No-Fault Case Law

The relevant facts considered by the court were that the defendant, National Liability & Fire Insurance Company, had moved for summary judgment in a case brought by Central Park Physical Medicine & Rehab., P.C. to recover assigned first-party no-fault benefits. The defendant sought to dismiss the fifth, seventh, ninth, eleventh, thirteenth, and fifteenth causes of action on the ground that the plaintiff's assignor had failed to appear for scheduled independent medical examinations (IMEs). The main issue decided by the court was whether the defendant had timely and properly mailed its IME scheduling letters and denial of claim forms. The holding of the court was that the defendant failed to establish that the IME scheduling letters had been timely and properly mailed, and therefore failed to demonstrate entitlement to summary judgment dismissing the specified causes of action. As a result, the court affirmed the order denying the branches of the defendant's motion seeking summary judgment.

The main issue of the case was whether to strike a pleading for failure to comply with court-ordered disclosure. The court considered the fact that the plaintiff had failed to provide discovery responses to outstanding demands within the given timeframe and had refused to adequately comply with discovery requests, even after being directed to do so by court order. The court held that the plaintiff's conduct was willful and contumacious, and there was an absence of a reasonable excuse for its failure to comply. Therefore, the court affirmed the order and granted the branch of the defendant's motion to dismiss the complaint pursuant to CPLR 3126.

The case involved a dispute over first-party no-fault benefits resulting from a motor vehicle accident. The insurance company had initiated a declaratory judgment action seeking a declaration that it was not obligated to pay the claims. The Supreme Court had granted a default judgment in favor of the insurance company against some of the medical providers involved. The insurance company then moved for summary judgment in the Civil Court, arguing that the action was barred by the doctrines of res judicata and collateral estoppel due to the default judgment in the prior action. The court granted summary judgment in favor of the insurance company, finding that the default judgment in the prior action barred the plaintiff from recovering for services rendered to one of the individuals involved in the accident. The court held that the claims underlying the fifth through eighth causes of action were barred by the prior judgment. In summary, the main issues decided were whether the doctrines of res judicata and collateral estoppel applied to the prior default judgment, and whether the plaintiff was barred from recovering no-fault benefits for services rendered to an individual based on the prior judgment. The court held that the prior judgment was a conclusive final determination barring the plaintiff from recovering for services rendered to the individual, and therefore, the branches of the insurance company's motion seeking summary judgment were granted.

The court considered the facts that in an action to recover assigned first-party no-fault benefits, the plaintiff entered into a stipulation with the defendant to provide legible copies of the claims at issue, and failed to do so. The defendant then moved to preclude the plaintiff from offering any evidence and to dismiss the complaint. The main issue decided was whether the plaintiff had failed to comply with the stipulation and the 60-day time requirement set forth in the order, and if so, whether the plaintiff should be precluded from using the claim forms at issue. The holding of the court was that the plaintiff did fail to comply with the stipulation and the 60-day time requirement, and therefore, the judgment to preclude the plaintiff and dismiss the complaint was affirmed.

This case involved an action by a medical provider to recover assigned first-party no-fault benefits. The defendant moved for summary judgment dismissing the complaint due to a judgment previously entered against the plaintiff in another action. The Civil Court previously denied this motion and granted the plaintiff's cross motion for summary judgment. After judgment was entered in the amount of $993.34, the defendant moved for summary judgment dismissing the complaint, as the amount due had been satisfied, or alternatively for an order granting a satisfaction of judgment. The Civil Court denied this second motion and all requested relief. The court modified the denial of the defendant's request for the entry of a satisfaction of judgment, remitting the matter to the Civil Court for further determination. Decision: The order was modified by vacating the denial of the defendant's motion for the entry of a satisfaction of judgment and the matter was remitted to the Civil Court for a new determination.

The court considered the defendant-insurer's motion for summary judgment dismissing the underlying first-party no-fault action. The main issue decided was whether the defendant had submitted competent proof of the assignor's nonappearance at scheduled independent medical examinations (IMEs). The court held that the defendant’s motion for summary judgment should have been denied, as the conclusory affidavits of the defendant's IME doctors lacked probative value and failed to adequately state the basis of their recollection that the assignor did not appear on the scheduled IME dates. Therefore, the court reversed the order and denied defendant's motion.

The court considered the fact that the defendant claimed the assignor failed to appear for two scheduled independent medical examinations (IMEs), but failed to show that the scheduling of the IMEs complied with Insurance Department Regulations. The main issue decided was whether the action seeking recovery of assigned first-party no-fault benefits was ripe for summary dismissal based on the assignor's failure to appear for the IMEs. The holding of the case was that the action was not ripe for summary dismissal, as the defendant failed to show that the scheduling of the IMEs complied with the required procedures and time frames set forth in Insurance Department Regulations. Therefore, the defendant's motion for summary judgment was reversed and denied.

The case involved a subrogation action by State Farm Mutual Automobile Insurance Company to recover additional personal injury protection benefits (APIP) it paid to its subrogor following an auto accident. The subrogor's employee had been awarded basic economic loss benefits as part of a workers' compensation hearing. The defendants moved to dismiss the complaint on the grounds that the workers' compensation benefits were the exclusive source of coverage and that the decision of the Workers' Compensation Board was res judicata. The issue at hand was whether APIP payments were synonymous with statutory basic economic loss benefits or a contractual benefit in addition to the statutory basic economic loss benefit. The court held that the workers' compensation award was not res judicata and plaintiff had the right to assert its subrogation rights for any amounts paid in addition to the statutory basic economic loss benefits paid by workers' compensation. Therefore, the defendants' motion to dismiss was denied. Additionally, the plaintiff's cross motion for sanctions against the defendants was also denied.

The relevant facts the court considered in this case were that TAM Medical Supply Corp. was seeking to recover assigned first-party no-fault benefits and the Civil Court denied the plaintiff's motion for summary judgment while granting the defendant's cross motion for summary judgment dismissing the complaint. The main issues decided were whether the provider could recover assigned first-party no-fault benefits and whether the defendant's cross motion for summary judgment dismissing the complaint should be granted or denied. The holding of the case was that defendant's cross motion for summary judgment dismissing the complaint is denied, and the order is affirmed, without costs.

The relevant facts considered by the court were that TAM Medical Supply Corp. was seeking to recover assigned first-party no-fault benefits from National Liability & Fire Insurance Company. The main issue decided was whether the defendant had demonstrated that it had not received the requested verification, and whether the plaintiff's action was premature. The court found that the affidavit by plaintiff's owner was sufficient to give rise to a presumption that the requested verification had been mailed to the defendant, creating a triable issue of fact as to whether the action was premature. The holding of the court was that defendant's cross motion for summary judgment dismissing the complaint was denied, and the order was affirmed with modification.