In New York Hosp. v. Country-Wide, it was held that after the carrier denies a no-fault claim because the carrier’s doctor claims that no further care is needed, a provider need not continue sending in bills to later establish a claim for payment. In other words, the carrier cannot later deny payment for failure to submit medical proofs of claim after the denial.
In Matter of Geico Ins Co. AAA Case No. 410201141253, the court held that the carrier asserting a violation of the fee schedule is precluded when not raised in a timely denial of claim.
If you are an attorney or medical provider and are having difficulty obtaining payment for services provided to your client we can help you with such matters. Please contact our firm for more information.
