the only thing they sent me with my signiture is an Assignment of Benifits form and it states.
I {My Name} Assignor hereby assign to;
{Preffered Med Imag. P.C}. Assignee all rights privileges and remedies to which i am entitled under Article 51(No-Fault provisions) of the Insurance law.
The Assignee hereby certifies that they have not received any payment from or on behalf of the Assignor and shall not pursue directly from the Assignor for services provided to said assignee for injuries sustained due to motor vehicle accident which occurred on 3/15/04 notwithstanding any prior written agreement ot the contrary.
The agreement may be revoked by the assignee when benefits are payable based upon the assignor's lack of coverage and/or violation of a policy condition due to the actions or conduct of the assignor.