The new no-fault regulations in New York that take effect on April 1st aim to:
1) Prevent insurers from having to pay for medical services that were not actually provided or pay more than the established fee schedule.
2) Require healthcare providers to respond to insurers' requests for medical necessity verification within 120 days or provide justification for not doing so, to speed up the claims process.
3) Specify that technical defects in insurers' denial of claims or verification requests will not invalidate them, to reduce unnecessary litigation.
ECC Benefits: Employees' Compensation Program. Unknown to many employers and employees, there are ECC benefits granted to employees in the event of work-related illness, injury, and death.
Providers seeing a 2 percent payment decrease on their Remittance Advice (RA) is due to a mandatory sequestration payment reduction. Claim adjustment reason code (CARC) 253 is used to report the sequestration reduction.
PhilHealth Benefits: National Health Insurance Program. Philippine Labor Law requires employers to contribute for the health insurance coverage of their employees through PhilHealth.
ECC Benefits: Employees' Compensation Program. Unknown to many employers and employees, there are ECC benefits granted to employees in the event of work-related illness, injury, and death.
Providers seeing a 2 percent payment decrease on their Remittance Advice (RA) is due to a mandatory sequestration payment reduction. Claim adjustment reason code (CARC) 253 is used to report the sequestration reduction.
PhilHealth Benefits: National Health Insurance Program. Philippine Labor Law requires employers to contribute for the health insurance coverage of their employees through PhilHealth.
Special Leave for Women: 2 months. For women employees who have undergone surgery for gynecological disorders, Philippine Labor Law grants them a 2-month special leave to recover.
A comprehensive view of how Medical Billing works. How to prepare medical claims, patient eligibility, example insurance cards, Medicare / Medicade, authorization of services, charge entry, fee schedules, claim submissions, posting ERAs / EOBs, rejected or denied claims (and their correction), secondary claims, cycle of a claim, revenue cycle, provider info needed on a claim, evaluation and management: coding and evaluations and basic components, etc,. By Medwave Medical Billing & Credentialing at http://medwave.io.
Premium Pay: Non-Work Days. Philippine Labor Code requires payment of a premium pay for work done on non-work days, such as rest days and special non-working days.
Holiday Pay: Regular Holidays. During holidays in the Philippines, Labor Law prescribes payment of holiday pay - even if no work is done. If work is done, the wage rate will be twice than the regular rate. If work is done on a double holiday, the wage rate will be thrice than the regular rate.
A comprehensive guide to the laws governing surrogacy arrangements in North Transatlantic (the UK, the USA, and Canada). DOI: 10.13140/RG.2.1.4485.2888
This Charter was developed in compliance with the provisions of Republic Act No. 9485, also known as the "Anti-Red Tape Act of 2007" but also as part of the SSS' desire to achieve its vision of providing world-class and delightful service to you our members.
COVID-19 Business Interruption Rulings as of Oct 30 2020JasonSchupp1
What COVID-19 Business Interruption Litigation Can Tell Us About How the Pandemic Risk Insurance Act (PRIA) Would Work (Or Not Work) for Small Businesses
PRIA would make sure small businesses could buy business income coverage without a virus exclusion – but that does not mean they would be covered for the next pandemic.
Special Leave for Women: 2 months. For women employees who have undergone surgery for gynecological disorders, Philippine Labor Law grants them a 2-month special leave to recover.
A comprehensive view of how Medical Billing works. How to prepare medical claims, patient eligibility, example insurance cards, Medicare / Medicade, authorization of services, charge entry, fee schedules, claim submissions, posting ERAs / EOBs, rejected or denied claims (and their correction), secondary claims, cycle of a claim, revenue cycle, provider info needed on a claim, evaluation and management: coding and evaluations and basic components, etc,. By Medwave Medical Billing & Credentialing at http://medwave.io.
Premium Pay: Non-Work Days. Philippine Labor Code requires payment of a premium pay for work done on non-work days, such as rest days and special non-working days.
Holiday Pay: Regular Holidays. During holidays in the Philippines, Labor Law prescribes payment of holiday pay - even if no work is done. If work is done, the wage rate will be twice than the regular rate. If work is done on a double holiday, the wage rate will be thrice than the regular rate.
