No-Fault Case Law

The court considered the motion for summary judgment brought by a health care provider to recover assigned first-party no-fault benefits. The motion was supported by an affirmation from the provider's counsel, an affidavit by a corporate officer of the provider, 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 provider's practices and procedures, and thus, failed to lay a foundation for the admission of the documents as business records. As a result, the court denied the provider's motion for summary judgment. The main issue decided was whether the affidavit submitted by the provider's corporate officer established a proper foundation for the admission of the documents as business records, and the court held that it did not. Therefore, the denial of the motion for summary judgment was affirmed.

The court considered a case in which Fair Price Medical Supply Corp. was seeking to recover assigned first-party no-fault benefits from Nationwide Mutual Insurance Company. Fair Price's motion for summary judgment was based on an affirmation from their counsel, an affidavit by a corporate officer, and various documents. However, the affidavit by the corporate officer was deemed insufficient to establish personal knowledge of the facts, specifically regarding Fair Price's office practices and procedures, to lay a proper foundation for the documents to be admitted as business records. The court held that Fair Price failed to make a prima facie showing of its entitlement to summary judgment, and therefore, the motion was properly denied. The main issue decided was whether Fair Price had established a proper foundation for the documents to be admitted as business records, and the holding was that they had not, leading to the denial of their motion for summary judgment.

The relevant facts that the court considered in this case were that the defendant moved for summary judgment dismissing the complaint based on the plaintiff's assignor's failure to attend independent medical examinations (IMEs). The plaintiff argued that the defendant failed to adequately prove mailing of the IME requests, but the court found that the defendant provided sufficient proof of having mailed the IME requests. The main issue decided in this case was whether the defendant was entitled to summary judgment dismissing the action, as the plaintiff's assignor failed to appear for the IMEs, and whether the defendant's requests and follow-up requests for IMEs were mailed in accordance with the time periods prescribed by the insurance regulations. The holding of the case was that the defendant was entitled to summary judgment dismissing the complaint, as the affidavits submitted by the defendant were sufficient to establish that the IME requests and follow-up requests were mailed in accordance with the regulations, and there was no support in the record for the court's finding of a question of fact regarding the reason for the plaintiff's assignor's nonappearance at the IMEs.

The court considered the fact that the plaintiff medical supply company was seeking to recover first-party no-fault benefits as the assignee of five individuals injured in separate motor vehicle accidents. The defendant insurance company moved to sever the five causes of action, arguing that they involved different questions of fact and law. The issue was whether the claims should be severed, as the plaintiff argued that all the claims were denied for the same reason and sought payment for the same type of medical equipment. The court held that the decision to grant a severance is an exercise of judicial discretion, and in the absence of a showing of prejudice to a substantial right, should not be disturbed on appeal. Since the denial of the claims was based on five different peer reviews, resulting in testimony at trial from different doctors on the issue of medical necessity, the court affirmed the order granting severance.

The court considered the denial of the plaintiff's cross motion for summary judgment and the granting of the defendant's motion to compel discovery, which required the plaintiff to produce a treating provider for a deposition in an action to recover assigned first-party no-fault benefits for health care services rendered to its assignor. The main issue decided was whether the denial of the plaintiff's cross motion for summary judgment and the granting of the defendant's motion to compel discovery were justified based on the evidence and procedures presented. The holding of the court was that the denial of the plaintiff's cross motion for summary judgment was without merit, as the affidavit submitted by the plaintiff's corporate officer was insufficient to establish personal knowledge of the plaintiff's practices and procedures. Therefore, the plaintiff failed to make a prima facie showing of entitlement to summary judgment, and the appeal from the denial of the cross motion for summary judgment was dismissed.

The main issue of the case was whether or not the affidavit submitted by the plaintiff's officer was sufficient to establish that said officer possessed personal knowledge of plaintiff's practices and procedures in order to lay a foundation for the admission of the documents as business records. The court considered the affirmation from plaintiff's counsel, an affidavit by an officer of plaintiff, and various documents annexed thereto. The holding of the court was that the affidavit submitted by plaintiff's officer was insufficient 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. As a result, plaintiff failed to make a prima facie showing of its entitlement to summary judgment, and therefore, plaintiff's cross motion for summary judgment was properly denied.

The court considered a motion for summary judgment in an action to recover assigned first-party no-fault benefits in which plaintiffs were denied their motion. The denial was based on the failure of the plaintiffs' assignor to comply with properly noticed independent medical examination (IME) requests. The main issue decided was whether the affidavit submitted by the defendant was sufficient to establish that the IME notices were mailed. The holding of the court was that the affidavit submitted by the defendant was indeed sufficient to establish that the IME notices were mailed, and therefore, the order denying plaintiffs' motion for summary judgment was affirmed.

The court considered a motion for summary judgment in an action by a provider to recover assigned first-party no-fault benefits. The motion was supported by an affirmation from the provider's counsel, an affidavit by a corporate officer of the provider, and various documents annexed thereto. However, the affidavit executed by the corporate officer was insufficient to establish that the officer possessed personal knowledge of the provider's practices and procedures so as to lay a foundation for the admission of the documents as business records. As a result, the court denied the provider's motion for summary judgment, holding that the moving papers failed to establish a prima facie case. The main issue decided was whether the provider's motion for summary judgment should be granted, and the holding was that the motion was properly denied due to the insufficiency of the affidavit to establish a prima facie case.

The court considered the fact that the defendant served an untimely answer, and the plaintiff sought and obtained a default judgment. The main issue decided was whether the plaintiff waived the untimeliness of the answer by failing to reject it, and whether this precluded the grant of a default judgment. The court held that a plaintiff's retention of an answer without a timely objection constitutes a waiver of objection as to untimeliness, and such a waiver precludes the grant of a default judgment. Therefore, the default judgment entered against the defendant was vacated, and the defendant's motion was granted to that extent. The court also held that to the extent the defendant sought to compel acceptance of the answer, that branch of the defendant's motion was denied as academic.

The main issues in this case revolve around an action to recover assigned first-party no-fault benefits, where the plaintiff, Vista Surgical Supplies, Inc., sought summary judgment after the denial of their motion by the Civil Court of the City of New York, Kings County. The court considered the fact that the plaintiff established its prima facie entitlement to summary judgment by proof of the submission of a statutory claim form, setting forth the fact and the amount of the loss sustained, and that payment of no-fault benefits was overdue. The defendant's denial was based upon the plaintiff's assignor's nonattendance at independent medical examinations (IMEs), but the defendant failed to establish by proof in admissible form that the IME notifications were mailed and that plaintiff's assignor failed to appear. Therefore, the appellate court reversed the order without costs, granted plaintiff's motion for summary judgment, and remanded the case to the court below for the calculation of statutory interest and an assessment of attorney's fees.