The Artvoice reported today that Blue Shield California twice refused to pay $2,700 emergency room claims by Rosalinda Miran-Ramirez, concluding that it was not a “reasonable” decision for her to go to the emergency room that morning when she awoke to a shirt saturated from blood with what turned out to be a breast tumor. Only after KPIX-TV reported the story did the insurance company pay the claim. Further, it reported that the National Women’s Law Center found that the laws of eight states permit insurance companies to deny health coverage to a battered spouse (as a “pre-existing condition”) since batterers tend to be recidivists.
Serious Injury Threshold Motion Does Not Necessarily Require Doctor’s Affirmation.
December 20, 2013
In Feggins v. Fagard, 52 AD 3d 1221 (4th Dept. 2008) the Court held that in response to a threshold motion plaintiff may rely on unsworn reports and uncertified medical records submitted by defendants or simply referenced in the submitted reports of defendant’s examining physicians.