No-Fault Case Law

The court considered whether a provider could recover first-party no-fault benefits, and the main issues decided were whether the amounts sought were in accordance with the workers' compensation fee schedule and whether the services provided were medically necessary. The court reversed the order granting the defendant's motion for summary judgment dismissing the complaint. It was held that the defendant did not establish its entitlement to summary judgment for the fee schedule issue, as it failed to provide an expert's affidavit to explain its interpretation of the fee schedule. Additionally, the court found that the plaintiff's opposition to the motion, including an affirmation by the treating acupuncturist, was sufficient to rebut the defendant's argument regarding the medical necessity of the services, despite the acupuncturist being ineligible to submit an affirmation under CPLR 2106. Therefore, the defendant's motion for summary judgment was denied.

The case involved an appeal by Country-Wide Ins. Co. from a judgment in favor of Valdan Acupuncture, P.C. The court affirmed the judgment, finding that there were no grounds for vacating an arbitration award. The insurer attempted to show that Valdan Acupuncture was involved in fraudulent incorporation, but the court found that the evidence did not support this claim. Additionally, the court ruled that there was no default in the case, and any delay in opposing the petition to vacate the arbitration award was deemed to be "good cause" for the delay. As a result of the appeal, Valdan Acupuncture was entitled to attorneys' fees calculated as 20% of the no-fault benefits awarded.

The court considered the fact that the plaintiff had filed a complaint to recover first-party no-fault benefits as a result of an accident that occurred on June 20, 2010, but the defendant did not answer the complaint. Instead, the defendant commenced a declaratory judgment action in the Supreme Court, New York County, which resulted in an order declaring that the defendant was not obligated to provide coverage for the claims by the plaintiff related to an accident on June 21, 2010. The main issue was whether the defendant had a reasonable excuse for its default and the existence of a potentially meritorious defense. The holding of the case was that the defendant failed to demonstrate a potentially meritorious defense due to the discrepancy in the dates of the accident and, therefore, the order denying the defendant's motion to vacate the default judgment was affirmed.

The relevant facts in this case involve an insurance company suing the Estate of Ronald L.L. Collins, seeking a declaration that they are not obligated to pay no-fault claims for medical services purportedly rendered by Collins. The main issue decided by the court was whether the Supreme Court was correct in directing the administrator of Collins's estate to appear for a deposition. The holding of the court was that the Supreme Court improperly directed the administrator to appear for a deposition, as the plaintiff failed to demonstrate that conducting the deposition would result in the disclosure of relevant evidence or lead to the discovery of information bearing on the claims. Therefore, the order was reversed, and the plaintiff's insurance company's argument was upheld.

The relevant facts considered by the court were that the defendant, Star of N.Y. Chiropractic Diagnostic, P.C., sought attorneys' fees against the plaintiff, Fiduciary Insurance Company of America. The main issue decided by the court was whether a prevailing party may recover attorneys' fees from the losing party in the absence of a statute, agreement, or court rule explicitly authorizing such recovery. The decision of the court was that the plaintiff owed no duty to defend the defendant as the defendant was merely seeking reimbursement for services rendered in a no-fault action, and therefore the defendant was not entitled to attorneys' fees in this case. The court did not find the defendant's remaining arguments to be valid.

The court considered a case in which plaintiff sought to recover first-party no-fault benefits for medical supplies provided to its assignor, who was injured in a motor vehicle accident. Defendant moved for summary judgment, claiming that the action was barred by the doctrines of res judicata and collateral estoppel due to a previous order obtained in a declaratory judgment action involving the same accident. The main issue decided by the court was whether the action was indeed barred by res judicata and collateral estoppel. The court held that, for the reasons stated in another case decided in conjunction with this one, the appeal was dismissed.

The court considered an appeal from an order of the Civil Court of the City of New York, Queens County, in which the defendant was awarded "$250 in fees" in a case involving a first-party no-fault benefits claim for medical supplies provided to the plaintiff's assignor who was injured in a motor vehicle accident. The main issue in the case was whether the action was barred by the doctrines of res judicata and collateral estoppel due to a previous order obtained by the defendant in a Supreme Court declaratory judgment action involving the same motor vehicle accident. The court ultimately dismissed the appeal, affirming the Civil Court's order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion, as well as the award of defense counsel fees.

The court considered the fact that the plaintiff was seeking first-party no-fault benefits for medical supplies provided to its assignor who sustained injuries in a motor vehicle accident. The defendant moved for summary judgment dismissing the complaint on the grounds of res judicata and collateral estoppel based on a previous order obtained in a Supreme Court declaratory judgment action. The court granted the defendant's motion for summary judgment, denied the plaintiff's cross motion, and awarded defense counsel $250 in fees. The main issue decided was the dismissal of the appeal. The holding was that no appeal as of right lies from the portion of an order that is decided sua sponte, and the appeal was dismissed.

The relevant facts in this case involve Harden Street Medical, P.C. seeking payment for medical services rendered as a result of a car accident under New York's No-Fault Law. The defendant, Charter Oak Fire Insurance Company, served a subpoena duces tecum on the plaintiff's non-party bank, J.P. Morgan Chase Bank, seeking bank records related to the plaintiff for the years 2012 through the present. The plaintiff sought a protective order to quash the subpoena, arguing it was overbroad and improperly served, while the defendant moved to strike the plaintiff's Notice of Trial and Certificate of Readiness, claiming the plaintiff had not complied with discovery demands. The main issues decided in this case were whether the subpoena duces tecum issued by the defendant to the plaintiff's bank was valid and enforceable, and whether the plaintiff's Notice of Trial and Certificate of Readiness should be struck due to noncompliance with discovery demands. The court held that the subpoena was valid and enforceable, as the defendant had demonstrated that its discovery demands were material and necessary. As a result, the motion to quash the subpoena was denied. Additionally, the court granted the defendant's motion to strike the Notice of Trial and Certificate of Readiness, ordering the action to be stricken from the trial calendar. Overall, the court's holding in this case was in favor of the defendant, permitting the enforcement of the subpoena and striking the action from the trial calendar due to the plaintiff's failure to comply with discovery demands.

The court considered the fact that the plaintiff had initiated an action to recover assigned first-party no-fault benefits for medical supplies provided to its assignor, who had been injured in a motor vehicle accident. The defendant then commenced a declaratory judgment action in Supreme Court, seeking a declaration that they were not obligated to pay any of the plaintiff's claims due to the plaintiff's failure to comply with conditions precedent. The Supreme Court granted the defendant a declaratory judgment on default, and then the defendant moved in Civil Court for summary judgment, which was granted. The main issue decided was whether there was a preclusive effect from the declaratory judgment, and the holding was that the Civil Court properly granted the defendant's motion under the doctrine of res judicata. The order was affirmed.