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March 5, 2014

The evidence indicates the respondent had a good faith basis for requesting the EUOs and the EUOs establish that the insured/EIP used a false residence address to procure this policy. Mado Rehab PT PC a/a/o Applicant 1 v. Allstate Insurance Company, AAA Case No.: 412013089576 (Arb. C. Nieves, 2014)...

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October 15, 2013

Defendant established its entitlement to depose the plaintiff’s doctor. W.W. Medical, P.C. a/a/o Andrew Warren v. Allstate Insurance Company, Docket No.: 2010-03142 KC, Supreme Court of the State of New York Appellate Term: 2nd, 11th and 13th Judicial Districts (2013)....

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October 15, 2013

Appellate Term affirmed the lower court’s order granting the defendant’s motion to vacate the notice of trial and compelling the plaintiff to provide discovery. Jamaica Dedicated Medical Care, P.C. v. Allstate Insurance Company, Docket No.: 2011-03008 KC, Supreme Court of the State of New York Appellate Term: 2nd, 11th and 13th Judicial Districts (2013)....

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July 26, 2013

“After reviewing the extensive EUO transcripts (567 pages), I find that there are significant, material inconsistencies in the testimony between Assignor and Assignor’s passenger. I find that said material inconsistencies constitute material misrepresentations and support Respondent’s defense that “the eligible injured parties made material misrepresentations during their examinations under oath.”” Kings County Physician Group PLLC ...

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April 26, 2013

Plaintiff, insurance carrier, by reason of defendant’s breach of a condition precedent to coverage, is not required to pay any third-party bodily injury claims to or on behalf of defendant. Allstate Insurance Company v. Absolute Chiropractic & Wellness, P.C., Index Number: 601029 (Nassau County Supreme 2013)....

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March 22, 2013

Defendant’s motion for summary judgment granted. Plaintiff failed to raise a triable issue of fact in opposition to plaintiff’s showing that defendant’s assignor failed to answer materially relevant questions at a properly scheduled examination under oath. A violation of a condition precedent to coverage. BCJ Medical, P.C. a/a/o Andres Benjamin; RGW Chiropractic, P.C. a/a/o Andres ...

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February 15, 2013

Based upon the aforementioned evidence and case law, I find that the respondent did present sufficient evidence to establish a defense based on lack of casual relationship of the lumbar spine injuries and the lack of medical necessity, and that the applicant has not satisfied its burden by presenting its own evidence of medical necessity...

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February 8, 2013

Defendant set forth detailed and specific reasons for believing that plaintiff a professional service corporation which fails to comply with applicable state or local licensing laws and, thus, is ineligible to recover no-fault benefits , a defense which is not precluded. By obtaining discovery of certain documents, such as plaintiff’s financial records, defendant will...

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January 31, 2013

Plaintiff, insurance carrier, is entitled to a declaratory judgment in its favor that it is not obligated to honor of pay claims or future claims for reimbursement or No-Fault benefits by the providers named herein… from the alleged accident. Allstate Insurance Company v. Active Chiropractic, P.C. et al., Index No.: 150980 (Hon. Donna Mills,...

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