A comprehensive guide to the laws governing surrogacy arrangements in North Transatlantic (the UK, the USA, and Canada). DOI: 10.13140/RG.2.1.4485.2888
This Charter was developed in compliance with the provisions of Republic Act No. 9485, also known as the "Anti-Red Tape Act of 2007" but also as part of the SSS' desire to achieve its vision of providing world-class and delightful service to you our members.
COVID-19 Business Interruption Rulings as of Oct 30 2020JasonSchupp1
What COVID-19 Business Interruption Litigation Can Tell Us About How the Pandemic Risk Insurance Act (PRIA) Would Work (Or Not Work) for Small Businesses
PRIA would make sure small businesses could buy business income coverage without a virus exclusion – but that does not mean they would be covered for the next pandemic.
A PowerPoint overview of New York No-Fault Law, including the background of the law and regulation, an explanation of the scope of coverage, exclusions and benefits, and exploration of several issues, including notice and claims handling.
Howard Ankin Presentation at ITLA Workers' Compensation SeminarAnkin Law Office, LLC
Howard Ankin gave a presentation at the Illinois Trial Lawyers Association workers’ compensation seminar on November 3, 2017. The Illinois Trial Lawyers is an association of lawyers who advocate on behalf of injured people.
Review Figure 10.1 on p. 239 and the Billing Workflow section .docxcarlstromcurtis
Review
Figure 10.1 on p. 239 and the Billing Workflow section on pp. 238-239 of
Health Information and Technology Management
.
Write
a 150- to 350-word response to the following:
Discuss
at least two components described in the Billing Workflow section in Ch. 10 of
Health Information and Technology Management
.
How do these components affect health care reimbursement?
Billing Workflow
1.
Providers of all types verify patient insurance eligibility with the health plan, either prior to or during the admission or visit. Medical offices collect and post copays at the visit.
2.
The patient is treated and discharged or checked out.
3.
As you learned in
Chapter 9
, the provider usually needs to bill a third party, the insurance plan, in order to receive payment. The insurance bill is called a
claim
. The first step in preparing the claim is to assign procedure codes for the services rendered and the supplies used and diagnosis codes representing the disease or medical condition.
4.
Using these codes and the patient registration information, a computer program generates a paper or electronic claim to be sent to the insurance plan.Before the claim is sent to the insurance plan, an insurance or claim specialist reviews the claim to make sure there are no errors. Because of the volume of claims, a computer program is used to examine the claim data and identify problems. Once the claim is correct, it is sent to the insurance plan (usually electronically).
5.
When the claim is received by the insurance plan, it is adjudicated. If the claim is correct, a payment is sent to the provider; this is called the
remittance
. A paper or electronic document is generated that explains the amounts that were paid. This is called the
remittance advice
or
explanation of benefits
(EOB).
6.
When the remittance is received by the provider, the payment amount is recorded in the patient accounts system. Frequently, the amount billed does not equal the amount paid. This may be the result of a contractual agreement that stipulates that the provider will accept a discounted payment and/or that a portion of the charges is the patient’s obligation. An accounting entry called a
write-down adjustment
is posted to adjust the charge.
7.
If the patient has a secondary insurance plan, a claim is next sent to the second plan. In certain cases the first plan will automatically forward the claim to the second plan. This is called a “piggyback” claim or
coordination of benefit
(COB) claim. For example, when a Medicare patient has a supplemental insurance policy with the fiscal intermediary who processes the Medicare claims, the company will sometimes process the secondary claim automatically. This eliminates the need for the provider to file a second claim. These are also known as crossover claims.
8.
Most health plans require the patient to pay a portion of the medical bill. These payments are referred to as the copay, coinsurance, and deductible amou ...
Fischetti Law Group is here to provide you with the legal guidance and resources needed for a variety of practice areas, no matter what happened. Our experienced professionals are qualified in a range of services, from car accidents to nursing home abuse, personal injury protection payouts, and homeowners insurance claims. Rest assured that your case will be handled by an expert. Take advantage of our broad list of services today!
Our attorneys primarily litigate cases related to homeowner’s insurance claims, personal injury protection (PIP), insurance claims, and bodily injury and/or harm caused by negligence. This includes car accidents, nursing home abuse, and slip-and-fall accidents. If you’re not sure if we can help you with your case, contact us today to find out more information. We’re available every Monday through Friday from 8:30 am to 6:00 pm. We can also schedule a time to meet with you on the weekends if that’s preferred.
Our present locations include Fort Pierce Attorney Office (satellite offices) and Boynton Beach Florida Attorney Office (central hub and primary office location). However, we’ve taken cases throughout the entire state of Florida.
