St. Barnabas Hosp. v Auto One Ins. Co., 2009 NY Slip Op 32819(U) (Sup Ct., Nassau County, 2009)
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Let’s take a guess. Defendant placed the UB-04 (not the DRG) values on the denial and the discrepancy was either not adequately addressed, or the Court failed to read defense counsel’s papers. My guess is the latter.
Now, with two bad decisions on this issue (one being the St. Barnabus v. Allstate case that had no business being appealed because the underlying papers [as I saw on another blog] were beyond sloppy), and this case, other carriers are now going to get hit for $10,000 + judgments on these cases.
How bad were the underlying papers? Use a scale of 1-10; 1 being a drunk four-year-old writing in unusually large crayon, and 10 being a normal attorney.