No-Fault Case Law
Integon Natl. Ins. Co. v Salazar-Ochoa (2026 NY Slip Op 50292(U))
January 7, 2026
An insurer need not provide coverage for an intentionally caused collision, even to innocent third parties. The Supreme Court, Suffolk County, granted the insurer's summary judgment motion in full in a CPLR 3001 action concerning eight collisions, declaring no obligation to provide no-fault or uninsured/underinsured motorist benefits. Investigator evidence, inconsistent EUO testimony, adverse drivers' affidavits and supporting documents established that the collisions were staged and intentional. Unsigned EUO transcripts were admissible under CPLR 3116 (a) after submission for review and expiration of 60 days, and as certified party admissions. The opposing passengers and providers failed to raise triable issues or justify further discovery under CPLR 3212 (f). The providers, as assignees, acquired no greater coverage rights than their assignors.
Matter of American Tr. Ins. Co. v Atlantic Med. Care, P.C. (2025 NY Slip Op 07297)
December 24, 2025
A master arbitrator's legal error does not warrant vacatur unless the determination is irrational. In this CPLR article 75 proceeding, the Appellate Division, Second Department, reversed the order remanding the claim to arbitration, denied the insurer's petition, and confirmed the award on the provider's cross-petition. Under 11 NYCRR 65-4.10 (h), review was limited to article 75 grounds. Despite any errors concerning burdens of proof, the award rationally rested on a reasonably justified minor notice delay: the assignor was a passenger claiming against another's insurer, under 11 NYCRR 65-3.5 (l). The matter was remitted for reasonable attorney fees under 11 NYCRR 65-4.10 (j) (4); the remaining contentions were not reached.
Cuevas v Everest Denali Ins. Co. (2025 NY Slip Op 52120(U))
December 23, 2025
The injured claimant avoided arbitration-based collateral estoppel because the claimant lacked a full and fair opportunity to litigate. The Supreme Court, Bronx County, denied the insurer's CPLR 3211 (a) (5) dismissal motion despite identity of issues and privity through assignment to the arbitrating provider. The claimant lacked notice of the arbitration and opportunities to submit evidence, testify, or cross-examine witnesses; available photographs and witness evidence had not been presented. Insurance Law § 5106 (e) did not apply to this benefits action, rather than a personal-injury action under Insurance Law § 5104, and Insurance Law § 3420 (d) did not apply absent policy coverage. The claimant's summary judgment cross motion was also denied because conflicting accounts of the accident required credibility assessments.
Longevity Med. Supply, Inc. v New York City Tr. Auth. (2025 NY Slip Op 52018(U))
December 17, 2025
Payment of no-fault principal before judgment ends the 2% monthly rate; unpaid accrued interest then bears 9% annual interest. The Civil Court, Kings County, granted the provider's summary judgment motion to the extent of awarding interest after the defendant paid the benefit principal in full before judgment. Under Insurance Law § 5106 (a) and 11 NYCRR 65-3.9 (a), 2% monthly simple interest accrued until principal payment. The court treated that accrued interest as the remaining debt, subject to 9% interest under CPLR 5004, with a toll for the provider's inactivity. It distinguished Matter of B.Z. Chiropractic, P.C. v Allstate Ins. Co. as addressing payment after judgment and rejected continued 2% interest on the unpaid interest alone.
Suarez Med., PLLC v Nationwide Ins. (2025 NY Slip Op 51996(U))
December 12, 2025
The insurer failed to establish that the provider's EUO statements conclusively waived the claims at issue. The Civil Court, Kings County, granted the provider's summary judgment motion only to establish its prima facie case for all purposes and denied the insurer's cross motion under CPLR 3212 (b). The insurer relied on an unsigned EUO transcript in which the provider's owner agreed to withdraw prior claims. The transcript contemplated a separate waiver affidavit, which the insurer did not produce, and noted an off-record discussion before the withdrawal statements. The EUO concerned different claimants and claims. The owner's intent presented a factual issue requiring trial, and the insurer failed to meet its initial burden. The action was to proceed to trial on the insurer's proof and defenses.
Balanced Channels Acupuncture, P.C. v USAA Cas. Ins. Co. (2025 NY Slip Op 51972(U))
December 5, 2025
The insurer failed to establish lack of coverage with an affidavit addressing a different company's insurance records. The insurer sought summary judgment on the ground that it had issued no policy covering the assignor, who therefore was not an eligible injured person. The adjuster did not establish employment by the defendant insurer, the relationship between the companies, personal knowledge of the defendant's policy-record practices, or any search of its records. The affidavit stated only that the adjuster's employer did not insure the assignor, the vehicle, or household residents. The Appellate Term, Second Department, reversed and denied the insurer's motion regardless of the sufficiency of the provider's opposition.
LV Med. Diagnostic Servs., P.C. v Safe Auto Ins. Co. (2025 NY Slip Op 51974(U))
December 5, 2025
The insurer's jurisdictional dismissal motion was denied because factual issues remained about whether it did business in New York. The Ohio insurer moved under CPLR 3211 (a) (8), asserting lack of personal jurisdiction and improper service, and also raised policy exhaustion. The Civil Court, Kings County, addressed only personal jurisdiction, finding evidentiary deficiencies in an out-of-state affidavit lacking a certificate of conformity and an uncertified declarations page lacking a foundation. It directed a trial on jurisdiction because factual issues remained concerning the insurer's New York business activity. The Appellate Term, Second Department, affirmed, finding that determination proper under the circumstances; the insurer's remaining contentions lacked merit or were unpreserved.
Prompt Med. Group, Inc. v Foremost Signature Ins. Co. (2025 NY Slip Op 51977(U))
December 5, 2025
The insurer failed to prove proper cancellation notice or that cancellation was effective against an assignor outside the insured's household. The insurer obtained summary judgment dismissing the provider's assigned no-fault claim on the ground that the vehicle's policy had been cancelled before the alleged accident. Its submissions did not establish by admissible proof proper notice to the insured under Vehicle and Traffic Law § 313 (1) (a). It also failed to demonstrate effectiveness against the assignor, who was neither the named insured nor a household member, under Vehicle and Traffic Law § 313 (2) (a) and (3). The Appellate Term, Second Department, reversed the order, insofar as appealed from, and denied the dismissal branch.
Medical Supply of NY Servs., Inc. v Foremost Signature Ins. Co. (2025 NY Slip Op 51978(U))
December 5, 2025
The insurer's summary judgment motion based on preaccident policy cancellation was denied on appeal. The Appellate Term, Second Department, reversed the order, insofar as appealed from, and denied the branch seeking dismissal of the provider's assigned no-fault claim. It relied on the reasons stated in the companion appeal involving Prompt Med. Group, Inc., decided the same day, No. 2024-1129 RI C.
Prompt Med. Group, Inc. v Foremost Signature Ins. Co. (2025 NY Slip Op 51979(U))
December 5, 2025
The insurer's summary judgment motion based on preaccident policy cancellation was denied on appeal. The Appellate Term, Second Department, reversed the order, insofar as appealed from, and denied the branch seeking dismissal of the provider's assigned no-fault claim. It relied on the reasons stated in the companion appeal decided the same day, No. 2024-1129 RI C.