Front, Inc., Plaintiff,v.Philip Khalil, et al., Defendants.--------------------------------Philip Khalil, Third-Party Appellant, v. Jeffrey A. Kimmel, et al., Third-Party Respondents.

Brief

N.Y.January 14, 2015

APL-2014-00089 Civil Court, Kings County, Index No. 120832/05 Appellate Term Docket No. 2009-1000 KC Court of Appeals of the State of New York VIVIANE ETIENNE MEDICAL CARE PC a/a/o Alem Cardenas, Plaintiff-Respondent, – against – COUNTRY-WIDE INS. CO., Defendant-Appellant. BRIEF FOR AMICI CURIAE AMERICAN TRANSIT INSURANCE COMPANY, ALLSTATE INSURANCE COMPANY AND NEW YORK CENTRAL MUTUAL FIRE INSURANCE COMPANY SHORT & BILLY, PC Attorneys for Amici Curiae American Transit Insurance Company, Allstate Insurance Company and New York Central Mutual Fire Insurance Company 217 Broadway, Suite 300 New York, New York 10007 Tel.: (212) 732-3320 Fax: (212) 732-3326 Date Completed: March 13, 2015 STATEMENT PURSUANT TO COURT OF APPEALS RULE 500.1(a) 1. American Transit Insurance Company has the following parent: American T., Inc. 2. Allstate Insurance Company has the following corporate parents, subsidiaries or affiliates: See Attached Schedule A. 3. New York Central Mutual Fire Insurance Company has the following subsidiaries: A Central Insurance Company and Albert F. Stager, Inc. Dated: March 13, 2015 New York, New York SCHEDULE A THE ALLSTATE CORPORATION Subsidiaries and Affiliates ALIC Reinsurance Company Allstate Assignment Company Allstate Assurance Company Allstate County Mutual Insurance Company Allstate Distributors, L.L.C. Allstate Enterprises, LLC Allstate Finance Company, LLC Allstate Financial Advisors, LLC Allstate Financial Corporation Allstate Financial Insurance Holdin~s Corporation Allstate Financial Services, LLC Allstate Financial, LLC Allstate Fire and Casualty Insurance Company Allstate Global Holdin~s Limited Allstate Indemnity Company Allstate Insurance Company Allstate Insurance Company of California Allstate Insurance Company of Canada Allstate Insurance Holdin~s, LLC Allstate International Assignments Ltd. Allstate International Holdin~s, Inc. Allstate Investment Mana~ement Company Allstate Investment Mana~ement Limited Allstate Investments, LLC Allstate Life Insurance Company Allstate Life Insurance Company of Canada Allstate Life Insurance Company of New York Allstate Motor Club, Inc. Allstate New Jersey Insurance Company Allstate New Jersey Property and Casualty Insurance Company Allstate Non-Insurance Holdin~s, Inc. Allstate North American Insurance Company Allstate Northbrook Indemnity Company Allstate Northern Ireland Limited Allstate Property and Casualty Insurance Company Allstate Settlement Corporation Allstate Solutions Private Limited Allstate Texas Lloyd's Allstate Texas Lloyd's, Inc. Allstate Vehicle and Property Insurance Company American Herita~e Life Insurance Company American Herita~e Service Company Answer Financial Inc. AP Real Estate, LLC AP Riverway Plaza, LLC AP Timber, LLC Arity Limited Castle Key Indemnity Company Castle Key Insurance Company Charter National Life Insurance Company Current Creek Investments, LLC E.R.J. Insurance Group, Inc. Encompass Floridian Indemnity Company Encompass Floridian Insurance Company Encompass Home and Auto Insurance Company Encompass Indemnity Company Encompass Independent Insurance Company Encompass Insurance Company Encompass Insurance Company of America Encompass Insurance Company of Massachusetts Encompass Insurance Company of New Jersey Encompass Property and Casualty Company Encompass Property and Casualty Insurance Company ofNew Jersey Esurance Holdin_gs, Inc. Esurance Insurance Company Esurance Insurance Company of Canada Esurance Insurance Company ofNew Jersey Esurance Insurance Services Company of Canada Esurance Insurance Services, Inc. Esurance Property and Casualty Insurance Company First Colonial Insurance Company Insurance Answer Center, LLC lntramerica Life Insurance Company Ivanta_ge Insurance Brokers Inc. !vantage Select A_gency, Inc. Kennett Capital, Inc. Lincoln Benefit Facility Company, LLC Lincoln Benefit Reinsurance Company North Li_ght Specialty Insurance Company Northbrook Services, Inc. Northeast A_gencies, Inc. Pablo Creek Services, Inc. Pafco Insurance Company Pembridge Insurance Company Ri_ght Answer Insurance Agency, LLC Road Bay Investments, LLC Signature Agency, Inc. Signature Motor Club of California, Inc. Signature Motor Club, Inc. Signature Nationwide Auto Club of California, Inc. Signature's Nationwide Auto Club, Inc. Tech-Cor, LLC The Allstate Corporation The Allstate Foundation The Allstate Foundation of Canada West Plaza RE Holdin_gs, LLC i Table of Contents Page Table of Authorities ii-iii Preliminary Statement 1 Argument 2 I. The Case Before the Court Arises Under a Prior Version 2 of the No-Fault Regulations. II The Plaintiff in This Case Did Not Use the Preferred Legislative 5 Forum and Should Not Have a Lesser Burden of Proof. III A No-Fault Applicant Who Chooses to File Their Claim in Court 8 Should be Subject to the Same Evidentiary Burdens As Other Litigants. A. The No-Fault Statute Does Not Provide First-Party 11 No-Fault Claimants With Greater Evidentiary Rights Than Negligence Plaintiffs. B. The Regulations Support Requiring No-Fault Plaintiffs To 13 Prove The Necessity of Their Claims. Conclusion 14 Exhibit 1 - New York State Senate, Notice of Public Hearing (Feb. 4, 2010) 4 Exhibit 2 – Adopted Regulation 68-E and Press Release of the Department of Financial Services 2 Exhibit 3 – Fourth Amendment to the No-Fault Regulations 2 Exhibit 4 - Senate Debate Transcript Tape 15: Act to Amend the Insurance Law, the Workmen’s Compensation Law and the Vehicle and Traffic Law. Number 138 2000-B, Chapter 13, 1973. New York Legislative Service, Inc. 7-8 ii Table of Authorities Cases Auto One Insurance Co. v. Hillside Chiropractic, P.C., 2015 Slip Op 01750 (1st Dept. 2015) ……………………………………………………………..6 Central General Hosp. v. Chubb Group, 90 N.Y.2d 195, 659 N.Y.S.2d 246 (1997) …………………………………………………………..9 Clemens v. Apple, 65 N.Y.2d 746 (1985).………………………………………..12 Country-Wide Ins. Co. v. Harnett, 426 F. Supp. 1030 (SDNY, 1977) affd 431 U.S. 934......................................................................................................6 Goldberg v. Corcoran, 153 A.D.2d 113, 549 N.Y.S.2d 503 (2d Dep’t 1989)………………………………………..….......................................................9 Khalil v. Marion, 200 A.D.2d 500 (1st Dept. 1994)………….……………………12 Medical Society v. Serio, 100 N.Y.2d 854 (2003)….………..………………….....4 Oquendo v. New York City Transit Authority, 246 A.D.2d 635 (2d Dept. 1998)…………………………………………………………………....12 Parker v. Defontaine-Stratton, 231 A.D.2d 412 (1st Dept. 1996)…………...........12 Pommells v. Perez, 4 N.Y.3d 566 (2005)…….………………………………...4, 12 Presbyterian Hosp. v. Maryland Ca. Co. 90 N.Y.2d 274, 660 N.Y.S.2d 536 (1997)………………………………………………...…......9-10 Roggio v. Nationwide Mut. Ins. Co., 66 N.Y.260 (1985) ….……….…………...6-7 Seminara v. Grossman, 253 A.D.2d 420 (2nd Dept. 1998)……………….……….12 State Farm Mut. Auto. Ins. Co. v. Mallela, 4 N.Y.3d 313 (2005)...………………..4 Walton v. Lumbermens Mut. Cas. Co., 88 N.Y.2d 211, 644 N.Y.S.2d 133 (1996)…………..........................................................................9 iii Statutes Insurance Law §409………………………………..…………………………….3, 6 Insurance Law §5102………………………………..………………………...11-14 Insurance Law §5106………………………………..…………………….....6, 8, 14 Regulations 11 NYCRR §65-3.5………………………………………………………..... 3-4, 11 11 NYCRR §65-3.8……..………………………………………………….……....3 11 NYCRR §65-5 ………………………………………………………………….4 11 NYCRR §65.6(5)………………………………………………………………13 11 NYCRR 65.6(e)………………………………………………………………..14 Secondary Sources New York State Legislative Annual -- 1973, p. 298. ……………………...……...9 McKinney’s Session Laws of New York, pgs 2450-51, 1977 ………………..