No-Fault Case Law

The relevant facts in this case involved Primary Psychiatric Health, P.C. seeking to recover first-party no-fault benefits from State Farm Mutual Auto Insurance for psychological services provided to multiple assignors. The only open claims were for psychological services provided to assignors Everald Poole and Terry Johnson. State Farm's sole defense to the claims was that there was "no coverage at all" under its policy because neither of the assignors suffered a psychological injury as a result of the underlying motor-vehicle accident. The court considered the testimony of two expert witnesses, Dr. Rosenfeld and Dr. Rock, who both testified that the assignors did not sustain a psychological injury as a result of the accident. The court held that, based on the evidence presented, there was no coverage for the claims, and entered judgment in favor of the defendant, dismissing the claims.

The court considered the terms of the insurance policy which required the insured to notify the insurance company as soon as reasonably possible of any accident or loss, including the names and addresses of injured persons and witnesses. The main issue decided was whether the insured's failure to comply with these notification duties prejudiced the insurance company, and thus relieved them of the duty to provide coverage under the policy. The court held that the duties under the insurance policy had to be strictly complied with in order for the insured to be entitled to coverage, and that the failure to notify the insurance company as required prejudiced them, thus relieving them of the duty to provide coverage. Therefore, the petition to stay arbitration was denied and the proceeding was dismissed.

The relevant facts that the court considered in "Montefiore Med. Ctr. v Nationwide Mut. Ins. Co." are that Montefiore Medical Center, as assignee of Sherice Haye, was seeking to recover no-fault medical payments under contracts of insurance. Montefiore appealed the denial of their motion for summary judgment on the first cause of action. The primary issue was whether there was a triable issue of fact as to whether the patient’s treatment was unrelated to her motor vehicle accident, as raised by the hospital records and other material submitted by the defendant. The court held that a triable issue of fact existed regarding whether the defendant's denial of no-fault benefits in this case was proper, and therefore they affirmed the lower court’s order.

The relevant facts considered by the court in this case were that the plaintiff, a medical supply company, had failed to comply with a court-ordered examination before trial in a lawsuit seeking no-fault benefits from the defendant insurance company. The main issue decided was whether the plaintiff's failure to comply with the court-ordered examination before trial warranted dismissal of the plaintiff's action. The holding of the court was that the plaintiff's failure to comply with the court-ordered examination before trial resulted in a waste of judicial resources and could not be tolerated, leading to the dismissal of the complaint. The court also affirmed the denial of the plaintiff's motion for reargument and renewal, as there was no reasonable justification for the failure to present new facts that would change the prior determination.

The relevant facts considered by the court in this case include the denial of the plaintiff's motion for summary judgment in an action to recover assigned first-party no-fault benefits. The plaintiff's motion was supported by an affirmation from their counsel, an affidavit by an officer of the plaintiff, and various documents annexed to the motion papers. However, the court found that the affidavit executed by the plaintiff's officer was insufficient to establish personal knowledge of the plaintiff's practices and procedures, and therefore failed to make a prima facie showing of entitlement to summary judgment. The main issue decided was whether the plaintiff had made a sufficient showing of entitlement to summary judgment, and the court held that they had not. The appeal from the order denying the plaintiff's motion for summary judgment was dismissed, and the order was affirmed without costs. The court also dismissed the appeal from the order entered February 22, 2006, as the plaintiff had raised no issue with respect to that order.

The relevant facts of the case were that a medical provider sought to recover assigned no-fault benefits from an insurance company and moved for a default judgment when the insurance company failed to appear or answer the complaint. The main issue decided was whether the medical provider had provided sufficient evidence to establish a prima facie case in support of their motion for a default judgment. The court held that the medical provider's affidavit was insufficient to establish that the officer had personal knowledge of the provider's practices and procedures, so as to lay a foundation for the admission of the documents. Additionally, the court found that the medical provider had failed to establish that it had submitted the necessary claim forms to the insurance company. Therefore, the court affirmed the denial of the medical provider's motion for a default judgment.

The relevant facts considered by the court in this case were that the plaintiff, Capri Medical, P.C., was seeking to recover assigned first-party no-fault benefits from the defendant, Allstate Insurance Company. The plaintiff's motion for summary judgment was supported by an affirmation from counsel, an affidavit by a corporate officer of the plaintiff, and various documents. However, the affidavit by the corporate officer was found to be insufficient to establish that the officer had personal knowledge of the plaintiff's practices and procedures to lay a foundation for the admission of the documents as business records. The main issue decided by the court was whether the plaintiff had made a prima facie showing of its entitlement to summary judgment. The court determined that the affidavit submitted by the plaintiff's corporate officer was insufficient, and as a result, the plaintiff failed to establish a prima facie case. The holding of the case was that the judgment in favor of the plaintiff was reversed, the order granting the plaintiff's motion for summary judgment was vacated, and the plaintiff's motion for summary judgment was denied. Therefore, the defendant, Allstate Insurance Company, prevailed in the case and was not required to pay the no-fault benefits to the plaintiff.

The main issue in this case was whether the provider, Fair Price Medical Supply Corp., was entitled to recover assigned first-party no-fault benefits from Allstate Insurance Co. The court considered the evidence presented, including an affirmation from the provider's counsel, an affidavit from a corporate officer of the provider, and various documents. However, the court found that the affidavit executed by the provider's corporate officer did not sufficiently demonstrate personal knowledge of the facts set forth, and therefore failed to establish a prima facie case. As a result, the court affirmed the denial of the provider's motion for summary judgment, as they had not demonstrated their entitlement to the benefits in question. Therefore, the holding of the court was that the provider's motion for summary judgment was properly denied.

The court considered the fact that Vista Surgical Supplies, Inc. was seeking to recover assigned first-party no-fault benefits, and had moved for summary judgment. The main issue decided was whether the affidavit submitted by plaintiff's corporate officer laid a proper foundation for the documents annexed to plaintiff's moving papers, and whether this constituted a prima facie case. The holding of the court was that the affidavit was insufficient to establish that the officer possessed personal knowledge of plaintiff's practices and procedures, and therefore did not lay a proper foundation for the documents. As a result, plaintiff failed to make a prima facie showing of its entitlement to summary judgment, and the judgment in their favor was reversed, the order was vacated, and plaintiff's motion for summary judgment was denied.

The relevant facts considered by the court in this case were that Delta Diagnostic Radiology, P.C. was seeking to recover assigned first-party no-fault benefits from Allstate Insurance Company. Plaintiff's motion for summary judgment was supported by an affirmation from plaintiff's counsel, an affidavit by an officer of plaintiff, and various documents annexed thereto. The court denied the motion on the ground that plaintiff failed to make a prima facie case because the affidavit executed by plaintiff's corporate officer was legally insufficient. Plaintiff appealed from the denial of its motion for summary judgment. The main issue decided in this case was whether the affidavit submitted by plaintiff's corporate officer was sufficient to establish that said 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 was insufficient to establish the officer's personal knowledge, and therefore plaintiff failed to make a prima facie showing of its entitlement to summary judgment, resulting in the denial being affirmed.