No-Fault Case Law

The court considered the plaintiff's failure to appear for scheduled examinations under oath (EUOs) and the sufficiency of the affirmation submitted by the defendant's attorney in establishing this failure. The main issue decided was whether the affirmation was sufficient to demonstrate that the plaintiff failed to appear for the EUOs. The holding of the court was that the affirmation submitted by the defendant's attorney was deemed sufficient to demonstrate prima facie that the plaintiff failed to appear for the EUOs, and the plaintiff failed to raise a triable issue of fact in response. Therefore, the court affirmed the order granting the defendant's motion for summary judgment and dismissing the complaint.

The court considered an appeal from an order granting the defendant's motion for summary judgment dismissing the complaint and denying the plaintiff's cross motion for summary judgment. This case involved a provider seeking to recover assigned first-party no-fault benefits. The main issue decided was whether the lower court's decision to grant the defendant's motion for summary judgment and deny the plaintiff's cross motion for summary judgment should be affirmed. The holding of the court was that the order was affirmed, with $25 costs, and the decision was based on the reasons stated in a similar case decided simultaneously.

The court considered the case of Energy Chiropractic, P.C., as Assignee of Reid, Shamel W. v Nationwide Ins., in which the plaintiff appealed from an order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion for summary judgment. The main issue decided was whether the provider was entitled to recover assigned first-party no-fault benefits. The court affirmed the order, with the reasoning stated in the case of MSB Physical Therapy, P.C., as Assignee of Reid, Shamel W. v Nationwide Ins. The holding of the case was that the order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion for summary judgment was affirmed.

The court considered a case in which Hands On Physical Therapy Care, as the assignee of Jacqueline Drouillard, appealed from an order of the Civil Court of the City of New York, Kings County that granted the defendant's motion for summary judgment dismissing the complaint and denied the plaintiff's cross motion for summary judgment. The main issue decided was whether the provider was entitled to recover assigned first-party no-fault benefits. The holding of the court was that the order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion for summary judgment is affirmed, with $25 costs. The court's decision was based on the reasons stated in a similar case, PFJ Med. Care, P.C., as Assignee of Simmond, Tylon B. v Nationwide Ins. The decision was entered on June 10, 2022.

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 main issue decided was whether the defendant's affirmations and transcripts of the examinations under oath were sufficient to establish that the plaintiff had failed to appear for the examinations. The holding of the case was that the affirmations submitted by the defendant's counsel and the transcripts of the examinations under oath were indeed sufficient to establish that the plaintiff had failed to appear for the examinations, and therefore, the order denying the motion for summary judgment and granting the defendant's cross motion for summary judgment dismissing the complaint was affirmed by the court.

The relevant facts the court considered in this case were that Columbus Imaging Center, LLC was seeking to recover assigned first-party no-fault benefits from Erie Insurance Company of New York. The main issue decided was whether defendant needed to demonstrate, as part of its prima facie case, that the first independent medical examination scheduling letter had been sent to plaintiff's assignor within 15 days of defendant's receipt of either the NF-2 or a claim received from another provider. The holding of the court was that defendant did not need to demonstrate this as part of its prima facie case, and therefore the order granting defendant's motion for summary judgment and denying plaintiff's cross motion for summary judgment was affirmed.

The court considered an order of the Civil Court of the City of New York, Kings County, which denied the branches of defendant's motion to dismiss the fifth and ninth causes of action seeking to recover in excess of the amounts permitted by the workers' compensation fee schedule. The main issues decided were whether the services rendered were medically necessary and whether the defendant was entitled to summary judgment dismissing all of the claims on the ground that all of the services were not medically necessary. The holding of the case was that the defendant was not entitled to summary judgment dismissing the fifth and ninth causes of action as sought to recover in excess of the amounts permitted by the workers' compensation fee schedule, and the appeal was dismissed.

The relevant facts considered by the court in Dr. Orenbakh Psychologist, P.C. v Nationwide Affinity Ins. Co. of Am. involved a dispute over the denial of first-party no-fault benefits by the insurance company. The insurer denied the claims on the basis that the plaintiff failed to appear for examinations under oath (EUOs). The main issue decided by the court was whether the insurer's denial of the claims was timely and whether the plaintiff failed to appear for the scheduled EUOs. The holding of the court was that the insurer sufficiently proved that the EUO scheduling letters were mailed and that the plaintiff failed to appear for the scheduled EUOs, leading to the granting of summary judgment in favor of the insurer for certain claims. However, the court also held that the insurer's denial of another claim was untimely because the EUO scheduling letter was mailed more than 30 days after receipt of the claim form, and therefore summary judgment was properly denied for that claim.

The relevant facts the court considered were that the plaintiff was seeking to recover assigned first-party no-fault benefits and had allegedly served the summons and complaint by mail, but had not obtained personal jurisdiction over the defendants. Defendant American Independent Ins. Co. moved to dismiss the complaint on the ground of lack of personal jurisdiction, and other defendants moved in a single motion to dismiss the complaint against them on the same ground. The main issue decided was whether the plaintiff had obtained personal jurisdiction over the defendants, and the court ultimately held that the appeal of the order denying the motion to dismiss insofar as asserted against American Independent Insurance Co. was reversed and the motion was granted, and the branches of the motion seeking to dismiss so much of the complaint as was asserted against the other defendants were granted as well.

The court considered the appeal from an order of the Civil Court of the City of New York, Kings County, which granted the defendant's motion for summary judgment dismissing the complaint and denied the plaintiff's cross motion for summary judgment. The main issue decided in this case was whether the defendant needed to demonstrate, as part of its prima facie case, that the first examination under oath scheduling letter had been sent to the plaintiff's assignor within 15 days of the defendant's receipt of either the NF-2 or a claim received from another provider. The holding of the court was that the defendant did not need to demonstrate this as part of its prima facie case and that the order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion for summary judgment was affirmed.