We Fight Tirelessly For You
Long Island No-Fault (PIP) Insurance Law Attorney
Obtain Fast Compensation for Your Recovery
Through our proven, time-effective approach, the Law Office of Gregory A. Goodman, P.C. has helped our clients recover millions of dollars from insurance carriers. From successfully representing medical providers and healthcare facilities for over 20 years, our unique approach ensures that you are compensated as quickly as possible. Call our Long Island insurance law attorney today to schedule your free consultation about your case.
New York Laws
In the state of New York, drivers are required to have no-fault insurance. This is to cover any medical expenses required to treat injuries in an accident. In a perfect world, the insurance company would cover all necessary medical expenses, lost wages, and other costs you incurred due to your accident, but this is not the case. It may be important to get help from an experienced legal professional to ensure you receive full and fair compensation.
Unlike regular insurance claims, the state requires you to testify at an examination under oath (EUO) in a no-fault claim. If you experience problems with an insurer refusing to pay your claims until you appear at an examination under oath, we can help you by responding to the request and representing you at said appearance.
When you work with the Law Office of Gregory A. Goodman, P.C., you receive benefits such as:
- A thorough review and legal analysis of each claim: Our firm methodically reviews each claim on a case by case basis to determine which forum and course of action would bring about the best results for your facility.
- Our attempts to settle cases before litigation: Based on our legal analysis and with client authorization, we will attempt to settle each claim before ever placing the claim into litigation or arbitration.
- Arbitration of medical necessity cases: Arbitration is a practical forum to prosecute denied claims, provided you have experienced legal representation, your case is well-organized for presentation, and you have strong documentation to support the necessity of the services you rendered. One benefit of arbitration is that it can be resolved much more quickly.
- Expedition of litigious cases: Should we determine that litigation is the proper forum, we will implement our “Active Litigation Policy,” which pushes your case in order to get you paid faster.
- Free consultation and updates on important changes in the law: We will keep you informed and help you retool your intake and billing procedures to get you paid on your future cases. We can send one of our partners to your place of business to train or instruct your employees on how to process future claims.
- Direct access to partners and vital information when you need it: We keep an open line of communication with our clients. When a situation arises in the collection of your no-fault bills, you will have complete access to a partner or employee with specific knowledge of your files to get the answers you need promptly.
Did You Provide Healthcare without Being Paid for It?
Just like patients, insurers abuse healthcare providers by using examinations under oath to deny, delay, and not pay viable claims submitted by legitimate healthcare practitioners. This can cause a significant financial strain on that provider. A provider EUO request can essentially freeze any and all pending payments.
It is extremely important to forward any provider EUO request to your attorney. Your attorney must be competent, skilled, knowledgeable, and experienced in this area of law. An insurance carrier may use an EUO request to look into your corporate structure, hoping to keep you from showing up and thereby not having to pay you for all bills submitted. In fact, there have been a number of carriers that will drop their EUO request once you inform them and they know you are serious of attending.
Where Are EUOs Held?
Most insurance carriers and their attorneys will schedule the EUO at a location convenient to their attorney’s law office, but you are entitled to have the EUO anywhere that is convenient for you, so long as you object to the carrier’s location in your response—otherwise you will waive this right.
What Are Insurance Carriers Looking for at an EUO?
The insurance carrier will typically ask you questions about your knowledge and treatment of the patient(s), including the type of treatment your facility rendered to them and the medical necessity of the services provided. An insurance carrier may also wish to inquire into your billing practices, the CPT codes you utilize and bill for, and frequency of billing. They will most likely ask questions pertaining to the names of your employees, whether they are employees or independent contractors, and how you get your referrals.
11 NYCRR § 65-3.2 (c) states an insurance carrier can only delay payment of a claim to pursue investigations solely for good cause, so the “good cause” they may use could be implying your practice exhibited behavior tantamount to fraud. You need to be represented by a skilled, competent, and experienced law firm to protect your rights.
Are You Entitled to Know What Information the Carrier Wants Before Sitting for an EUO?