The Health Care and Education Affordability Reconciliation Act of 2010 was recently passed by the House and will be signed into law 03/30/2010. NAHU (National Association for Health Underwriters) published a comprehensive timeline of the changes coming over the next few years. Please contact me with any questions.
Health Reform Bulletin 135 | Repeal of Individual Penalty Mandate, Review of ...CBIZ, Inc.
While there has been much energy over the past year focused on repealing, replacing, or repealing and replacing the Affordable Care Act (ACA), the bulk of the law remains in full force and effect.
This notwithstanding, Congress passed the “Tax Cuts and Jobs Act” (H.R. 1) on December 20, 2017; the President is expected to sign the bill into law. This tax reform bill repeals the individual penalty mandate. As background, beginning in 2014, all individuals residing in the United States are required to maintain a minimum level of health coverage, or be subject to a tax penalty. This tax penalty will be repealed, effective for tax years beginning January 1, 2019.
http1500cms.comBECAUSE THIS FORM IS USED BY VARIOUS .docxpooleavelina
http://1500cms.com/
BECAUSE THIS FORM IS USED BY VARIOUS GOVERNMENT AND PRIVATE HEALTH PROGRAMS, SEE SEPARATE INSTRUCTIONS ISSUED BY
APPLICABLE PROGRAMS.
NOTICE: Any person who knowingly files a statement of claim containing any misrepresentation or any false, incomplete or misleading information may
be guilty of a criminal act punishable under law and may be subject to civil penalties.
REFERS TO GOVERNMENT PROGRAMS ONLY
MEDICARE AND CHAMPUS PAYMENTS: A patient’s signature requests that payment be made and authorizes release of any information necessary to process
the claim and certifies that the information provided in Blocks 1 through 12 is true, accurate and complete. In the case of a Medicare claim, the patient’s signature
authorizes any entity to release to Medicare medical and nonmedical information, including employment status, and whether the person has employer group health
insurance, liability, no-fault, worker’s compensation or other insurance which is responsible to pay for the services for which the Medicare claim is made. See 42
CFR 411.24(a). If item 9 is completed, the patient’s signature authorizes release of the information to the health plan or agency shown. In Medicare assigned or
CHAMPUS participation cases, the physician agrees to accept the charge determination of the Medicare carrier or CHAMPUS fiscal intermediary as the full charge,
and the patient is responsible only for the deductible, coinsurance and noncovered services. Coinsurance and the deductible are based upon the charge
determination of the Medicare carrier or CHAMPUS fiscal intermediary if this is less than the charge submitted. CHAMPUS is not a health insurance program but
makes payment for health benefits provided through certain affiliations with the Uniformed Services. Information on the patient’s sponsor should be provided in those
items captioned in “Insured”; i.e., items 1a, 4, 6, 7, 9, and 11.
BLACK LUNG AND FECA CLAIMS
The provider agrees to accept the amount paid by the Government as payment in full. See Black Lung and FECA instructions regarding required procedure and
diagnosis coding systems.
SIGNATURE OF PHYSICIAN OR SUPPLIER (MEDICARE, CHAMPUS, FECA AND BLACK LUNG)
I certify that the services shown on this form were medically indicated and necessary for the health of the patient and were personally furnished by me or were furnished
incident to my professional service by my employee under my immediate personal supervision, except as otherwise expressly permitted by Medicare or CHAMPUS
regulations.
For services to be considered as “incident” to a physician’s professional service, 1) they must be rendered under the physician’s immediate personal supervision
by his/her employee, 2) they must be an integral, although incidental part of a covered physician’s service, 3) they must be of kinds commonly furnished in physician’s
offices, and 4) the services of nonphysicians must be included on the physician’s bills.
For CHA ...
The purpose of this Act is to set forth standards for the investigation and disposition of claims arising under policies or certificates of insurance issued to residents of different states. Cease and Desist and Penalty Orders. Unfair Claims Practices Defined.
An overview of the Form 1002 process enacted as a result of the Louisiana Workers Compensation Law as presented by Micheal Rodriguez of www.2Hurt2Work.com
Service Tax Voluntary Compliance Encouragement Scheme, 2013Ashish Gupta
This is about One time amnesty scheme launched by the Central Government under Service Tax Regime vide Finance Act, 2013. Last date to filed 31st December 2013.
