No-Fault Case Law
American Tr. Ins. Co. v Graves (2022 NY Slip Op 51273(U))
December 14, 2022
The relevant facts in this case involved a no-fault-insurance-coverage action where the plaintiff, American Transit Insurance Company, sought a default judgment against the defendant Shawarbi Graves and several medical-provider assignees of Graves. The main issue decided by the court was whether American Transit had established proper service on the defendants and whether the defendants had defaulted. The court denied the motion for default judgment against Graves, Dr. Ronald P. Mazza, Nassau Health Care Corp., and Nassau University Medical Center due to improper service. However, the motion was granted against defendants Hector Melgar, PT P.C., Orthopro, Services, Prompt Medical Spine Care, PLLC, and Stand-Up MRI of Carle Place, P.C. as they were timely served and had failed to respond. The holding of the case was that the motion for default judgment was denied for improper service on certain defendants and granted against others for failing to respond.
Orthotics & Professional Supply, Ltd. v Country-Wide Ins. Co. (2022 NY Slip Op 51221(U))
December 9, 2022
The relevant facts considered by the court included the history of the case in which the plaintiff sought to recover first-party no-fault benefits for medical equipment provided to its assignor following a motor vehicle accident in 1999. Defendant appeared and answered, but failed to submit opposition when plaintiff moved for summary judgment. The court granted plaintiff's motion on default in 2002, awarding judgment and interest, and then plaintiff applied for a judgment in 2019. The main issue decided was whether statutory no-fault interest, at 2 percent per month, should accrue during the period from 2002 to 2019, given the delays in entering judgment. The court held that the accrual of statutory no-fault interest should be tolled from 2002 to 2019 due to the plaintiff's inordinate delay in entering judgment, while also allowing for interest from 2019 to 2021.
Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2022 NY Slip Op 51217(U))
December 9, 2022
The court considered the case of Burke Physical Therapy, P.C., as assignee of Kyana Fonrose, against State Farm Mutual Automobile Insurance Company. The main issue was whether the plaintiff provided requested verification for first-party no-fault benefits. The court held that the affidavit by the plaintiff's owner was insufficient to raise a triable issue of fact as to whether plaintiff provided the requested verification. Additionally, the exhibits annexed to the defendant's reply papers did not demonstrate that the plaintiff "did, in fact, respond" to the verification requests. The court affirmed the order, denying the plaintiff's motion to dismiss the defendant's affirmative defenses and granting the defendant's cross motion for summary judgment dismissing the complaint.
Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2022 NY Slip Op 51216(U))
December 9, 2022
The case involves an appeal from an order of the Civil Court of the City of New York, Kings County, granting the defendant's motion for summary judgment and denying the plaintiff's cross motion for summary judgment. The plaintiff, Burke Physical Therapy, P.C., sought to recover assigned first-party no-fault benefits from the defendant, State Farm Mutual Automobile Ins. Co. However, the court affirmed the order, with the reasons stated in a prior case between the same parties. The main issue decided was whether the plaintiff was entitled to recover assigned first-party no-fault benefits, and the court held that the order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion for summary judgment was affirmed. The decision date was December 9, 2022.
FJL Med. Servs., P.C. v Nationwide Ins. (2022 NY Slip Op 51213(U))
December 9, 2022
The court considered the fact that the plaintiff had failed to appear for scheduled examinations under oath (EUOs) and the defendant's argument that the claim at issue was timely denied. The main issue was whether the defendant had established that it timely denied the claim at issue and whether the plaintiff demonstrated its prima facie entitlement to summary judgment. The holding was that the order was modified to provide that the defendant's motion for summary judgment dismissing the complaint is denied, as the defendant failed to establish that it timely denied the claim at issue. The plaintiff also failed to demonstrate its prima facie entitlement to summary judgment.
