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Appellate Win for Andrea Ferruci , Congratulations for a summary judgment dismissal of the claim of Omar Tawancy v. Daniel Fitzsimmons (64764/2013). The plaintiff, Omar Tawancy, was struck by the defendant's vehicle as he was walking over the Fire Island Inlet bridge of the Robert Moses Causeway (in the roadway) at 4:00 a.m. on August 10, 2013. The plaintiff testified on the evening before the accident he was at a party on Fire Island and drank several beers. He was walking over the bridge at the time of the accident and sustained serious injuries from the accident. Probably not the best of choices to cross the Fire Island Bridge in the travel lane for cars while intoxicated at 4:00 a.m. Read the complete decision here.
About Andrea Ferruci:
As Managing Attorney of the Summary Judgment and Appellate Department, Andrea heads the team responsible for reviewing and making recommendations on every file involving bodily injury claims. Since taking over the department, she has implemented numerous procedures to expedite and streamline matters. She is an organized and efficient manager as well as a stellar attorney. She has drafted and argued close to 70 appeals since 2009 when she took over the Appellate Department. Read full bio

Congratulations to Chris Amato for a defense verdict on the issue of liability on July 6, 2016 in Richmond County before Judge Desmond Green in BECKY MORALES v. MIRJANA SCARSELLI (100391/2014).

About Chris Amato:

As Richmond County Team Leader, Chris is in court daily. His role is to stay on top of every matter whether it involves arguing motions, attending conferences or going to trial. He draws on the strong relationships he has with court personnel and attorneys to keep cases moving smoothly.

An accomplished litigator, Chris has successfully resolved numerous high-exposure liability claims. He has over 27 years of insurance defense experience as both in-house and outside counsel. His practice focuses on bodily injury automobile accident cases as well as some general liability matters.

Congratulations to Tim Jones for a defense verdict on July 7, 2016, in Bronx County before Judge Barbato on the issue of liability in CHRISTINE WILLIAMS v. DONALD CARROLL (300777/2013).

About Tim Jones

As Bronx County Team Leader, Tim ensures all cases are ready to go to trial. He monitors when they are likely to come up for trial, prepares witnesses and filings, and litigates many of the cases himself. He brings a great blend of experience to each matter. Prior to joining the firm, he spent 15 years working on the plaintiff’s side, which gives him a unique perspective on countering his opponent’s strategies and tactics. His background also includes working in-house at Hartford and US Fidelity & Guaranty as well as with other outside defense counsel firms.

Tim is a skilled trial attorney who relishes being in the courtroom and taking on opposing counsel. Educating juries and getting at the truth of what happened in a case are a big part of what he enjoys about being a lawyer. He also likes that every case is different and involves learning something new, whether it’s about medicine, physics, biology, human experience or another area. His practice covers a broad range of personal injury defense claims.  Read full bio

Defense Verdict for Paul Duer: Congratulations to Paul Duer for a defense verdict in the case of ISMAEL ABREAU v. FORTUNE DONUT CORP.(2343/2014) on July 15, 2016, before Judge Ritholtz in Queens.

About Paul Duer:

Paul is the Queens County Team Leader responsible for managing the firm’s busy court calendar. A skilled litigator, he has an impressive portfolio of defense verdicts on the issues of liability and damages. Paul thrives on challenge and he brings his competitive spirit to every case. His practice focuses on automobile accident cases and he handles all aspects from inception through resolution. Read full bio

