No-Fault Case Law

The relevant facts in this case include that Lefferts Gardens Chiropractic, P.C. was seeking to recover assigned first-party no-fault benefits from New York Central Mutual Fire Insurance Company. The defendant appealed from an order of the Civil Court that denied their motion for summary judgement dismissing the complaint on the ground that the action was premature, as the plaintiff failed to respond to requests for additional verification. The main issue was whether the defendant's proof was sufficient to demonstrate that verification requests had been timely sent to the plaintiff, and whether the follow-up verification requests issued by the defendant were proper. The holding of the case was that the Court reversed the order and granted the defendant's motion for summary judgement, dismissing the complaint, as they found that the proof submitted by the defendant was sufficient to demonstrate that verification requests had been timely sent to the plaintiff and that they had not received a response to the verification letters.

The court considered the case of JOA Chiropractic, P.C. v Hereford Ins. Co. in which the plaintiff, a healthcare provider, sought to recover assigned first-party no-fault benefits. The main issue was whether the defendant's motion for summary judgment to dismiss the complaint on the grounds that the action was premature due to plaintiff's failure to respond to timely requests for additional verification. The court held that the defendant's motion was properly denied as they failed to establish that their requests for additional verification were proper, as their letters to the plaintiff merely stated that they were waiting for specified documents without actually requesting verification. Therefore, the order denying the defendant's motion for summary judgment was affirmed.

In this case, Lev Aminov, M.D., as the assignee of Joyce Brout, brought an action to recover assigned first-party no-fault benefits from National Liability and Fire Insurance. The main issue before the court was whether the denial of claim forms were properly addressed and mailed by the defendant, as demonstrated by the affidavit submitted by the defendant in support of its motion for summary judgment. The court considered the discrepancy between the affidavit and the mailing logs annexed as exhibits to the motion, and the existence of an issue of fact as to whether the denial of claim forms were mailed pursuant to a standard office practice or procedure. The court ultimately held that the defendant did not demonstrate its entitlement to summary judgment, and affirmed the order denying defendant's motion for summary judgment.

The relevant facts of the case were that Prestige Medical, P.C. was seeking to recover assigned first-party no-fault benefits from Metropolitan Property and Casualty Insurance Co. The main issue decided by the court was whether the plaintiff failed to appear for duly scheduled examinations under oath (EUOs) and if the EUO scheduling letters had been properly mailed. The holding of the court was that the defendant established that the EUO scheduling letters had been properly mailed, and that the plaintiff had failed to appear for the scheduled EUOs. As a result, the court reversed the order of the Civil Court and granted the defendant's motion for summary judgment, dismissing the complaint.

The relevant facts in this case involved a medical provider seeking to recover assigned first-party no-fault benefits from an insurance company. The insurance company had sought summary judgment to dismiss the complaint on the grounds that the plaintiff's assignor failed to appear for scheduled independent medical examinations (IMEs) and that the amount charged by the medical provider exceeded the amounts permitted by the workers' compensation fee schedule. The defendant failed to establish its entitlement to summary judgment because it did not sufficiently establish that the IME scheduling letters were timely generated and properly addressed. Additionally, the affirmations from the doctors who were scheduled to perform the IMEs did not establish their personal knowledge of the nonappearance of the plaintiff's assignor. Therefore, the court held that the defendant was not entitled to summary judgment to dismiss the complaint and affirmed the order in favor of the medical provider.

The relevant facts the court considered in Veraso Medical Supply Corp. v State Farm Mutual Automobile Ins. Co. were that the plaintiff, Veraso Medical Supply Corp., was seeking to recover assigned first-party no-fault benefits from the defendant, State Farm Mutual Automobile Ins. Co. The main issue decided was whether the affidavit submitted by the plaintiff in opposition to the defendant's motion for summary judgment was sufficient to demonstrate the existence of an issue of fact. The holding of the court was that the affidavit submitted by the plaintiff was insufficient, and therefore the order granting the defendant’s motion for summary judgment and denying the plaintiff's cross motion for summary judgment was affirmed.

The case involved Veraso Medical Supply Corp. bringing an action to recover assigned first-party no-fault benefits from State Farm Mutual Automobile Insurance Co. The appellate court affirmed the lower court's order, which granted State Farm's motion for summary judgment dismissing the complaint and denied Veraso's cross motion for summary judgment. Veraso's main contention on appeal was that its affidavit was sufficient to demonstrate the existence of an issue of fact, but the court disagreed. The court cited previous cases to support its decision and ultimately held that the order was affirmed.

The relevant facts of this case involved an action by a provider to recover assigned first-party no-fault benefits. The court considered the defendant's motion for summary judgment dismissing the complaint. The main issue decided was whether the defendant's motion for summary judgment should have been denied, based on the plaintiff's arguments. The court held that the plaintiff's arguments as to why the defendant's motion for summary judgment should have been denied were not properly before the court, as they were being raised for the first time on appeal, and therefore declined to consider them. As a result, the court affirmed the order granting defendant's motion for summary judgment dismissing the complaint.

The main legal issue in this case was whether the complaint against an insurance company seeking to recover assigned first-party no-fault benefits should be dismissed. The insurance company argued that the claims were submitted more than 45 days after the supplies had been furnished, lacked medical necessity, and that the fees sought exceeded the amounts permitted by the workers' compensation fee schedule. The court considered the affidavit of the insurance company's claims representative, which established that the claims had been submitted late and that the denial of claim form had been timely mailed. The court found that the plaintiff failed to raise a triable issue of fact in response to the insurance company's showing, as the claim forms were dated more than 45 days after the supplies at issue were furnished. Ultimately, the court held that the insurance company's motion for summary judgment dismissing the complaint should have been granted, reversing the lower court's order and granting the insurance company's motion.

The relevant facts considered in this case include the provider's attempt to recover assigned first-party no-fault benefits and the method of service of the summons and complaint, which alleged service by mail but did not contain an acknowledgment of service. The main issue decided was whether the provider had obtained personal jurisdiction over the defendant. The holding of the case was that the order denying the defendant's motion to dismiss the complaint was reversed, and the defendant's motion to dismiss the complaint was granted. The court cited a similar case, Longevity Med. Supply, Inc. v American Ind. Ins. Co., in which the order to dismiss the complaint was reversed based on similar circumstances.