New York's highest court of appeals has held that no-fault insurers cannot deny no-fault benefits where they unilaterally determine that a provider has committed misconduct based upon alleged fraudulent conduct. The Court held that this authority belongs solely to state regulators, specifically New York's Board of Regents, which oversees professional licensing and discipline. This follows a similar recent ruling in Florida reported in this publication.
I.Q. -- Interesting Quote
The Vertebral Lesion
The chiropractic profession's theory on disease and its relationship to spinal lesions and subluxations has been scoffed at in the past. But recently, after years of seeing patients whose back surgery has failed to help them, medical practitioners are becoming more and more receptive to different ideas about what causes functional disorders and disease. The following quote from a German medical school professor involves just such a patient:
"The situation, of course, is not always as clear-cut as in the case described above. Nevertheless, we have records of numerous cases similar to the one described here, in which a definite connection appears to exist between a functional disorder in an internal organ and a spinal lesion. Despite this, however, we would emphasize in conclusion that the diagnostic importance of spinal lesions must not be overestimated, as it so frequently is, and that, in particular, the origin of disorders of the internal organs should be sought in such lesions only when all other possible explanations have been examined and discarded. Nothing can discredit the inherent diagnostic value of the relationship between the spine and the internal organs more than to insist on finding such a connection where none exists, and to seek corroboration in threadbare hypotheses. We have no evidence that lesions of the spinal column can cause genuine organic diseases. They are, however, perfectly capable of simulating, accentuating, or making a major contribution of such disorders. There can, in fact, be no doubt that the state of the spinal column does have a bearing on the functional status of the internal organs."
Reference Professor W. Kunert Oberarzt, University Medical Polyclinic, Bonn, Germany: Functional disorders of internal organs due to vertebral lesions.