No-Fault Case Law

The main issue in Art of Healing Medicine, P.C. v. Travelers Home and Marine Insurance Company was an action to recover assigned first-party no-fault benefits under an insurance contract. The plaintiffs appealed from a denial of their motion for partial summary judgment by the Civil Court of the City of New York, Kings County. The Appellate Term of the Supreme Court for the Second and Eleventh Judicial Districts affirmed the lower court's order, holding that the plaintiffs had failed to establish their entitlement to judgment as a matter of law. The court found that the medical service providers failed to demonstrate the admissibility of their billing records under the business records exception to the hearsay rule. Therefore, the plaintiffs' motion was properly denied, regardless of the sufficiency of the opposing papers. The court did not address the defendant's cross motion for summary judgment dismissing the complaint, as it remained pending and undecided.

The primary issue in this case was whether the 90-day statute of limitations began on the date that the arbitrator's decision was mailed to the petitioner or the date on which it was received. The court held that the relevant date is the date on which the decision was received by the petitioner or their agent. The case involved a situation where the petitioner had pursued no-fault arbitration to recover personal injury protection benefits for injuries sustained in a motor vehicle accident. The master arbitration award was mailed to the parties and received by the petitioner's attorney. The court concluded that the proceeding was timely commenced because it fell within the 90-day period from receipt of the award, rather than the date of mailing. This interpretation of "delivery" as the date of receipt rather than mailing was supported by previous case law.

The main issue in this case was whether the plaintiff was entitled to summary judgment to recover assigned first-party no-fault benefits. The court considered the affidavit of plaintiff's employee and various documents annexed thereto, as well as the argument by the defendant that the affidavit failed to lay a proper foundation for admission of the attached documents as business records. The holding of the court was that the plaintiff failed to make a prima facie showing of its entitlement to summary judgment because the affidavit of plaintiff's employee did not refer to the documents attached to the moving papers and did not assert that they were plaintiff's business records, as required by CPLR 4518(a). Therefore, the court reversed the order granting summary judgment to the plaintiff and denied plaintiff's motion for summary judgment. No other issues were considered in light of this decision.

The main issues in this case were whether the affidavits submitted in support of the plaintiff's cross motion for summary judgment laid a proper foundation for the documents annexed to the moving papers, as well as whether the defendant's motion seeking summary judgment dismissing the complaint as premature should have been granted. The court considered the fact that an insurer must accept a completed hospital facility form submitted on behalf of a provider of health services in lieu of a prescribed application for motor vehicle no-fault benefits, and that the insurer is entitled to receive verification of all relevant information requested. The court held that the defendant was entitled to summary judgment dismissing the plaintiff's second cause of action, but that the plaintiff's cross motion for summary judgment was granted with respect to the first cause of action.

The court considered the appeal from an order of the Civil Court of New York, dated January 24, 2006, which granted the plaintiff Devonshire Surgical Facility summary judgment in the amount of $3,000 and granted plaintiff Carnegie Hill Orthopedic Services partial summary judgment in the amount of $41,157.88. The court dismissed the appeal due to the untimeliness of the notice of appeal, as it was not filed within 30 days of the service of the order with notice of entry. If the appeal had been properly before the court, they would have affirmed the decision, as the plaintiffs had established their entitlement to first-party no-fault benefits and the defendant failed to raise a triable issue to defeat summary judgment. The holding of the court was that the appeal was dismissed, and if it had been properly before them, they would have affirmed the decision of the lower court.

The court considered the appeal from an order of the Civil Court of New York granting plaintiff Devonshire Surgical Facility summary judgment in the amount of $3,000. The main issue decided was whether the notice of appeal from the order was filed within the required 30 days of service, and whether the plaintiff had established a prima facie case for entitlement to first party no-fault benefits. The holding of the court was that the appeal was dismissed as untimely, as the notice of appeal was not filed within the required 30 days of service. Additionally, the court stated that if the appeal had been properly before them, they would have affirmed the decision, as plaintiff Devonshire had established a prima facie case for entitlement to first party no-fault benefits and the defendant failed to raise a triable issue to defeat summary judgment.

The court considered the procedural background of the case, including the initial action to recover first-party no-fault benefits and the subsequent motion to vacate the judgment. The main issues decided were whether the judgment entered against defendant should be vacated based on newly discovered evidence, whether there was a meeting of the minds when the parties entered into a written stipulation of settlement, and whether the case was subject to a stay issued by the Supreme Court in a separate action involving the same parties. The holding of the case was that the defendant's motion to vacate the judgment was denied in its entirety because they failed to meet any of the criteria necessary for the court to vacate the voluntary stipulation of settlement. The court emphasized that stipulations of settlement are judicially favored, should not be lightly set aside, and should only be invalidated if there is cause sufficient to do so, such as fraud, collusion, mistake, or accident. The court pointed out that the evidence and allegations provided by the defendant were insufficient to support their claim that the settlement was procured through fraud or mistake.

The main issues decided in this case were whether the action to recover first-party no-fault benefits was brought within the six-year statute of limitations and whether the plaintiff had provided sufficient admissible proof to establish its prima facie case. The court held that the action to recover the no-fault benefits was timely initiated, as the statute of limitations began to run when the benefits became overdue, not when the defendant denied the claim. The court also ruled that the plaintiff did not provide enough admissible proof to establish its case, as there was no affidavit from someone familiar with the plaintiff's business practices to establish the admissibility of the claim form as a business record. Therefore, the court denied both the defendant's motion for summary judgment and the plaintiff's cross-motion for summary judgment.

The main issues for consideration were whether the defendant was entitled to medical expenses and lost earnings relating to a hospitalization because of an auto accident. The court considered the no-fault statute, evidence provided by the plaintiff's expert witness, an anesthesiologist, that the condition was unrelated to the accident and the testimony of the defendant's expert witness, a neurologist. The holding of the court was that the evidence could not support the determination by the Supreme Court regarding the plaintiff's condition was not causally related to the accident. It held that the testimony of the plaintiff's expert was speculative, and the defendant's expert was reliable in his determination that the condition was causally related to the accident. Regarding the defendant's lost wages, the court held that the evidence was insufficient to establish his alleged lost earnings with reasonable certainty and therefore sustained the Supreme Court's determination that the defendant failed to demonstrate a compensable lost wage claim.

The plaintiff, Hospital for Joint Diseases, appealed an order granting the defendant’s motion to vacate a judgment in favor of the plaintiff in an action to recover no-fault medical benefits under an insurance contract. The scope of the defendant’s motion was whether proper service of the summons and complaint was effectuated, and if the defendant had received actual notice of the summons in time to defend against the claim. The Court held that the defendant met its burden of showing it did not receive actual notice of the summons in time, with an affidavit detailing its standard office practice concerning the handling of summonses and complaints and asserting that the summons and complaint in this action were not received until after the entry of judgment. Additionally, the defendant established that it may have a meritorious defense to the action, and accordingly, the defendant's motion to vacate the clerk's judgment was properly granted.