LMR's Major PIP Appellate Victories

PART TWO OF A SIX PART WEEKLY SERIES

FLAX POND CHIROPRACTIC CARE v. QUINCY MUTUAL INSURANCE COMPANY

2014 Mass. App. Div. 239

https://www.masscasesarchive.com/masscases.com/cases/distapp/2014/2014massappdiv239.html

Representing the medical provider, Flax Pond Chiropractic Care, Attorney LaMothe successfully challenged a premature summary judgment ruling for the insurer, ensuring his client’s right to a fair trial and costs and fees for unpaid medical services.

Case Overview

The dispute began when Quincy Mutual Insurance Company refused to pay the final $575.00 of a $5,585.00 bill for Personal Injury Protection (PIP) benefits. The insurer relied on an Independent Medical Examination (IME) to claim the patient had reached a "medical end result." After suit was filed, the insurance company finally tendered the $575.00 check to the medical provider.

Attorney LaMothe then pursued a ruling that sought to prohibit the Insurer from continuing the practice of asserting “throwaway denials” where it is unlikely to defend to a jury.

Key Legal Victory

LaMothe’s strategic planning meant his client recovered 100% owed to him and that he owed nothing to Attorney LaMothe out of his recovery.

Securing a Reversal: Thanks to Attorney LaMothe's advocacy, the Appellate Division vacated the summary judgment. The court ruled that Quincy Mutual was not entitled to a win simply by paying late, especially when factual disputes regarding "reasonable" and "necessary" treatment remained.

The Impact of Attorney LaMothe’s Advocacy

Attorney LaMothe protected his client's path to recovering not just the base medical costs, but also attorney’s fees and costs provided under G.L. c. 90, § 34M.

Through this appeal, Attorney LaMothe ensured that insurance companies cannot use late payments to bypass the legal consequences of withholding necessary PIP benefits.