No-Fault Case Law

The main issues in this case were whether the defendant, State Farm Mutual Inc. Co., had the right to dismiss the plaintiff, Bay Plaza Chiropractic's complaint due to the plaintiff's failure to appear for an examination before trial or provide verified, complete, and meaningful responses to the defendant's discovery demands. The court also had to consider whether there was evidence to support the defendant's claim that the plaintiff was a fraudulently incorporated facility and therefore ineligible to collect non-fault benefits. The court ultimately held that the defendant had a "founded belief" that the plaintiff was actually controlled by a non-licensed professional, and therefore had made allegations sufficient to raise an issue of fact as to whether the plaintiff was fraudulently incorporated. As a result, the court directed the plaintiff to produce their purported owner, Dr. Geraldine McGowan, for an exam before trial within 30 days and comply with all discovery requests related to corporate structure and fraudulent incorporation. The court also ordered the plaintiff to respond to the applicable defendant's discovery requests within 45 days and to renotice Dr. McGowan for an EBT within 30 days after receiving plaintiff's responses. However, the court declined to dismiss the plaintiff's complaint, as they had responded to some of the discovery requests and had not engaged in willful, contumacious, or bad faith conduct.

The court considered the timing of interest accruing on first-party benefits and the validity of section 65-3.9 (c) of the Insurance Law. The main issue decided was whether section 65-3.9 (c) was contrary to Insurance Law § 5106 (a). The holding was that the regulation was not contrary to the statute's clear language and was a valid regulation within the scope of the superintendent's authority. The court concluded that the regulation was not unreasonable or contrary to the statute under which it was promulgated, and that it had a rational basis for providing a penalty against insurers who do not comply with the time frames of the No-Fault Law. Therefore, the petition was denied, and the cross-petition to confirm the arbitration award was granted.

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.