…...9 1 Preliminary Statement This case presents what appears to be a simple issue concerning the evidentiary requirements for a no-fault plaintiff when there is a bill without a timely denial of claim. While this issue seems straightforward, the arguments made, in particular by the Respondent Etienne, implicate other rulings and issues of this Court. However, neither party has brought to the Court’s attention the fact that key changes were made to the no-fault Regulations in 2013. While the new Regulations are not applicable in the case before the Court, to avoid general pronouncements that might arguably be claimed to apply to these new Regulations, the Amici Allstate, Central Services Gorup, and American Transit wish to bring this to the Court’s attention, as well as to cite other relevant material that has not been brought to the attention of the Court. The Amici have a strong interest in this matter. Allstate is one of the largest writers of automobile liability insurance in the State of New York. Central Services Group is one of the largest writers of property/casualty insurance in the State of New York. American Transit is the largest writer of commercial automobile liability insurance in the State of New York. The Amici have significant experience with no-fault claims issues. 2 The parties to this case discuss prior rulings of this Court. The Amici would like to bring to the Court’s attention that the Regulations considered in some of this Court’s prior cases have been amended by the Department of Financial Services (the successor to the Insurance Department), effective April 1, 2013, pursuant to the Fourth Amendment to Regulation 68-C. These amendments made significant changes to the burden of proof, verification and denial issues. While the new Regulations are not applicable to the case before the Court, we would ask the Court to comment, if appropriate, in the context of any decision that this case does not arise under or seek to construe the current version of the Regulations. ARGUMENT I The Case Before the Court Arises Under A Prior Version of the No-Fault Regulations. The parties to this case have presented argument and discussed a number of this Court’s prior cases in the no-fault field. However, no mention has been made to the Court that the no-fault Regulations have been amended by the Department of Financial Services (the successor agency to the Insurance Department) and the rules for the claims in question exist only for claims submitted prior to April 1, 2013. The new Regulations do not 3 apply in this case and were not discussed or construed in this case. Allstate, Central Services Group, and American Transit ask that the Court clarify, in any decision, that it is deciding issues under the version of the Regulations in effect at the time of the accident in question and prior to the regulatory amendments of April 1, 2013. The Department of Financial Services adopted the Fourth Amendment to the No-Fault Insurance Regulations, effective April 1, 2013, addressing the burden of proof and the verification process. See http://www.dfs.ny.gov/insurance/r_finala/2013/rf68ca4t.pdf and Exhibit 3 annexed hereto for the convenience of the Court. The Department of Financial Services amended 11 NYCRR 65-3.8 to include new subsections (g) and (h), changing the burden of proof in certain circumstances and upholding denials with mere technical defects, respectively. Specifically, subsection (g) states that proof of the fact and amount of loss is not deemed submitted to an insurer and no payment shall be due when 1) such services were never provided to the claimant and 2) the charges exceed the established fee schedules for the services provided. Such situations had been previously precluded absent a timely denial. In the same Amendment, the Department of Financial Services amended Regulation 65-3.5 to allow 4 insurers to deny claims when a provider fails to provide verification within 120 days of the initial request for verification. These changes were made by the Department to try to protect the industry from abuse. They represent a continuation of the process that the Department had previously embarked upon to limit the cost of coverage and to seek to control abusive claims. This Court took notice of the problem of fraud that has permeated the insurance industry and upheld prior regulatory changes of the Department in Medical Society v. Serio, 100 N.Y.2d 854 (2003) and State Farm Mut. Auto. Ins. Co. v. Mallela, 4 N.Y.3d 313 (2005). See also, Pommells v. Perez, 4 N.Y.3d 566 (2005). Notwithstanding these changes, the State Senate still found a serious problem of fraud in the coverage as of 2010. See New York State Senate, Notice of Public Hearing (Feb. 4, 2010) (discussing “fraud and abuse of [New York’s] no-fault system”) a copy of which is annexed hereto as Exhibit 1. In the opinion of the Department of Financial Services the situation had become so grave that it proceeded to adopt, on an emergency basis in 2012, amendments to its Regulations permitting it to decertify health providers who abuse and/or defraud the no-fault system. Such emergency amendments were then adopted and codified in 2013 as 11 N.Y.C.R.R. § 65- 5, et al. under Regulation 68-E. See Exhibit 2 and 5 http://www.dfs.ny.gov/insurance/r_finala/2013/rf68et.pdf. As the Department of Financial Services noted in its reasons for the issuance of the emergency regulation in the accompanying press release, these abusive practices not only drive up the cost of insurance, they place in peril the quality of health care available to the public. In its continuing effort to try to address fraud in the coverage, the Department also adopted the Fourth Amendment to the No-Fault Insurance Regulations, effective April 1, 2013, addressing the burden of proof, the verification process and minor defects in denials of claim. These provisions were not addressed in this case, nor do they apply to the claims at issue in this case. They will apply to future claims, and the Amici ask that the Court clarify that any ruling in this case is for claims under the prior version of the Regulations. II The Plaintiff in This Case Did Not Use the Preferred Legislative Forum and Should Not Have a Lesser Burden of Proof. The Legislature enacted the No-Fault Law with the goals of reducing the burden on the Courts and prompt payment and with the hope that disputes would be resolved in arbitration. It was never envisioned that hundreds of thousands of no-fault collection cases would be filed in the Courts as a litigation strategy. This is contrary to the Legislative goals. It 6 delays the Legislative goal of prompt resolution. It burdens the Courts. And it is ultimately costly to the process and the public. The evidentiary burden that a Court litigant is normally required to meet should not be lessened for a no-fault applicant. Arbitration exists as an option with informal procedures and relaxed rules of evidence. See, e.g., Auto One Insurance Co. v. Hillside Chiropractic, P.C., 2015 Slip Op 01750 (1st Dept, March 3, 2015). An applicant who forgoes this option should not find a lesser standard in Court than other litigants. The applicant in a no-fault case has a statutory option to litigate or to arbitrate. Only the applicant has this choice and once the applicant makes an election, the insurer must honor the choice as to the forum. See Country-Wide Ins. Co. v. Harnett, 426 F. Supp. 1030 (SDNY, 1977), affd 431 U.S. 934. This Court stated in Roggio v. Nationwide Mut. Ins. Co., 66 N.Y.260 (1985) that: A legislative objective in enacting the No-Fault Law was to reduce significantly the burden of automobile personal injury litigation on the courts (Memorandum of State Executive Department, 1977 McKinney's Session Laws of N.Y., at 2445, 2448; Governor's Message of Approval of L.1977, ch. 892, id., at 2534, 2535). Reading into Insurance Law § 5106(b) an option to litigate after disappointments in arbitration is obviously inconsistent with this legislative purpose. 