No-Fault Case Law

The court considered the fact that the plaintiff, a health care service provider, sought to recover no-fault benefits for supplies furnished to its assignor, while the defendant argued that the claim was premature because the plaintiff failed to comply with an additional verification request. The main issue decided was whether the defendant was obligated to notify the plaintiff that its response to their additional verification request was insufficient and/or incomplete. The court held that once the plaintiff submitted its response to the defendant's additional verification request, it was then incumbent on the defendant to inform the plaintiff that said response was insufficient and/or incomplete. Therefore, the court granted the plaintiff's motion, awarding judgment in favor of the plaintiff for $2,118.33 plus interest, attorney's fee, costs, and disbursements.

The main issue in this case was whether the Civil Court of the City of New York, Kings County, erred in denying plaintiff's motion to compel the deposition of the defendant in an action to recover assigned first-party no-fault benefits. The court held that under CPLR 3101 (a), parties to an action are entitled to reasonable discovery of any facts bearing on the controversy which will assist preparation for trial. The relevant facts considered by the court were the plaintiff's motion to compel the deposition of the defendant and the defendant's opposition to the motion. The holding of the court was that the order denying plaintiff's motion was reversed without costs and the motion was granted to the extent that the defendant was ordered to appear for a deposition within 30 days of the order entered.

The relevant facts of the case involved Bath Medical Supply, Inc. seeking to recover assigned first-party no-fault benefits and moving to compel the deposition of defendant American Transit Insurance Co. Defendant failed to oppose the motion. The main issue decided was whether the court should grant plaintiff's motion to compel defendant to appear for a deposition. The holding of the case was that the order denying plaintiff's motion was reversed without costs and plaintiff's motion was granted to the extent that defendant was ordered to appear for a deposition within 30 days of the order.

The relevant facts of the case involve a provider, Bath Medical Supply, Inc., seeking to recover first-party no-fault benefits, and filing a motion to compel the deposition of the defendant, American Transit Insurance Co. The defendant did not oppose the motion, and the court denied the plaintiff's motion, which included a request for a conditional order striking the defendant's answer or precluding the defendant from testifying if they did not comply. The main issue decided was whether the court should have granted the plaintiff's motion to compel the defendant to appear for a deposition, and the holding of the case was that the order was reversed, and the plaintiff's motion was granted to the extent that the defendant was ordered to appear for a deposition within 30 days of the order. The decision was made by Pesce, P.J., Rios and Steinhardt, JJ., and was published by the New York State Law Reporting Bureau.

The relevant facts of the case included a provider's motion to compel the deposition of the defendant in an action to recover assigned first-party no-fault benefits. Defendant failed to oppose the motion. The main issue decided was whether the court should grant the plaintiff's motion to compel the defendant to appear for a deposition, and for a conditional order striking the defendant's answer or precluding the defendant from testifying in the event of failure to comply. The holding of the case was that the order denying the plaintiff's motion was reversed without costs, and the plaintiff's motion was granted to the extent that the defendant was ordered to appear for a deposition within 30 days of the order. This decision was based on the failure of the defendant to oppose the motion and the legal precedent indicating that the court should have granted the plaintiff's motion to compel the defendant to appear for a deposition.

The court considered whether the provider, Infinity Health Products, Ltd., was entitled to recover assigned first-party no-fault benefits from New York Central Mutual Fire Insurance Company. The main issues were whether the provider's motion for summary judgment should be granted and whether the defendant's cross motion for summary judgment dismissing the complaint should be denied. The court held that the provider failed to establish its prima facie case for summary judgment, as the affidavit submitted in support of the motion did not lay a proper foundation for the admission of the documents annexed to the moving papers. The defendant also failed to establish that its verification requests and denial of claim forms were timely mailed, so its cross motion was properly denied. Therefore, the court modified the order by providing that the provider's motion for summary judgment is denied, and affirmed the decision without costs.

The court considered the fact that the plaintiff was seeking to recover $882.39 in assigned first-party no-fault benefits for medical supplies provided to its assignor for injuries sustained in a motor vehicle accident on October 12, 2004. The defendant argued that the action was premature since they had not received claims pertaining to the accident. The main issue decided was whether the plaintiff established its entitlement to summary judgment and whether the defendant's motion for summary judgment dismissing the complaint should be granted. The holding of the case was that the plaintiff failed to establish its entitlement to summary judgment, as it did not submit the statutory claim forms setting forth the facts and amounts of the losses sustained. The defendant was granted summary judgment dismissing the complaint.

The relevant facts the court considered in this case include the plaintiff, Odessa Medical Supply, Inc., seeking to recover first-party no-fault benefits from Kemper Auto & Home Insurance Company, which involved a claim submitted to Unitrin Advantage Insurance Company. Unitrin had scheduled examinations under oath of the assignor's physician, but when the physician failed to appear, Unitrin issued a denial of claim form. The plaintiff then commenced an action against Kemper, with Unitrin serving and filing an answer, stating it was incorrectly sued as Kemper. The main issue decided was whether the plaintiff's motion for summary judgment against Kemper should be denied since it was served upon Unitrin and based on a claim submitted to Unitrin, and whether Unitrin's cross motion to dismiss the complaint should also be denied. The holding of the case was that the plaintiff's motion for summary judgment against Kemper was denied, as the motion papers were served upon Unitrin and the action was based on a claim submitted to Unitrin, with no showing that Kemper and Unitrin are a single entity. Additionally, since Unitrin was not a formal party to the action and sought to dismiss the complaint against a different entity, its cross motion was also denied.

The court considered an action by a medical provider to recover assigned first-party no-fault benefits. The defendant's cross-motion for summary judgment was denied by the Civil Court of the City of New York, Queens County, as they had not established that the fee charged was excessive. The defendant's affirmed peer review report established prima facie that there was no medical necessity for the supplies provided by the plaintiff. Plaintiff's contention that the peer review report was inadmissible since it contained a stamped facsimile of the doctor's signature was raised for the first time on appeal, and thus, waived any objection. The main issue decided was whether the defendant was entitled to summary judgment dismissing the balance of the claim, and whether the peer review report was admissible. The holding of the court was that the defendant was not entitled to summary judgment dismissing the balance of the claim, but was entitled to summary judgment dismissing the plaintiff's second and third causes of action. Additionally, the court held that the plaintiff waived their objection to the admissibility of the peer review report.

The court considered a motion for summary judgment in a case by a provider to recover assigned first-party no-fault benefits. The court denied the motion on the ground that the affidavit submitted by the plaintiff's officer and medical billing manager was insufficient to establish personal knowledge of plaintiff's practices and procedures, so as to lay a foundation for the admission of the documents annexed to plaintiff's moving papers as business records. As a result, the plaintiff failed to make a prima facie showing of its entitlement to summary judgment. The main issue decided was whether the plaintiff had provided sufficient evidence to establish its entitlement to summary judgment in a case to recover assigned first-party no-fault benefits. The holding of the court was that the plaintiff's affidavit was insufficient to make a prima facie showing of its entitlement to summary judgment, and therefore the order denying plaintiff's motion for summary judgment was affirmed.