No-Fault Case Law
North Bronx Med. Health Care v Chubb Ins. Co. (2017 NY Slip Op 51200(U))
September 15, 2017
The relevant facts considered by the court were that the plaintiff, North Bronx Medical Health Care, was seeking to recover first-party no-fault benefits as the assignee of Luis Restituyo. The defendant, Chubb Insurance Company, appealed an order from the Civil Court denying their motion for summary judgment to dismiss the complaint on the grounds that the plaintiff's assignor had failed to appear for scheduled independent medical examinations. The main issue decided by the court was whether the plaintiff's assignor's failure to appear for the independent medical examinations was a valid reason for the defendant to dismiss the complaint. The holding of the case was that the order denying the defendant's motion for summary judgment was affirmed, with the court citing a previous case, Kappa Med., P.C. v Chubb Indem. Ins. Co., as the basis for their decision.
Kappa Med., P.C. v Chubb Indem. Ins. Co. (2017 NY Slip Op 51199(U))
September 15, 2017
The relevant fact the court considered was that a provider was seeking to recover assigned first-party no-fault benefits, and the insurance company had denied the claims due to the failure of the assignor to appear for independent medical examinations (IMEs). The main issue decided was whether the insurance company's motion for summary judgment dismissing the complaint should be granted, and whether the plaintiff's cross motion for summary judgment should be denied. The holding of the court was that the insurance company failed to provide sufficient evidence to demonstrate that the assignor had failed to appear for the IMEs, and therefore was not entitled to summary judgment dismissing the complaint. The court also found that the insurance company did not provide a sufficient basis to strike the Civil Court's findings in favor of the plaintiff. Therefore, the order denying the insurance company's motion and making findings in favor of the plaintiff was affirmed.
Charles Deng Acupuncture, P.C. v 21st Century Ins. Co. (2017 NY Slip Op 51197(U))
September 15, 2017
The court considered a case in which Charles Deng Acupuncture, P.C. sought to recover first-party no-fault benefits from 21st Century Insurance Company. Charles Deng Acupuncture, P.C. moved for summary judgment on a claim for $80, and 21st Century Insurance Company cross-moved for summary judgment dismissing the complaint. The main issue decided was whether there was a triable issue of fact as to whether 21st Century Insurance Company properly denied plaintiff's claim for $80. The holding of the court was that there was indeed a triable issue of fact as to whether the defendant properly denied the claim for $80, therefore, the branch of the plaintiff's motion seeking summary judgment on that claim was denied.
Tam Med. Supply Corp. v Hereford Ins. Co. (2017 NY Slip Op 51196(U))
September 15, 2017
The court considered the fact that Tam Medical Supply Corp. was seeking to recover assigned first-party no-fault benefits, and the defendant, Hereford Insurance Co., moved for summary judgment dismissing the complaint on the ground of premature action due to failure to provide requested verification. The main issue decided was whether the requested verification remained outstanding. The holding of the court was that while the defendant made a prima facie showing that it had not received the requested verification, the affidavit submitted by the plaintiff in opposition to the defendant's motion was sufficient to give rise to a presumption that the requested verification had been mailed to and received by the defendant. As a triable issue of fact existed as to whether the requested verification remained outstanding, the Civil Court properly denied the defendant's motion for summary judgment dismissing the complaint as premature. Thus, the order was affirmed.
Compas Med., P.C. v American Tr. Ins. Co. (2017 NY Slip Op 51194(U))
September 15, 2017
The relevant facts considered in this case involved a provider seeking to recover first-party no-fault benefits from an insurance company. The provider appealed from an order of the Civil Court which denied their motion seeking summary judgement on certain causes of action and granted the insurance company's cross motion seeking summary judgement dismissing those causes of action on the ground that they were premature because the provider had failed to provide requested verification. The main issue decided was whether the causes of action at issue were premature due to lack of verification, and the holding was that there was a triable issue of fact as to whether the causes of action were premature, and thus the branches of the insurance company's cross motion seeking summary judgement dismissing the causes of action were denied.
Compas Med., P.C. v American Tr. Ins. Co. (2017 NY Slip Op 51193(U))
September 15, 2017
The court considered a motion for summary judgment in an action by a healthcare provider to recover assigned first-party no-fault benefits. The main issues decided were whether the provider's assignor was eligible for workers' compensation benefits and whether the provider had filed the claims underlying the causes of action with the Workers' Compensation Board. The court held that the defendant's proof raised an issue of fact as to whether they had received the claims underlying some of the causes of action, and that if the provider failed to file proof within 90 days showing that it had filed the claims with the Workers' Compensation Board, those causes of action would be dismissed. The court affirmed the denial of the provider's motion for summary judgment and granted the branches of the defendant's cross motion seeking summary judgment dismissing several causes of action. The court found that the remainder of the order was also correctly decided and deemed the plaintiff's remaining contentions to be academic.
Compas Med., P.C. v American Tr. Ins. Co. (2017 NY Slip Op 51192(U))
September 15, 2017
The relevant facts of this case involved an action by a medical provider to recover no-fault benefits, with the defendant arguing that the plaintiff's assignor may have been eligible for workers' compensation benefits. The main issue before the court was whether there was sufficient evidence to support the contention that the assignor had been acting as an employee at the time of the accident and whether workers' compensation benefits might be available. It was decided that the defendant proffered sufficient evidence to support this contention and that the issue of eligibility for workers' compensation benefits must be resolved in the first instance by the Workers' Compensation Board. The holding of the case was that the order, insofar as appealed from, was affirmed.
Compas Med., P.C. v American Tr. Ins. Co. (2017 NY Slip Op 51191(U))
September 15, 2017
The court considered an appeal from an order by the Civil Court denying the plaintiff's motion for summary judgment and granting the defendant's cross motion for summary judgment dismissing the complaint in a dispute over first-party no-fault benefits. The main issue decided was whether the defendant had received timely notice of the accident, as required by 11 NYCRR 65-1.1 (d). The court held that the defendant had not received timely notice of the accident, as proven by the evidence submitted by the defendant and not rebutted by the plaintiff. Therefore, the court affirmed the order, ruling in favor of the defendant and dismissing the complaint.
Compas Med., P.C. v American Tr. Ins. Co. (2017 NY Slip Op 51190(U))
September 15, 2017
The main issues decided in this case involved an action by a medical provider to recover assigned first-party no-fault benefits, with the court considering whether the defendant had received timely notice of the accident and whether the proof submitted by the defendant raised an issue of fact as to whether the claim had been received. The court ultimately denied the plaintiff's motion for summary judgment and granted the defendant's cross motion seeking summary judgment, dismissing several causes of action. The holding of the case was that the defendant's proof was sufficient to raise an issue of fact as to whether the claim had been received, and as a result, the defendant's cross motion for summary judgment was granted, and the plaintiff's motion was denied. As a result, the order was affirmed, and the plaintiff's remaining arguments were deemed academic.
Charles Deng Acupuncture, P.C. v New S. Ins. Co. (2017 NY Slip Op 51189(U))
September 15, 2017
The court considered the denial of plaintiff's motion for summary judgment and the granting of defendant's cross motion for summary judgment dismissing the complaint in an action to recover assigned first-party no-fault benefits. The main issue decided was whether the denial of plaintiff's motion for summary judgment and the granting of defendant's cross motion for summary judgment dismissing the complaint was proper. The holding of the court was that the denial and granting of the motions were affirmed, with $25 costs. The court found that plaintiff's arguments as to defendant's cross motion either lacked merit or were not properly before the court, as they were being raised for the first time on appeal. Therefore, the order was affirmed.