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Where a defendant insurance company was held liable under G.L.c. 93A and 176D for not promptly reimbursing a plaintiff for medical treatment provided to a passenger who was injured in an automobile insured by the defendant, the defendant's appeal must be rejected because of its failure to (1) pay personal injury protection benefits within 10 days after receiving the plaintiff's bill, (2) notify the plaintiff or the patient of its intention not to pay and (3) have the patient examined by a practitioner licensed in the same medical specialty as the plaintiff.
Background
"A $990 dispute, reduced shortly before a bench trial in the District Court to a claim for $188.10, has resulted in an award totaling $25,343.53 against Pilgrim Insurance Company (Pilgrim). Pilgrim now appeals from the decision and order of the Appellate Division of the District Court affirming the District Court judgment in favor of Byron Hartunian, M.D., P.C. (Hartunian), on his claim that Pilgrim unfairly delayed payment for orthopedic treatment rendered by Hartunian to the claimant under Pilgrim's policy. ...
"... A personal injury protection (PIP) benefits application was received by Pilgrim approximately ninety days after the accident. Some ninety additional days thereafter Pilgrim received treatment records and bills from Hartunian for five different dates of treatment. Pilgrim initially paid $515 to Hartunian, constituting payment for the first two treatment dates of May 15 and June 20, 2007. Thereafter, Pilgrim paid Hartunian an additional $495 for the remaining three treatment dates of July 19, August 14, and October 2, 2007. Although these two payments were intentionally $990...