7 ...The objective of providing an efficient informal mechanism for recovery of benefits is disserved if a claimant can arbitrate disputes as to certain expenses and also litigate disputes as to other expenses arising out of one accident. 66 N.Y2d at.264 During the legislative process a number of options were considered for the no-fault coverage. Concerns were raised over the cost of litigating a no-fault denial, and an amendment was offered that would have lessened the burden of proof in Court. This amendment was defeated after the sponsor of the bill explained that the purpose of including arbitration as an option was to have a mechanism for the resolution of such disputes. On February 12, 1973, the bill to enact No-Fault into the laws of the State of New York was debated during the Senate session. During this session, numerous amendments were proposed. Senator Lewis proposed an amendment to the no-fault law to make it easier on the insured to submit a medical bill to the insurer. The senator specifically noted at that time that currently “the insured must send his bills and must have reasonable and necessary – show that his medical expenses are reasonable and necessary.” See Senate Debate Transcript Tape 15, page 4: Act to Amend the Insurance Law, the Workmen’s Compensation Law and the Vehicle and Traffic Law. Number 138 2000-B, Chapter 13, 1973. New York Legislative Service, Inc. Senator Zaretzki in further support of this amendment noted that a claimant 8 would have to hire a doctor to appear in court “to prove your reasonableness of the doctor’s bill.” Id. at p. 5. To remedy this burden on the insured, the senator’s amendment contained a provision that the “medical expense to be substantiated by a bill from the doctor and an affidavit by the insured.” Id. This was to ease the burden on the insured from having to submit an affidavit from the doctor or from having the doctor appear in Court. The amendment to lessen the threshold and reduce the burden on the insured was defeated and the sponsor of the bill specifically referred to the “binding arbitration” portion of the proposed bill, penalties imposed on the insurer and responsibility for attorneys fees as reasons why this amendment was not necessary. A copy of this part of the legislative history is included as Exhibit 4 herein. A complete copy of the section that this was taken from is included as Exhibit 4 to the motion to submit an Amicus brief. Clearly, the Legislature never intended for the burden to be lowered to a lesser standard than for other litigants when an applicant chooses to file their claim in Court and not in arbitration. III A No-Fault Applicant Who Chooses to File Their Claim in Court Should be Subject to the Same Evidentiary Burdens As Other Litigants. 9 The Amici recognize, as this Court has previously explained, that the no-fault law balances a number of goals and policies. Prompt processing and resolution of claims, reducing the burden on the Courts and containment of costs are all part of this balance. There have been changes since the statute was enacted, and the Amici ask this Court to consider the endangerment of the entire coverage to fraud if the option to litigate brings with it a lowered evidentiary standard. New York’s No-Fault statute was enacted in 1973 and took effect in 1974. Its goals were to provide prompt payment of medical bills and lost wages, reduce the burden on the courts, and provide premium savings to consumers. See, e.g., Walton v. Lumbermens Mut. Cas. Co., 88 N.Y.2d 211, 214, 644 N.Y.S.2d 133, 135 (1996) and New York State Legislative Annual -- 1973, p. 298. In 1977, the Legislature amended the No-Fault Laws to achieve the additional goal of controlling health care costs. See McKinney’s Session Laws of New York, 1977, pp. 2450-51, 2534-35; see also Goldberg v. Corcoran, 153 A.D.2d 113, 117, 549 N.Y.S.2d 503, 506 (2d Dep’t 1989). When the no-fault statute was enacted, and even two decades later when Central General Hosp. v. Chubb Group, 90 N.Y.2d 195, 659 N.Y.S.2d 246 (1997) and Presbyterian Hosp. v. Maryland Ca. Co. 90 N.Y.2d 10 274, 660 N.Y.S.2d 536 (1997) were decided, the cost of health care had not proliferated to what it is today, even though containment of such costs had been first sought in the 1977 amendments. Health care fraud was not a general problem in 1973. The concept that hundreds of thousands of cases, many for a couple of hundred dollars, would flood the courts was not even considered as a theoretical possibility when the law was enacted. In the past twenty years, the goals of containing cost and limiting fraud and abuse have become more and more urgent as this Court, the State Senate and the Department of Financial Services have all recognized. This Court has in some circumstances precluded an insurer from defending a bill when it does not have a timely denial of claim. The insurer is also subject to the statutory penalties of 2% monthly interest and legal fees when it improperly fails to pay a claim. There is no reason to go beyond this when an applicant forgoes the remedy the Legislature created to resolve no fault disputes swiftly and expeditiously, but instead files a collection lawsuit burdening the Courts. At that point the Legislative and Regulatory goals of containing cost, removing disputes from the Courts and limiting fraud should be considered and the burden for a motion for summary judgment should be the same as for other litigants in Court. 11 A. The No-Fault Statute Does Not Provide First-Party No-Fault Claimants With Greater Evidentiary Rights Than Negligence Plaintiffs. The no-fault statute did not make any changes to the burden of proof or evidentiary requirements that a plaintiff must ordinarily meet. The governing statute, Insurance Law §5102 provides that: (a) "Basic economic loss” means, up to fifty thousand dollars per person of the following combined items, subject to the limitations of section five thousand one hundred eight of this article: (1) All necessary expenses incurred for: (i) medical, hospital (including services rendered in compliance with article forty-one of the public health law, whether or not such services are rendered directly by a hospital), surgical, nursing, dental, ambulance, x-ray, prescription drug and prosthetic services; (ii) psychiatric, physical therapy (provided that treatment is rendered pursuant to a referral) and occupational therapy and rehabilitation; (iii) any non-medical remedial care and treatment rendered in accordance with a religious method of healing recognized by the laws of this state; and (iv) any other professional health services; all without limitation as to time, provided that within one year after the date of the accident causing the injury it is ascertainable that further expenses may be incurred as a result of the injury…. (b) "First party benefits" means payments to reimburse a person for basic economic loss on account of personal injury arising out of the use or operation of a motor vehicle,… (emphasis added) Thus, before no-fault coverage can be provided, two statutory prerequisites must be met. First, the payment must be “on account of 12 personal injury arising out of the use or operation of a motor vehicle.” [§5102(b)] Second, the expenses by statute must be “necessary.” [§5102(a)]. The Legislature determined that in order for the statutory coverage to be applicable these statutory prerequisites must be met. There is no basis in the statute to hold that once an applicant shows it mailed a bill to the insurer, it proves its case in Court and has no other burden in presenting a prima facie case. The Insurance Law requires that expenses be necessary and that there be a causal relationship to a covered accident. See, e. g. Clemens v. Apple, 65 N.Y.2d 746 (1985). Article 51 of the Insurance Law sets forth the requirements for both personal injury and first party benefits. The requirements that a Plaintiff must meet to establish a serious injury as set forth in Insurance Law §5102(d) have consistently included admissible medical evidence. See Oquendo v. New York City Transit Authority, 246 A.D.2d 635 (2d Dept. 1998); Parker v. Defontaine-Stratton, 231 A.D.2d 412 (1st Dept. 1996); Khalil v. Marion, 200 A.D.2d 500 (1st Dept. 1994); and Seminara v. Grossman, 253 A.D.2d 420 (2nd Dept. 1998). This Court in a different context has recently encouraged strict construction of the requirements for a serious injury. See Pommells v. Perez, 4 N.Y.3d 566 (2005). 