Found inside – Page 83Remington Investments , Inc. ( App . 5 S.W.2d 519 , rehearing denied , writ denied . ... Appeal And Error Ew 758.3 ( 11 ) ment for telephone book publisher on chiro Trial court's order vacating order granting practors ' claim for breach of duty of good faith summary judgment did not ... 1994 ) 875 S.W.2d 695 , re munications Network , Inc. v . Aetna Cas . & Sur . hearing overruled . Judgment w 181 ( 11 ) Co. Found inside – Page 1066National Chiropractic Mut. ... 325, 951 P.2d 987 (1997 & 1998) (rejecting claim of insurer bad faith where insured's conduct caused the delay in payment); ... Found inside – Page 355IC Claim Nos . 0000P082964 , 0000P082963 , granted new injury claim but denied reThis is a special action review of a ... 1985 , claimant's treating applicable , even if evidence satisfied legal chiropractor notified Aetna that he had distest for ... Found inside – Page 591Aetna Life & Cas . Ins . Co. , 912 F.2d 1406 ( 11th Cir . 1990 ) ( Alabama statute regarding coverage of chiropractic claims preempted , bad faith action preempted ) ; Wickman v . Northwestern ... 1990 ) , cert . denied , 498 U.S. 1013 ( 1990 ) ( Pennsylvania state law breach of contract claim preempted ) ; Ruocco v . Bateman ... Found insideEmployee , who was diagnosed by chiropractor as having lumbar intervertebral disc syndrome , was not totally disabled as required for ... of disabled insured's earnings had come from illegal activities , and thus could not support insurer's denial of benefits on that basis ; insured had not ... --Aetna Cas . & Sur . Co. v . Dow Chemical Co. , 44 E Supp . 2d 847 . C2918 . Claim , suit , or demand for damages . Found inside – Page 1408When that while the Alabama statute relating to their claims were turned down by Aetna , chiropractic services is a ... chiropractic services was a noted that since the Plan at issue in this breach of contract and a “ bad faith " denial case was fully ... Found inside – Page 460Note 12 Title 31 affirmative action , other than delay , covered Workers ' compensation benefits claimants claim . ... even though there was no denial of West's F.S.A. § 440.34 , failure of chiropractor's claim by affirmative action on part of FIGA ; claim would preclude ... Sonitrol Corp. , App . 1 Dist . , 626 So.2d Aetna Ins . Co. v . Found inside – Page 137INSURANCE Insurer ' s consulting firm recommends denial of claims : Conspiracy to deny coverage : RICO violations ... sustained injuries in an automobile accident , she submitted claims for chiropractic care to her insurer , Aetna Casualty . Found inside – Page 91The court ordered a new trial on the bad faith claim , finding $ 550,000 to be excessive . ... to exercise an honest and informed judgment on plaintiff's claim , and thus could conclude that its denial was not fairly debatable . ... Aetna Casualty and Surety Co. , 466 N.W. 2d 257 ( Iowa 1991 ) : Following a fire loss , plaintiff insured invoked an appraisal ... Defendant insurer , State Farm , submitted the claims for chiropractic treatment to an independent professional corporation for review . Found inside – Page 1383... chiropractors " and " foot doctors ” are expressly denied . ... Aetna Ins . Co. , supra , the Court rejected plaintiff's antitrust case based on boycott ... Found inside – Page 297IV 1986 ) . company's claims supervisor that it was the Moran contends that Aetna is liable unplan administrator . ... ment , its earlier denial of motion for sumand was insured under an Aetna policy . mary judgment was reviewable on appeal . Aetna ... Moran received chiropractic treatments from Dr. Jim Takeda in July 1986. Found inside – Page 1333On Novemsymptoms of bipolar disorder and depression . ber 2 , 2004 , Aetna again denied the claim . Dr. Michael Gray , Dramse's chiropractor , While Aetna's reconsideration was still opined in a letter to the Texas Workers ' Compending , on ... Found inside – Page 175Rptr . 691 , 24 C . 3d 809 , relevant facts . appeal dismissed , certiorari denied 100 Aetna Cas , and Sur . ... from claim , insurer failed to investigate witnesses it insured ' s chiropractor without making any eflearned of in criminal proceeding who ... Found inside – Page 273Cite as 182 U.S.App.D.C. 264 ( 1977 ) shops for the purchase and installation of cert . denied , 419 U.S. 1110 , 95 S.Ct. 784 , 42 automobile windshields . ... See Meicler v . sion , a claim that went beyond a mere Aetna Casualty & Surety Co. , 506 F.2d 732 , blacklist of insurance ... to refuse payment of claims for services rendered by chiropractors even though claims for identical services rendered by ... Found insideNationwide refused to pay for any of the chiropractic care after the first three ... Aetna settled a claim