WeSuThem

  Lumbermens Mut. Cas. Co. v A B Med. Servs., PLLC , 2020 NY Slip Op 07280 (1st Dept. 2020) “As an initial issue, 11 NYCRR 65-3.11 (a) limits no-fault medical billing to employees of the provider that submits claims for no-fault benefits. It is submitted that Supreme Court properly granted judgment in favor of plaintiffs, because the treating providers were independent contractors, as opposed to employees. The record supports a finding that the “degree of control exercised by the purported employer” ( Bynog v Cipriani Group , 1 NY3d 193 , 198 [2003]), “not only over the results produced but also over the means used to produce the results” ( Matter of O’Brien v Spitzer , 7 NY3d 239 , 242 [2006]), was insufficient to give rise to an employer-employee relationship. “Factors relevant to assessing control include whether the worker (1) worked at his [or her] convenience, (2) was free to engage in other employment, (3) received fringe benefits, (4) was on the employer’s payroll and (5) w...

CEDA HEALTH OF HIALEAH, LLC, etc., vs STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY   , 3D21-11 Similar to the 2012 NY regulatory changes, the Florida law prohibits billings for services not rendered.  See  FSA 627.736(5)(b)1.c.. The statute, when triggered, applies to all billings. The NY regulation only seems to apply to services that were billed but not provided. Here are the facts: ” Dr. Canizares testified that he did not have personal knowledge of the treatments, but that based on his review of the records, it appeared that two units of Current Procedural Terminology (“CPT”) code 97110 were mistakenly billed at $90.00 each instead of one unit of CPT code 97110 at $90.00 and one unit of CPT code 97112 at $95.00. Dr. Canizares attested that two units of code 97110 were billed, although only one unit was performed on the date of treatment, and that there was no entry for code 97112 although one unit was performed on that date” The question is whether the provider’s us...

Pavlova v Nationwide Ins. , 2021 NY Slip Op 50213(U)(App. Term 2d Dept. 2021) “To establish its prima facie entitlement to summary judgment dismissing a complaint on the ground that a plaintiff’s assignor failed to appear for an EUO, an insurer must demonstrate, as a matter of law, that it twice duly demanded an EUO from the assignor, that the assignor twice failed to appear, and that the insurer issued a timely denial of the claims ( see Interboro Ins. Co. v Clennon , 113 AD3d 596, 597 [2014]). Contrary to the determination of the Civil Court, the affirmations of defendant’s counsel, as well as the transcripts of the EUOs, were sufficient to establish that plaintiff’s assignor had failed to appear for the EUOs. It is irrelevant whether plaintiff’s assignor was represented by counsel, as defendant was only required to mail the EUO scheduling letters to plaintiff’s assignor ( see  11 NYCRR 65-3.5 [e]; 3.6 [b]). Consequently, as plaintiff failed to raise a triable issue of fact in op...

Might it be said that you are searching for a  Personal Injury Law Firm ? If you're in a mishap, there are notable things to be aware of. You might be qualified for remuneration if another person was careless and caused your wounds. You want the right lawyer close by who will battle for what is fair and just. Yet, how would you track down that individual? What would it be a good idea for you to pay special attention to while picking a personal injury lawyer? Picking the perfect personal injury lawyer for your case is one of the main choices you will make. The most effective way to find a decent lawyer that meets your requirements and spending plan is by asking companions, relatives, or collaborators who they would suggest. You ought to talk with nearby lawyers to pose inquiries about the amount it will cost and what they anticipate charging. As a last resort, take a stab at looking on the web for audits from others who have utilized the administrations of these lawyers previously s...

Business and Commercial Law Firm Florida   are two areas of legitimate practice that have so many covering issues that most lawyers who practice one will have the capacity in the other. Commercial law depends on the course of action and dissipating of things. They support express exchanges. Business law depends on different businesses counting illustrating affiliation and associations. Acquisitions financial sponsor respect, and property issues. For example - renting office or stockroom space. Business selling things will require a lawyer with experience in these fields. Commercial law is obliged by the Uniform Commercial Code (UCC), which is a model arrangement of laws concerning the courses of action of things, leases of items, questionable instruments, and got exchanges. All states have embraced the UCC or some likeness thereof. Notwithstanding, each state is permitted to make changes to the laws as it sees fit. Have A Glance at Services Provided by Our Law Firm? Our  Fort ...

Personal injury law (generally called "wrongdoing" law) allows a hurt person to report a typical lawsuit in court and get an authentic fix ("hurts") for all disasters beginning from a setback or other event.  Personal Injury Law Firm in NY city helps with promising it. The personal injury structure allows the hurt person to be reimbursed fiscally or "made whole" after the individual has persevered through harm as a result of someone else's imprudent or deliberate lead. In this article, we'll: cover the basics of personal injury law debate where personal injury law arrives from, and figure out how an all-around ordinary personal injury case works. The Basics Knowledge Anbout Personal Injury There is a wide scope of conditions where personal injury rules apply: Setbacks.  Personal injury rules apply in conditions, where someone misbehaves, and that rudeness harms another person. Models consolidate car crashes, slip and fall episodes, and clinical ro...

This is not too off topic. The Court of Appeals is run by the prior DA of Westchester. Nassau County DA Singas has now been elevated to the Court of Appeals. Finally, Judge Garcis was a former prosecutor. Judge Cannataro was just elevated to the Court of Appeals but he reminded me of Judge Jeremy Weinstein – a professional administration judge, Not a bad thing mind you. So how does a bench with a dearth of Civil non-criminal experience handle insurance disputes and personal injury disputes? I really do now know. I have read on the criminal law blogs that the defense bar is crying, and I can understand their concern. But it seems that much of the decisions seem to be not necessarily on the pro-consumer side.  Simmons v Trans Express Inc. , 2021 NY Slip Op 03484 (2021)(in effect killing a wage and hour case through limited the bar on collateral estoppel found in the uniform small claims acts);  Himmelstein, McConnell, Gribben, Donoghue & Joseph, LLP v Matthew Bender & Co...