No-Fault Case Law

The court considered the fact that the plaintiff, New Way Medical Supply Corp., was appealing an order from the Civil Court of the City of New York that granted the defendant's motion for summary judgment, dismissing the complaint. The main issue decided was whether the action by the provider to recover assigned first-party no-fault benefits was premature, as the defendant had not received requested verification. The holding of the case was that the record demonstrated that the defendant had not received requested verification and, thus, the action was premature. The court affirmed the order granting the defendant's motion for summary judgment dismissing the complaint, with $25 costs.

The main issues considered in this case were whether the defendant properly denied the claims at issue based on the plaintiff's failure to appear for scheduled examinations under oath (EUOs). The court held that the evidence submitted by the defendant did not demonstrate that the claims had been properly denied based on the plaintiff's failure to appear for the EUOs. The court pointed out that the first EUO scheduling letter sent to the plaintiff was mailed more than 30 days after the defendant had received the claims, making it a nullity. Additionally, the defendant had rescheduled each EUO before the date set for each EUO, and was aware that the plaintiff was unable to appear. As a result, the court held that the defendant failed to establish the existence of a triable issue of fact and affirmed the judgment in favor of the plaintiff.

The main issues being decided in this case were whether the defendant timely denied the plaintiff's claims based on a late notice of the accident and whether the plaintiff failed to provide necessary responses for discovery. The court considered the discrepancy in the date when the claims were received and the notice of the claims in relation to the timely denial of the claims. It was also considered whether the plaintiff failed to serve responses to the defendant's demand for interrogatories and appear for an examination before trial, which was necessary for the defendant's defense. The holding of the case was that the branch of the defendant's cross motion seeking summary judgment dismissing the complaint was denied. However, the branch of the defendant's cross motion seeking, in the alternative, to strike the complaint and dismiss the action pursuant to CPLR 3126 was granted to the extent of compelling the plaintiff to provide responses to defendant's demand for interrogatories, demand for discovery and inspection, and demand for expert disclosure within a specific timeframe, and to appear for an examination before trial within a set timeframe. The order was modified in this regard and affirmed as modified.

The court considered the fact that St. Locher Medical, P.C. was seeking to recover first-party no-fault benefits and that IDS Property Casualty Ins. Co. had moved for summary judgment to dismiss the complaint, claiming that the plaintiff and assignor had failed to attend scheduled examinations under oath. The main issue decided was whether defendant had sufficiently established that the first notice for examination under oath had been timely sent and whether the claims had been timely denied. The holding of the court was that the defendant had failed to demonstrate its entitlement to summary judgment based on the plaintiff's alleged failure to comply with a condition precedent to coverage, and as a result, the order was reversed and the defendant's motion for summary judgment was denied.

The court considered the fact that the provider was seeking to recover first-party no-fault benefits that had been assigned to them. The main issue was whether the defendant's motion for summary judgment dismissing the complaint should be granted. The court held that the defendant's evidence did not satisfy the burden of proving the nonappearance of the plaintiff at the examinations under oath. As a result, the defendant failed to establish their entitlement to summary judgment dismissing the complaint, and the court reversed the order and denied the defendant's motion for summary judgment.

The court considered the fact that Compas Medical, P.C. was seeking to recover first-party no-fault benefits and that American Transit Ins. Co. had denied the claim on the basis that Compas Medical had failed to provide requested verification. The main issue decided was whether the action by Compas Medical was premature due to the failure to provide verification. The court held that while American Transit Ins. Co. had demonstrated that it had timely mailed the verification request and had not received the requested verification, there was a triable issue of fact as to whether the action was premature. Therefore, the court modified the order by denying American Transit Ins. Co.'s cross motion for summary judgment dismissing the complaint.

The court considered the fact that the plaintiff, Bay LS Medical Supplies, Inc., had moved for summary judgment to recover assigned first-party no-fault benefits, while the defendant, Allstate Insurance Company, had cross-moved for summary judgment to dismiss the complaint on the basis that the plaintiff had failed to appear for scheduled examinations under oath. The main issue decided was whether the plaintiff's failure to appear for scheduled examinations under oath warranted the dismissal of the complaint. The holding of the court was that the defendant's cross motion for summary judgment dismissing the complaint was granted and the plaintiff's motion for summary judgment was denied. The court reversed the previous order in favor of the plaintiff and in accordance with the reasons stated in the previous case of Bay LS Med. Supplies, Inc. v Allstate Ins. Co. (50 Misc 3d 147[A], 2016 NY Slip Op 50319[U]), the defendant's motion for summary judgment to dismiss the complaint was granted.

The relevant facts the court considered include the defendant's failure to timely answer or appear in the action, as well as their commencement of another action seeking a declaration that the plaintiff was not entitled to recover no-fault benefits for a motor vehicle accident. The main issue decided was whether the judgment obtained against the defendant should be vacated and the plaintiff be compelled to accept the defendant's late answer. The holding of the case was that the default judgment against the defendant should not be vacated and that the Civil Court's determination not to set off the judgments was not an improvident exercise of discretion.

The relevant facts considered by the court were that Lenox Hill Radiology was seeking first-party no-fault benefits in the sum of $6,651.66 for medical services rendered to a patient involved in an automobile accident. The main issue was whether the time to pay or deny the claims commenced, considering the defendant's contention that the verification requests were not responded to by the plaintiff. The holding of the case was that the defendant's motion for summary judgment to dismiss the complaint was denied, as the court found that the defendant failed to establish a prima facie showing of entitlement to summary judgment. The court found that the defendant's no-fault claims adjuster failed to sufficiently demonstrate the standard office practice or procedure used to ensure that the verification requests were properly addressed and mailed, in addition to failing to establish an objective, reasonable basis for the contents of the verification demands.

The main facts of the case involve Charles Deng Acupuncture, P.C. appealing from an order of the Civil Court of the City of New York, Queens County, which denied plaintiff's motion for summary judgment and granted defendant's cross motion for summary judgment dismissing the complaint. The main issue decided in the case was whether the provider, as an assignee of Tanis, Leonel, was entitled to recover first-party no-fault benefits from Country Wide Insurance Company. The holding of the case was that defendant's cross motion for summary judgment dismissing the complaint was denied and the order was affirmed. This decision was based on the reasoning provided in the case Island Life Chiropractic Pain Care, PLLC v Country Wide Ins. Co. (53 Misc 3d 131[A], 2016 NY Slip Op 51378[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2016]) which supported the denial of the cross motion for summary judgment.