 2 Comments

V.S. Med. Servs., P.C. v State Farm Mut. Ins. Co., 2014 NY Slip Op 50615(U)(App. Term 2d Dept. 2014) “Prior to trial, the parties stipulated that the

Policy can be rescined under PA law; proof insufficient as to particular Assignor

April 19, 2014 No Comments

Delta Diagnostic Radiology, P.C. v Infinity Group, 2014 NY Slip Op 50602(U)(App. Term 2d Dept. 2014) The EUO was sufficient to raise an issue of fact as

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