13 The first party claims section of Article 51 of the Insurance Law similarly requires that claims arise out of a covered accident and that medical services be necessary. See Insurance Law §5102(b) and (a)(1). No distinction is made in Insurance Law §5102 between the burden of proof in third-party negligence cases and the burden of proof in first party basic economic loss cases. B. The Regulations Support Requiring No-Fault Plaintiffs To Prove The Necessity of Their Claims. The Department of Financial Services and its predecessor the Insurance Department have authority to implement the governing statute and, by their actions, they too have made it clear that there is no reduced standard of proof in a first party claim - although early in the history of no- fault such a rule was tried. In the period shortly after the enactment of the No-Fault Law, the Regulations provided that: “For the purpose of the 30 day period set forth in §675 of the Insurance Law [now §5106], a claim will be deemed to have been proven when the applicant satisfies the claims obligations reasonably specified by the insurer and has submitted the relevant claims form the insurer has requested.” This provision was added in the Third Amendment to Regulation No. 68, effective February 1, 1974. (11 NYCRR §65.6(5) (emphasis added). In 1977, the Insurance Department amended this 14 Regulation and deleted this language, replacing it with the current language that: “A failure to observe any of the time frames specified in this section shall not prevent an insurer from requiring proper proof of claim.” This change was made by the Eighth Amendment to Regulation 68 effective December 1, 1977 [(11 NYCRR 65.6(e)]. This language is included in the current Regulation. Thus, similar to the litigation of serious injury as defined by Insurance Law §5102, litigation of basic economic loss including medical services as defined by Insurance Law §5102 should require the Plaintiff to submit admissible evidence that the services were necessary as a result of a covered accident. Since a no-fault claimant has the option of arbitrating a claim pursuant to Insurance Law §5106, there is no reason to lessen their evidentiary requirements if they choose contrary to the purpose of the no- fault law to burden the Courts by filing such collection lawsuits in Court. Indeed, in a no-fault case only the claimant has an option to arbitrate and such an option if chosen must be honored by the insurer. Conclusion The Amici respectfully request that the decision in this case make clear that the ruling of the Court does not effect the interpretation of the new Regulations and the amendments which took effect on April 1, 2013 and set forth new rules for future claims. In addition, the Amici ask this Court to set forth a rule that the evidentiary standard in a no-fault case is the same evidentiary standard as in any other case in litigation. This is true whether or not a denial has been submitted. The legislative history of the no-fault regulation and case law both support the conclusion that the standards of evidence do not change in a no-fault case in court. The ruling of the Appellate Division should be reversed because it sets forth a lowered evidentiary burden for an applicant who forgoes the arbitration forum and tiles a case in Court. Dated: March 12, 20 15 New York, New York 15 Respectfully submitted Gregory\. id'', ' Skip Short: sq. SHORT & BILLY, P.C Attorneys for Amici 217 Broadway, Suite 300 New York, N.Y. 10007 (212) 732-3320 Our File Number 50997 New York State Senate Notice of Public Hearing Senate Standing Committee on Insurance Neil D. Breslin, Chair SUBJECT: No-fault Fraud in New York Stale PURPOSE: The purpose oflhis hearing is to (l) identll)l !he 1\mdDmental causes of no-fault tiuud: (2) delmnine why !here has been 110 appatent Inc= in no-fault fraud in m:cnt years; (3) beUer underslllnd how no-fault fraud is perpctnUed; and (4) to expl01e potential solutions to reduce the incidence5 of no-fault fraud in New York State. February 4'",2019 10:00 a.m. Hearing Roo111 A legislative Ollke Building Albany, New York &) ~~ 11te cosiS of !laud tutd abuse of the state's no-fault system is ultimately borne by New York's !':~~! ;:!:'!!~~~d:::;;. ~..!:0:~:;; :...'!'! ~!. ::.~·: :·::::-: ~!~"t '!~~!!':: ~.!!t- ~~~~ !':~::-::-:..~~55 percent increl!!e in the aYel'llge cost of no-lilult claims. which accotding to many expertS is the result of fraud and abuse of the no-fault system in New York. Accotding to the Insurance !::f:.:m:::~~ !~i~ ... 1:-, ~~zo.o.: Y:.:!~':; ::.~!z :;-.=.:...-:::.. -::::~ ~:!: ~~!..::!! n£~--f~~!! ~;::::~nt f::: t~:a medical care of accident victims rise from approximately SS,61S per claim in 2004 to approximately $11,748 per claim in 2009. It is estimated that a significant percentage of each :.mii...-:O!un!:; po.;tcr::cbH: :;;!iur.:ne; prcmh:m ::t:n he ~cntrlhut:d b ir.::m::mcc f.-.:z:d. The Committee would like to hear from representatives from government. insurance industl}', und ndvocntes. Persons wishing to present pertinent testimony to the Committee at this public hearing should complcrc and return the enclosed reply tbrm llS- SODit os po5Sible Otwllell~ lJ 111 i11•ittJIIMt 11n/y. Fifteen copies of any prepared rcstimony should be submitted at the hearing registration desk. Written testimony will also be accepted and may be sent to the contact per.son listed on the reply fonn. In order to publicize the hearing further, please infonn interested parties of the Committee's intm:st in receiving written testimony ftom all sources. In order to meet the needs of those who may have a disability, the Senate, in accordance with their policy of non-discrimination on the bases of dbability, as well as the 1990 Americans with Disabilities Act (ADA). hos made its facilities and services available to all individuals with dbabilitics. For individuals wilh disabilities, accommodations will be provided. upon reasonable request. to nffotd such individuals access and admission to Senate and Assembly facilities and activities. NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICES 11 NYCRR 65-5 (INSURANCE REGULATION 68-E) UNAUTHORJZED PROVIDERS OF HEALTH SERVICES I, Benjamin M. Lawsky, Superintendent of Financial Services, pursuant to the authority granted by Section 202 and Articles 3 and 4 of the Financial Services Law, and Sections 301, 5109, and 5221 and Articles 4 and 51 of the Insurance Law, do hereby promulgate the following new subpart 65-5 to Part 65 of Title II of the Official Compilation of Codes, Rules and Regulations (Insurance Regulation 68-E) to take effect upon publication in the State Register, to read as follows: (ALL MATERJAL IS NEW) Section 65-5.0 Preamble. (a) For years, certain owners and operators of professional service corporations or other similar business entities have abused the no-fault insurance system. These persons are involved in activities that include intentionally staging accidents and billing no-fault insurers for health services that were unnecessary or never in fact rendered. This fraud costs