No-Fault Case Law

The relevant fact that the court considered was that the plaintiffs, who issue automobile insurance policies, wanted to seek judgment in court that they were not obligated to pay any past, pending, or future claims for no-fault benefits submitted to them by the defendants based on fraudulent incorporation on the grounds that defendants were fraudulently incorporated in the names of licensed medical professionals, while they were owned, operated, and controlled by a nonphysician. The main issue that the court considered was whether an insurance carrier may withhold payment for medical services provided by a professional corporation which has been fraudulently incorporated to allow nonphysicians to share in its ownership and control. The holding of the court was that the trial court should reversed the order, as the documented evidence did not show that the defendant exercised dominion and control over the assets of the professional corporation. Thus, the plaintiffs failed to demonstrate their prima facie entitlement to judgment as a matter of law and the motion for summary judgment was denied.

The main issue in this case was whether a provider could recover assigned first-party no-fault benefits when the plaintiff had failed to appear for scheduled examinations under oath. The court considered the motion for summary judgment by the plaintiff, as well as the cross-motion for summary judgment by the defendant. The court ultimately decided to vacate the portion of the order that awarded defense counsel $250 in "fees," and affirmed the rest of the order without costs. The holding was based on the reasoning stated in a related case, and the decision was made by Justices Michelle Weston, Michael L. Pesce, and Martin M. Solomon.

The relevant facts considered by the court were that plaintiff Gentlecare Ambulatory Anesthesia Services sought to recover assigned first-party no-fault benefits from defendant Geico Ins. Co. The main issue decided in the case was whether plaintiff had failed to appear for scheduled examinations under oath, which led to defendant cross-moving for summary judgment to dismiss the complaint. The holding of the case was that the order denying plaintiff's motion for summary judgment, granting defendant's cross motion for summary judgment, and awarding defense counsel $250 in "fees" was modified by vacating the portion awarding defense counsel the "fees." The court also referred to a similar case decided herewith to support its decision.

The relevant facts the court considered in this case were that plaintiff sought to recover assigned first-party no-fault benefits, but defendant argued that plaintiff had failed to appear for scheduled examinations under oath. The main issue decided was whether plaintiff was entitled to summary judgment in their favor, and whether the complaint should be dismissed due to the failure to appear for scheduled examinations. The holding of the court was that the order denying plaintiff's motion for summary judgment, granting defendant's cross motion for summary judgment, and awarding defense counsel $500 in "fees" was affirmed. However, the court also modified the order by vacating the portion that awarded defense counsel the $500 in "fees."

The court considered evidence submitted by the defendant in support of its cross motion, indicating that the plaintiff had failed to appear for duly scheduled examinations under oath (EUOs). The main issue decided was whether the proof submitted by the defendant was sufficient to demonstrate that the EUO scheduling letters and denial of claim form had been timely mailed, and that the plaintiff had failed to appear for the EUOs. The holding of the case was that the proof submitted by the defendant was sufficient to establish its prima facie entitlement to summary judgment, and plaintiff had not provided any basis to disturb the Civil Court's granting of defendant's cross motion. The court also held that the award of costs to defense counsel was vacated as the court had failed to provide a reasonable opportunity to be heard.

The main issue in this case was whether the defendant's motion to vacate a default judgment was granted properly. Plaintiff had filed a complaint to recover assigned first-party no-fault benefits, and defendant was served with the complaint, but plaintiff subsequently applied to the clerk for a default judgment when defendant did not respond. Defendant's counsel asserted that an answer had been served on plaintiff's attorney and filed with the court, but plaintiff's counsel stated that the answer had not been received. The court held that the defendant's belief that it had mailed the answer in accordance with its law firm's standard mailing procedures was sufficient to constitute a reasonable excuse for its default, and defendant demonstrated the existence of a potentially meritorious defense to the action. Therefore, the Civil Court did not improvidently exercise its discretion in granting the motion to vacate the default judgment.

The main issues in this case were whether the Civil Court should have granted a motion by the defendant to compel the plaintiff to appear for an examination before trial and to strike the notice of trial in an action by a provider to recover assigned first-party no-fault benefits. The court considered the denial of the branches of the defendant's motion and decided that, for the reasons stated in another case, the branch of the defendant's motion seeking to compel the plaintiff to appear for an examination before trial should have been granted, and therefore the branch seeking to strike the notice of trial should also have been granted. The holding of the court was that the order of the Civil Court, insofar as appealed from, was reversed, the branches of the defendant's motion seeking to compel the plaintiff to appear for an examination before trial and to strike the notice of trial were granted, and the examination was ordered to be held within 60 days of the date of the decision.

The relevant facts considered by the court were that S.J. Pahng, M.D., P.C. was seeking to recover assigned first-party no-fault benefits. The main issue decided by the court was whether the branch of the defendant's motion seeking to compel the plaintiff to appear for an examination before trial should be granted. The court held that the branch of the defendant's motion seeking to compel plaintiff to appear for an examination before trial should be granted, and that the examination should be held within 60 days of the date of the decision and order. The court cited a previous case, S.J. Pahng, M.D., P.C., as Assignee of Jin Hee Ma v AutoOne Ins. Co., to support their decision.

The main facts that the court considered were that the defendant served the plaintiff with a notice for an examination before trial (EBT), which was considered material and necessary to the defendant's lack of medical necessity defense. The main issue decided was whether the branch of the defendant's motion seeking to compel the plaintiff to appear for an examination before trial should be granted. The holding of the case was that the branch of the defendant's motion seeking to compel the plaintiff to appear for an examination before trial was granted, and the examination was to be held within 60 days of the date of the decision and order. The court also found that the examination was material and necessary to the defendant's lack of medical necessity defense, and as a result, the order denying the branch of the defendant's motion seeking to compel the plaintiff to appear for an examination before trial was reversed.

The court considered the fact that TAM Medical Supply Corp. was seeking to recover assigned first-party no-fault benefits, and that the defendant had filed a cross motion for summary judgment dismissing the complaint on the grounds that TAM had failed to appear for scheduled examinations under oath. The main issue decided was whether TAM had failed to comply with the requirement to appear for examinations under oath, and if so, whether this failure justified the dismissal of their complaint. The holding of the court was that the order granting the defendant's cross motion for summary judgment was affirmed, and the complaint was dismissed.