No-Fault Case Law
M.H.Z. Physical Therapy, P.C. v Allstate Ins. Co. (2016 NY Slip Op 51701(U))
November 21, 2016
The relevant facts considered by the court were that plaintiff was seeking to recover first-party no-fault benefits as an assignee of Kevindale Nurse. The main issue decided was whether defendant provided insurance coverage for the vehicle involved in the accident. The holding of the court was that defendant's affidavit demonstrated prima facie that plaintiff's claim did not arise out of a covered incident, and as plaintiff failed to raise a triable issue of fact, the court properly denied plaintiff's motion for summary judgment and granted defendant's cross motion for summary judgment dismissing the complaint. Therefore, the order was affirmed.
Art of Healing Medicine, P.C. v Allstate Ins. Co. (2016 NY Slip Op 51685(U))
November 17, 2016
The court considered the denial of the plaintiff's motion for summary judgment and the granting of the defendant's cross motion for summary judgment in a case involving a provider seeking to recover assigned first-party no-fault benefits. The main issue decided was whether the defendant's cross motion for summary judgment dismissing the complaint should be granted. The holding of the court was that the defendant's cross motion for summary judgment dismissing the complaint is denied, and the order is affirmed as modified.
Art of Healing Medicine, P.C. v Allstate Ins. Co. (2016 NY Slip Op 51684(U))
November 17, 2016
The court considered the denial of plaintiff's motion for summary judgment and granting of defendant's cross motion for summary judgment in a case involving recovery of assigned first-party no-fault benefits. The main issue decided was whether plaintiff, as the assignee of an individual, was entitled to recover these benefits from the defendant insurance company. The holding was that the defendant's cross motion for summary judgment dismissing the complaint was denied, effectively allowing the plaintiff to proceed with their claim to recover the no-fault benefits.
Fontanella v Allstate Ins. Co. (2016 NY Slip Op 51679(U))
November 17, 2016
The court considered the appeal from an order of the Civil Court that denied the defendant's motion for leave to renew its previous motion for summary judgment dismissing the complaint. The main issue decided was whether the defendant had established its entitlement to summary judgment based on the provider's failure to appear for duly scheduled examinations under oath. The holding of the case was that the court affirmed the denial of the defendant's motion for summary judgment on different grounds than those stated by the Civil Court, as the defendant failed to establish the timely denials of claims and the nonappearance of the plaintiff at the examinations under oath.
Art of Healing Medicine, P.C. v Allstate Ins. Co. (2016 NY Slip Op 26387)
November 17, 2016
In Art of Healing Medicine, P.C. v Allstate Ins. Co., the court considered an action by a provider to recover first-party no-fault benefits on behalf of an assignee. The insurance company, defendant, cross-moved for summary judgment to dismiss the complaint on the grounds that the insurance policy for the vehicle in question had been terminated prior to the accident in question. The main issues involved the sufficiency of the defendant's notice of termination to the Department of Motor Vehicles (DMV) and the plaintiff's demonstration of entitlement to judgment as a matter of law. The court held that defendant's cross motion for summary judgment dismissing the complaint was denied, as the notice of termination had not been properly filed with the DMV. Additionally, the court found that the plaintiff's motion for summary judgment was properly denied, as the proof submitted in support of the motion failed to establish that the claims at issue had not been timely denied or that the denials issued by the defendant were conclusory, vague, or without merit as a matter of law.
New Capital Supply, Inc. v Chubb Ins. Co. (2016 NY Slip Op 51677(U))
November 15, 2016
The court considered an action by a provider to recover first-party no-fault benefits on three claims. Defendant moved for summary judgment based on lack of medical necessity, supported by two peer review reports. Plaintiff moved for summary judgment and opposed defendant's motion. The main issue was whether there was an issue of fact as to the medical necessity of the supplies at issue. The court held that plaintiff failed to establish their entitlement to summary judgment on the claim for $591.10, and neither of the peer review reports submitted by the defendant established that the supplies at issue were not medically necessary. Therefore, the court reversed the judgment and denied the branch of plaintiff's motion seeking summary judgment on the claim for $591.10, while affirming the order in all other respects.
North Bronx Med. Health Care v Auto One Ins. Co. (2016 NY Slip Op 51625(U))
November 1, 2016
The main issue in this case was whether the defendant, Auto One Insurance Company, was entitled to summary judgment dismissing the complaint or if they should be allowed to compel the plaintiff's treating doctor to appear for a deposition. The trial court had denied the defendant's motion for summary judgment, limiting the remaining issue for trial to the medical necessity of the claims at issue. Upon review, it was found that there was a triable issue of fact regarding medical necessity, so the branch of the defendant's motion seeking summary judgment was properly denied. However, the Appellate Court found that the deposition of the plaintiff's treating doctor was material and necessary to the defendant's defense, and as such, they were entitled to such discovery. Therefore, the holding of the case was that the order of the trial court was modified to grant the branch of the defendant's motion seeking to compel a deposition of the plaintiff's treating doctor.
TAM Med. Supply Corp. v American Tr. Ins. Co. (2016 NY Slip Op 51624(U))
November 1, 2016
The court considered an appeal from an order of the Civil Court of the City of New York, Queens County denying the plaintiff's motion for summary judgment and granting the defendant's cross motion for summary judgment dismissing the complaint. The main issue decided was whether the letters scheduling the independent medical examinations were addressed properly. The court held that the argument about the letters being addressed improperly was not properly before the court as it was being raised for the first time on appeal, and therefore declined to consider it. As a result, the court affirmed the order denying the plaintiff's motion and granting the defendant's cross motion.
Adelaida M. Laga, Pt v 21st Century Ins. Co. (2016 NY Slip Op 51623(U))
November 1, 2016
The court considered a motion seeking summary judgment dismissing the first through fourth causes of action. The provider, Adelaida M. Laga, PT, was seeking to recover assigned first-party no-fault benefits from 21st Century Insurance Company. The main issue decided was whether the denial of claim forms at issue had been timely mailed, and the court found that the defendant had indeed established that they had been mailed in a timely manner. The holding of the case was that the order, insofar as appealed from, was affirmed, with $25 costs, and the defendant's motion seeking summary judgment dismissing the first through fourth causes of action was granted.
Daily Med. Equip. Distrib. Ctr., Inc. v American Tr. Ins. Co. (2016 NY Slip Op 51621(U))
November 1, 2016
The main issues in this case were whether the defendant had submitted proof of nonappearance of the plaintiff for independent medical examinations and whether the plaintiff had demonstrated entitlement to summary judgment. The court considered that the defendant failed to submit proof by someone with personal knowledge attesting to the nonappearance of the plaintiff for the examinations, which led to the denial of defendant's cross motion for summary judgment. However, the court also found that the plaintiff failed to demonstrate its entitlement to summary judgment, as the affidavit submitted in support of its motion did not establish that the claims at issue had not been timely denied. Therefore, the court modified the order by denying the defendant's cross motion for summary judgment dismissing the complaint but affirming the order with this modification.