no-fault insurers tens if not hundreds of millions of dollars, which insurers ultimately pass on to New York consumers in the form of higher automobile insurance premiums. It also threatens the affordability of health care and the public's health, safety, and welfare. (b) Insurance Law section 5109 requires the Superintendent of Financial Services, in consultation with the Commissioner of Health and the Commissioner of Education, to establish standards and procedures for the investigation and suspension or removal of a provider of health services' authorization to demand or request payment for health services provided under Insurance Law article 51. This Subpart implements Insurance Law section 5109. Section 65-5.1 Definitions. As used in this Subpart, the following terms shall have the meaning ascribed to them: (a) "Health services" or "medical services" means services, supplies, therapies, or other treatments as specified in Insurance Law section 5102(a)(l)(i), (ii), or (iv). (b) "Insurer" shall have the meaning set forth in Insurance Law section5102(g), and also shall include the motor vehicle accident indemnification corporation and any company or corporation providing coverage for basic economic loss, as defined in Insurance Law section 5102(a), pursuant to Insurance Law section 5103(g). (c) "Noticing commissioner" means the Commissioner of Health or the Commissioner of Education, whomever sends a notice of hearing under this Subpart. (d) "Provider of health services" or "provider" means a person or entity who or that renders or has rendered health services. (e) "Superintendent" means the Superintendent of Financial Services. Section 65-5.2 Investigations. (a) The superintendent may investigate any reports made pursuant to Insurance Law section 405, allegations, or other information in the superintendent's possession, regarding providers of health services engaging in any of the unlawful activities set forth in Insurance Law section 5109(b ). After conducting an investigation, the superintendent will send to the Commissioner of Health or the Commissioner of Education, as appropriate, a list of any providers who or that the superintendent believes may have engaged in any of the unlawful activities set forth in Insurance Law section 51 09(b ), together with a description of the grounds for inclusion on the list. Within 45 days of receipt of the list, the Commissioner of Health or Commissioner of Education shall notify the superintendent in writing whether he or she confirms that the superintendent has a reasonable basis to proceed with notice and a hearing for determining whether any of the listed providers should be deauthorized from demanding or requesting any payment for medical services in connection with any claim under Insurance Law article 51. (b) The Commissioner of Health and the Commissioner of Education also may investigate any reports, allegations, or other information in their possession, regarding providers engaging in any of the unlawful activities set forth in Insurance Law section 51 09(b ). If either commissioner conducts an investigation, then that commissioner, or the superintendent, if requested by the commissioner, shall be responsible for providing notice and an opportunity to be heard to the providers of health services that they are subject to deauthorization from demanding or requesting any payment for medical services in connection with any claim under Insurance Law article 51. Nothing in this section, however, shall preclude the superintendent, Commissioner of Health, or Commissioner of Education from conducting joint investigations and hearings, or the Commissioner of Health or Commissioner of Education from conducting professional misconduct proceedings against the providers of health services pursuant to the Public Health Law or Title VIII of the Education Law. Section 65-5.3 Notice; how given. (a)(l) The superintendent, Commissioner of Health, or Commissioner of Education shall give notice of any hearing to a provider at least 30 days prior to the hearing, in writing, either by delivering it to the provider or by depositing the same in the United States mail, postage prepaid, registered or certified, and addressed to the last known place of business of the provider or if no such address is known, then to the residence address of the provider. (2) The notice shall refer to the applicable provisions of the law under which action is proposed to be taken and the grounds therefor, but failure to make such reference shall not render the notice ineffective if the provider to whom it is addressed is thereby or otherwise reasonably apprised of such grounds. (3) It shall be sufficient for the superintendent or noticing commissioner to give to the provider: (i) notice of the time and the place at which an opportunity for hearing will be afforded; and 2 (ii) if the person appears at the time and place specified in the notice or any adjourned date, a hearing. (b) At least ten days prior to the hearing date fixed in the notice, the provider may file an answer to any charges with the superintendent or noticing commissioner. (c) Any hearing of which such notice is given may be adjourned from time to time without other notice than the announcement thereof at such hearing. (d) The statement of any regular salaried employee of the Department of Financial Services, Department of Health, or Department of Education, subscribed and affirmed by such employee as true under the penalties of peJjury, stating facts that show that any notice referred to in this section has been delivered or mailed as hereinbefore provided, shall be presumptive evidence that such notice has been duly delivered or mailed, as the case may be. Section 65-5.4 Hearings. (a) Unless otherwise provided, any hearing may be held before the superintendent, Commissioner of Health or Commissioner of Education, any deputy, or any designated salaried employee of the Department of Financial Services, Department of Health, or Department of Education who is authorized by the superintendent or noticing commissioner for such purpose. The hearing shall be noticed, conducted, and administered in compliance with the State Administrative Procedure Act. (b) The person conducting the hearing shall have the power to administer oaths, examine and cross- examine witnesses, and receive documentary evidence, and shall report his or her findings, in writing, to the superintendent or noticing commissioner with a recommendation. The report, if adopted by the superintendent or noticing commissioner, may be the basis of any determination made by the superintendent or noticing commtsstoner. (c) Every such hearing shall be open to the public unless the superintendent or noticing commissioner, or the person authorized by the superintendent or noticing commissioner to conduct such hearing, shall determine that a private hearing would be in the public interest, in which case the hearing shall be private. (d) Every provider affected shall be permitted to: be present during the giving of all the testimony; be represented by counsel; have a reasonable opportunity to inspect all adverse documentary proof; examine and cross-examine witnesses; and present proof in support of the provider's interest. A stenographic record of the hearing shall be made, and the witnesses shall testify under oath. (e) Nothing herein contained shall require the observance at any such hearing of formal rules of pleading or evidence. Section 65-5.5 Report of hearing and findings. (a) Pending a final determination by the superintendent, Commissioner of Health, or Commissioner of Education, if the superintendent or noticing commissioner believes that the provider has engaged in any activity set forth in Insurance Law section 51 09(b ), then the superintendent or noticing commissioner may temporarily 3 