No-Fault Case Law

The court considered the facts of the case, where Performance Plus Medical, P.C., as the assignee of Earl Best, brought an action to recover first-party no-fault benefits from Nationwide Ins. The main issue decided was whether the plaintiff's action was premature due to the failure to provide requested verification. The holding of the court was that the order granting defendant's motion for summary judgment dismissing the complaint was reversed, and the defendant's motion for summary judgment was denied. The court stated that the action was not premature and the plaintiff's failure to provide requested verification did not warrant summary judgment in favor of the defendant.

The court considered that TAM Medical Supply Corp. was seeking to recover first-party no-fault benefits as the assignee of Arsene Macajoux. 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 granting the defendant's motion for summary judgment dismissing the complaint was reversed and the defendant's motion for summary judgment dismissing the complaint was denied. The court's decision was based on a previous case, Mollo Chiropractic, PLLC, as Assignee of Miguel Concepcion v Farmington Cas. Co., and was made by Pesce, P.J., Aliotta, and Solomon, JJ.

The court considered an appeal from a denial of a motion for summary judgment in a case involving a provider seeking to recover assigned first-party no-fault benefits. The main issue was whether the action was premature because the provider had failed to provide requested verification. The court held that the denial of the motion for summary judgment was to be modified by providing that the defendant's cross motion for summary judgment dismissing the complaint was denied, thus allowing the action to proceed. The court's decision was based on a similar case, TAM Med. Supply Corp., as Assignee of Shameca Dudley v National Liab. & Fire Ins. Co., and the judges Pesce, Aliotta, and Solomon all concurred.

The court considered the case of TAM Medical Supply Corp. v American Transit Ins. Co., in which the plaintiff, TAM Medical Supply Corp., sought to recover assigned first-party no-fault benefits. The Civil Court denied the plaintiff's motion for summary judgment and granted the defendant's cross motion for summary judgment, dismissing the complaint on the basis that the action was premature due to the plaintiff's failure to provide requested verification. The main issue decided was whether the plaintiff's failure to provide requested verification rendered the action premature. The holding of the case was that the defendant's cross motion for summary judgment dismissing the complaint was denied, as the court found that the action was not premature due to the failure to provide requested verification. Therefore, the court modified the order to provide that the defendant's motion for summary judgment was denied.

The relevant facts in this case involved an action by a medical supply provider to recover assigned first-party no-fault benefits. The Civil Court denied the plaintiff's motion for summary judgment and granted the defendant's cross motion for summary judgment on the basis that the action was premature due to the plaintiff's failure to provide requested verification. The main issue decided was whether the plaintiff's action was premature, with the defendant demonstrating that it had timely mailed its verification request and follow-up verification request, and had not received the requested verification. In opposition, the plaintiff submitted an affidavit from the owner, giving rise to a presumption that the requested verification had been received by the defendant. The holding of the case was that there was a triable issue of fact as to whether the action was premature, and the order was modified to provide that the defendant's cross motion for summary judgment dismissing the complaint was denied.

The main issue in this case was whether an action to recover assigned first-party no-fault benefits was premature because the plaintiff had failed to provide requested verification. 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 dismissing the complaint. The holding of the case was that the defendant's cross motion for summary judgment dismissing the complaint was denied, thereby modifying the original order. The court provided this ruling based on the reasoning stated in a similar case, TAM Med. Supply Corp., as Assignee of Shameca Dudley v National Liab. & Fire Ins. Co., decided herewith. The order was affirmed with modifications and without costs.

The main issue in this case was whether the provider had provided requested verification for a first-party no-fault benefits claim. The court considered the fact that the defendant had demonstrated that they had not received the requested verification, leading to their argument that the action was premature. The plaintiff argued that an affidavit submitted by the owner of the plaintiff company was sufficient to presume that the verification had been mailed to and received by the defendant. The court ultimately held that there was a triable issue of fact as to whether the action was premature, and reversed the order granting the defendant's motion for summary judgment, denying the motion to dismiss the complaint.

The relevant facts considered by the court include an action by a provider to recover assigned first-party no-fault benefits. The plaintiff had appealed from an order of the Civil Court which 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 because the plaintiff had failed to provide requested verification. The holding of the court was that the defendant's cross motion for summary judgment dismissing the complaint was denied. The decision was made by Pesce, P.J., Aliotta, and Solomon, JJ., and was handed down on October 11, 2016.

The court considered the appeal from a judgment of the Civil Court of the City of New York which granted the defendant's motion for summary judgment, dismissing the complaint in an action by a provider to recover assigned first-party no-fault benefits. The main issue was whether the defendant's motion for summary judgment, which sought to dismiss the complaint on the grounds that the plaintiff had failed to appear for examinations under oath, should have been granted. The court held that the defendant's motion for summary judgment dismissing the complaint should have been denied, as they had failed to submit proof by someone with personal knowledge of the plaintiff's nonappearance. As a result, the judgment was reversed, the order granting summary judgment was vacated, and the defendant's motion for summary judgment was denied.

The main issue considered in this case was whether the defendant, Mercury Insurance Group, was entitled to summary judgment dismissing the complaint brought by High Quality Medical Supplies, Inc., as assignee of Charles Botwee, seeking to recover assigned first-party no-fault benefits. The court affirmed the order denying the defendant's motion for summary judgment, stating that the "NYS Medicaid DME Services Fee Schedule" being adopted as the Durable Medical Goods Fee Schedule for Workers' Compensation is not a basis to hold that billing for durable medical equipment not included within the fee schedule is not compensable. The court also referred to 11 NYCRR 65-3.16 (a) regarding payment of "medical expenses," which shall be in accordance with fee schedules contained in 11 NYCRR 68, and noted that reimbursement for durable medical equipment is regularly treated as interchangeable with reimbursement for healthcare services under the No-Fault Regulations. Therefore, the order denying the defendant's motion for summary judgment was affirmed.