Filing a No-Fault Case in NY
As a medical provider, your business depends on quick payment for the services you have rendered. But when you deal with a no-fault claim, you may find that insurance companies deny your claim and create other headaches for you.
In situations like this, an attorney can stand up for your rights and advise you of your legal options, which might include the pursuit of a no-fault claim in arbitration or the filing of a no-fault lawsuit.
If you decide on arbitration for your no-fault case, let The Tadchiev Law Firm, P.C., help. Our no-fault attorneys have deep experience and knowledge of the claims process. We are ready to help with every aspect of your case. From responding to verification requests or filing arbitration requests with the American Arbitration Association (AAA), our firm can handle all your no-fault needs.
We are proud to help medical providers obtain the no-fault compensation they need. We are prepared to provide the aggressive advocacy and personalized service that you deserve.
We hope that the FAQs below will help you understand the process of filing a no-fault case with the AAA. If you have specific questions about your no-fault case or want to know more about how we can help, contact us today.
Process for Filing a No-Fault Arbitration Case
Before you can file a claim, the insurance company must have denied or failed to respond to your claim. Once the insurer has issued a denial or failed to respond, you may move forward with the process.
As part of your filing, you must complete several forms and you will need copies of medical records and bills for services rendered. The forms for the arbitration filing process may include:
- NF-10, which the insurance company may issue if your claim is denied
- AR-1, a request for arbitration form
- An executed assignment of benefits form
- NF-3 forms that cover verification of treatment
Once you have filled out these forms, the AAA recommends that you bundle them with these documents:
- A cover sheet with a summary of your bills
- An AR-1 form
- Your bills in chronological order
- NF-10 forms
- Medical reports, test results and other documents in chronological order
- Assignment of benefits forms
- Miscellaneous documents, especially those involving verification responses and rebuttals
- Any relevant case law or relevant prior arbitration awards
You must submit your collection of documents to the AAA with a $40 filing fee. Please see the FAQs below for further information on mailing and electronic filing methods. If you are uncertain about the filing process, call us today for the help you need.
Filing a No-Fault Case
To avoid policy exhaustion and other issues, it is best to file for arbitration as soon as possible.
After the insurance company either denies my claim or fails to issue a timely response, how do I file my arbitration request with the AAA?
Arbitration requests can be filed with AAA online using the New York Insurance ADR Center. Alternatively, you can file for no-fault arbitration by mail. Send your no-fault arbitration request to:
American Arbitration Association
New York Insurance Case Management Center
32 Old Slip, 33rd Floor
New York, NY 10005
The following documents must be filed with every no-fault claim: (i) AR-1 form, and (ii) all NF-3 forms or bills in dispute. An Assignment of Benefits (AOB) form is also required if the carrier issues a timely denial that relates to the AOB.
It is also preferable to include all pertinent medical reports as well as an NF-10 form (if applicable) indicating the reason for denial.
Depending on the particular case, other documents may be necessary. Those documents include a peer review/IME rebuttal, proof of mailing, verification responses and fee schedule documents.
There is no requirement that documents be placed in a specific order when filing for arbitration. However, AAA suggests that you include a cover sheet with a breakdown of the bills in chronological order, with the following exhibit format:
- AR1 Form.
- Exhibit A: Bills in chronological order.
- Exhibit B: NF-10’s/EOB’s.
- Exhibit C: Medical reports, test results and other related documents in chronological order.
- Exhibit D: Assignment of Benefits (AOB).
- Exhibit E: Miscellaneous documents (e.g. proofs of mailing, verification responses, rebuttals).
- Exhibit F: Case law, prior arbitration awards, as deemed relevant.
Can I submit additional documents for arbitration after my arbitration request has already been filed?
Yes. You may submit additional documentation after the arbitration request has been filed. However, following the original submission of documents, any other documents you submit are marked “late submission.” Those documents are admitted into the record at the arbitrator’s sole discretion. In practice, most arbitrators include late submissions as part of the record.
Claims that are filed for arbitration within 90 days after the claim was denied or became overdue qualify for “Priority Arbitration.” If your file qualifies for Priority Arbitration, it is scheduled for a hearing within 45 days from the date it was transmitted from the conciliation center. A “Special Expedited Arbitration” is used for cases that are denied because the Notice of Claim was not submitted within 30 days of the accident. To qualify for this process, you must request Special Expedited Arbitration within 30 days after the mailing of the denial.