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6 New York opinions name it 4 courts 2005–2012 0 in the last five years
The cases below were cited by New York courts in a sentence that names this issue. Sides come from how each citing opinion treated the case (Syfertize flag on that citation), so a case can appear on both: that is where the law is contested. A red or yellow chip is the case's own overall treatment.
| Case | Followed | Cited |
|---|---|---|
State Farm Mutual Automobile Insurance v. Mallelagreen2 sentences2009The Mallela Court proceeded to apply 11 NYCRR 65-3.16 (a) (12) to the facts that were being alleged and held that if the plaintiff insurer’s claims were true, 4 the defendant medical corporations would not be eligible for reimbursement under section 5102 (a) (1) of the Insurance Law since they “undisputedly fail to meet the applicable state licensing requirements, which prohibit nonphysicians from owning or controlling medical service corporations” (Mallela, 4 NY3d at 320-321 ). 5 While plaintiff does not now question the validity of 11 NYCRR 65-3.16 (a) (12), plaintiff maintains that the Mall 2009The holding in Mallela centered on 11 NYCRR 65-3.16 (a) (12), a regulation promulgated by the Superintendent of Insurance which provides that “[a] provider of health care services is not eligible for reimbursement under section 5102 (a) (1) of the Insurance Law if the provider fails to meet any applicable New York State or local licensing requirement.” The Mallela Court rejected defendants’ contention that 11 NYCRR 65-3.16 (a) (12) conflicted with the prompt payment goals of the no-fault statutes and held that the Superintendent acted within the scope of his authority in promulgating the regul | 1 | 3 |
| Case | Negative | Cited |
|---|---|---|
| No negative-treatment citations attached to this issue in New York. Read the followed side critically anyway. | ||
| Case | Cited | Years |
|---|---|---|
Medical Society v. Serio
green
1 sentence2012A failure by plaintiff to have complied with the relevant licensing laws of New York State would be a failure to satisfy a “condition precedent” (Matter of Medical Socy. of State of N.Y., 100 NY2d at 866 ) necessary to recovery of no-fault benefits. | 1 | 2012–2012 |
Youssef v. Triborough Bridge & Tunnel Authority
green
1 sentence2012Among these conditions precedent is Insurance Department Regulations (11 NYCRR) § 65-3.16 (a) (12), which provides that “[a] provider of health care services is not eligible for reimbursement under section 5102(a)(1) of the Insurance Law if the provider fails to meet any applicable New York State or local licensing requirement necessary to perform such service in New York or meet any applicable licensing requirement necessary to perform such service in any other state in which such service is performed.” Thus, when defendant’s answer is read in a manner allowing defendant “every reasonable int | 1 | 2012–2012 |
Multiquest, P.L.L.C. v. Allstate Insurance
green
2 sentences2008(Multiquest, P.L.L.C. v Allstate, supra; Metroscan Imaging, P.C. v GEICO Ins. 2008Co., 17 Misc 3d 37 [App Term, 2d & 11th Jud Dists 2007].) Insurance Department Regulations (11 NYCRR) § 65-3.16 (a) (12) provides in part: “A provider of health care services is not eligible for reimbursement under Section 5102(a)(1) of the Insurance Law if the provider fails to meet any applicable New York State or local licensing requirement necessary to perform such service in New York.” The provision set forth in 11 NYCRR 65-3.16 (a) (12) bars payment to a fraudulently formed entity regardless of whether the services it performed occurred before or after April 2, 2002, the effective date o | 1 | 2008–2008 |
Medical Malpractice Insurance Ass'n v. Superintendent of Insurance
green
1 sentence2005Assn, v Superintendent of Ins. of State of N.Y., 72 NY2d 753 [1988], cert denied 490 US 1080 [1989]). | 1 | 2005–2005 |
Medical Malpractice Insurance Ass'n v. Superintendent of Insurance
neutral
1 sentence2005Assn, v Superintendent of Ins. of State of N.Y., 72 NY2d 753 [1988], cert denied 490 US 1080 [1989]). | 1 | 2005–2005 |
Counted by distinct opinions that both name this issue and are annotated to the section; sections every opinion cites regardless of issue are not filtered here, so read the counts against the total above.