Does the 'No Fault Law' Provide More Efficient Means for Adjusting Financial Responsibilities ?
In Aetna Life & Cas. Co. v. Nelson (67 NY2d 169, 175), a case involving application of the Statute of Limitations to be used in certain no-fault situations where the insurer seeks to recoup first-party benefits it paid, the Court of Appeals articulated a principle applicable herein, which is "the No-Fault Law does not codify common-law principles; it creates new and independent statutory rights and obligations in order to provide a more efficient means for adjusting financial responsibilities arising out of automobile accidents."
Insurance Law former 670 (now art 51) abrogates a common-law right and thus must be strictly construed. (Morgan v. Bisorni, 100 AD2d 956 .)
Insurance Law 5108 (a) and (b) authorize a health provider to receive fees as per the schedules prepared and established by the Workers' Compensation Board.
In section 5108 (c) a health care provider is forbidden to "demand or request" any payment in excess of the authorized charges from the no-fault patient.
Under the applicable provisions of 11 NYCRR 65.15 the term "assignee" is used in regard to payment by the insurer:
"(j) Direct payments.
(1) An insurer shall pay benefits for any element of loss ... or, upon assignment by the applicant ... shall pay to the providers of services ... directly.
"(2) If an assignment has been furnished an insurer, the assignor or legal representative of the assignor shall not unilaterally revoke the assignment after the services for which the assignment was originally executed were rendered. If the assignment is revoked for services not yet rendered, the assignor or legal representative shall provide written notification to the insurer that the assignee has been notified of the revocation."