Matthew A. Gray

We were successful in having a New York No-Fault (PIP) action fully discontinued, with prejudice. The plaintiff, a major medical provider, filed suit in Kings County Civil Court in the total amount of $25,805.85, claiming our client owed it for the claimant’s unpaid medical billing. The claimant had been involved in a motor vehicle accident and sought payment for medical treatment. Counsel for the medical provider argued that, since the billing was never paid by the insurer, it was due in full—despite the fact that the same matter had previously been fully exhausted and was processed/handled in full compliance with the applicable medical fee schedule(s). While there were evidentiary issues in our client’s case, our arguments and position were strong. After negotiations and arguments, plaintiff’s counsel acquiesced to a full discontinuance of the matter, with prejudice.

We obtained full dismissal in a medical billings claim against our insurance carrier client in a New York No-Fault/PIP Action. The plaintiff, a major medical provider, filed suit in Kings County Civil Court in the total amount of $22,610.79, claiming our client owed it for the claimant’s unpaid medical billing. The claimant had been involved in a motor vehicle accident and sought payment for medical treatment. Counsel for the medical provider argued that, since the billing was never paid by the insurer, it was due in full—despite the fact that the same matter had previously been fully exhausted and denied on similar grounds. While there were evidentiary issues in our client’s case, our arguments and position were strong. After negotiations, plaintiff’s counsel acquiesced to a full dismissal of the matter. Thereby, our client was absolved from any fiscal liability in this action.

We successfully defended and submitted post-hearing arguments and secured dismissal of a New York no-fault arbitration matter. The applicant, a major medical provider, filed an arbitration matter in the amount of $361,601.62, claiming our client owed it for the claimant’s unpaid medical bills following a major motor vehicle accident. The claimant had been involved in the motor vehicle accident and sought payment for medical treatment for a series of treatments rendered while hospitalized, post-accident. Counsel for the medical provider argued that the medical billing was never properly nor timely denied, therefore, payment of the claims was overdue. However, we successfully argued at the arbitration hearing that the applicant’s client failed to provide the requisite statutorily required medical assignment-of-benefits form, assigning the hospital the right to sue on behalf of the injured party. After arguments were heard, the arbitrator ordered post-hearing submissions to be filed by both sides. After researching, drafting and filing a post-hearing submission, the arbitrator ruled in our client’s favor, thereby dismissing the matter based on the applicant’s total failure to submit the requisite form, saving our client hundreds of thousands of dollars.

The plaintiff, a major medical provider, filed suit in Suffolk County’s 3rd District Court in the total amount of $14,999.99, claiming our insurance company client owed it for the claimant’s unpaid medical billing. The claimant was involved in a motor vehicle accident and sought payment for medical treatment. Counsel for the medical provider argued that, since the billing was never paid by the insurer, it was due in full—despite the same matter having been successfully argued and won in arbitration in June of 2021. However, after successful arguments and motion practice, and without significant opposition by plaintiff’s counsel, the matter was dismissed, in full, by the court, which found that both res judicata and collateral estoppel applied. Therefore, the court found in full favor of our client and dismissed the suit and its accompanying complaint.

The applicant, a major medical provider, filed joint arbitration matters in the aggregate amount of $46,095.41, claiming our client owed it for the claimant’s unpaid medical bills. The claimant had been involved in a motor vehicle accident and sought payment for medical treatment. Counsel for the medical provider argued that the original denial basis was insufficient to deny the payment of the claims. However, after our successful argument at the arbitration hearing, our client’s policy of insurance was found to be completely and properly exhausted. Therefore, the arbitrator found in full favor of our client and denied the applicant’s entire claim, on both matters.

We successfully argued and obtained a full dismissal of an arbitration matter filed against a major insurance company. ​The plaintiff filed it, claiming the insurer owed payment for unpaid medical bills. He alleged the injuries arose from a motor vehicle accident on February 28, 2017, and sought payment for medical treatments provided to him in the amount of $92,043.28. His position was that the entire amount was owed as our client had not reimbursed the medical provider for the services/surgery rendered. The defense countered that the treatment rendered was not medically necessary and presented documentation from an independent medical peer review of the plaintiff’s medical claims record to support that position. The arbitrator heard arguments, concluded that our argument was persuasive, and found in full favor of our client.