01062024_First India Newspaper Jaipur.pdfFIRST INDIA
Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
CLICK:- https://firstindia.co.in/
#First_India_NewsPaper
role of women and girls in various terror groupssadiakorobi2
Women have three distinct types of involvement: direct involvement in terrorist acts; enabling of others to commit such acts; and facilitating the disengagement of others from violent or extremist groups.
31052024_First India Newspaper Jaipur.pdfFIRST INDIA
Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
CLICK:- https://firstindia.co.in/
#First_India_NewsPaper
हम आग्रह करते हैं कि जो भी सत्ता में आए, वह संविधान का पालन करे, उसकी रक्षा करे और उसे बनाए रखे।" प्रस्ताव में कुल तीन प्रमुख हस्तक्षेप और उनके तंत्र भी प्रस्तुत किए गए। पहला हस्तक्षेप स्वतंत्र मीडिया को प्रोत्साहित करके, वास्तविकता पर आधारित काउंटर नैरेटिव का निर्माण करके और सत्तारूढ़ सरकार द्वारा नियोजित मनोवैज्ञानिक हेरफेर की रणनीति का मुकाबला करके लोगों द्वारा निर्धारित कथा को बनाए रखना और उस पर कार्यकरना था।
In a May 9, 2024 paper, Juri Opitz from the University of Zurich, along with Shira Wein and Nathan Schneider form Georgetown University, discussed the importance of linguistic expertise in natural language processing (NLP) in an era dominated by large language models (LLMs).
The authors explained that while machine translation (MT) previously relied heavily on linguists, the landscape has shifted. “Linguistics is no longer front and center in the way we build NLP systems,” they said. With the emergence of LLMs, which can generate fluent text without the need for specialized modules to handle grammar or semantic coherence, the need for linguistic expertise in NLP is being questioned.
‘वोटर्स विल मस्ट प्रीवेल’ (मतदाताओं को जीतना होगा) अभियान द्वारा जारी हेल्पलाइन नंबर, 4 जून को सुबह 7 बजे से दोपहर 12 बजे तक मतगणना प्रक्रिया में कहीं भी किसी भी तरह के उल्लंघन की रिपोर्ट करने के लिए खुला रहेगा।
03062024_First India Newspaper Jaipur.pdfFIRST INDIA
Find Latest India News and Breaking News these days from India on Politics, Business, Entertainment, Technology, Sports, Lifestyle and Coronavirus News in India and the world over that you can't miss. For real time update Visit our social media handle. Read First India NewsPaper in your morning replace. Visit First India.
CLICK:- https://firstindia.co.in/
#First_India_NewsPaper
2. • For nearly a year now, the industry has been buzzing about
the proposed changes to 11 NYCRR 65-3 (Insurance
Regulation No. 68-C), some speculating that the proposed
changes would spell the end of no-fault insurance as we know
it. The proposed Fourth Amendment to 11 NYCRR 65-3 was
initially released in May 2012 as part of the Cuomo
administration's aggressive insurance reform campaign aimed
at ending no-fault fraud and stopping the rapid rise in
automobile insurance rates.
• According to the Department of Financial Services, the
proposed new amendment was cultivated with two
predominant goals in mind: to prevent health care providers
from being paid for services they do not actually provide; and
to address certain technical issues that may be used to prevent
a decision on a claim or keep an otherwise faulty claim open.
Both of these issues, according to the department, increase
costs to consumers.
3. • To tackle these issues, the department's amendment would:
(1) do away with certain statutory requirements, which in
effect require insurers to pay for treatments that were never
actually provided or pay more than the established fee
schedule for a given service; (2) prevent health care providers
from ignoring requests for verification concerning the medical
necessity of treatment by setting a 120-day deadline to
provide such requested information; and (3) close the
apparent loophole that requires insurers to pay for non-
rendered medical services simply because of technical errors
made by those insurers during the claims process.
• On the whole, both insurers and applicants for benefits did not
object to the Superintendent's attempts to protect consumers
from unjust depletion of benefits by attempting to streamline
the claims process, limit excessive billing or "phantom billing,"
and limit litigation over technicalities in the claims process.
There were, however, concerns that the changes would be
placing an unfair and disproportionate burden on applicants.