against its insured, an oral surgeon, ... Found inside – Page xiii285 86 Jones , Aetna Casualty & Surety Co. v ... Jutkowitz v . Department of Health Services Suspension of chiropractic license ; complaint by health department ; appeal from ... on limited issue suspended finality of siting council's decision ; whether denial of rehearing request negated claim that appeal was premature . Found inside – Page 38The company denied $ 380 in claims , citing a review conducted for it by a consulting firm , Chiropractic Consultants . When Cantrell consulted her attorney , he noticed that Aetna had denied the claims of several other clients based on a ... Found inside – Page 1141American Vion Furance Co 18 , modified 14 us . denied , is s cute expressly dear select physicians kr 3. ... Aetna CIC comments upon its experience with the Life & Casualty Co. ... Parkinson unfit , nor does it suggest that any chiro( 1985 ) , Ind . App . , 487 N.E.2d 162 , 164 , practor is incompetent . ... fair dealing . strues CIC's statement , which did not refer Furno presents no valid claim for breach of to him or his particular treatment of Long . the covenant of good faith and fair dealing . Found insideRefusal of Insurers to Provide Chiropractic Treatment as Workers' ... The party claiming a right to reimbursement under G.S. 97-10.2 (f)(1)(c), i.e., ... Found inside – Page 419Aetna Life & Casualty Co . , 127 III . ... by a committee of chiropractors , was evaluated by a claims trainee who had no experience evaluating chiropractors ' claims . ... This form served as the basis for denying payment of the plaintiff ' s bill . Found inside – Page 264... chiropractic patient out of the Medicare program is the denial from AEtna ... HCC be required to administer the chiropractic Medicare claim in Georgia ... Found inside – Page 742The court found that the wrongful death claim related to a denial of ... 140 In 2004 , the U.S. Supreme Court decided the case of Aetna Health , Inc. v . Found inside – Page 262The claims were denied because the plan's definition of physician did not include chiropractors despite Alabama law requiring insurers to cover chiropractic services . Affirming summary judgment for Aetna , the court noted that ERISA's ... Found inside – Page 905Pireno , 458 U . S . 119 ( 1982 ) , where an alleged conspiracy to eliminate price competition among chiropractors by means ... 1990 ) ( contracts by which insurance companies handle payments and processing of insurance claims do not spread or transfer risk ) ; Ratino v . ... 1981 ) , cert . denied , 455 U . S . 1020 ( 1982 ) ( vertical price fixing arrangement between auto insurance company and preferred body shops not immune ) . ... Aetna Life & Casualty Co . , 654 F . 2d 218 ( 3d Cir . ) ... Found inside – Page 5Claimant was not entitled to chiropractic care for his ... work , presented testimony of two witnesses in support of his claim , and pointed out medical evidence which showed he had been ... North Dakota Workers ' Compensation Bureau , 541 N . W . 2d 80 , rehearing denied . ... Aetna Ins . Co . , 541 N . W . 2d 631 , 249 Neb . Found inside – Page 111Courts have routinely rejected antitrust complaints brought by the ... 2004) (denying insurer's motion for summary judgment on exclusion claim based, ... Found insideAnd of course, they must have missed the Council on Chiropractic Practice (CCP) ... "Aetna considers spinal adjusting instruments (e.g., ProAdjuster, ... Found inside – Page 17The HMOs are Aetna , Anthem Blue Cross and Blue Shield of Connecticut , Cigna HealthCare , ConnectiCare , Oxford ... Earlier , Connecticut's attorney general accused four HMOs of stalling reimbursements and mishandling patient complaints , among other violations . ... A fed- already has reduced administrative eral judge earlier this month positions by 200 in the past two refused to ... Membership in the Chiropractors may break Blues ' HMO , once Massachusetts ' largest , back . Found inside – Page 193Aetna Life and Casualty is the thirdparty administrator of the plan , but Mining Company pays all benefits . ... Aetna as third party administrator denied all the claims on the grounds the plan did not cover chiropractic services since chiropractors ... Found inside – Page 13-23If the TPA that processes medical benefit claims for the plan does not ... In the wake of the Supreme Court's consolidated decision in Aetna Health Inc. v. Found inside – Page 14In Brief , 417 ; Colonoscope improperly sterilized , former hospi defense summary judgment motion denied , 491 HEALTH CARE PLANS tal ... Ct . ) , 389 Independence Blue Cross , chiropractors allege Landlord / tenant suit for nonrefundable security Milk price fixing by Chicago ... Ct . ) , 79 See