No-Fault Case Law

In the case of Rite Aid Medical Supply Corp. v New York Central Mutual Fire Insurance Company, the main issue was whether the defendant's motion to sever the claim of each assignor into separate actions should be granted. The relevant facts considered by the court included the claims arising from two different accidents on different dates, as well as the denial of one claim on the ground of lack of medical necessity and the denial of the other claim due to a failure to cooperate with the defendant's attempt to investigate the alleged accident. The court ultimately held that the defendant's motion to sever the claim of each assignor into separate actions should have been granted due to the different questions of fact and law involved. The order denying the defendant's motion was reversed, and the defendant's motion to sever the claim of each assignor into separate actions was granted.

The court considered the fact that the plaintiff, Valeriy Sabodash, MD, sought payment of no-fault benefits for medical treatment for an individual who was involved in a motor vehicle accident and sought medical treatment from the plaintiff for injuries sustained. The treatment provided totaled $1,789.19 and was covered by the defendant's policy but was not paid. The main issue was whether the defendant's denial of the claims for medical services under the no-fault portion of its policy, on grounds that it did not insure any of the vehicles involved in the assignor's accident, was valid, and if the plaintiff could not establish the defendant's lack of coverage. The holding of the court was that the defendant's motion was denied, and the plaintiff's cross-motion was granted, as the defendant failed to establish prima facie entitlement to summary judgment and there was an issue of fact regarding the denial of the claim and payment of benefits for medical treatment.

The relevant facts considered by the court were that the defendant in the case had moved for summary judgment dismissing the complaint on the ground that the plaintiff's assignors had failed to appear for duly scheduled independent medical examinations (IMEs). The main issue decided was whether the plaintiff's assignors had failed to appear for the IMEs, and if so, whether the defendant was entitled to summary judgment dismissing the complaint. The holding of the case was that the proof submitted by the defendant was sufficient to demonstrate that the plaintiff's assignors had failed to appear for the IMEs, and as the plaintiff had not rebutted this showing, the defendant's motion for summary judgment dismissing the complaint was granted.

The court considered whether to strike the complaint or preclude the plaintiff from offering evidence at trial for failure to comply with discovery orders, as well as whether to allow the defendant to amend his answer to include a counterclaim for $24,938.59 in no-fault benefits. The main issues decided were whether the plaintiff's responses to discovery were sufficient, and if the defendant had a reasonable excuse for his delay in seeking leave to amend his answer. The holding of the case was that the court affirmed the denial of the defendant's motions, as the court found that the plaintiff's responses to discovery were sufficient, and the defendant did not have a reasonable excuse for the delay in seeking leave to amend his answer. The court also found that the proposed amendment would prejudice the plaintiff at that stage of the proceedings.

The relevant facts the court considered include that notice was served on defendants' insurer about payments of personal injury protection benefits for medical bills covering the nonparty injured person and that a general release was executed by the injured party after the payment demand was sent. The main issues decided were whether the insurer's right to subrogation accrued before the release was signed and whether the notice was required to be sent directly to the defendants. The holding of the case was that the rights were accrued before the release was signed, as the insurer had imputed knowledge of the right to subrogation and that the notices were properly sent to the defendants' insurer and did not require direct service to the defendants, which establishes the plaintiff insurer's right to subrogation. As such, the defendants' motion to dismiss the action was denied.

The relevant facts considered by the court were that Quality Health Supply Corp. was seeking to recover $1,176.95 in assigned first-party no-fault benefits for durable medical products it sold to its assignor in June 2015. The main issue in the case was whether the plaintiff was properly licensed at the time it sold the durable medical products to its assignor. The court held that the evidence presented by the defendant, including a Freedom of Information Law (FOIL) request, was insufficient to establish that the plaintiff did not have a Department of Consumer Affairs license for the relevant time period. As a result, the court reversed the judgment and remitted the matter to the Civil Court for the entry of a judgment in favor of the plaintiff in the principal sum of $1,176.95.

The court considered a dispute over a claim made by an injured individual, Mostafa Hekal, in a motor vehicle accident. Hekal sought no-fault benefits through Hereford Insurance Company, who initially denied the claim. Hekal then submitted the claim to the Motor Vehicle Accident Indemnification Corporation (MVAIC), who also denied the claim based on coverage by AutoTeam Inc. The arbitrator determined that Hereford was responsible for processing the claim since they were the first to receive it, but the court found that Hereford's policy did not cover the vehicle involved in the accident. The court held that the arbitrator's decision was arbitrary and capricious, and vacated the awards made in favor of Hereford and MVAIC. The cross-petitions of MVAIC and Corona Medical were denied, and the court entered judgment accordingly. The main issue decided by the court was whether Hereford Insurance Company was liable for processing the claim for no-fault benefits, and the court held that there was no basis in the record to find that coverage by Hereford existed. The court also found that both the petition and the cross-petitions were denied, and vacated and set aside the awards.

The relevant facts the court considered included the history of the lawsuit, which was initially filed in 2003 to recover unpaid first party No-Fault benefits for medical services provided to the plaintiff's assignor in 2002. The case became "inactive" in 2007, and the defendant filed a motion to dismiss the complaint in 2017, citing abandonment and laches. The main issues decided by the court were whether the plaintiff's complaint should be dismissed as abandoned or barred by laches and whether interest accruing should be stayed. The holding of the case was that the defendant's motion to dismiss on the grounds of abandonment was denied, but their motion to fix the accrual of interest was granted. The court further ordered that, in the event the plaintiff prevails on its claims, interest shall accrue from the filing date of the notice of trial.

The relevant facts of this case include Solution Bridge, Inc.’s action to recover assigned first-party no-fault benefits. GEICO Ins. Co. moved for summary judgment to dismiss the complaint on the grounds that the action was barred by a declaratory judgment entered in the Supreme Court, Nassau County, or that Solution Bridge, Inc. had failed to appear for duly scheduled examinations under oath (EUOs). The main issue decided was whether GEICO Ins. Co. was entitled to summary judgment dismissing the complaint. The holding of the court was that the order denying the motion and cross motion was reversed, and GEICO Ins. Co.'s motion for summary judgment dismissing the complaint was granted.

The court considered the fact that the defendant had properly scheduled independent medical examinations (IMEs) for the plaintiff's assignor, but the assignor failed to appear for those scheduled IMEs. The main issue decided was whether the plaintiff's assignor failed to appear for duly scheduled IMEs and whether the amounts sought by the plaintiff exceeded the amounts permitted by the workers' compensation fee schedule. The holding of the case was that the defendant was entitled to summary judgment dismissing the complaint, as the plaintiff failed to raise a triable issue of fact in opposition to the defendant's motion or challenge the implicit findings in the defendant's favor. Therefore, the order denying the defendant's motion for summary judgment was reversed, and defendant's motion for summary judgment dismissing the complaint was granted.