Publication Details

Tejal Forrar Prevails in $173,000 PIP Claim

Tejal Forrar Prevails in $173,000 PIP Claim

Tejal Forrar recently succeeded in defending Allstate New Jersey Insurance Company on a Demand for PIP Arbitration in Forthright which sought over $173,000 in PIP benefits.  In the matter of J.T. v. Allstate, (Forthright #1617259), the Demand, which was filed on behalf of the patient directly, asserted a claim for bills of 13 different medical providers and also included a health care lien.  Ms. Forrar successfully convinced the Dispute Resolution Professional assigned to the matter that the bills should be denied for several reasons.  First, many of the bills were not submitted on proper Health Insurance Claim Forms and were lacking supporting documentation to establish that the amount claimed in the Demand was appropriate.  Secondly, Claimant did not have sufficient information regarding the health care lien to demonstrate that same was appropriate, related to the accident, or was still being sought by the health insurer.  Finally, by relying on a Medical Review Organization (“MRO”) report, Ms. Forrar was able to convince the arbitrator that the surgical procedures at issue were not medically necessary or related to the subject motor vehicle accident.  Having agreed with each of Ms. Forrar’s defenses, the arbitrator denied the Demand for Arbitration in its entirety.