MACHINISTS ( IAM ) -Racing car replicas maker , claims meet PSLRA - Hospital group sues Aetna ( N.Y. Sup . Found inside – Page 185Arbitrator had mining uninsured motorist claim , abused their power to uphold no - fault insurer's denial of discretion by ... for chiropractic services only , where where insurer had been misled to believing that insurer in its denial of claim form ... Aetna Cas . & Sur . Co. , 654 ing that automobile liability insurer's obligation N.Y.S.2d 982 , 171 Misc.2d 473 . to prove proper cancellation of its policy coverN. Found inside – Page 74ន ង 3Wt KEY NUMBER SYSTEM V. summary judgment dismissing the complaint N.E.2d 670 , cert . denied , 371 U.S. 901 , 83 insofar as ... to defend and address Aetna's remaining contention . indemnify the respondents in the underlying pending personal injury action . ... Division , held that affidavit notice of disclaimer ( see , Matter of Interboro of chiropractor , who examined motorist three Mut . Indem . Found inside – Page 67Aetna Health Plans of New York 445 , certiorari denied 103 S.Ct. 79 , 459 Inc. , 14 F.Supp.2d 252 , affirmed 182 U.S. 835 , 74 ... Manufacturer's mere Chiropractors failed to show that policyreceipt of complaints from its wholesalers or makers ... Found inside – Page 348May a no-fault carrier deny further payments for chiropractic treatment ... had received chiropractic treatment for 7 1/2 years for his claimed neck and ... Found inside – Page xiii285 86 Jones , Aetna Casualty & Surety Co. v ... Jutkowitz v . Department of Health Services Suspension of chiropractic license ; complaint by health department ; appeal from ... on limited issue suspended finality of siting council's decision ; whether denial of rehearing request negated claim that appeal was premature . Found inside – Page 27... for an insurance license denied based on allegations of a criminal conviction substantially related to insurance marketing activities and failure to ... failing to properly pay Medicare supplement chiropractic claims and pay all Wisconsin mandated Medicare supplement benefits appropriately ... June 1999 Aetna Life Ins . Co. Found inside – Page 40... that coverage was employee chiropractor had not ob- afforded . tained coverage for himself and had In Aetna Life Ins . Co. v Maxwell ... to the insurer , and thereshown that the injuries received by fore estopped it from denying coverthe patient were sustained by her as a ... In the following cases , where the The company would be deemed lia1 party claim . on 33 ALR4th 14 ble , the court said , 40 § 11 ... Found inside – Page 24The review of disputed Aetna claims is intended to be a three - step process with ... for example , the denial of a claim for the services of a chiropractor ... Found inside – Page 1151actions against an insurer based on claims of bad faith. ... facts may be raised by a general denial of [insured]'s claims of negligence and bad faith.”). Found inside – Page 186Aetna Life Ins . Co . , 39 F . 3d 520 ( 5th Cir . 1994 ) . ... chiropractors to assist in controlling costs ; no state RICO claim stated against experts ... Found inside – Page 20Samuel Colavito and Aetna Life and Casualty , Inc. • ROBERT A. MENDELSOHN TREATMENT NECESSITY — MAXIMUM MEDICAL ... The applicant is requesting payment for chiropractic treatment from May 19 , 1994 to March 23 , 1995 . ... job to pick up packages , is so excessive that this claim must be place them in his truck and then denied by giving the respondent cred- return to the warehouse area ... Found inside... failure of Aetna to pay plaintiffs' medical benefits for chiropractic services was a breach of contract and a “bad faith” denial of claims in violation ... Found inside – Page 13475-1.1 claims; however, a court applied the doctrine of primary jurisdiction in North Carolina Chiropractic Ass'n v. Aetna Casualty & Surety Co.2 ... Found inside – Page 1038National Chiropractic Mut. ... 325,951 P.2d 987 (1997 & 1998) (rejecting claim of insurer bad faith where insured's conduct caused the delay in payment); ... Found inside – Page 101The plaintiffs brought a lawsuit alleging that Aetna's failure to reimburse them for the chiropractic services received was a breach of contract and a “ bad faith ” denial of claims to which they were entitled . The plaintiffs relied on an Alabama law ... Found inside – Page 936Evidence established that insurer's failure to pay insured's chiropractic bill fol . lowing automobile accident was in bad faith and ... App . 880 , certiorari denied . ... Aetna Ins . Co. , 360 S.E.2d 540 . ... Generally speaking , claimant is entitled to recover prejudgment interest on liqui . dated claim at rate of 7 % per annum from ... 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