No-Fault Case Law

The main issues in this case were whether the plaintiff had failed to appear for examinations under oath and whether he had failed to provide requested verification, as claimed by the defendant. The court reversed the order granting the defendant's motion for summary judgment and denying the branch of the defendant's motion seeking summary judgment dismissing the complaint on the ground that the plaintiff had failed to appear for examinations under oath. The court found that the defendant had failed to submit proof by someone with personal knowledge attesting to the plaintiff's failure to appear for examinations under oath. As a result, the branch of the defendant's motion seeking summary judgment dismissing the complaint on the ground that the plaintiff had failed to appear for duly scheduled examinations under oath was denied. The court remitted the matter to determine the undecided branch of the defendant's motion, seeking summary judgment dismissing the complaint on the ground that the plaintiff had failed to provide requested verification.

The court considered a case where a provider sought to recover assigned first-party no-fault benefits, and the main issue was whether the defendant received timely notice of the accident. The court ultimately affirmed the order of the Civil Court, which denied the plaintiff's motion for summary judgment and granted the defendant's cross motion for summary judgment dismissing the complaint. The holding of the case was that the defendant had not received timely notice of the accident, and therefore the plaintiff's motion was denied and the defendant's motion was granted.

The relevant facts that the court considered in this case are that the plaintiff, a provider, was seeking to recover assigned first-party no-fault benefits from the defendant, an insurance company. The plaintiff's motion for summary judgment was denied, and the defendant's cross motion for summary judgment was granted by the Civil Court on the basis that the defendant had not received timely notice of the accident. The main issue decided by the court was whether the proof submitted by the defendant was sufficient to give rise to a presumption that the denial of claim forms had been properly mailed. The holding of the case was that the order of the Civil Court denying the plaintiff's motion for summary judgment and granting the defendant's cross motion for summary judgment dismissing the complaint was affirmed. The court found that the proof submitted by the defendant was sufficient, and declined to consider any arguments raised by the plaintiff for the first time on appeal.

The court considered a case in which a provider was seeking to recover assigned first-party no-fault benefits. The defendant argued that they had either paid the plaintiff for the services at issue in accordance with the workers' compensation fee schedule or had denied the claims on the ground of lack of medical necessity. The main issue decided was that defendant's motion for summary judgment dismissing the complaint was denied, but the only remaining issues for trial were medical necessity and the reduction of plaintiff's claims in accordance with the workers' compensation fee schedule for acupuncture services performed by chiropractors. The holding of the court was that the branches of defendant's motion seeking summary judgment dismissing so much of the complaint as sought to recover upon the unpaid portion of claims for services rendered from specific dates were granted, as defendant demonstrated that it had fully paid plaintiff for the services in accordance with the workers' compensation fee schedule for acupuncture services performed by chiropractors.

The court considered an appeal from an order of the Civil Court of the City of New York, which denied the plaintiff's motion for summary judgment and granted the defendant's cross motion for summary judgment dismissing the complaint. The main issue decided was whether the defendant's cross motion for summary judgment dismissing the complaint should be denied. The holding of the case was that the defendant's cross motion for summary judgment dismissing the complaint is denied.

The main issue in this case was whether the defendant insurance company was entitled to summary judgment dismissing the complaint by a provider seeking to recover assigned first-party no-fault benefits. The court considered whether the affidavits submitted by the defendant sufficiently set forth a standard office practice or procedure that would ensure that the denial of claim form had been timely mailed, as well as whether the plaintiff's affidavit failed to establish that the claim at issue had not been timely denied. The court held that the defendant's cross motion for summary judgment dismissing the complaint is denied, as the defendant did not demonstrate that it is not precluded from asserting its proffered defense, and the plaintiff's motion for summary judgment was properly denied. Therefore, the order was modified to provide that the defendant's cross motion for summary judgment dismissing the complaint is denied.

The court considered an appeal from a denial of a motion for summary judgment in a case involving a provider seeking to recover first-party no-fault benefits. The main issue at hand was whether the defendant's motion papers established the proper mailing of the denial of claim forms and whether the amount sought to be recovered for services rendered was in excess of the workers' compensation fee schedule. The court ultimately held that the defendant had made a prima facie showing that the amount sought by the plaintiff was in excess of the fee schedule, and the plaintiff failed to present evidence to raise a triable issue of fact in opposition. Therefore, the order was reversed and the motion seeking summary dismissal of the complaint was granted.

The court considered the appellant's appeal from an order of the Civil Court which granted the respondent's motion for summary judgment dismissing the complaint. The main issue decided was whether the proof submitted by the respondent was sufficient to demonstrate that the appellant's assignor had failed to appear for scheduled examinations under oath (EUOs). The court held that the proof submitted by the respondent was indeed sufficient to demonstrate that the appellant's assignor had failed to appear for the scheduled EUOs, and affirmed the order granting the respondent's motion for summary judgment dismissing the complaint.

The court considered the fact that the plaintiff, Moon Rehab, P.T., P.C., had failed to appear for examinations under oath (EUOs) and that the defendant, Ameriprise Insurance Company, had moved for summary judgment dismissing the complaint on these grounds. The main issue was whether the evidence submitted by the defendant was sufficient to demonstrate that the plaintiff had failed to appear for the EUOs and to give rise to a presumption that the EUO scheduling letters and the denial of claims form had been timely mailed. The court held that the proof submitted by the defendant was indeed sufficient to establish these facts and affirmed the order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion.

The court considered the fact that the defendant's motion for summary judgment dismissing the complaint was granted because the plaintiff's assignor had failed to appear for scheduled EUOs. The main issue decided was whether the defendant submitted proof of the assignor's nonappearance at the EUOs by someone with personal knowledge. The holding of the case was that the order was reversed, and defendant's motion for summary judgment dismissing the complaint was denied because the defendant failed to submit proof of the assignor's nonappearance at the scheduled EUOs. Therefore, the plaintiff's appeal was successful and the complaint was not dismissed.