Tuesday, July 1, 2008

July Coverage Counsel Poll

The results for our June poll are final. 63.3% (19) of the 30 of you who voted answered "yes" to the following question:

With the Court of Appeals having affirmed Fair Price Medical, will insurers be able to counterclaim or sue and recover for 5106(a)-required payments of no-fault services or DMEs they can prove were not rendered or delivered?

July's poll (scroll down, right side of this page) is up through the end of the month. Here's this month's question:

What constitutes a "claim" for purposes of calculating and awarding attorneys' fees in no-fault recovery suits:

  • all bills for a single date of service (DOS)?
  • each bill (NF-3, NF-4, NF-5 or UB-92) submitted to the insurer?
  • each cause of action alleged by the complaint, regardless of the DOS or number of discrete bills at issue? -or-
  • something else (please comment).

For a discussion of two recent cases in which the "per claim" question was at issue, see my posts here.


David M. Gottlieb, Esq. said...

This was addressed during oral argument in Fair Price.

Roy A. Mura said...

May have been, but the decision doesn't explicate. It only refers to "claims dated September 18, 2001 and October 13, 2001" and the "two claims itemized the medical supplies allegedly received by Nivelo in May and June 2001", implying that the answer to this month's poll should be the "each bill" choice, yes?

. said...

I was only talking about the counterclaim thing.