No Standing Where EIP Fails to Sign Release of Assignment

Applicant_1 and Liberty Mutual Insurance Company

AAA Case No. 412009044891, Arbitrator Laura A. Yantsos
Amount in Dispute: $12,195.00

The named Applicant in this arbitration was the Eligible Injured Party.  The EIP had originally assigned his right to collect benefits for his knee surgery to the provider.  The provider then, for a reason not altogether clear, signed a release of assignment.  The Applicant EIP however, did not sign the is release.

The release stated that the provider had released the assignment of benefits and authorized the law firm now before it to file arbitration on behalf of the Applicant EIP.

The arbitrator stated that the EIP’s failure to sign the release suggested that he did not even know that the claim had been brought to arbitration.  The arbitrator stated that “Once the medical provider releases his assignment of benefits, he has no authority to hire or retain law firms on behalf of the Applicant/eligible injured person or authorize that this claim be brought to arbitration.”

The claim was thus, denied.

Interestingly, the issue once again came up as to whether the provider had an obligation to continue submitting bills to the insurer after benefits had been terminated. (See, Better Smile of Western New York, PLLC and Unitrin Auto & Home Ins. Co.)

The insurer argued that given the language of the NF-10, not “all” benefits had been terminated, and that even if they had, the provider had a continuing obligation if it hoped to preserve any rights under the insurance contract. (Citing to Opinion Letter, General Counsel to N.Y.S. Insurance Department, dated 9/2/04)

The standing issue however, prevented the arbitrator from elaborating on this issue and adding anything to Arbitrator McCorry’s recent decision.