No-Fault Case Law
Gentlecare Ambulatory Anesthesia Servs. v Geico Ins. Co. (2017 NY Slip Op 51519(U))
November 3, 2017
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."
Gentlecare Ambulatory Anesthesia Servs. v Geico Ins. Co. (2017 NY Slip Op 51518(U))
November 3, 2017
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.
Mind & Body Acupuncture, P.C. v GEICO Gen. Ins. Co. (2017 NY Slip Op 51517(U))
November 3, 2017
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.
Holtsville Chiropractic, P.C. v AutoOne Ins. Co. (2017 NY Slip Op 51516(U))
November 3, 2017
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.
S.J. Pahng, M.D., P.C. v AutoOne Ins. Co. (2017 NY Slip Op 51515(U))
November 3, 2017
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.
S.J. Pahng, M.D., P.C. v AutoOne Ins. Co. (2017 NY Slip Op 51513(U))
November 3, 2017
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.
TAM Med. Supply Corp. v 21st Century Ins. Co. (2017 NY Slip Op 51512(U))
November 3, 2017
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.
TAM Med. Supply Corp. v 21st Century Ins. Co. (2017 NY Slip Op 51511(U))
November 3, 2017
The relevant facts the court considered were that TAM Medical Supply Corp. was seeking to recover first-party no-fault benefits that had been assigned to them. The main issue decided was whether plaintiff had failed to appear for scheduled examinations under oath. The holding of the case was that the order granting defendant's cross motion for summary judgment dismissing the complaint on the grounds of plaintiff's failure to appear for scheduled examinations under oath was affirmed.
TAM Med. Supply Corp. v 21st Century Ins. Co. (2017 NY Slip Op 51510(U))
November 3, 2017
The court considered the fact that the plaintiff, TAM Medical Supply Corp., had filed a complaint to recover assigned first-party no-fault benefits from 21st Century Insurance Company. The main issue decided by the court was whether the plaintiff had failed to appear for scheduled examinations under oath (EUOs) and whether the denial of claim forms had been timely mailed. The court determined that the plaintiff's assignor had failed to appear at the EUOs, as established by the affirmations of the attorneys and certified transcripts. It was also found that the denial of claim forms had been timely mailed. As a result, the court affirmed the order granting the defendant's cross motion for summary judgment dismissing the complaint, and the plaintiff's remaining contentions were deemed to lack merit.
Flatbush Chiropractic, P.C. v State Farm Mut. Auto. Ins. Co. (2017 NY Slip Op 51508(U))
November 3, 2017
The court considered the fact that the plaintiff, Flatbush Chiropractic, P.C., had failed to appear for scheduled examinations under oath in a case to recover assigned first-party no-fault benefits from State Farm Mutual Automobile Insurance Co. State Farm had filed a motion for summary judgment to dismiss the complaint based on this failure to appear. The main issue decided by the court was whether the plaintiff's failure to appear for the scheduled examinations under oath warranted the dismissal of the complaint. The court held that the plaintiff's failure to appear for the examinations under oath did warrant dismissal of the complaint, and therefore affirmed the lower court's order granting State Farm's motion for summary judgment.