No-Fault Case Law
Charles Deng Acupuncture, P.C. v Titan Ins. Co. (2016 NY Slip Op 26211)
June 30, 2016
The court considered multiple cases consolidated for trial, all involving disputes over first-party no-fault benefits under the same insurance policy. The main issue decided was whether or not unsworn transcripts of examinations under oath (EUO) were admissible as business records. The court found that the transcripts were admissible as business records under CPLR 4518 (a), due to their reliability, the requirements and licensing of notaries in the State of New York, and the consequences to the attorney and notary if they mislead the court. The court weighed the evidence, including the transcripts and testimony regarding the defendant's policies and procedures, and ultimately found that the defendant had proven by a preponderance of the evidence that the providers failed to appear for their scheduled EUOs, resulting in a final judgment in favor of the defendant and dismissal of the complaint.
TC Acupuncture, P.C. v Tri-State Consumer Ins. Co. (2016 NY Slip Op 50978(U))
June 27, 2016
The court considered the evidence provided by both the plaintiff and the defendant in relation to the plaintiff's claims for first-party no-fault benefits for services rendered within specific dates. The main issue decided was whether the defendant was entitled to partial summary judgment dismissing the plaintiff's no-fault claims for certain services. The holding of the court was that the defendant made a prima facie showing of entitlement to partial summary judgment dismissing the claims for services rendered within certain dates based on medical evidence, but there were still triable issues remaining in connection with the plaintiff's claims for services rendered within a different set of dates. Therefore, the court modified the order to reinstate certain claims for first-party no-fault benefits and affirmed the order with costs.
City Care Acupuncture, P.C. v Ameriprise Ins. Co. (2016 NY Slip Op 51036(U))
June 23, 2016
The court considered the facts of a case in which an insurance company moved for summary judgment to dismiss a complaint brought by healthcare providers seeking to recover no-fault benefits. The insurance company argued that the healthcare provider's assignor had failed to appear for scheduled examinations under oath (EUO), and therefore, the claim for benefits should be dismissed. The main issue decided by the court was whether the healthcare provider's assignor had failed to comply with the scheduled EUO requirements. The court held that the healthcare provider's assignor had failed to comply with the scheduled EUO requirements and therefore affirmed the lower court's decision to grant the insurance company's motion for summary judgment and deny the healthcare provider's cross motion for summary judgment.
Atlantic Radiology Imaging, P.C. v Interboro Mut. Ins. Co. (2016 NY Slip Op 51031(U))
June 23, 2016
The main issue in this case was whether the defendant's motion to vacate an order granting the plaintiff's motion for summary judgment should be granted. The court considered the fact that the defendant had failed to submit opposition papers to the plaintiff's motion for summary judgment, but later moved to vacate the order based on law office failure. The defendant's counsel and a paralegal from the counsel's office provided a detailed and credible excuse for the default, which was considered sufficient to excuse the default. Additionally, the defendant demonstrated a meritorious defense by submitting a copy of the motion papers that it had submitted in support of its separate motion for summary judgment. As a result, the court held that the defendant's motion to vacate the order was granted and the plaintiff's motion for summary judgment was denied.
Professional Health Imaging, P.C. v State Farm Mut. Auto. Ins. Co. (2016 NY Slip Op 51029(U))
June 23, 2016
The court considered the motion for summary judgment by the defendant to dismiss the complaint, which was on the grounds that the plaintiff had failed to appear for scheduled examinations under oath. The plaintiff had also filed a cross motion for summary judgment, or in the alternative, to strike the defendant's answer and affirmative defenses, and to compel the defendant to respond to discovery demands. The main issue decided was whether the defendant's motion for summary judgment to dismiss the complaint was granted, and if the plaintiff's cross motion for summary judgment or alternative relief was denied. The holding of the case was that the court affirmed the order, with costs of $25, on the basis of the reasons stated in another similar case, and the decision date was June 23, 2016.
Professional Health Imaging, P.C. v State Farm Mut. Auto. Ins. Co. (2016 NY Slip Op 51028(U))
June 23, 2016
The court considered the fact that the plaintiff, a medical provider, was seeking to recover assigned first-party no-fault benefits from the defendant, an insurance company. The main issue before the court was whether the plaintiff had failed to appear for scheduled examinations under oath, which was grounds for the defendant's motion for summary judgment. The court also considered the plaintiff's cross motion for summary judgment or to compel the defendant to respond to discovery demands. The holding of the case was that the court affirmed the order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion. The court's decision was based on the same reasons stated in another case, Professional Health Imaging, P.C., as Assignee of Luis Lopez v State Farm Mut. Auto. Ins. Co., and the order was affirmed with $25 costs.
Professional Health Imaging, P.C. v State Farm Mut. Auto. Ins. Co. (2016 NY Slip Op 51026(U))
June 23, 2016
The relevant facts considered by the court were the failure of the plaintiff to appear for scheduled examinations under oath (EUOs) as required by the defendant. The main issue decided was whether the defendant's motion for summary judgment dismissing the complaint based on the plaintiff's failure to appear for the EUOs was justified. The holding of the court was that the defendant sufficiently proved the plaintiff's failure to appear for the scheduled EUOs, and the plaintiff failed to respond to the EUO requests at issue. As a result, the court affirmed the order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion.
Atlantic Radiology Imaging, P.C. v Interboro Mut. Ins. Co. (2016 NY Slip Op 51014(U))
June 23, 2016
The court considered the fact that the defendant had served the plaintiff with a notice for an examination before trial, which was material and necessary to the defendant's defense in an action by a provider to recover assigned first-party no-fault benefits. The main issue before the court was whether the branch of the defendant's motion seeking to compel the plaintiff to appear for an examination before trial should be granted. The court held that the branch of the defendant's motion seeking to compel the plaintiff to appear for an examination before trial should have been granted as the examination was material and necessary to the defendant's defense, and therefore reversed the order, granting the branch of defendant's motion and ordering the examination to be held within 60 days.
S & R Med., P.C. v GEICO Gen. Ins. Co. (2016 NY Slip Op 51013(U))
June 23, 2016
The relevant facts the court considered in this case were that S & R Medical, P.C. sought to recover assigned first-party no-fault benefits from GEICO General Insurance Company. Plaintiff motioned for summary judgment, and defendant cross-motioned for summary judgment dismissing the complaint. The Civil Court denied both motions, finding that there were triable issues of fact. The main issue decided was whether the Civil Court should have made findings, pursuant to CPLR 3212 (g), that plaintiff had established certain facts for all purposes in the action. The holding of the court was that the order denying plaintiff's motion for summary judgment was affirmed, as the court declined to limit the issues for trial.
Stephen v NY Cent. Mut. Fire Ins. Co. (2016 NY Slip Op 51010(U))
June 23, 2016
The relevant facts considered in this case were that a provider was seeking to recover assigned first-party no-fault benefits from the defendant insurance company. The defendant moved for summary judgment to dismiss 50 of the complaint's causes of action, which the Civil Court granted in part and denied in part. The main issue decided by the court was whether the defendant had established its entitlement to summary judgment in dismissing the remaining 50 causes of action, based on the defendant's failure to conclusively demonstrate that its time to pay or deny the claims at issue had been tolled. The holding of the court was that the order of the Civil Court, insofar as appealed from, was affirmed, with the defendant being ordered to pay $25 in costs. The decision was made by Pesce, P.J., Aliotta and Solomon, JJ., and the date of the decision was June 23, 2016.