Scott A. Ginsberg

We successfully defended and submitted post-hearing arguments and secured dismissal of a New York no-fault arbitration matter. The applicant, a major medical provider, filed an arbitration matter in the amount of $361,601.62, claiming our client owed it for the claimant’s unpaid medical bills following a major motor vehicle accident. The claimant had been involved in the motor vehicle accident and sought payment for medical treatment for a series of treatments rendered while hospitalized, post-accident.

The arbitrations were commenced by medical providers against the respondent-carrier for non-payment of medical bills insofar as the policyholder and the claimant engaged in material misrepresentation in the procurement of the policy, and in the presentation of the claim. We submitted a defense brief that included numerous exhibits, including examination under oath transcripts, an affidavit from the respondent-carrier’s underwriting department and screenshots of insurance premium payments from the claimant to the policyholder.

We successfully secured dismissal of a New York no-fault/PIP arbitration commenced by a medical provider against a major insurance carrier for non-payment of medical bills. At the hearing, the carrier argued that the provider was ineligible for reimbursement of the disputed charges because it was not licensed in New York State with the Department of Education and the Department of State when the services at issue were rendered.

Obtained a dismissal at trial in Civil Court of the City of New York, Queens County. ​The plaintiff, an acupuncture facility, alleged wrongful denial of personal injury protection/no-fault benefits relating to acupuncture services rendered to its assignee, a claimant who sought benefits under the defendant-carrier’s policy. The trial judge granted dismissal of the complaint on the basis of the carrier’s defense, that payments were issued in accordance with the applicable fee schedule and, therefore, nothing further was owed to the plaintiff.

We obtained summary judgment in Civil Court of the City of New York, New York County. ​The plaintiff commenced an action seeking reimbursement of PIP benefits under the defendant-carrier's policy for anesthesia rendered to the claimant during a surgical procedure. After establishing that the claimant failed to appear at multiple, duly-scheduled independent medical examinations—a condition precedent to coverage—the complaint was dismissed.