Barry Zalma 4441 Sepulveda Boulevard CULVER CITY CA 90230 310-390-4455 <mailto:zalma@...> zalma@... <http://www.zalma.com/> www.zalma.com Fraud...
2260
Lawrence
insurancelawyer
Jan 4, 2010 8:48 pm
AFFIDAVIT FROM ADJUSTER WHO BEGAN WORKING AFTER DENIAL WAS MAILED, CANNOT ESTABLISH MAILING Points of Health Acupuncture, P.C. a/a/o Elizabeth Caraballo v...
2261
Sherri
mshlyn01
Jan 4, 2010 9:49 pm
Is there case law that states you are able to deny further treatment based on claimant's failure to show for an IME exam from the date of the first exam, and...
2262
Sherri
mshlyn01
Jan 4, 2010 10:04 pm
so you are saying that with two no shows you can deny from the date of the first no-show ALL No-Fault benefits for any specialty, is that correct? Thank you ...
2263
Sherri
mshlyn01
Jan 4, 2010 10:14 pm
I just need some clarity as I read through the case you suggested. Am I reading correctly that case precedent is that you can deny ALL no-fault benefits...
2264
Sherri
mshlyn01
Jan 5, 2010 7:48 pm
what are your thoughts with prevailing on peer reviews for medical bills and if and when they should be done? Thanks [That's a big subject, too much to cover...
2265
Lawrence
insurancelawyer
Jan 5, 2010 8:08 pm
ONCE AGAIN, INSURER IS CRITICIZED FOR CLAIMS PRACTICES: IT "BORDERS ON IMPROPRIETY" TO SELECTIVELY CITE OLD, OBSOLETE ARB DECISIONS In the Matter of the...
2266
Jeena Belil
wuhanmom3
Jan 5, 2010 8:16 pm
Lawrence, The scenario you described at the bottom of your email sounds like hearsay and perhaps no objection was made, or not formulated correctly (?) or the ...
2267
Sherri
mshlyn01
Jan 6, 2010 11:36 pm
As per the regulation, if a bill is submitted and not paid, delayed or denied in a timely fashion, do you have to pay as you have lost all your defenses? and...
2268
Mitchell S. Lustig
lbins123
Jan 7, 2010 12:30 am
Larry,in regard to your answer to Sheri regarding a fee schedule defense. The way I read the case law is that under all circumstances a fee schedule denial...
2269
Lawrence
insurancelawyer
Jan 14, 2010 11:18 pm
POLICYHOLDER'S ALLEGATION THAT HOMEOWNERS POLICY IS DECEPTIVE AS TO SUBROGATION RIGHTS SURVIVES DISMISSAL MOTION Wilner v Allstate Ins. Co. 2010 NY Slip Op...
2270
Renee Breitner
reneebreitner@...
Jan 15, 2010 7:26 pm
WOW! ... From: Lawrence To: TheRogakReport@yahoogroups.com Sent: Thursday, January 14, 2010 6:11 PM Subject: The Rogak Report: The Most Useful Publication In...
2271
Lawrence
insurancelawyer
Jan 15, 2010 7:47 pm
Dear Readers: I invite all of you to submit your comments and thoughts on the following unsettled question of law: "Should the medical necessity of any given...
2272
Lawrence
insurancelawyer
Jan 19, 2010 11:31 pm
COURT REJECTS ATTEMPT TO CLAIM CONSEQUENTIAL DAMAGES FROM NO-FAULT INSURER Devonshire Surgical Facility & Carnegie Hill Orthopedic Servs., P.C. a/a/o Jose...
2273
Lawrence
insurancelawyer
Jan 19, 2010 11:40 pm
TECHNICAL DEFECT IN OUT-OF-STATE AFFIDAVIT CAN BE CORRECTED EVEN AFTER MOTION DATE Eastern Star Acupuncture, P.C. a/a/o Charles Jeter v Clarendon Natl. Ins....
2274
Julie Avdeeva
julieavdeeva
Jan 20, 2010 8:43 pm
Hi Larry,  Hope all is well. I have an interesting out of state dilemma. The insured is a PA resident with a PA PIP policy who gets involved in a New...
2275
Julie Avdeeva
julieavdeeva
Jan 20, 2010 9:17 pm
Excellent! Thank you! Do you have anything that I can cite in support of this? ... From: Julie Avdeeva <julieavdeeva@...> Subject: Re: The Rogak...
2276
Julie Avdeeva
julieavdeeva
Jan 20, 2010 10:06 pm
This case is great thanks! And I found even more helpful stuff in your excellent book. Thank you! Julie ... From: Julie Avdeeva <julieavdeeva@...> ...
2277
patricia kessler
pakkessler
Jan 20, 2010 11:04 pm
If the situation is a NY resident passenger- NJ accident- NJ policy-treated by provider in NY, NJ PIP benefits being applied must the case remain in NY and...
2278
Louis Schepp
ljschepp
Jan 20, 2010 11:10 pm
What if the PA insurance carrier is present in NY. A suit against them would survive a jurisdiction challenge, would it not, although the law to be applied...
2279
Louis Schepp
ljschepp
Jan 20, 2010 11:42 pm
But aren't you ignoring the fact that treatment was in New York. Even with less, in a no-fault recovery action, a motion, based upon forum non conveniens has...
2280
Sherri
mshlyn01
Jan 21, 2010 12:30 am
Hi Larry, First thank you for all the help you provide. Ok here is the situation, if you set up an IME and the claimant reschedules the first exam and you set...
2281
royamura
Jan 21, 2010 2:18 pm
Box score is actually 1-1 with this decision, Larry. First reported decision on this issue was Savino v. The Hartford ...
2282
SEIDELDAN@...
danielrseidel
Jan 21, 2010 4:25 pm
Check also AETNA v CIERVO, Index# 2021/87, Kings Supreme (6/18/89); NYLJ 6/28/89, p.1, Decisions of Interest - p.27, col2 - NY Policy considerations with NY/NJ...
2283
Lawrence
insurancelawyer
Jan 23, 2010 4:03 am
ONCE NO-FAULT INSURER ISSUES DENIAL, INSURED MAY SETTLE BI CASE WITHOUT PRESERVING APIP SUBROGATION RIGHTS Scalzo v. State Farm Ins. Co., 2010 NYSlipOp 30109...
2284
Lawrence
insurancelawyer
Jan 25, 2010 8:13 pm
CLAIMANT WHO LOST HIS DENTURES DUE TO POST-ACCIDENT MEMORY IMPAIRMENT GETS AWARD FOR REPLACEMENTS In the Matter of the Arbitration between [Applicant] and...
2285
Sherri
mshlyn01
Jan 25, 2010 9:28 pm
Hi Larry, What happens if you receive a no fault claim from a passenger who is a UK resident and they get injured and do not reside in the states....
2286
Sherri
mshlyn01
Jan 25, 2010 10:07 pm
Hi Larry, So when they do not provide the requested information you are able now to deny stating that we are unable to process your claim without a valid...
2287
SEIDELDAN@...
danielrseidel
Jan 27, 2010 7:58 pm
Morning all, if push come to shove, pltf's atty can make application for "emergency medicaid" coverage for the intitial billings for Amb, ER, Admit, etc. even...
2288
Sherri
mshlyn01
Jan 27, 2010 8:16 pm
Hi Larry, Just as a follow up, I was under the impression that all carriers / tpa's had to provide at minimum, the claimant's full name, date of birth, social...
