No-Fault Case Law

The relevant facts in the case of Global Liberty Ins. Co.v W. Joseph Gorum, M.D., P.C. are that the plaintiff, a no-fault insurance carrier, commenced an action for a de novo adjudication of two separate insurance disputes concerning the denial of no-fault claims against W. Joseph Gorum, M.D., P.C., and Laxmidhar Diwan, M.D. Both Gorum and Diwan had been awarded more than $5,000 against the plaintiff as a result of master arbitration awards. The plaintiff moved for leave to enter a default judgment against Gorum, who failed to answer the complaint or appear in the action, and for summary judgment on the complaint insofar as asserted against Diwan. The main issues decided were whether the court erred in denying the motion for leave to enter a default judgment against Gorum and whether the court properly denied the motion for summary judgment against Diwan. The holding of the case was that the court erred in denying the motion for leave to enter a default judgment against Gorum, but properly denied the motion for summary judgment against Diwan, since the plaintiff had failed to sufficiently demonstrate that the surgery performed by Diwan on Jerry Souffront was not medically necessary.

The relevant facts considered by the court in the case of Renelique v American Tr. Ins. Co. were that the plaintiff, Pierre Jean Jacques Renelique, as assignee of Susan Santiago, was seeking to recover assigned first-party no-fault benefits from the defendant, American Transit Ins. Co. The main issue decided was whether the plaintiff's complaint was premature due to the failure to provide requested verification. The holding of the case was that the court reversed the order granting the defendant's motion for summary judgment dismissing the complaint, and denied the defendant's motion for summary judgment dismissing the complaint. The court's decision was based on reasoning similar to a related case and was concurred by Pesce, P.J., Aliotta and Solomon, JJ.

The court considered an appeal from an order of the Civil Court in a case where a medical provider was seeking to recover assigned first-party no-fault benefits from an insurance company. The main issues decided were whether the branches of the plaintiff's motion seeking summary judgment on the first through fifth causes of action should be denied and whether the branches of the defendant's cross motion seeking summary judgment dismissing those causes of action should be granted. The holding of the court was that the branches of the defendant's cross motion seeking summary judgment dismissing the first through fifth causes of action were denied, and the order, insofar as appealed from, was affirmed.

The relevant facts of the case include a dispute between Arguelles, M.D., P.C. as the assignee of Joseph Estimem, and American Transit Ins. Co. regarding the recovery of first-party no-fault benefits. Arguelles, M.D., P.C. appealed the denial of their motion seeking summary judgment on the second through sixth causes of action, while the defendant cross-moved for summary judgment dismissing those causes of action on the grounds that they were premature due to a failure to provide requested verification. The main issue decided by the court was whether the branches of the defendant's cross motion seeking summary judgment dismissing the second through sixth causes of action should be denied or granted. The holding was that the branches of defendant's cross motion seeking summary judgment dismissing the second through sixth causes of action were denied, and the order was affirmed without costs.

The court considered the fact that this was an action by a healthcare provider to recover no-fault benefits and that the defendant had filed a motion for summary judgment to dismiss the complaint on the grounds that the action was premature due to lack of requested verification. The main issue decided was whether the plaintiff's failure to provide requested verification made the action premature and therefore subject to dismissal. The holding of the court was that, in line with a similar decision in another case, the defendant's motion for summary judgment was denied and the order granting it was reversed, allowing the plaintiff's complaint to proceed.

The court considered an appeal from an order of the Civil Court of the City of New York, Queens County, which granted defendant's motion for summary judgment dismissing the complaint by LMS Acupuncture, P.C., as Assignee of Jose Cajas, to recover assigned first-party no-fault benefits. The main issue decided was whether the action was premature because the plaintiff had failed to provide requested verification. The holding of the court was that the order was reversed and defendant's motion for summary judgment dismissing the complaint was denied. The court referenced another case, Performance Plus Med., P.C., as Assignee of Melanna Luckie v Nationwide Ins., and stated that for the reasons stated in that case, the defendant's motion for summary judgment dismissing the complaint was denied.

The relevant facts of the case were that Island Life Chiropractic, P.C. was seeking to recover first-party no-fault benefits as the assignee of Edison Bond, but the Civil Court denied their motion for summary judgment and granted the defendant's cross motion for summary judgment. The main issue decided was whether the action was premature due to the plaintiff's failure to provide requested verification. The holding of the case was that the defendant's cross motion for summary judgment dismissing the complaint was denied, and the order was affirmed with modification. The court found that the action was not premature and the plaintiff was entitled to pursue their claim for first-party no-fault benefits.

The court considered the case of Performance Plus Medical, P.C., seeking to recover assigned first-party no-fault benefits from Nationwide Ins. The main issue decided was whether the action was premature because the plaintiff had allegedly failed to provide requested verification. The court ultimately reversed the order of the Civil Court of the City of New York, which had granted defendant's motion for summary judgment dismissing the complaint, and denied defendant's motion for summary judgment. Therefore, the holding of the case was in favor of Performance Plus Medical, P.C., allowing them to continue their action to recover the assigned first-party no-fault benefits from Nationwide Ins.

The relevant facts of the case involved LMS Acupuncture, P.C. appealing an order from the Civil Court granting Nationwide Ins.'s motion for summary judgment, which dismissed the complaint. The issue decided was whether the action to recover assigned first-party no-fault benefits was premature due to the plaintiff's failure to provide requested verification. The holding of the case was that the order was reversed, and Nationwide Ins.'s motion for summary judgment dismissing the complaint was denied, in line with the decision in another case, Performance Plus Med., P.C. v Nationwide Ins., decided at the same time. The decision was made by Pesce, P.J., Aliotta, and Solomon, JJ. on October 11, 2016.

The court considered the case of Pierre Jean Jacques Renelique, as the assignee of Sherita Johnson, who was appealing an order from the Civil Court of the City of New York, Queens County. The order granted the defendant's motion for summary judgment dismissing the complaint, stating that the action was premature because the plaintiff had failed to provide requested verification. However, the court reversed the order and denied the defendant's motion for summary judgment, citing a similar case as precedent. The main issue decided was whether the provider could recover assigned first-party no-fault benefits, and the holding of the court was that the defendant's motion for summary judgment was denied.