A.M. Med. Servs., P.C. v. Travelers Ins. Co.

3 Citing cases

  1. A.M. Med. Servs., P.C. v. Progressive Cas. Ins. Co.

    101 A.D.3d 53 (N.Y. App. Div. 2012)   Cited 23 times

    At issue here is whether the PC was entitled to recover first-party no-fault benefits under assignment from the applicant where the treating medical professionals were identified in the PC's claim forms as independent contractors rather than owners or employees of the PC. The Appellate Term, interpreting 11 NYCRR 65–3.11(a), has held that, “[w]here a billing provider seeks to recover no-fault benefits for services which were not rendered by it or its employees, but rather by a treating provider who is an independent contractor, it is not a ‘provider’ of the medical services rendered within the meaning of Insurance Department Regulations” (A.M. Med. Servs., P.C. v. Travelers Ins. Co., 23 Misc.3d 145[A], 2009 N.Y. Slip Op. 51147[U], *1, 2009 WL 1606432 [App.Term, 2d Dept., 2d, 11th & 13th Jud. Dists.], quoting 11 NYCRR 65–3.11[a] ). The Appellate Term has consistently followed this rule ( see e.g. Health & Endurance Med., P.C. v. Travelers Prop. Cas. Ins. Co., 31 Misc.3d 150[A], 2011 N.Y. Slip Op. 51120[U], 2011 WL 2505465 [App.Term, 2d Dept., 2d, 11th & 13th Jud. Dists.];Health & Endurance Med., P.C. v. Liberty Mut. Ins. Co., 19 Misc.3d 137[A], 2008 N.Y. Slip Op. 50864[U], 2008 WL 1886339 [App.Term, 2d Dept., 2d & 11th Jud. Dists.]; V.S. Med. Servs. P.C. v. Allstate Ins. Co., 14 Misc.3d 130[A], 2007 N.Y. Slip Op. 50016[U], 2007 WL 29056 [App.Term, 2d Dept., 2nd & 11th Jud. Dists.];V.S. Med. Servs., P.C. v. New York Cent. Mut. Fire Ins. Co., 14 Misc.3d 134[A], 2006 N.Y. Slip Op. 52553[U], 2006 WL 4007566 [App.Term, 2d Dept., 2nd & 11th Jud. Dists.];Boai Zhong Yi Acupuncture Servs. P.C. v. Allstate Ins. Co., 12 Misc.3d 137 [A], 2006 N.Y. Slip Op. 51288[U], 2006 WL 1865029 [App.Term

  2. Painless Med., Pc. v. Geico

    32 Misc. 3d 715 (N.Y. Civ. Ct. 2011)   Cited 3 times

    However, if Ms. Val voted to sell substantially all of the assets of the plaintiff corporations, including the outstanding claims for assigned first-party no-fault benefits, the claims might cease to be actionable. It is fairly well settled that an individual or corporation cannot recover assigned no-fault benefits for medical services rendered to an injured party unless the individual or corporation, or one of their employees, actually performed the services ( 11 NYCRR 65-3.11 [a]; Rockaway Blvd. Med. PC. v Progressive Ins., 9 Misc 3d 52, 54 [App Term, 2d 11th Jud Dists 2005]; AM. Med. Servs., PC. v Travelers Ins. Co., 23 Misc 3d 145[A], 2009 NY Slip Op 51147[U] [App Term, 2d, 11th 13th Jud Dists 2009]). The rationale for this rule is that 11 NYCRR 65-3.11 (a) only permits the "provider[]" of medical services to recover payment for those services.

  3. Painless Med. v. Geico

    32 Misc. 3d 715 (N.Y. Civ. Ct. 2011)

    However, if Ms. Val voted to sell substantially all of the assets of the plaintiff corporations, including the outstanding claims for assigned first-party no-fault benefits, the claims might cease to be actionable. It is fairly well settled that an individual or corporation cannot recover assigned no-fault benefits for medical services rendered to a injured party unless the individual or corporation, or one of their employees, actually performed the services (11 NYCRR § 65–3.11(a); Rockaway Blvd. Med. P.C. v. Progressive Ins., 9 Misc.3d 52, 54, 802 N.Y.S.2d 302 [App. Term, 2d & 11th Jud. Dists. 2005]; A.M. Medical Services, P.C. v. Travelers Ins. Co., 23 Misc.3d 145(A), 2009 WL 1606432, 2009 N.Y. Slip Op. 51147(U) [App. Term, 2d, 11th & 13th Jud. Dists. 2009] ). The rationale for this rule is that 11 NYCRR § 65–3.11(a)