prohibit the provider from demanding or requesting any payment for medical services under Insurance Law article 51 for up to 90 days from the date of the notice of such temporary prohibition pursuant to Insurance Law section 5109( e). (b) The hearing officer shall issue to the superintendent or noticing commissioner the report described in Section 65-5.4(b) of this Subpart, with a recommendation. The superintendent or noticing commissioner may adopt, modify, remand, or reject the hearing officer's report and recommendation. (c)( I) Upon consideration of the hearing officer's report and recommendation, the superintendent or noticing commissioner may issue a final order prohibiting the provider from demanding or requesting any payment for medical services in connection with any claim under Insurance Law article 51 and requiring the provider to refrain from subsequently treating, for remuneration, as a private patient, any person seeking medical treatment under Insurance Law article 51, for a period specified by the superintendent or noticing commissioner. (2) If the superintendent or noticing commissioner issues a final order prohibiting the provider from demanding or requesting any payment for medical services in connection with any claim under Insurance Law article 51 and requiring the provider to refrain from subsequently treating, for remuneration, as a private patient, any person seeking medical treatment under Insurance Law article 51, for a period longer than three years, then the provider may, after the expiration of three years, submit a written application to the superintendent or noticing commissioner requesting that the superintendent or noticing commissioner reconsider his or her order. The written application shall explain why revising the order would not jeopardize the health, safety, and welfare of the people of this State. 4 NEW YORK STATE DEPARTMENT of FINANCIAL SERVICES I, Benjamin M. Lawsky, Superintendent of Financial Services, do hereby certify that the foregoing is a new subpart 65-5 to Part 65 of Title 11 of the Official Compilation of Codes, Rules and Regulations (Insurance Regulation 68-E), entitled "Unauthorized Providers of Health Services," signed by me on October 24, 2013, pursuant to the authority granted by Section 202 and Articles 3 and 4 of the Financial Services Law, and Sections 301, 5109, and 5221 and Articles 4 and 51 of the Insurance Law, to take etTect upon publication in the State Register. Pursuant to Section 202( 6) of the State Administrative Procedure Act, prior notice of the proposed amendment was published in the State Register on August 7, 2013. No other publication or prior notice is required by statute. Date: October 24, 2013 311212015 Press Release- March 8, 2012: Governor Cuomo Announces New Statewide Initiative To Rid The State's No-Fault Insurance System Of Deceptive Doc ... Skip to Contmt Search DFS Search \1 { Home ABOUT US Consumers t:lanking lndustry tnsurance Industry legal Reports K Publications Mission & leadership Initiatives History News Room Who We Supervise Careers with DFS Contact Us Procurement NewsRoom Press Releases- 2015 Press Releases- 2014 Press Releases - 2013 Press Releases - 2012 Press Releases - 2011 Banking Division Press Archive Insurance Division Press Archive Press Release March 8, 2012 Contact: David Neustadt 212-709-1691 GOVERNOR CUOMO ANNOUNCES NEW STATEWIDE INITIATIVE TO RID THE STATE'S NO-FAULT INSURANCE SYSTEM OF DECEPTIVE DOCTORS AND SHUT DOWN MEDICAL MILLS "New Regulation Enables DFS to Ban Doctors from No-Fault System if They Cheat the System" "Without Doctors' Licenses, Fraudulent Medical Practices Will Be Forced to Close" Governor Andrew M. Cuomo today announced a statewide initiative to stop deceptive doctors and shut down medical mills that plague New York's no-fault insurance payment system and cost New Yorkers hundreds of millions of dollars in insurance costs. At the Governor's direction, the Department of Financial Services (DFS) is issuing a new regulation that will enable it to ban doctors who engage in fraudulent and deceptive practices as part of the no-fault system. The regulation implements a 2005 law that gives DFS the power to regulate doctor participation in the no-fault system. Through audits as well as through information from law enforcement and insurance companies, DFS has already identified 135 medical providers whose billing practices have raised concerns regarding possible no-fault fraud. As part of an ongoing investigation, letters are being sent to all135 medical providers demanding information. Failure to answer the letters may automatically lead to the medical provider being banned from the no~ fault system "The state has no tolerance for medical providers or doctors ripping off the system,'' said Governor Cuomo. "This affects all New Yorkers because we all pay the consequences with higher insurance premiums, and that's why I asked the Department of Financial Services to take this action. I commend Superintendent lawsky and the team at DFS for their dedication to this investigation and look forward to bringing these health care providers to justice." Superintendent lawsky said, "Rather than caring for victims of auto accidents, these doctors and other health care providers engage in scams, bilking millions of dollars from insurance companies each year. Their unlawful schemes are also directly responsible for driving up insurance premiums for everyone. We are going to call them to account and put them out of the no-fault business." A DFS investigation has found evidence of doctors and other practitioners providing unnecessary treatment to car accident victims as well as doctors "renting" their tax ID number to fraudulent medical practices that submit fake bills to insurance companies. Without the doctors, the scheme cannot work. The plan has two parts: • Issuing a new regulation enabling DFS to ban doctors who engage in fraudulent and deceptive practices from participating in the no-fault system. • Sending letters to the already identified 135 medical providers, whose billing practices have raised concerns regarding possible no-fault fraud, and demanding information regarding their corporate structure, payment requests, and the doctor's direct participation in the practice. The providers are being directed to complete and return the DFS form 14 days after they receive the notice. The agency will use the answers to investigate their no-fault insurance billing practices and determine whether the providers are the true owners and operators of their businesses. Any provider who refuses to respond to the DFS letters may be banned from participating in the no-fault system. The regulation says that DFS will have to send a list of any medical providers suspected of no-fault fraud to the Departments of Health (DOH) and the State Education Department (SED) for their review. DFS will then conduct hearings. Providers found to have violated the law will be banned from participating in the no-fault payment system. In appropriate cases, DOH and SED may revoke any medical licenses and law enforcement will decide whether criminal charges should be flied. http://www .dfs.ny .gov/about/press/pr 12030B1.htm 1/2 3/1212015 Press Release- March 8, 2012: Governor Cuomo Announces NeoN Statewide Initiative To Rid The State's No-Fault Insurance System Of Deceptive Doc ... Rampant criminal abuse of New York's no-fault auto insurance system has driven up auto insurance premiums for consumers. Currently, New York has the fourth highest auto insurance rates in the nation. These sky high rates are due, in large part, to heavy fraud in NY's no-fault system. The no-fault insurance Jaw was designed to lower insurance premiums and make it easier for accident victims to receive medical treatment, regardless of who is at fault. Usually, no-fault insurers