Great Result for Mark S. Zemcik: Congratulations to Mark S. Zemcik for a great result on Advanced Orthopedics v State Farm, an AAA case. The amount claimed in the Arbitration Request, was $ 6,343.25. The decision is worth a quick read. Great work Mark!
"It is well settled that a health care provider establishes its prima facie entitlement to No-Fault benefits as a matter of law by submitting evidentiary proof that the prescribed statutory billing forms had been mailed and received and that payment of No-Fault benefits were overdue. Westchester Medical Center v. Lincoln General Insurance Company, 60 A.D.3d 1045, 877 N.Y.S.2d 340 (2nd Dept. 2009); Mary Immaculate Hospital v. Allstate Insurance Company, 5 A.D.3d 742, 774 N.Y.S.2d 564 (2nd Dept. 2004). Applicant submits an NF-10 denial of claim form for what it claims is the bill at issue in this case. Respondent argues that this denial does not satisfy Applicant's prima facie burden, as the NF-10 shows Dov J. Berkowitz as the applicant for benefits, not Advanced Orthopedics PLLC, the Applicant in the case before me.
Applicant then called Kitty D'Alto as a witness. Ms. D'Alto has worked at Advanced Orthopedics, PLLC as a billing manager for seven or eight years. As part of her duties she is in charge of all billing for Applicant, including generating bills and ensuring they are submitted to the insurance companies.
Ms. D'Alto initially testified that the bill at issue in this case was mailed on 6/10/2015. She explained that the bill in evidence is dated 8/10/2015, as it was reprinted for the purpose of filing this arbitration and the amount at issue was changed in consideration for partial payments. She further testified other than the date on the bill, and the letter "F" after the patient's account number, the bill submitted for arbitration is identical to the bill that was submitted to the insurance carrier for reimbursement. She specifically testified that box 33 on the original bill, indicating the billing provider info, indicated Advanced Orthopedics, PLLC on both the original bill and the copy before me. She stated that box 33 could not have had Dov J. Berkowitz listed as provider.
In rebuttal, Respondent showed the witness a copy of the bill which listed Dov J. Berkowitz as the provider in box 33. Ms. D'Alto then changed her testimony that this could be the bill submitted to Respondent. To make out a prima facie case, a claimant must present in its original papers the claim
form it submitted to the insurer. Complete Orthopedic Supplies, Inc. v. State Farm Ins. Co., 16 Misc.3d 996, 999, 838 N.Y.S.2d 861, 866 (Civ. Ct. Queens Co. 2007). Due to the inconsistencies in her testimony and in the evidence presented, I find that Applicant has failed to make out its prima facie."

Congratulations to Dave Tetlak and our No-Fault Team for a great result on an ATIC arbitration. The amount demand demanded, $80,994.83, was denied in its entirety. The relevant portion of the decision is below:

The only other relevant evidence with respect to the question of the timeliness of the bill is the "proof of mailing" referred to by the billing manager. The ECF contains a heavily redacted log sheet that bears a US Postal Service post mark of 3/2/15. I note that the billing manager, Mike Manzo, swore in his affidavit that he personally maintains the logbook and that all claims are mailed on the first business day of each week. 3/2/15 was in fact a Monday. 4/17/15 was a Thursday. The post marked page of the log book that was submitted was redacted so that only the fourth entry on the page is legible. The column on the far left of the page is headed "article number" and the visible entry in that column has the relevant information necessary to identify the claim that is the subject of this arbitration. However, the second column, headed "Addressee (Name, Street, City, State & Zip Code)", has the Respondent's name and address in totally different handwriting than that identifying the claim. I also note that the second column has ruled lines on which to write the addressee's information. However, on the single section of the log that is visible the first column, again in obviously different handwriting than the second, is not lined, at least suggesting the possibility that the entry was whited out and rewritten.

I find that absent a direct affidavit of mailing, the discrepancy in the handwriting and the appearance that the claim information may have been added, particularly in view of the fact that the remainder of the log page is redacted so that no comparison to other entries of that day could be made, the log itself lacks credibility and is insufficient to establish timely mailing of the bill in issue. Although not required, I find the failure of theApplicant to attempt to justify its late bill directly prior to filing for arbitration further calls the actions of the billing company into question. I find nothing in the telephone call of 4/17/15 to indicate that a bill was actually mailed prior to that phone call. I note that the degree of redaction was completely unnecessary to preserve patient confidentiality insofar as the only necessary redaction for each entry would be the patient's name and file/claim number. There was no reason whatsoever to redact any portion of the column listing addressees. I find that these overly extensive redactions render the log virtually useless in establishing mailing on 3/2/15. As such, I find that the Applicant is not entitled to any reimbursement due to having submitted its bill in excess of forty-five days after the services reflected in the bill were rendered and find that the remaining unaddressed issues are therefore moot.

Read the complete decision here.

Congratulations to Andrea Ferrucci for another Appellate Victory in Hartsuff v Michaels (2016 NY Slip Op 04020) decided on May 25, 2016 by the Appellate Division, Second Department. Great result and great work!!! Read the decision here.

Congratulations to Tom Craven for an outstanding result in Johnson v. Yang in Queens County (Index No: 703829/13). We thought we would share this very gracious thank you letter from the client. The impression this client was left with is one we strive to achieve for all of our clients. Great job Tom!

Read the letter here.

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