No-Fault Case Law

The court considered a motion to dismiss a declaratory judgment action and a motion for a protective order in a case where plaintiffs sought to make a declaration regarding the eligibility of defendants to recover no-fault benefits under relevant policies. The main issues decided were whether proper causes of action for declaratory judgment had been stated and whether the court should exercise its discretion to dismiss the claims, grant a protective order, or sever the claims into separate actions. The court held that plaintiffs had stated proper causes of action for declaratory judgment and that their request for a declaration regarding the eligibility of defendants to recover no-fault benefits constituted a justiciable controversy. The court also held that it properly declined to dismiss the claims, grant a protective order, or sever the claims, and declined to dismiss the claims that had also been asserted by the defendants in separate Civil Court actions.

The main issue in this case was whether the provider was entitled to recover first-party no-fault benefits, despite failing to appear for scheduled examinations under oath (EUOs). The court considered the fact that the defendant had filed a motion for summary judgment, arguing that the plaintiff had failed to appear for the EUOs and had therefore forfeited their right to the benefits. The court also considered the plaintiff's cross motion for summary judgment. The court held that the defendant's motion failed to establish that the claims had been timely denied after the assignor's failure to appear for the EUOs. Therefore, the defendant's motion for summary judgment was denied. However, the plaintiff also failed to demonstrate their entitlement to summary judgment, as they did not establish that the claims had not been timely denied, or that the denial of claim forms issued by the defendant were without merit. Therefore, the court modified the order to deny the defendant's motion for summary judgment, but also denied the plaintiff's cross motion for summary judgment.

The relevant facts considered in this case were that MSB Physical Therapy, P.C. was seeking to recover assigned first-party no-fault benefits from Nationwide Ins. The main issue decided was whether defendant was entitled to summary judgment dismissing the complaint on the ground that plaintiff had failed to appear for scheduled examinations under oath (EUOs). The holding of the case was that the defendant had failed to establish that it had timely denied plaintiff's claims after plaintiff's failure to appear for an EUO, and therefore defendant's motion for summary judgment dismissing the complaint was properly denied. The court also found that the defendant's papers were insufficient to demonstrate that there is a triable issue of fact as to its EUO no-show defense, and therefore plaintiff's cross motion for summary judgment was affirmed.

The main issue in the case was whether the insurance policy in question was fraudulently procured by the plaintiff's assignor. The court also had to decide if the amounts being sought for recovery exceeded the amounts permitted by the workers' compensation fee schedule. The court held that the defendant failed to demonstrate as a matter of law that the alleged material misrepresentation in procuring the insurance policy was actually material. They also held that the plaintiff's cross-motion for summary judgment should be denied because the proof submitted failed to establish that the defendant failed to timely deny the claims at issue or that the defendant issued timely denial of claim forms that were conclusory, vague or without merit as a matter of law. Therefore, the order was modified to deny the branch of defendant's motion seeking summary judgment dismissing the complaint on the ground of fraudulent procurement of the insurance policy and remit the matter to the Civil Court for a determination of the alternate ground that the amounts being sought exceeded the amounts permitted by the workers' compensation fee schedule.

The court considered the no-fault insurance-coverage action brought by Country-Wide Insurance Company against defendants Lifeline Medical Imaging, P.C., Autumn PT, P.C., and 334 Grand Concourse Medical, P.C. all of whom were medical-provider assignees of the eligible injured person, Steven Henderson. Country-Wide sought a declaration of no coverage on the ground that Henderson failed twice to appear for scheduled examinations under oath (EUOs), vitiating coverage for himself and for his assignees. The main issue decided was whether Country-Wide had a specific objective justification for requesting the EUOs, as required by governing regulations. The court held that Country-Wide's justifications for seeking Henderson's EUO were insufficient, as they failed to provide a clear basis for the request and did not identify the source of their knowledge for the lapse of time asserted in their affidavit. The court also held that Country-Wide's summary-judgment motion was premature, as they had not provided the discovery being sought by the opposing defendants. The court denied Country-Wide's motion for summary judgment without prejudice, including against defendant Autumn PT, and ordered Country-Wide to serve a copy of the order on the relevant parties.

The court considered the plaintiff, Country-Wide Insurance Company's, motion for default judgment against non-appearing defendants Quality Custom Medical Supply, Inc., Atlas Radiology P.C., Zhong Qing Zhou L.A.C., and Guy Brewer Pharmacy, Inc., and a separate motion for summary judgment against appearing defendants Chohayea Duff and the remaining medical-provider assignees. The main issues were whether Country-Wide had established proper service, default, and the facts constituting its claims against the defaulting defendants, and whether Country-Wide had established that Duff and the remaining medical-provider assignees failed to appear for an independent medical examination (IME) justifying a summary judgment motion. The holding of the court was that Country-Wide's default judgment and summary judgment motions were granted, as Country-Wide had established proper service and that its requests for IMEs were timely and proper, as well as that the opposing defendants failed to raise a dispute of material fact warranting trial.

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.

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.

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.

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.