No-Fault Case Law

The court considered the fact that JSI Expert Services, Inc. was seeking to recover assigned first-party no-fault benefits in this case. They also considered that the plaintiff's motion for summary judgment was supported by an affirmation from plaintiff's counsel, an affidavit by an employee of plaintiff, and various documents annexed to the motion. The main issue decided in this case was whether the affidavit executed by plaintiff's employee was sufficient to establish that the officer possessed personal knowledge of plaintiff's practices and procedures so as to lay a foundation for the admission, as business records, of the documents annexed to plaintiff's moving papers. The holding of the case was that the affidavit submitted by plaintiff's employee was insufficient to establish that said officer possessed personal knowledge of plaintiff's practices and procedures, and therefore failed to make a prima facie showing of its entitlement to summary judgment. The court affirmed the denial of plaintiff's motion for summary judgment.

The main issue in this case was whether the defendant should be granted its motion to vacate a default judgment and compel the plaintiff to accept its answer. The relevant facts considered by the court were that the defendant served an untimely answer, and more than two months later, the plaintiff sought and obtained a default judgment. The court held that the plaintiff's retention of an answer without a timely objection constituted a waiver of objection as to untimeliness, precluding the grant of a default judgment. Therefore, the vacatur of the "default" judgment was warranted, regardless of whether the defendant demonstrated a meritorious defense. The court affirmed the order without costs, ruling that the court below had properly exercised its discretion in granting the defendant's motion to vacate the default judgment.

The court considered the case where defendant movants jointly moved the court under CPLR 5003-a for an order directing that plaintiff State Farm Mutual Automobile Insurance Company pay defendant Wilda Norgaisse the amount of $25,000 plus interest from September 29, 2005 in accordance with their stipulation of settlement. The underlying facts involved a claim made against a policy by Marie Mirville for injuries to the driver of another vehicle, Barry Mamadou, and two other individuals. State Farm paid Wilda Norgaisse $25,000 in connection with the underlying loss, but later stopped payment on the check after conducting an investigation and alleging the accident was staged. The main issue decided was whether CPLR 5003-a, which provides a time limit for paying settlements in actions, could be invoked to seek judicial enforcement of an agreement made before an action commences. The holding of the case was that CPLR 5003-a and 2104 are inapposite to the instant motion for the exact same reason, and therefore, judicial enforcement of the stipulation by the instant order to show cause was denied.

The court considered the Defendant's twenty-two affirmative defenses, which included allegations that the treatment in question was performed by an unlicensed psychologist, that the Plaintiff's organizational structure was defective, and that the Plaintiff limited liability company was fraudulently formed. The main issue was whether the Plaintiff could recover no-fault first party benefits for medical services performed by an unlicensed psychologist and whether the Plaintiff's organizational structure was fraudulent. The holding was that genuine issues of material fact existed concerning the Plaintiff's formation and whether the psychologist was an employee or an independent contractor. The court also held that the Plaintiff could not recover no-fault benefits for services rendered by an independent contractor, and that the Plaintiff's formation was fraudulent.

The relevant facts were that the defendant made an unopposed motion to reargue the court's denial of a prior motion for severance of two claims pending in the action, which were both brought by the same no-fault plaintiff assignee, arising out of services rendered to two unrelated assignors. The defendant cited cases suggesting that no-fault claims should be severed if they arise out of different accidents. However, the court found that the claims in this case did not pose a risk of an unwieldy trial or confusion to the trier of fact, and had been joined lawfully under CPLR 601(a). The main issue decided was whether two unrelated no-fault claims may be lawfully joined by the same plaintiff, and the holding was that the motion to reargue was denied because the court found no evidence that it had misapprehended the law.

The court was asked to review an order denying a petition to confirm an arbitration award in a dispute between Lutheran Medical Center, as assignee of Maher Kiswani, and Hereford Insurance Company. Maher Kiswani was injured in a car accident while driving a livery cab and sought medical treatment from Lutheran Medical Center. Lutheran attempted to seek payment from Hereford, the no-fault insurance carrier for the livery cab, but Hereford refused to pay and demanded arbitration. The court held that Hereford should have been given notice of the workers' compensation hearing and vacated the arbitration award, directing the parties to resubmit the employment issue to the Workers' Compensation Board. The court affirmed that Hereford should not have been bound by the Board's determination because it was not given an opportunity to participate in the hearing.

The relevant facts of the case involved an accident on February 3, 2006, resulting in serious injuries to the driver of the vehicle insured under a policy with Progressive Casualty Insurance Company. The driver was transported to Westchester Medical Center and the Hospital sought no-fault benefits from Progressive. The issue was whether Progressive had timely paid or denied the claim for no-fault medical payments within 30 days, as required by regulations. The court held that while the Hospital provided evidentiary proof that Progressive did not meet the timeline for payment or denial of the claim, Progressive timely sought additional verification regarding the driver's alleged intoxication at the time of the accident, and that such information was never received. The court ruled that under such circumstances, where there is no triable issue of fact as to whether the Hospital provided Progressive with the required information, the Hospital's claim for payment was premature, and thus correctly granted Progressive's motion for summary judgment dismissing the complaint.

The case involved an action to recover no-fault benefits under an insurance contract. The plaintiff, a hospital, filed a complaint against the defendant insurance company seeking payment for overdue benefits. The defendant appealed from an order granting the plaintiff's motion for summary judgment and from a judgment in favor of the plaintiff. The issue before the court was whether the plaintiff had made a prima facie showing of entitlement to judgment as a matter of law under the statutory billing forms and whether the defendant insurer had raised a triable issue of fact in opposition. The court held that the plaintiff had made a prima facie showing by submitting evidentiary proof that the forms were mailed and payment was not received within 30 days, and that the defendant failed to raise a triable issue of fact in opposition. Therefore, the court affirmed the judgment in favor of the plaintiff.

The relevant facts considered by the court were that plaintiff failed to provide adequate discovery responses and failed to amend or supplement incomplete responses. Defendant had moved to strike the complaint on the grounds of plaintiff's inadequate response to discovery demands. The main issue decided by the court was whether defendant's motion to strike plaintiff's complaint should be granted. The court held that plaintiff's conduct was willful and contumacious, as evidenced by its inadequate response to discovery demands, failure to supplement or amend its responses, and failure to offer any response to supplemental interrogatories. Consequently, defendant's motion to strike the complaint was granted.

The main issue in the case was whether the plaintiff, PDG Psychological, P.C., should be compelled to provide responses to the defendant's discovery demands and produce their principal for an examination before trial. The court considered the fact that the defendant had raised concerns about the plaintiff's licensing, which could make them ineligible to receive reimbursement of no-fault benefits. The court denied the plaintiff's motion for summary judgment, as the defendant was unable to set forth sufficient facts to establish their defense due to the plaintiff's failure to comply with discovery demands. The court also determined that the appeal from the part of the order which granted the defendant's cross motion to compel disclosure was dismissed, as it was entered on default and no appeal lies therefrom by the defaulting party. Therefore, the plaintiff was required to provide responses to the defendant's discovery demands and appear for an examination before trial, and the decision of the lower court was affirmed.