No-Fault Case Law

Maiga Prods. Corp. v 21st Century Ins. Co. (2018 NY Slip Op 50845(U))

The court in this case considered whether a provider was entitled to recover assigned first-party no-fault benefits when the plaintiff failed to appear for scheduled examinations under oath (EUOs). The main issue decided was whether the defendant had provided sufficient proof to give rise to a presumption that the EUO scheduling letters and the denial of claim forms had been properly mailed. The court found that the proof submitted by the defendant was indeed sufficient, and therefore granted the defendant's cross motion for summary judgment dismissing the complaint. As a result, the order denying plaintiff's motion for summary judgment was affirmed.
Read More

Pavlova v Country Wide Ins. Co. (2018 NY Slip Op 50843(U))

The court considered the denial of summary judgment to the appellant and the granting of summary judgment to the respondent in a case where a healthcare provider was seeking to recover assigned first-party no-fault benefits. The main issue decided was whether the respondent had issued an insurance policy covering the subject loss, and the court held that the proof submitted by the respondent was sufficient to demonstrate that no policy had been issued. Therefore, the court affirmed the order denying the appellant's motion for summary judgment and granting the respondent's cross motion for summary judgment dismissing the complaint.
Read More

Gl Acupuncture, P.C. v Allstate Ins. Co. (2018 NY Slip Op 50842(U))

The relevant facts considered in this case involved a provider seeking to recover assigned first-party no-fault benefits. The court considered the denials of claim forms submitted by the defendant, as well as the timeliness of these denials. The main issues decided involved whether the plaintiff's motion for summary judgment on the first, second, and fourth through sixth causes of action, as well as a portion of the third cause of action seeking to recover $295.68, should be granted. Additionally, the court had to determine the validity of the denials of claim forms submitted by the defendant. The holding of the case was that the defendant did not demonstrate that it was not precluded from asserting its defense, and therefore, it was not entitled to summary judgment dismissing certain causes of action and part of the third cause of action. The court also found that the plaintiff's motion seeking summary judgment on the relevant causes of action was properly denied due to the failure to establish that the claims at issue had not been timely denied.
Read More

Gl Acupuncture, P.C. v Allstate Ins. Co. (2018 NY Slip Op 50841(U))

The court considered the denial of a claim form being timely mailed, and whether a provider was entitled to recover assigned first-party no-fault benefits for services rendered prior to April 1, 2013. The main issue was whether the amounts sought for recovery were in excess of the workers' compensation fee schedule. The holding of the case was that the affidavits submitted by the defendant did not sufficiently set forth a standard office practice or procedure to ensure that the denial of claim form had been timely mailed. As a result, the defendant was not entitled to summary judgment dismissing the complaint, and the order was reversed in favor of the plaintiff.
Read More

Mostun v Countrywide Ins. (2018 NY Slip Op 50840(U))

The court considered the appellant's delay in the prosecution of the action and the respondent's posttrial motion to toll the accrual of no-fault statutory prejudgment interest. The main issue was whether interest should accrue based on the delay in the prosecution of the action, and if so, from what date. The holding of the court was that the order was modified to provide that no-fault statutory prejudgment interest shall accrue from January 23, 2014, as opposed to December 18, 2014 as originally held by the lower court. The court affirmed the order with this modification.
Read More

Mostun v Countrywide Ins. (2018 NY Slip Op 50839(U))

The case involved a dispute between Paul Mostun, a chiropractor, and Countrywide Insurance regarding the accrual of no-fault statutory prejudgment interest. The Civil Court of the City of New York, Queens County granted defendant's posttrial motion to toll the accrual of interest based upon plaintiff's delay in the prosecution of the action, holding that interest shall accrue from December 18, 2014. The main issue decided was the accrual date of no-fault statutory prejudgment interest. The court modified the order, providing that the interest shall accrue from January 23, 2014. The holding of the case was that no-fault statutory prejudgment interest shall accrue from January 23, 2014, as modified by the court.
Read More

Vitality Chiropractic, P.C. v Countrywide Ins. (2018 NY Slip Op 50838(U))

The court considered the fact that the provider had taken no meaningful action to prosecute the case, which was commenced in 2002, until January 23, 2014 when it served a motion to compel discovery. Defendant filed a posttrial motion to toll the accrual of no-fault statutory prejudgment interest based upon plaintiff's delay in the prosecution of the action, and the lower court held that interest shall accrue from December 18, 2014, the date the notice of trial was filed. The main issue decided was whether the plaintiff should be rewarded for its years of inaction by receiving a windfall of interest, and the holding of the case was that the Civil Court determined that statutory interest began to accrue when the motion to compel discovery was served, rather than when the notice of trial was filed, almost a year later. Therefore, the order was modified to provide that no-fault statutory prejudgment interest shall accrue from January 23, 2014.
Read More

Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2018 NY Slip Op 50837(U))

The case involved a dispute over first-party no-fault benefits. The plaintiff, a medical provider, appealed from an order of the Civil Court which denied their motion for summary judgment and granted the defendant's cross motion for summary judgment. The basis for the denial of plaintiff's motion and the granting of the defendant's cross motion was that the plaintiff had failed to appear for scheduled examinations under oath (EUOs). The defendant was able to establish that the EUO scheduling letters and denial of claim form had been properly mailed, and that the plaintiff had failed to appear for the scheduled EUOs. The court found that the defendant's proof was sufficient to give rise to a presumption of proper mailing, and therefore affirmed the order, denying the plaintiff's motion and granting the defendant's cross motion.
Read More

Acupuncture Healthcare Plaza I, P.C. v Allstate Ins. Co. (2018 NY Slip Op 50835(U))

The main issue decided in this case was whether the denial of claim forms at issue had been timely mailed. The court considered the affidavits submitted by the defendant and found that they did not sufficiently set forth a standard office practice or procedure to ensure timely mailing. As a result, the defendant did not demonstrate that it was not precluded from asserting its defense, and therefore was not entitled to summary judgment dismissing the first through fourth causes of action. The holding of the case was that the order of the Civil Court denying the defendant's motion seeking summary judgment was affirmed.
Read More

Active Care Med. Supply Corp. v American Tr. Ins. Co. (2018 NY Slip Op 50832(U))

The relevant facts considered by the court were that Active Care Medical Supply Corp. was seeking to recover assigned first-party no-fault benefits. The main issue decided was whether the provider was entitled to recover these benefits, and the court ultimately affirmed an order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion for summary judgment. The holding of the case was that the court affirmed the order, with the costs of $25, and that the provider was not entitled to recover the assigned first-party no-fault benefits.
Read More