No-Fault Case Law

The court considered the appellant's appeal from an order of the Civil Court of the City of New York, Queens County granting the defendant's motion for summary judgment dismissing the complaint. The main issue decided was whether the plaintiff's assignor had failed to appear for scheduled examinations under oath. The holding was that the order granting the defendant's motion for summary judgment dismissing the complaint was affirmed. The court found that the plaintiff's assignor had failed to appear for duly scheduled examinations under oath, and therefore, the defendant's motion for summary judgment was granted.

The court considered the case of Omphil Care, Inc. as Assignee of Paolo Poponneau v Allstate Insurance Company, in which the plaintiff was seeking first-party no-fault benefits. The main issue was whether the provider failed to appear for scheduled examinations under oath, which the defendant used as grounds for dismissing the complaint. The Civil Court initially denied the plaintiff's motion for summary judgment and granted the defendant's cross motion. However, the Appellate Term, Second Department modified the order and denied the defendant's cross motion for summary judgment dismissing the complaint. The holding of the case was that the defendant's cross motion for summary judgment dismissing the complaint was denied.

The relevant facts of the case involved Omphil Care, Inc., as the assignee of Paul Fabiola, seeking to recover assigned first-party no-fault benefits from Allstate Insurance Company. Plaintiff moved for summary judgment, while defendant cross-moved for summary judgment, arguing that the plaintiff had failed to appear for duly scheduled examinations under oath. The Civil Court denied plaintiff's motion and granted defendant's cross motion. The main issue decided was whether the defendant's cross motion for summary judgment dismissing the complaint should be granted. The holding of the case was that the order was modified by providing that defendant's cross motion for summary judgment dismissing the complaint is denied.

The relevant facts considered by the court were that Omphil Care, Inc., as the assignee of Asuncion Villagra, had moved for summary judgment to recover first-party no-fault benefits from Allstate Insurance Company. Allstate had cross-moved for summary judgment to dismiss the complaint on the grounds that Omphil Care had failed to appear for scheduled examinations under oath. The main issue decided was whether Allstate's cross motion for summary judgment should be granted, and the holding of the court was that the cross motion was denied. The court affirmed the denial of Omphil Care's motion for summary judgment, but modified the order to deny Allstate's cross motion for summary judgment. Therefore, the court's decision allowed Omphil Care to continue with its lawsuit to recover the no-fault benefits.

The court considered a case where Omphil Care, Inc. as the assignee of Rocio Cruz, was seeking to recover first-party no-fault benefits from Allstate Insurance Company. The main issue decided was whether Allstate had the grounds to dismiss the complaint on the basis that Omphil Care, Inc. had failed to appear for scheduled examinations under oath. The court ultimately held that Allstate's cross motion for summary judgment dismissing the complaint was denied, affirming the decision of the lower court. The court cited the reasons stated in a similar case, Omphil Care, Inc., as Assignee of Paul Fabiola v Allstate Ins. Co., as the basis for their decision. The appellate term judges Pesce, Aliotta, and Solomon all concurred with the decision.

The relevant facts considered by the court were that the plaintiff, Omphil Care, P.C., sought to recover assigned first-party no-fault benefits from the defendant, Allstate Insurance Company. The plaintiff had moved for summary judgment, while the defendant had cross-moved for summary judgment, arguing that the plaintiff had failed to appear for duly scheduled examinations under oath. The main issue decided by the court was whether the defendant's cross motion for summary judgment dismissing the complaint should be denied. The holding of the court was that the defendant's cross motion for summary judgment dismissing the complaint was denied, and the order was affirmed with the modification. The decision date for this case was November 1, 2016.

The relevant facts the court considered in this case were that the plaintiff, Omphil Care, Inc., as the assignee of Paul Fabiola, sought to recover first-party no-fault benefits from Allstate Insurance Company. The main issue decided was whether the denial of claim form had been timely mailed. The court held that the defendant's cross-motion for summary judgment dismissing the complaint was denied. The court found that the defendant failed to demonstrate that the denial of claim form had been timely mailed, and therefore, the defendant was not entitled to summary judgment. Additionally, the court found that the plaintiff failed to demonstrate its entitlement to summary judgment, as the affidavit submitted by the plaintiff did not establish that the claim at issue had not been timely denied. Therefore, the court modified the order by providing that the defendant's cross-motion for summary judgment dismissing the complaint is denied.

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.