The short answer is yes—the better answer is you should be. The developing case law seems to support disclosure of said information. Although most insurance carriers and their attorneys generally and routinely refuse to give you information pertaining to the basis and reason for said EUO request prior to you appearing, there is some developing case law requiring said production. As such, you need an attorney who is knowledgeable about the law and a law firm that has experience arguing these issues before a court or arbitrator.
If your insurance claim is being denied with a requirement to submit diagnostic tests, let our firm help. While they may suggest reasons for why there are issues with the test, the truth is most of them simply don’t want to pay.
We have helped providers prove the medical necessity of diagnostic tests such as:
- pf-NCS exams
Call the Law Office of Gregory A. Goodman, P.C. today to schedule your free consultation and hold the insurance carrier accountable. Dial (800) 242-3740 now.
If you have just been involved in an automobile accident—no matter how severe you think it is—there are several important things you keep in mind to preserve and protect your rights under the law.
Here are a few important steps and actions you should follow immediately following your accident:
- Seek immediate medical attention if injured. Be sure to document everything.
- Inform any and all healthcare providers of your injuries, complaints, medical history, and pain. Tell your doctors each and every area of pain, no matter how slight the pain is. Properly and honestly documenting your complaints can be the difference between successfully recovering on your case.
- Take photos of any and all injuries.
- Take photos of any vehicles involved in an accident.
- Take photos of your car—documentation is vital.
- Report to the police if they did not arrive.
- Get a copy of the police report.
- Review police report and make corrections with a police officer.
- Keep a detailed accounting of any expenses you have accrued as a result of your accident, including gas and mileage costs incurred from traveling to and from your doctor’s office for treatment related to injuries sustained from your automobile accident, lost time from work, unpaid bills, co-pays if applicable, etc.
- Immediately contact and report a claim to your insurance carrier A.S.A.P. (There are strict time requirements and documents you need to send to your insurance carrier. We can fully assist you with this process and handle most of these actions for you when retained)
- Complete and submit an application for a no-fault insurance claim (NF-2), which will enable you to receive medical treatment for the injuries you sustained in your automobile accident.
- Get an insurance claim number from your insurance carrier and the defendant’s carrier.
- Contact us immediately to discuss and preserve your rights. We will offer you a free consultation.
Along with what you should do, here are some important things not to do:
- Do not discuss or share any of the details of your accident or injuries with anyone except your attorneys.
- Do not post any details or photos regarding the details of your accident and injuries to Facebook, Twitter, or any other social media account. This information can be used against you and is often discoverable, which means you may have to share this information with the defendant should you pursue a lawsuit.
- Do not spare any details to your healthcare provider about the full extent of your injuries. Documenting the full details of your injuries and complaints can increase the chances of your success. Failure to document and failure to disclose honestly the details can result in decreasing your chances of recovery on your claim.
- Do not enter into an agreement with an insurance carrier without first consulting and retaining an experienced personal injury trial lawyer. Sometimes, when an insurance carrier knows they are liable, they may try to offer the victim money in an effort to save money. Their strategy is to get to you before you seek legal representation and before you know your legal rights.
Property owners are expected to keep their premises safe. If you injured yourself in a slip and fall accident, you need to prove that the owner likely knew about the dangerous area, failed to repair it, and failed to warn people about the dangerous condition. Photo evidence is crucial, as well as proof of the owner’s awareness of the defect and their failure to repair it. It also helps to have a Long Island personal injury lawyer on your side who can help you establish a strong case for compensation for your injuries.
The goal of no-fault insurance is to make sure all victims of an accident are cared for, regardless of who caused the accident. This means the insurance policy should cover medical costs and hospitalization fees, lost wages, and any funeral expenses incurred.
As a physician, can an insurance carrier withhold payment of my fee if I split fees with a billing agency?No. Splitting fees with a management company is not a crime. In 2015, an insurance carrier tried to withhold payment of a provider’s medical fees by claiming that their management agency—which collected 6% of their total costs—was not medical staff. This was an attempt to argue that the healthcare provider was committing fraud, but the court ruled against the insurance carrier.
Yes. If you want to be reimbursed for medical costs, you are required by law to appear. However, you do not have to appear alone. The Law Office of Gregory A. Goodman, P.C. can represent you during your EUO to help you avoid making any statements that would injure your ability to obtain full and fair compensation.