pay medical providers directly, assuming that a licensed doctor provided the treatment and the treatment was necessary. Manhattan District Attorney Cyrus R. Vance, Jr., said, "My office has seen the massive fraud and abuse stemming from our state's no-fault insurance program, which has contributed to inordinately high auto insurance rates for New Yorkers. For example, we successfully prosecuted the members of a large medical mill ring called the St. Nicholas Group, which netted millions of dollars in fraudulent claims. I thank Governor Cuomo for his work to stop criminals from taking advantage of our state's insurance program. " Senator James L. Seward, Chair of the Senate Insurance Committee, said, "I applaud Superintendent Lawsky and stand ready to support him in his fight to crack down on no-fault fraud and the criminals who profit from this illegal enterprise. Activating this powerful tool to decertify doctors who cheat the system is long overdue. I sponsored this reform in 2005 and am pleased the Superintendent is taking steps to implement it-helping fight fraud and get insurance rates under control. " Assemblyman Joseph D. Morelle, Chairman of the Assembly Insurance Committee, said, "Every year auto insurance fraud unnecessarily costs New Yorkers millions of dollars. I applaud Governor Cuomo and Superintendent Lawsky for their commitment to ending auto insurance fraud in our state and bringing unscrupulous medical providers to justice." About OFS Contact OFS Reports & Publications licensing laws and Regs Connect With OFS Yt f')' -·-y:( -[\\' htlp:l/www .dfs .ny .gov /abouVpress/pr1203081.htm 212 NEW YORK STATE DEPARTMENT OF FINANCIAL SERVICES FOURTH AMENDMENT TO 11 NYCRR 65-3 (INSURANCE REGULATION 68-C) CLAIMS FOR PERSONAL INJURY PROTECTION BENEFITS I, Benjamin M. Lawsky, Superintendent of Financial Services of the State of New York, pursuant to the authority granted by Sections 202 and 302 of the Financial Services Law, Sections 301, 2601, 5221 and Article 51 of the Insurance Law, and Section 2407 of the Vehicle and Traffic Law, do hereby promulgate the following Fourth Amendment to Subpart 65-3 ofTitle II of the Official Compilation of Codes, Rules and Regulations of the State of New York (Insurance Regulation 68-C), to take effect on April!, 2013, to read as follows: (NEW MATTER IS UNDERSCORED; MATTER IN BRACKETS IS DELETED) New subdivisions (o) and (p) are added to section 65-3.5 to read as follows: ( o) An applicant from whom verification is requested shall, within 120 calendar days from the date of the initial request for verification, submit all such verification under the applicant's control or possession or written proof providing reasonable justification for the failure to comply. The insurer shall advise the applicant in the verification request that the insurer may deny the claim if the applicant does not provide within 120 calendar days from the date of the initial request either all such verification under the applicant's control or possession or written proof providing reasonable justification for the failure to comply. This subdivision shall not apply to a prescribed form (NF-Form) as set forth in Appendix 13 of this Title, medical examination request, or examination under oath request. This subdivision shall apply, with respect to claims for medical services, to any treatment or service rendered on or after April 1, 2013 and with respect to claims for lost earnings and reasonable and necessary expenses, to any accident occurring on or after April I. 2013. (p) With respect to a verification request and notice, an insurer's non-substantive technical or immaterial defect or omission, as well as an insurer's failure to comply with a prescribed time frame, shall not negate an applicant's obligation to comply with the request or notice. This subdivision shall apply to medical services rendered, and to lost earnings and other reasonable and necessary expenses incurred, on or after Aprill. 2013. Paragraph (3) of section 65-3.8(b) is amended to read as follows: (3) Except as provided in subdivision (e) of this section, an insurer shall not issue a denial of claim form (NYS form N-F 10) prior to its receipt of verification of all of the relevant information requested pursuant to [section] sections 65-3.5 and 65-3.6 of this Subpart (e.g., medical reports, wage verification, etc.). However, an insurer may issue a denial if, more than 120 calendar days after the initial request for verification, the applicant has not submitted all such verification under the applicant's control or possession or written proof providing reasonable justification for the failure to comply, provided that the verification request so advised the applicant as required in section 65-3.5(o) of this Subpart. This subdivision shall not apply to a prescribed form (NF- Form) as set forth in Appendix 13 of this Title, medical examination request, or examination under oath request. This paragraph shall apply, with respect to claims for medical services, to any treatment or service rendered on 1 or after April l, 2013, and with respect to claims for lost earnings and reasonable and necessary expenses, to any accident occurring on or after April!, 2013. Subdivisions (g) through (j) of section 65-3.8 are relettered subdivisions (i) through (I) and new subdivisions (g) and (h) are added to read as follows: (g)(l) Proof of the fact and amount of loss sustained pursuant to Insurance Law section 5106(a) shall not be deemed supplied by an applicant to an insurer and no pavment shall be due for such claimed medical services under any circumstances: (i) when the claimed medical services were not provided to an injured partv; or (ii) for those claimed medical service fees that exceed the charges permissible pursuant to Insurance Law sections 5108(a) and (b) and the regulations promulgated thereunder for services rendered by medical providers. (2) This subdivision shall apply to medical services rendered on or after April 1, 2013. (h) With respect to a denial of claim {NYS Form N-F 10), an insurer's non-substantive technical or immaterial defect or omission shall not affect the validity of a denial of claim. This subdivision shall apply to medical services rendered. and to lost earnings and other reasonable and necessary expenses incurred. on or after April!. 2013. 2 Andre\\' ~L Cuomo G-overn1_1r NEW YORK STATE DEPARTMENT of FINANCIAL SERVICES Benjamin M. Lawsky Superintendent I, Benjamin M. Lawsky, Superintendent of Financial Services, do hereby certify that the foregoing is the Fourth Amendment to Part 65-3 of Title 11 of the Official Compilation of Codes, Rules and Regulations of the State of New York (Insurance Regulation 68-C), signed by me on January 30, 2013, pursuant to the authority granted by Sections 202 and 302 of the Financial Services Law, Sections 301, 2601, 5221 and Article 51 of the Insurance Law, and Section 2407 of the Vehicle and Traffic Law, to take effect on April!, 2013. Pursuant to the provisions of the State Administrative Procedure Act, prior notice of the proposed amendment was published in the State Register on May 16, 2012. No other publication or prior notice is required by statute. Date: January 30, 2013 Benjamin M. Lawsky Superintendent of Financial Services ClNE ST,c\TE STREET, f•JfW YORK. NY 100iHi VVW\1\UIFS.NY.GOV '" ' ,_ .. " . • • I" I SENATE DEBATE TRANSCRIPTS " 1973 Chapter 13 ; " .. ' , i - _ - I , ; " ~ - , 166· PAGES". ~-- '. ' - - . , ' NEW YORK LE9ISLATIVE SERVICE, INC: 299 Broadway, Neir Yoik,NY 10007 (212) 962-2826 . . - .. . .-. .,&.o.g - C .AIIapjdkololo riQhk. , ' ' • • ··-· • • • . ,,_ . TAI'l. U . IIWTii ltlllDI ra•IWI'f U, lm PAIII 4 . . .. ""'' PIUIDPIO 0",'~~111 ~. •nodatat it dilt .. lNo ~~tor, l.wllo tltm IDAtol Llltlll Met 'oalr H l nw Ito Wt ,.., 11111111 lt 1114 U I 11M •-Mh _-' '\:> --: <.