No-Fault Medical Coverage: What You Need To Know

Suppose you are a medical care provider in New York. In that case, you know that claiming compensation for your work can be problematic sometimes. After a long day of hard work, you face endless documents that need to be filed to receive your well-deserved payment.

A no-fault attorney in New York City knows that dealing with various insurance companies can take time. Even when you file your claims perfectly, there is a chance that the insurance company will deny them based on technicalities. In such cases, hiring a lawyer to mediate your case through mediation will save you much trouble.

After providing treatment to all of your patients, you deserve to receive your rightful compensation. Dealing with delayed or denied claims can be frustrating when you do not have the time to do it. If you are a medical care provider facing a denied compensation claim, the following points might help you reach a resolution.

What Is the No-Fault Law?

A no-fault law’s intent is to ensure timely medical care for car accident victims regardless of fault. Medical professionals treat their patience in good faith, expecting the insurance companies to compensate them for their work. Unfortunately, the law has become a legal loophole that insurance companies use to delay or even deny compensation. Some insurance companies use complicated insurance jargon and fine print technicalities to motivate a claim denial.

In other cases, they might base their reason for denial on the Independent Medical Exam (IME). Some IME doctors are financially motivated to find reasons to deny a claim and might state that the patient does not need long-term medical care. Usually, a qualified attorney can easily dismiss this by comparing the victim’s own medical records.

Seek Payment Through the Arbitration Process

If your compensation claim is denied, you can file for arbitration. To resolve this faster, a neutral third-party will review your case and mediate by hearing both sides of the case. The arbitrator’s decision is usually binding, meaning that the insurance company will have to pay your compensation if the arbitrator rules in your favor.

Typically, the arbitration process is much faster than going to court, which means you can obtain your compensation without waiting for the court to schedule a hearing. Despite this, the arbitration process is still a complex legal proceeding. If you are a healthcare provider, your time is probably limited. Having an attorney dealing with the entire process will help you keep up with all the requirements while maintaining your job performance.

Hire a Qualified Attorney

The arbitration process is a legal proceeding, unlike mediation which is more or less an informal process. In a situation like this, having proper representation to ensure the protection of your rights is vital for your case. Insurance companies have armies of lawyers that are ready to defend their claims. If you do not have legal representation, you might get confused during the process and lose a significant sum from your compensation.

As mentioned above, insurance companies will use details from the fine print to invalidate your claim or base their reasoning on the IME doctor’s peer review. A qualified no-fault law lawyer will be able to discover all the inconsistencies in their claim by providing solid proof so that you can receive your well-deserved payment.

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