No-Fault Case Law

The relevant facts the court considered were that the plaintiff failed to file written opposition to the defendant's motion for summary judgment in a timely manner, resulting in the motion being granted on default. The main issue decided was whether the plaintiff had a reasonable excuse for the default and a potentially meritorious opposition to the defendant's motion. The holding of the case was that the plaintiff's excuse for the default was not reasonable, as it was attributed to law office failure, and the plaintiff failed to demonstrate a potentially meritorious opposition to the defendant's motion for summary judgment. As a result, the court affirmed the denial of plaintiff's motion to vacate the prior order granting summary judgment to the defendant.

The court considered the fact that the defendant had timely and properly mailed letters scheduling examinations under oath (EUOs) and denial of claim forms due to the plaintiff's failure to appear at the EUOs. The main issue was whether the defendant's EUO scheduling letters were defective and if the plaintiff's objections regarding the letters would be heard. The holding of the case was that the defendant's cross motion for summary judgment dismissing the complaint should have been granted, as the plaintiff did not claim to have responded in any way to the EUO requests, and therefore the objections regarding the scheduling letters would not be heard. Therefore, the order was reversed, the plaintiff's motion for summary judgment was denied, and the defendant's cross motion for summary judgment dismissing the complaint was granted.

The court considered the case of Atlantic Radiology Imaging, P.C. as Assignee of Kareem Hoyte v. Esurance Ins. Co. The main issue decided was whether the plaintiff's assignor had failed to appear for duly scheduled examinations under oath (EUOs), and if so, whether the defendant's motion for summary judgment dismissing the complaint should be granted. The court held that the defendant's employee affidavit was sufficient to establish the mailing of the EUO scheduling letters, and that the affirmation by the managing partner of defendant's law firm did not establish that the assignor had failed to appear for the EUOs. Therefore, as the plaintiff failed to demonstrate any basis to disturb the Civil Court's order, the order granting the defendant's motion for summary judgment to dismiss the complaint was affirmed.

The court considered that the plaintiff, EMC Health Products, Inc., was seeking to recover no-fault benefits from Allstate Insurance Company, as the assignee of Peter Esquilin. The main issue decided was whether Allstate Insurance Company provided insurance coverage for the vehicle on the date of the accident. The holding of the case was that the court affirmed the order denying the plaintiff's motion for summary judgment and granting the defendant's cross motion for summary judgment dismissing the complaint. The court found that the defendant's affidavit was sufficient to demonstrate that the plaintiff's claim did not arise out of a covered incident, and as the plaintiff failed to raise a triable issue of fact, the civil court properly granted the defendant's cross motion for summary judgment.

The relevant facts considered in this case were that a provider was seeking to recover first party no-fault benefits that had been assigned to them. The main issue decided was whether the provider had made a prima facie showing of entitlement to summary judgment, and whether the denial of claim forms pertaining to the claims in question had been timely mailed. The holding of the case was that the court granted the provider's motion for summary judgment, but only in part. The branches of the provider's motion seeking summary judgment upon the third and fourth causes of action were denied, as the denial of claim forms had been timely mailed, raising triable issues of fact. Therefore, the order was modified to provide that the branches of the motion seeking summary judgment upon the third and fourth causes of action were denied.

The relevant facts the court considered in this case were that the defendant insurer moved for summary judgment to dismiss the complaint brought by the plaintiff provider, who was seeking to recover assigned first-party no-fault benefits on behalf of Jose Espinosa. The insurer argued that it had timely and properly denied the claim because the plaintiff's assignor had failed to appear for scheduled independent medical examinations (IMEs). The main issue decided by the court was whether the insurer had properly scheduled the IMEs and whether they had been timely mailed. The holding of the court was that the defendant had failed to establish that the letters scheduling the IMEs had been timely mailed, and therefore had not demonstrated that the IMEs had been properly scheduled. As a result, the court affirmed the order denying the insurer's motion for summary judgment.

The court considered the facts of an action by a provider to recover assigned first-party no-fault benefits. The defendant had moved for summary judgment dismissing the complaint, alleging that the claims at issue had been timely and properly denied on the ground that the plaintiff's assignor had failed to appear at duly scheduled examinations under oath (EUOs). The main issue decided was whether the defendant had properly scheduled the EUOs, and thus, whether the plaintiff's assignor had failed to appear at the examinations. The holding was that the defendant failed to establish that the initial and follow-up EUO scheduling letters had been timely mailed and failed to demonstrate that the EUOs had been properly scheduled, therefore the defendant was not entitled to summary judgment dismissing the complaint. As a result, the order was reversed, and the defendant's motion for summary judgment dismissing the complaint was denied.

The relevant facts the court considered in the case of Acupuncture Healthcare Plaza I, P.C. v Truck Ins. Exch. involved a dispute over first-party no-fault benefits for acupuncture services rendered by the plaintiff. The defendant argued that they had properly used the workers' compensation fee schedule applicable to chiropractors who provide similar services to reimburse the plaintiff for the acupuncture services. The main issue decided by the court was whether the defendant had properly reimbursed the plaintiff for the services rendered. The holding of the case was that the defendant had established that the denial of the claim form had been timely mailed and that they had fully paid the plaintiff in accordance with the workers' compensation fee schedule for acupuncture services provided by chiropractors. Therefore, the court affirmed the order granting the defendant's motion for summary judgment dismissing the complaint.

The relevant facts considered by the court in this case include the defendant's motion for summary judgment dismissing the complaint on various grounds, including failure of the plaintiff's assignor to appear for scheduled independent medical examinations (IMEs) and the allegation that the fees sought exceeded the amounts permitted by the workers' compensation fee schedule. The court also considered the defendant's contention that the claim underlying one of the causes of action had been untimely submitted. The main issues decided by the court were whether the defendant had established its entitlement to judgment as a matter of law on the grounds raised in its motion for summary judgment, and whether there was a triable issue of fact as to whether the claim at issue was timely submitted to the defendant. The holding of the case was that the order of the Civil Court denying the defendant's motion for summary judgment was affirmed, with the court finding that the defendant had failed to establish its entitlement to judgment as a matter of law in dismissing the claims on the grounds brought forth.

The relevant fact the court considered in this case was a provider's attempt to recover assigned first-party no-fault benefits from an insurance company. The main issue decided was whether the insurance company was entitled to summary judgment dismissing the complaint based on the alleged failure of the plaintiff's assignor to appear for duly scheduled examinations under oath (EUOs). The holding of the court was that the insurance company failed to establish a prima facie showing of its entitlement to summary judgment, as it did not prove that the EUO notices and the denial of claim forms had been properly and timely mailed. Therefore, the court affirmed the order denying the insurance company's motion for summary judgment.