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 High Cost of Medical Practice
The number of malpractice cases has been spiraling upward at an unprecedented rate, and medical doctors are feeling the crunch. The following quote demonstrates that the AMA has been compiling data on malpractice costs:
"The median medical malpractice award last year rose 40% over 1994 returning to the record setting half-million dollar level of 1993. In addition, juries awarded million dollar awards in 35% of the cases, which is up from 27% in 1994.One wonders to what extent this trend will affect the chiropractic profession."Despite the high-dollar awards, 70% of all claims filed against physicians never result in any payment to the plaintiff, according to the Physician Insurers Assn. of America. In addition, 80% of the cases that go to trial are won by the defendant.
"Long odds, however, haven't stopped patients from filing suit. Lawsuit filings against physicians are up by 11.4% since 1993, according to the American Medical Assn."
Reference
Personal Injury Awards Rise. Business Insurance, January 8, 1996.