4. Phantom Billing, Over-Billing
With regard to billing for services not actually performed and/or
billed in excess of the New York State Workers' Compensation
fee schedule, the current law requires insurers to pay for these
claims if they fail to timely process such, either through a
timely denial or verification request. The amendment adds two
new subdivisions to section 65-3.8, providing that no payment
is due where the treatments were not actually provided or to
the extent that the fees charged exceeded the fee
schedule, effectively abrogating the Court of Appeals holding in
Fair Price Medical Supply v. Travelers Indem., 10 NY3d 556
(2008).
Specifically, Subdivisions (g) through (j) of section 65-3.8 are
re-lettered subdivisions (i) through (l) and new subdivisions
(g)??and (h) are added to read as follows:
(1) Proof of the fact and amount of loss sustained pursuant to
Insurance Law section 5106(a) shall not be deemed supplied
by an applicant to an insurer and no payment shall be due for
such claimed medical services under any circumstances:
5. (i) When the claimed medical services were not provided to an
injured party; or
(ii) for those claimed medical service fees that exceed the charges
permissible pursuant to Insurance Law sections 5108(a) and
(b) and the regulations promulgated thereunder for services
rendered by medical providers.
(h) With respect to a denial of claim (NYS Form N-F 10), an
insurer's non-substantive technical or immaterial defect or
omission shall not affect the validity of a denial of claim.
As a result, an insurer is no longer precluded from denying
payment on these grounds beyond the statutory period. The
justification for this change is that when providers over-bill or
bill for phantom services, the consumer's no-fault monetary
limit, typically $50,000, is unjustly depleted.
The new regulation does not explicitly state that billing in
excess of the mandated fee schedule or billing for services not
rendered are non-waivable defenses,
6. but rather that proof of the fact and amount of loss sustained
shall not be deemed to be received by the insurer in the first
instance, a condition precedent to coverage, when the
applicant for benefits has billed in excess of the mandated fee
schedule and/or for services not rendered. Further, and
crucially, amid concerns
that the new amendment would result in the denial of a claim
in its entirety when the applicant for benefits has billed in
excess of the mandated fee schedule, not just to the extent of
the excess, the Superintendent has clearly stated that only the
excess portion of an excessive bill is not due, rather than the
entire bill.
This amendment, applicable to medical services rendered on
or after April 1, 2013, will have a tremendous impact on the
current state of no-fault law.
7. Time Limit for Responding
Currently, an insurer is required, within 30 days of receiving a
no-fault claim from a health care provider, to pay or deny the
claim, or, within 15 days, send a request for additional
information to verify the claim. Once the insurer receives
verification, it has 30 additional days to pay or deny the claim.
However, there is currently no statutory deadline for a provider
to respond to a verification request. Moreover, an insurer is not
permitted to deny or close a claim if it never receives the
requested verification. As a result, some claims remain
open, or tolled, indefinitely. This can become very costly for
insurers as under the law, insurers must pay a very high
interest rate on delayed payments.
The amendment addresses this issue by setting a strict
deadline for responding to the insurer's verification request.
The healthcare provider must now provide a response within
120 days of an insurer's verification request, or provide
reasonable justification why it cannot do so
8. . Should the applicant fail to do one or the other, the
amendment permits an insurer to deny the claim, thus
speeding up the claims process and reducing the number of
claims that remain tolled indefinitely.
Specifically, new subdivisions (o) and (p) are added to section
65-3.5 to read as follows:
(o) An applicant from whom verification is requested shall, within
120 calendar days from the date of the initial request for
verification, submit all such verification under the applicant's
control or possession or written proof providing reasonable
justification for the failure to comply. The insurer shall advise
the applicant in the verification request that the insurer may
deny the
claim if the applicant does not provide within 120 calendar
days from the date of the initial request either all such
verification under the applicant's control or possession or
written proof providing reasonable justification for the failure
to comply.
9. • This subdivision shall not apply to a prescribed form (NF-Form)
as set forth in Appendix 13 of this Title, medical examination
request, or examination under oath request. This subdivision
shall apply, with respect to claims for medical services, to any
treatment or service rendered on or after April 1, 2013 and
with respect to claims for lost earnings and reasonable and
necessary expenses, to any accident occurring on or after April
1, 2013.
(p) With respect to a verification request and notice, an
insurer's non-substantive technical or immaterial defect or
omission, as well as an insurer's failure to comply with a
prescribed time frame, shall not negate an applicant's
obligation to comply with the request or notice. This
subdivision shall apply to medical services rendered, and to
lost earnings and other reasonable and necessary expenses
incurred, on or after April 1, 2013.
