Sunday, June 21, 2009

Assignment of Benefits

- “The authorization by plaintiff's assignor to pay no-fault benefits constitutes an assignment enabling the plaintiff health care provider to sue to recover the insurance proceeds applicable to the medical service provided. (Rehab. Medical Care of New York, P.C., as Assignee of Dor Vania v. Travelers Insurance Company, 188 Misc.2d 176, 727 N.Y.S.2d 247 [App Term 2nd Dept 2001]; Gingold v. State Farm Ins. Co, 168 Misc2d 62, 642 N.Y.S.2d 812 [Civ Ct Queens Co 1996]; see also, Pain Resource Ctr. v. Travelers Ins. Co. 185 Misc 2d 409, 713 N.Y.S.2d 258 [Civ Ct Kings Co 2000].) The authorization is permitted by 11 NYCRR § 65.15 (j) which states: "Direct Payments. (1) An insurer shall pay benefits [***3] for any element of loss, ... directly to the applicant or, ... upon assignment by the applicant ... shall pay the providers of services ... directly."” S&M Supply Inc., v New York Central Mutual Fire Ins. Co. 193 Misc. 2d 282; 748 N.Y.S.2d 910; 2002 N.Y. Misc. LEXIS 1293

- “There is no mention in the assignment language of any intent to revoke the assignment, and thus it operates as a valid assignment allowing plaintiff to sue as an assignee for the medical supplies it provided to its assignor. (Craniofacial Pain Management, as Assignee of Noemi Rivera, v. New York Central Mutual Fire Insurance Co., 186 Misc2d 309, 718 N.Y.S.2d 130 [Civ Ct, Queens County 2000].).” S&M Supply Inc., v New York Central Mutual Fire Ins. Co. 193 Misc. 2d 282; 748 N.Y.S.2d 910; 2002 N.Y. Misc. LEXIS 1293

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