-, . .; ___ '-,-}."=") ~ '' 'r -, ' -,, the· P"Plt l!l(lt "- llllht tn bell Ito n. _, -MMtlt II I ¥tr)' tlloflt ' . ' -' ' . thlna•. 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Thr 'l'~arfml In my 1dnrl •M aeverAJ,,arJ.,.rll:! cert•lnly Senator Dunrut 11 ~tolnR to hn lr1,nlv,.tf In thl•• 1•--whother tG UUtnd~~rortlon I.O:.lM ·of the t:Pt.Jl t•r Juwe il r.h..ptrr ,..,..nd,...nt or· npprtlllr.h it In onolhar vny. 5o th"l _rhh t~ nf -•ndmant, I · aa•ur.to you without~ pr.Jrdal~JC, .;nu t )lllot-~ It'' r,an eur.rrtnl ,• I r•aJ 1 y Va'l_t you to knov that. lt .. ~ - I• r .. aJ ly. utul .. r 11rt tv"" • ,,.._-i-dal-et--tori•.· Th•r.• •r• ·~Yerr,•·J oth•r · thlna• that h•v• ~··i . •• .: •• IOIIhlhl nhr•ll ......... ftnrltal!ntr u ••• Ara Un•l•r ....... , ...... tlon, Thli cm'y ..... u.rt. I ol1U11rn wfth, oo f nr h S.O~t~r Str""b - I olon' I ••" hi,;. here: - ~Itt I dldn 't -~ant . to rr•pon.d bPCIIIJIIU! O,f .. arty. <~• pll••ll;J.,,_ · tl;.ll'c.lll\ol ,.·ndet7 011 a7 j.ar_t.'•t ll'UI l~ havo the .bUl;aet-.1 upon •• ' ' - ' - 1 - I ~~aor;; 7ou.. ·~•In, "~'"'rr, rhnr •-.,•rt •••n,.•t ton· vt 11 he ... rullnhe4 b)• th.- slon~; .. -,· ..... utea an lnai.ranq•, .1 p~n.Joio you·tl;•t• . 1 don't~knnw ';,-'. --·- ;-· __ ., _;~ __ ~,.>~-.; '\:, "'--,_,,_-";_,·_- ·- ."- ;; __ •• - • '_.:::-.( :~_:, whot""r n.n..tor r~rrln'• ""'an.!Mnt· io ra.Ju.·•·•'"' llor .. holrl wl.ll rroeeha •uch favor•bl• ._ • f.\::~---<;,_,,'·._-._: .. ·-'~ t ~- •. I ' •!J ,,,., uopnn•~· lour pro!·•_duul~~~ ,thoa~ tlti~R'"' that. uy.hav• ID ha dDnw 1 I auirra yolllvlU .-, - ' -- + - 'f ~ '' • '· R•t ,.,.,, r.ln•• iorirritlny b)' the c ... lttoa.· , - • '. 'l . ., ~~- - PRP.I!IIIIH!< OFFIC:U 1 ., llenati>r·lloohoit;, :, ,..,, ~r.ifATOR IKXJKSilllt ""' Preillolont·, uy I 11141\llr". 111 llanotilr !lar.ton In vi..,_ or hla r•nrml npnall I at; .Ia to ~~ thw prnR·real vU I lw wll·h r~t~~arcl to ~till I 1 .. " ••. : . ' . '. : - - . ' : ' . - ' . . ' .• ~ . . -. ' wliat rnr.l'f'll• u• to act tllrl•1 at tM• ••at!·• of the. ••l•lon! · • ' .. • ••• • • • ·li. •-,". . --~r. .,. ' •... : ... .. ~- -·~. ,• '. '; ,. PAc£ 7 "'_. _-. Sr.IATillt r.o~JMJS: tn roopon .. to· :rcr.:r• qrtut1on, I dori' t 1tnav wha~har. U.,.· ; . ,, .-.', ond I aay thla v,ry candidly, I don't kn"" .whethat:. 0111 o:;oauC:cnt v,ciu~d ba asrud upon ber.•u .. we do knOw th.at th11 Va~ a bU:l that V&l-r Agrtad upon &I a c:oria•n1u1 .mo~ . . . Iead•nhip ond th~. l.::lcledlate .. parti .. involvad in ,uia o- ault propo .. la. I pr.,.iu yoo. only frca a p.raol\&1 viavpo1nt, and that 1a ~ far aa I Call 110, that ·th11 Uat of propo•od a .... nd...,nu where' pon1bly applicable, and I don't knDII vhitbar they all ara, alr•ady, I quoallon aovora~ of thea, but 1 vant'you to know that tbay ar~ ROlnK to Rat . ' ... ,41f•~.;ar.:~ot!:m. n-~ r~s~ t~at. T Be- Mt !."'"! ~''1 f••rt.h!'r than· thf=:- !:. ~c:=:2c in 117 . . ,_ .- why wi are dninR whllt· ve ora datriJ!. SEIIATOR BOolSON: Ma:r .I jtsat reapood to you. brtafly.. .Tha uaa of the ward, rona~naua bill .>: l~Aat to thou of ua· ,in th~ Minor,ltJ~ 1a a~tvhat rftPUj!IIIUit•• 1';..,;1~ think a blll of thh Mtura Wbich b aa·radleal aa baa bun aaloi bora 111 ehAn110 .··•· ·~ . . · thit\tllr~· oywt- "...t th~ c.o"O:t ayat• of~ our SUta.voul4 han r~irecl htartnu •. Rov I -·. ' - - - ' ~ ., I' <' , ~ ·_ • ' ' ., racnl.l, senator, thla btU' ia ~ary allatlar''tn .a;.,. r~ap,octl to th~ b111 that. JOU bad la ' - ,- ' - 1 _. -,:;- ' .: --- •.-i • ' ' 1971. You thon dlcl • c001platt tao.dillroia tum tn't97.1 ~.tho blll tha't you ~ol - 1n - :_ , ' : I 0 • 0 ~· ,-' _> ~ ',- ·~-,- :-~~- J' - "":~ ',;'c 0 _' _,', '- ,--,,~ _ _-, :,··,\ !• •' tadt, if I roenll <'orractly, you Uda tho ltatment that thil blll or 1971, Jour' blll, ' - - - '.c. - ~. -· 4 ""' not aee.;ptabl~ I•' 1912. ·Nov hare,;. ara· 'fifl97l and onea •••In ve have aone .a nw • ' - ·"" c ')',, - ' < - rO..t~ vlthout. any hl'arl~>&•• .;..;. 1-1r1 ~htri~r~l'._~· whhout .;,II op,.;rtutill,. i•i-'a 1r~at ',.:_. -~_:. -_ <- -~-- \.--;}·, ', .< ( _---_:. _·_. -_ -,;- ~ __ , _)- .. ,. ~putlclpatlo.i !.,: th~ public,- an 1idorUd lncl ~nUJ!Irtan .. t publ.c,'- •• to vhu tha; err.e·t > ·;' and lapact or thlit lloalalatlcm 'vul li•~ •. ,· '''.'.. . _ ---~:-,. ~:, ·-::',~---'_,._·_,'_, .. ·: :_:.-J·;·-->·;·T~,.\---_~. : ,., _______ ~- :. __ :;_,_,. PIU!SIDING ot'riCPJlr 1'118 quitetlan art••• II!\ tha •mdooant. .~•utar i..wta. . ' - ' . -,, - ' * - • - - ·~- ' ' ~ - . --' -"' ' - -, . . • ' . •, • , . - - . T '- ., -- . - '• '• . -. , ~ { - < • ": 5t:!IATOR: 1 ••. ~15'1 . With ell'. due ra.,aet; to hnal or .!:ardon, tiiU. he ta 1ft IIIII ·to· c:ona~dPr thta, u' ·~~~:~~n.·ay ~-~~~nii.i thai ~-~"•'IIUI.anch •• t.b;• e..,l1.'1111 the flOor t~.,-t1~u~d o~. havtn~:~t 6;~~t•~ ·~~111·~~ ;~~~~a~rl, b eo r_;ta ~·,to 4aJY ~, ..:.or7 ... • '. -. • • -•• .' • ' '!,. , • ,, ~ • ' ' ; • - • -· . of· .an,. ~uch .. tnclde.nt: .. ·..,.': : . ': oecutrl~.;'\ u' aha'~ ..... to ... that than k .. ht!' ·. ' . . . : ~ :- . : -~ . ',. ·-~ ~ ... - ·.:· .. _. ' ' ; - ' ~ ,'1. - • ~ _,,,_ -- ~ . • • • • PAC£ 'or oho1.1d have been u.al.neUon of thb particular probh:! ,~lpe~lally, ainoe ill the Stat. of Florida, today they, an. ColaplalntitJI bitterlr that tiuo, tnouriiJI!'• ~ ... p ... 1 .. ar<' ha~al1n11 on each and every .,.dt~al pai-nt, upe. !aUy a boo' thoao' of y;.., vho have . . . ' ' cedlcal papoeau· and hava approached- tbair avn tnaunnce caapanl.eio, have oubllitud bills and have Ukoviu been hauled. IIDV, senaior, 1 am oure that you or .. •·~d thta. , I t.hinlr. ~bat you aava it avay ~'ban you a&ld thb- bUl ~ ataod an ita ovn tva !ut. llell, Senator, 1 cball~e you u; advbe' thla Bod) vbat an inaur.d \:hO baa incurred firat party e~p~eo - ~octor and. Dldical ~enoeo - to to da vhan he oubal.ta hio bill, and the g;.nu-n on tha otbar line tallli bl.Jl that tbte ,to ,..,t u .. onabla and neceooary. We thlftk you oli!>uld heva. only patti 20%, lO.t. Wbat doeo ba do ~bent lit m~t. then ~et an att~rnay. He then .uat proceed vith Arbitration. ~v I don't kDIIV about your community, but I dareoay that lm ·_, oooaunl.ty,. tho)" won't kn~ vbat tO do. Tho '~•1'7 !.aet of the Ntter ia thna 1a nothln11 .to do oo 'you thrDV up your banda and you toke vhat )"011 can 1.•t and .. you juat bop on rurmtna. The' .lnauraace ccapany Jr.oopa ~t happanl vlwln '''" i1111uranre , .. pany _telb a f•llov that ba. thould nat han paid• tr h not reuonabl• ~nd It I.~: no_t necouar,. •. tolhat ~.; .. he dot· · PA!SlDlliG OFFIC!Ill n.. q~,~ .. uon arb .. oa the -ndaent. oflili'ed li1• ·.' SEHo\TOR LEI/lSI · I 11111 Uk tbe S~IIUCII 10 :tlehl vhh 1 1>0\'1 .d•rtaielYI . < • • s~.;.~~r:. you atllteil I boh~v• that th.fi ~~~ i u~ •tanol 0.. lt~ _: 1 • -- r- - , . • ' 111Y• )'OU, thenfore 0, thlo pr•l11 -~ v"'-t 1a the lnauioc~•o r....d,.i'. llhould h•. oub.tt · -hi. ~we::J~~. on • flnt •• rty. Clloi., ~ tba balln!'c• :..tj\.tit ,.,, .... ~~ P.l)' ln .. of l t 1 llhat h ht.. f;..c~yi . swto'~·ciotmoera Unclor the. b~·i1; tenator,· there- So I blndlna 'orbiUIUDJi '. . ·, . ·,,o_codur• to be pr.Ulaa~ad bi the-~~in~endant or. 1~1!~~~~ • .: 1'1111 lo vllir~.th•: ciatilo c~ ••. Till·~ ti ~i· ~· ~~~.t.sJ u ~~ ... i~1~.: ·~~·~~~~ .·ni~ lo Vhf';.;. 'pmlll..l. ' ' ' ' . . , .. ·. .. ' . ' . . . '~ ~ . . . . . . . ... ·•lao that U there 11i' • dloputld· clllia ana'. ttW lnavranco .c~an:t ta founcl· to he WDI\lo ·, '· ·-· . . ' .. . ·., • • • • • • • • • • • TAl'!' li . .. '" ~ a•ttln~ An &ttf'rn.-y tO c-c.M·--tn;. 'I P•~·Mr• .~ht~ut'~n•t hA,v• ln11r1•ct•d cy~elf~ -~•natof.. an.l ,..,.,,, tJ••t W Ar• ~to1na -~o c:on•l,1of' •oa•thlna ,that you_ haY~ t\lltJt••ted b•Cau~e 1t juot or~nf'or ' . thh hill. 1 ool)' .. aura 70u thAt t .. liu•pllnK to do vhat 1 ca" lor tho varloull prnpr>anlo I hnl haVP her\' Of forod • 1:1.'11 .or ThPY. I'> \. ' ' ' ~ .. -· .. . '- .. ' . ·: .• .'' ': . .. . ·._. . ;· : I. •