Further, paragraph (3) of section 65-3.8(b) is amended to read
as follows:
10. (3) Except as provided in subdivision (e) of this section, an
insurer shall not issue a denial of claim form (NYS form N-F
10) prior to its receipt of verification of all of the relevant
information requested pursuant to [section] sections 65-3.5
and 65-3.6 of this Subpart (e.g., medical reports, wage
verification, etc.). However, an insurer may issue a denial
if, more than 120 calendar days after the initial request for
verification, the applicant has not submitted all such
verification under the applicant's control or possession or
written proof providing
reasonable justification for the failure to comply, provided that
the verification request so advised the applicant as required in
section 65-3.5(o) of this Subpart. This subdivision shall not
apply to a prescribed form (NF Form) as set forth in Appendix
13 of this Title, medical examination request, or examination
under oath request. This paragraph shall apply, with respect
to claims for medical services, to any treatment or service
rendered on or after April 1, 2013, and with respect to claims
for lost earnings and reasonable and necessary expenses, to
any accident occurring on or after April 1, 2013.
11. In order to comply with this new regulation, applicants will be
burdened with additional paperwork and internal procedure
changes, as they will now be required to provide additional
justification for non-compliance and to ensure timeliness of
their responses. However, insurers will share in this burden, as
the amendment mandates that they must notify their
policyholders of the new time-frame requirement and that
failure to adhere to the requirement may result in a denial of
the claim.
Critically, there are several important exceptions to the 120-
day verification rule. The new provision will not apply to a
prescribed form (NF-Form), a medical examination request, or
an examination under oath request.16 This carve-out should
provide some relief to applicants, since a large percentage of
verification requests involve these items. However, because it
is standard practice in the industry for insurers to request
multiple items in one verification request, it raises the question
of whether the 120-day deadline applies to a single request
that contains both exempted and non-exempted items.
Additionally, the amended regulation explicitly stipulates
12. that the applicant is only required to provide, within 120 days
of the initial request, only such verification that is in the
applicant's possession or control, or provide written proof
providing reasonable justification for the failure to comply.17
Finally, it is also important to note that the new provision
regarding verification requests also provides that "an insurer's
failure to comply with a prescribed time frame, shall not
negate an applicant's obligation to comply with the request or
notice."
Technical Defects
Under the current no-fault law, if there is an insignificant, non-
substantive or technical defect in an insurer's otherwise
presumably valid verification request or denial, the applicant
may seek to challenge its legitimacy through the courts or
arbitration.19 In an effort to cut down on what the Department
of Financial Services views as unnecessary litigation and
delay, the new amendment explicitly provides that an
applicant's obligation to comply with a notice or verification
request is not
13. • negated—and a denial of claim is not invalidated—due to a
non-substantive technical or immaterial defect contained in any
of these documents.
With regard to a denial of claim form (NYS Form NF-
10), subsection 65-3.8 (h) provides that "an insurer's non-
substantive technical or immaterial defect or omission shall not
affect the validity of a denial of claim. The subdivision will be
applicable to medical services rendered, and to lost earnings
and other reasonable and necessary expenses incurred, on or
after April 1, 2013."With respect to a verification request and
notice, subsection 65-3.5(p) provides that "an insurer's non-
substantive technical or immaterial defect or omission, as well
as an insurer's failure to comply with a prescribed time
frame, shall not negate an applicant's obligation to comply with
the request or notice. This subdivision shall apply to medical
services rendered, and to lost earnings and other reasonable
and necessary expenses incurred, on or after April 1, 2013."
14. • Notably absent from the new regulation is any definition or
description of what constitutes a "non-substantive technical or
immaterial defect or omission." Such glaring ambiguity will
inevitably create a situation where the courts and arbitrators
will be called upon to offer clarification and conclusiveness.
Despite its best efforts, it seems that the Department of
Financial Services, in trying to craft an amendment that would
reduce unnecessary litigation and speed up the resolution of
claims, has created a new potential "loophole" to be litigated
for years to come.
• David M. Barshay is a member of Baker Sanders, in Garden
City. Jennifer L. Zeidner, a senior associate with the
firm, assisted in the preparation of this article.
POSTED BY ATTORNEY RENE G. GARCIA:
For more information:- The Garcia Law Firm, P.C. was able to successfully
handle no fault cases. For a free consultation please call us at 1-866-
SCAFFOLD or 212-725-1313.