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No-Fault Arbitration
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As a medical provider, you give the care, attention, and healing that an injury victim needs after a no-fault accident. But sometimes the insurance companies refuse to pay you the compensation you deserve. Insurance companies may deny your claim, make verification demands, or refuse to give you the resources you need to run your business.
How Our No-Fault Lawyers Can Help You
New York state no-fault accidents can lead to complications for medical providers. If you are dealing with insurance company denials of your no-fault claims, contact The Bangiyev Law Firm PLLC, and an experienced no-fault attorney in NY, will assist you. The attorney can:
- Help you gather key documents you need for your case, including essential forms and billing records. This may include AAA-required forms, medical records, billing statements, the denial, and many other documents.
- Respond to requests for verification from insurance companies. In some cases, insurers may ask for additional information to verify a claim. These requests are subject to the law and its restrictions. Our lawyers can review the request, let you know your options, and respond accordingly.
- Provide in-depth knowledge of New York no-fault law. No-fault law can be complex and frustrating for medical providers. Our talented lawyers have a deep knowledge of the law and the claims process. They can put their knowledge to work for you.
- File arbitration requests and prepare arguments for your claim. Our lawyers can handle everything you need to file for arbitration and manage your case from start to finish.
- Stand up for your rights in any arbitration proceedings. Arbitration is run according to detailed rules promulgated by the NYS Department of Financial Services. Our lawyers can manage the process and fight for you during the proceedings.
Medical Professionals We Represent in No-Fault Arbitration Claims
Medical professionals routinely deal with no-fault claims. Our firm has a deep understanding of the claims process and its impact on medical providers. We help these medical professionals and these medical facilities with no-fault claims:
- Ambulatory surgical centers
- Orthopedic surgeons
- Pain management physicians
- Anesthesiologists
- Physical therapists
- Multi-specialty practices
- Acupuncturists
- DME suppliers
- Pharmacies
- MRI facilities
- Laboratories
- Many other types of healthcare providers
What Is a No-Fault Arbitration Process?
Arbitration is often used when a car accident claim is disputed because the claimant’s demand is either ignored or denied. A no-fault arbitration (also called Alternative Dispute Resolution or “ADR”) is a legal proceeding in which, before an impartial third party referred to as a neutral referee (arbitrator), information is presented by all the involved parties to resolve a legal matter within 90 days. Each party must be represented at the hearing, and the presiding officer is usually an attorney.
If you are considering arbitration in a no-fault accident case, it is important to know the steps that are involved:
- You must receive a denial of your claim from the insurance company before you can file a request for arbitration. You can also file a request for arbitration when an insurance company simply fails to respond to your claim and the response is overdue. This denial, or failure to respond, must occur before you can start the arbitration process.
- Forms must be completed and filed with the American Arbitration Association (AAA). These forms may include pages of the NF-10 that you may have received from the insurance company. Alternatively, you can fill out the Form AR-1, which is a request for arbitration. A filing fee of $40 must accompany the filing.
- As part of your filings, you must include key information on the forms. When our office is requesting arbitration, we need these documents:
- A cover sheet showing disputed dates of service and balances
- A fully executed assignment of benefits form (AOB)
- All NF-3 forms or bills in dispute
- Medical reports
- The NF-10 form indicating the reason for denial (if the denial was issued)
- The request will pass through a process known as conciliation. In this process, the parties submit their evidence. Then the conciliator has up to 90 days to hold discussions with the parties and see if they can settle the dispute. If a settlement can be reached, then the matter is resolved. If a settlement cannot be reached, the conciliator will refer the case to arbitration.
- The case goes through several stages of arbitration, including the appointment of an arbitrator and hearings held according to AAA rules. The parties may make their case to the arbitrators over the phone, through written documents, or in person. Once the arbitrators have heard the case, they will issue an award.
No-Fault Arbitration Claim vs. Litigation
Arbitration is generally more cost-effective than litigation, and it typically provides a faster resolution for no-fault claims. Litigation may involve multiple rounds of filings with a court that may take a significant amount of time to schedule. Litigation is often more expensive since it may require costly discovery and an attorney’s appearance at multiple hearings.
Arbitration is often the optimal path to success in resolving no-fault claims. Our legal team can help ensure you have the documents needed to file your no-fault claims. That will allow you to begin the arbitration process as soon as possible. If it appears your case may benefit from litigation rather than arbitration, a no-fault insurance attorney can review your case and help determine your best path forward.
If an insurance company has denied your no-fault claim, do not wait to get the legal help you need. Contact The Bangiyev Law Firm PLLC, to schedule your consultation with a no-fault attorney.