Medical and No-Fault Collections

A popular Nassau County judge was recently faced with the issue of how much to award an anesthesiologist whose bill was not covered by any available insurance, where there was no agreement to the price. After reviewing the amount that the doctor would have accepted from various insurers and government programs, such as Medicare and Medicaid, the judge ruled that the fair and reasonable value awarded would be the least that is accepted from insurance companies.

I have sued on claims by no-fault health service providers and lost wage claimants for almost 30 years. My office was the first to get court decisions to:

  • knock out denials for IME defaults because the insurer did not have enough proof of mailing of the notices
  • knock out denials on the ground of no medical necessity where the denial did not say that there was a peer review
  • knock out denials based upon peer reviews which only disallowed because there was not enough information
  • knock out denials based upon fraud, where there was not any genuine evidence of an intentional collision
  • knock out denials based upon a nurse's review
  • knock out denials alleging that the patient was in the course of employment when the insurer did not have any actual evidence of that
  • knock out denials that refused to pay for treatment claimed to be novel or experimental without alleging any supporting peer review

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If You Think You’re Owed Money and Don’t Want to Pay a Lawyer