No-Fault Case Law

The court considered an appeal from an order of the Civil Court of the City of New York, Queens County, which denied the plaintiff's motion for summary judgment and granted the defendant's cross motion for summary judgment. The main issue was whether the plaintiff was entitled to recover $2,361.87 in first-party no-fault benefits, and whether the defendant's defense that the amounts sought to recover were in excess of the workers' compensation fee schedule was valid. The holding of the case was that the defendant did not sufficiently demonstrate that the denial of claim form had been timely mailed, and therefore was not entitled to summary judgment dismissing the portion of the complaint seeking to recover the sum of $2,361.87. As a result, the order was modified to deny the branch of the defendant's cross motion seeking summary judgment dismissing that portion of the complaint.

The court considered the fact that the plaintiff, a medical supply company, was seeking to recover assigned first-party no-fault benefits from the defendant, an insurance company. The main issue decided was whether the plaintiff had failed to appear for duly scheduled examinations under oath (EUOs) as required. The holding of the court was that the defendant's proof sufficiently established proper mailing of the EUO scheduling letters and that the plaintiff had indeed failed to appear for the scheduled EUOs. As a result, the court affirmed the order denying the plaintiff's motion for summary judgment and granting the defendant's cross motion for summary judgment dismissing the complaint.

The court considered the fact that the plaintiff, as an assignee of Molina, Jose, was seeking to recover first-party no-fault benefits from the defendant, American Transit Ins. Co. The main issue at hand was that the defendant argued that the plaintiff had failed to appear for scheduled examinations under oath (EUOs), while the plaintiff argued that the EUO scheduling letters were not properly mailed. The court ultimately affirmed the order of the Civil Court, granting the defendant's motion for summary judgment and dismissing the complaint, while also denying the plaintiff's cross motion for summary judgment. The holding was that the defendant's proof sufficiently established the proper mailing of the EUO scheduling letters and that the plaintiff had indeed failed to appear for the scheduled EUOs, thus leading to the affirmation of the order.

The relevant facts considered by the court were that the plaintiff, Staten Island Advanced Surgical Supply, was seeking to recover assigned first-party no-fault benefits for medical supplies provided to its assignor. The main issue decided was whether the judgment of the Civil Court, which awarded the plaintiff the principal sum of $1,277.26, should be reversed. The holding of the court was that the judgment was indeed reversed, with the matter remitted to the Civil Court for a new trial. This decision was made for the same reasons stated in a related case, Staten Is. Advanced Surgical Supply, as Assignee of Gu Zhang v GEICO Ins. Co, which was decided at the same time. The Justices Pesce, Aliotta and Solomon all concurred with this decision.

The court considered the appeal of a judgment from the Civil Court of New York, Queens County, in a case where Staten Island Advanced Surgical Supply sought to recover first-party no-fault benefits for medical supplies provided to its assignor. The judgment awarded the plaintiff $1,670.30 after a nonjury trial. The main issue decided was whether the plaintiff was entitled to recover no-fault benefits for the medical supplies provided. The court reversed the judgment and remitted the matter to the Civil Court for a new trial. The decision to reverse the judgment was based on the reasons stated in a similar case, Staten Is. Advanced Surgical Supply, as Assignee of Gu Zhang v GEICO Ins. Co., decided in the same time period. The decision was made by Justices Pesce, Aliotta, and Solomon. The holding of the case was that the judgment of the Civil Court was reversed and remitted for a new trial.

The court considered a judgment from the Civil Court of the City of New York, Queens County, in which the plaintiff, Alur Medical Supply, Inc., as Assignee of Daniels, Donald, was awarded $740.25 in a nonjury trial against GEICO Ins. Co. The main issue was whether Alur Medical Supply, Inc. was entitled to recover assigned first-party no-fault benefits for medical supplies it had provided to its assignor. The court reversed the judgment and remitted the matter to the Civil Court for a new trial, citing similar reasoning from a related case. The holding of the court was that a new trial was warranted in this case, and the judgment was reversed.

The court considered the appeal of a judgment in a case where a medical supply provider was seeking to recover first-party no-fault benefits for medical supplies provided to its assignor. The main issue was whether the provider was entitled to the principal sum of $1,937. The court held that the judgment was reversed, with $30 costs, and the matter was remitted to the Civil Court for a new trial. The court referenced a similar case and stated that for the reasons stated in that case, the judgment was reversed and a new trial was ordered. The decision was made on December 22, 2017.

The case involved an appeal from a judgment of the Civil Court of the City of New York, Queens County, where a provider sought to recover assigned first-party no-fault benefits for medical supplies provided to an assignor. The defendant, GEICO Insurance Company, appealed a judgment awarding the plaintiff, Staten Island Advanced Surgical Supply, $1,698.30 after a nonjury trial. The main issue of the case was whether the defendant's expert medical witness should have been permitted to testify as to her opinion about the lack of medical necessity of the supplies at issue, even though she was not the person who had prepared the peer review report. The court held that the defendant's expert medical witness should have been allowed to testify, and therefore reversed the judgment and remitted the matter to the Civil Court for a new trial.

The case involved an appeal from an order of the Civil Court of the City of New York, Kings County, that granted the defendant's motion for summary judgment dismissing the complaint brought by a provider to recover assigned first-party no-fault benefits. The main issue was whether the defendant demonstrated that it was entitled to summary judgment dismissing the complaint, as the plaintiff's assignor had failed to appear for duly scheduled examinations under oath. The court found that the defendant had failed to demonstrate this entitlement and that the EUO requests had been sent more than 30 days after the defendant had received the bills, making them nullities with respect to those bills. As a result, the branches of the defendant's motion seeking summary judgment dismissing those portions of the complaint should have been denied. The holding of the case was that the order was modified by providing that the branches of the defendant's motion seeking summary judgment dismissing so much of the complaint as sought to recover on bills received by the defendant between January 26, 2012, and March 8, 2012 are denied.

The court considered the fact that plaintiff, Z. M. S. & Y Acupuncture, P.C., was seeking to recover assigned first-party no-fault benefits from defendant, GEICO General Insurance Company. The main issue was whether defendant had fully paid plaintiff for the services rendered in accordance with the workers' compensation fee schedule for acupuncture services performed by chiropractors. Defendant demonstrated that it had fully paid plaintiff for the services at issue, and as plaintiff failed to rebut defendant's showing, the court held that the branches of defendant's cross motion seeking summary judgment dismissing so much of the complaint as sought to recover for services billed under certain CPT codes should have been granted. Therefore, the order, insofar as appealed from, was reversed, and the branches of defendant's cross motion seeking summary judgment dismissing so much of the complaint as sought to recover for services billed under certain CPT codes were granted.