Comments on: Alternative Dispute Resolution and the Personal Injury Case http://www.zifflaw.com/NYInjuryLawBlog/alternative-dispute-resolution-and-the-personal-injury-case Legal Answers from Lawyers Who Know New York & Pennsylvania Law Mon, 06 Feb 2012 15:03:01 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: AdamGee http://www.zifflaw.com/NYInjuryLawBlog/alternative-dispute-resolution-and-the-personal-injury-case/comment-page-1#comment-714 AdamGee Fri, 28 Mar 2008 13:29:49 +0000 http://www.zifflaw.com/blog/alternative-dispute-resolution-and-the-personal-injury-case#comment-714 Dr. Eisenberg - my answer depends on the circumstances giving rise to the treatment. In a case where the injuries you are treating arise out of an automobile accident, I believe that disputes with the no-fault carrier are required to be arbitrated with the American Arbitration Association (AAA). The injured party also has the right to arbitration, but we refuse to arbitrate denials of care for our personal injury clients as a finding that the medical care recieved was not necessary and appropriate, or worse, that the injury for which treatment was rendered is not causally related to the motor vehicle accident, is binding on the Plaintiff in the personal injury case. In all other cases you will need to look at your contract language to determine the rights that you have. Very often, you will have the right to sue. When you have that right, my recommendation would be to sue whenever possible, as a judge is far more likely to be sympathetic to your cause and skeptical of the insurance company trying to shirk its obligation to pay for medical care than an arbitrator will be. Depending on the amount of the bill, you may be able to bring your claim in Small Claims Court or New York City's Civil Court. Your attorney's fees will be much less in Civil Court, and you can proceed in Small Claims Court without an attorney at all. The insurance companies really dislike the court system, because they are deathly afraid of creating binding precedent that can be used against them in future cases. You may find that once a case is sued, they are more willing to amicably discuss the matter. I wish you the best of luck. Dr. Eisenberg – my answer depends on the circumstances giving rise to the treatment. In a case where the injuries you are treating arise out of an automobile accident, I believe that disputes with the no-fault carrier are required to be arbitrated with the American Arbitration Association (AAA). The injured party also has the right to arbitration, but we refuse to arbitrate denials of care for our personal injury clients as a finding that the medical care recieved was not necessary and appropriate, or worse, that the injury for which treatment was rendered is not causally related to the motor vehicle accident, is binding on the Plaintiff in the personal injury case. In all other cases you will need to look at your contract language to determine the rights that you have. Very often, you will have the right to sue. When you have that right, my recommendation would be to sue whenever possible, as a judge is far more likely to be sympathetic to your cause and skeptical of the insurance company trying to shirk its obligation to pay for medical care than an arbitrator will be. Depending on the amount of the bill, you may be able to bring your claim in Small Claims Court or New York City’s Civil Court. Your attorney’s fees will be much less in Civil Court, and you can proceed in Small Claims Court without an attorney at all. The insurance companies really dislike the court system, because they are deathly afraid of creating binding precedent that can be used against them in future cases. You may find that once a case is sued, they are more willing to amicably discuss the matter. I wish you the best of luck.

]]> By: Daniel Eisenberg, D.C. http://www.zifflaw.com/NYInjuryLawBlog/alternative-dispute-resolution-and-the-personal-injury-case/comment-page-1#comment-711 Daniel Eisenberg, D.C. Fri, 28 Mar 2008 04:10:20 +0000 http://www.zifflaw.com/blog/alternative-dispute-resolution-and-the-personal-injury-case#comment-711 Hi, I am the clinical administrator of a very large mulitispecialty medical center in the Bronx. I found your last post very informative. Can you comment on which direction you advise for providers fighting with the insurance company. Hi,
I am the clinical administrator of a very large mulitispecialty medical center in the Bronx. I found your last post very informative. Can you comment on which direction you advise for providers fighting with the insurance company.

]]> By: AdamGee http://www.zifflaw.com/NYInjuryLawBlog/alternative-dispute-resolution-and-the-personal-injury-case/comment-page-1#comment-707 AdamGee Thu, 27 Mar 2008 14:15:49 +0000 http://www.zifflaw.com/blog/alternative-dispute-resolution-and-the-personal-injury-case#comment-707 Louis is correct in noting that the Summary Jury Trial Process in Bronx County is binding. This is different than the way it is generally run upstate. Chautaqua County (in the southwest corner of New York) is generally credited with starting the SJT process in New York, and it is and generally remains a non-binding process. It remains that way in Chautaqua County, here in Chemung County where our firm is based, and to my knowledge remains that way in the upstate cities where it is starting to gain a foot hold. Personally, I like the idea of a binding SJT process better, as the biggest downside of SJT's is that there is no agreement at the end of the day, and little to be gained from the Plaintiff's perspective. Thanks for the information and link, Louis! Louis is correct in noting that the Summary Jury Trial Process in Bronx County is binding. This is different than the way it is generally run upstate. Chautaqua County (in the southwest corner of New York) is generally credited with starting the SJT process in New York, and it is and generally remains a non-binding process. It remains that way in Chautaqua County, here in Chemung County where our firm is based, and to my knowledge remains that way in the upstate cities where it is starting to gain a foot hold. Personally, I like the idea of a binding SJT process better, as the biggest downside of SJT’s is that there is no agreement at the end of the day, and little to be gained from the Plaintiff’s perspective.
Thanks for the information and link, Louis!

]]> By: Louis Schepp http://www.zifflaw.com/NYInjuryLawBlog/alternative-dispute-resolution-and-the-personal-injury-case/comment-page-1#comment-699 Louis Schepp Thu, 27 Mar 2008 00:44:41 +0000 http://www.zifflaw.com/blog/alternative-dispute-resolution-and-the-personal-injury-case#comment-699 At http://www.nycourts.gov/courts/12jd/civil/filingrules.shtml#summary is the Summary Jury Trial Program (SJT) Information Sheet for Bronx Supreme Court. The first entry is the following: "An SJT is a binding one day jury trial with relaxed rules of evidence." So it would appear that a SJT is a binding mini-trial, at least in the Supreme Court 12th Judicial District, Bronx County, NY site says it is? At

http://www.nycourts.gov/courts.....ml#summary

is the Summary Jury Trial Program (SJT) Information Sheet for Bronx Supreme Court. The first entry is the following: “An SJT is a binding one day jury trial with relaxed rules of evidence.” So it would appear that a SJT is a binding mini-trial, at least in the Supreme Court 12th Judicial District, Bronx County, NY site says it is?

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