American Kinetics Lab, Inc. v Travelers Ins. Co. (2022 NY Slip Op 51212(U))
December 9, 2022
The case involved American Kinetics Lab, Inc. seeking to recover assigned first-party no-fault benefits from Travelers Insurance Company. Travelers moved for summary judgment to dismiss the complaint, arguing that American Kinetics Lab, Inc. had failed to provide requested verification. The Civil Court granted Travelers' motion and denied American Kinetics Lab's cross motion for summary judgment. The main issue was whether Travelers had properly requested additional verification from American Kinetics Lab, Inc., and the court held that Travelers had failed to establish that it properly requested any additional verification. Therefore, the court modified the order and denied Travelers' motion for summary judgment dismissing the complaint. Additionally, the court held that American Kinetics Lab's cross motion for summary judgment was properly denied as the proof submitted failed to establish that the claims had not been timely denied or that Travelers had issued timely denial of claim forms that were conclusory, vague, or without merit.
Ezra Supply, Inc. v Nationwide Affinity Ins. Co. of Am. (2022 NY Slip Op 22383)
December 9, 2022
The court considered the failure of the plaintiff's assignor to appear for scheduled examinations under oath (EUOs) and whether the defendant's denial of the claims was timely. The main issues that were decided were whether the defendant's motion to dismiss the complaint on the ground that the plaintiff's assignor had failed to appear for the scheduled EUOs could be granted, and whether the defendant had established that the denial of the claims was timely. The holding of the court was that the defendant had failed to establish that the denial of the claims was timely, and therefore its motion for summary judgment dismissing the complaint was properly denied. The order, insofar as appealed from, was affirmed.
Matter of Wesco Ins. Co. v Government Empls. Ins. Co. (2022 NY Slip Op 06936)
December 7, 2022
The main facts of the case involved a motor vehicle collision in which the injured party was seeking payment of no-fault benefits from the insurer of the loaner vehicle involved in the accident. The insurer, Wesco Insurance Company, was held liable for the benefits paid to the injured party in a compulsory arbitration proceeding. Wesco then sought to vacate the arbitration award, but the Supreme Court denied the petition, affirming the arbitrator's decision.
The main issue decided was whether Wesco Insurance Company was liable for the no-fault benefits paid to the injured party under the circumstances of the collision involving the loaner vehicle. The court held that Wesco was indeed liable for the benefits, affirming the decision of the arbitration award.
The holding of the case was that the Supreme Court properly denied the petition to vacate the arbitration award and dismissed the proceeding, upholding the decision that Wesco Insurance Company was liable for the benefits paid to the injured party.
Matter of Wesco Ins. Co. v GEICO Indem. Co. (2022 NY Slip Op 06935)
December 7, 2022
The court considered a proceeding to vacate an arbitration award dated September 26, 2019, where the appellant sought to recover benefits paid to a party injured in a motor vehicle collision. GEICO sought to recover the benefits paid from Wesco in a compulsory arbitration proceeding, and the arbitrators determined that Wesco was liable for the benefits paid. Wesco then commenced a proceeding seeking to vacate the arbitration award, which was denied by the Supreme Court. The main issue decided was whether the Supreme Court properly denied the petition and confirmed the arbitration award, and whether the petitioner presented evidence of actual bias or the appearance of bias on the part of one of the arbitrators. The holding was that the Supreme Court properly denied the petition and confirmed the arbitration award, and that the petitioner failed to present evidence of actual bias or the appearance of bias on the part of one of the arbitrators.
Matter of Wesco Ins. Co. v GEICO Indem. Co. (2022 NY Slip Op 06933)
December 7, 2022
The court considered the facts that in August 2017, Sarah Pierre was injured while operating a loaner vehicle owned by Bay Ridge Volvo and insured by Wesco Insurance Company. GEICO Indemnity Company paid basic no-fault benefits to Pierre from her GEICO policy and sought to recover these benefits from Wesco in a compulsory arbitration proceeding. The main issue the court decided was whether Wesco, as the insurer of the loaner vehicle, was liable for the benefits paid to Pierre according to the terms of the GEICO policy. The holding of the case was that the Supreme Court should have denied Wesco's petition to vacate the arbitration award and dismissed the proceeding, as the PIP endorsement in the GEICO policy did not provide coverage for the injuries Pierre sustained while operating the loaner vehicle.