No-Fault Case Law

The relevant facts considered by the court in this case were that the plaintiff, a medical provider, was seeking to recover assigned first-party no-fault benefits. The defendant, an insurance company, moved for summary judgment to dismiss the complaint on the basis that the plaintiff had failed to appear for duly scheduled examinations under oath (EUOs), and was supported by an affirmation from a partner in the law firm representing the defendant. The plaintiff also cross-moved to disqualify the defendant's law firm from representing them in the case, on the ground that a member of the firm was a necessary witness in the case. The main issues decided by the court were whether the defendant had made a prima facie showing of its entitlement to summary judgment on the ground that the plaintiff failed to appear for the scheduled EUOs, and whether the defendant's law firm should be disqualified based on the attorney-witness rule. The holding of the case was that the court affirmed the order granting the defendant's motion for summary judgment dismissing the complaint and denying the plaintiff's cross motion to disqualify the defendant's law firm from representing them in the case. The court ruled that the defendant had made a prima facie showing of entitlement to summary judgment and that the attorney-witness rule did not warrant disqualifying the defendant's law firm.

The court considered the fact that plaintiff had previously motioned for summary judgment to recover assigned first-party no-fault benefits for services provided to an individual injured in a motor vehicle accident. Defendant did not oppose the motion, and a judgment was entered in favor of the plaintiff. However, defendant later moved to vacate the judgment, claiming that the action had been stayed by an order of the Supreme Court at the time of the original motion. The Supreme Court also issued a declaratory judgment declaring that the accident was intentional and that the insurance policy was null and void. As a result, the court ruled that defendant had a reasonable excuse for not opposing the original motion, and there was a conclusive determination of the merits of the claim in question, therefore granting defendant's motion to dismiss the complaint. The main issue decided was whether the defendant had a reasonable excuse for not opposing the original motion and whether there had been a conclusive determination of the merits of the claim in question. The holding of the case was that the order to vacate the previous judgment and dismiss the complaint was affirmed.

The court considered the facts related to Jeffrey Delacruz being the driver of a vehicle involved in a collision covered by a no-fault insurance policy with Country-Wide and the denial of the medical providers' application for no-fault benefits. The main issue decided concerned Country-Wide's potential obligation to pay no-fault benefits and their motion for summary judgment based on Delacruz's failure to appear for scheduled examinations under oath. The court held that Country-Wide's motion for summary judgment was denied as untimely and premature under CPLR 3212 (f) as they had not provided sufficient evidence of timely request for defendant Dr. Parisien to appear for an examination under oath. Therefore, the requests for summary judgment as to the other medical providers were denied as well.

The court considered the fact that the defendant moved for summary judgment dismissing the complaint on the basis that the plaintiff had failed to comply with a discovery order, and as a result, should be precluded from offering testimony at trial. The main issue decided in the case was whether the plaintiff's failure to comply with the discovery order warranted preclusion of testimony at trial. The holding of the court was that upon a review of the record, they agreed with the Civil Court's implicit determination that preclusion was not warranted under the circumstances presented. As a result, the order denying the defendant's motion for summary judgment was affirmed.

The main issue in this case was whether Allstate Insurance Company was liable to pay no-fault insurance benefits to DHD Medical, P.C. after an arbitration award in DHD Medical's favor of $5,786.91. Allstate had denied DHD Medical's claim for benefits on the ground that the treatment provided was not medically necessary. DHD Medical challenged the denial of benefits in a no-fault arbitration proceeding under Insurance Law § 5106 (b) and the arbitrator ruled in DHD Medical's favor. Allstate then brought this action under Insurance Law § 5106 (c) seeking a de novo adjudication of the benefits dispute. The court ultimately denied both Allstate and DHD Medical's motions for summary judgment, as well as DHD Medical's motion for default judgment on its counterclaims. Allstate's motion to compel DHD Medical to accept its untimely reply to the counterclaim was granted. The parties were ordered to inform the court how they intended to proceed with the action at a future status conference.

The case was about a provider of health services who was attempting to recover first-party no-fault benefits from an insurance company. The insurance company was trying to dismiss the complaint, arguing that New Jersey law should apply to the case, as the accident took place there. However, the court held that the conflict of law should be resolved following the relevant law to contracts, not torts. They used a flexible "center of gravity" or "grouping of contacts" approach to give controlling effect to the state's law with the most significant relationship to the transaction and the parties. In this case, it was held that New York law applied, and the decision to grant the plaintiff's motion for summary judgment and denying the defendant's cross motion for summary judgment stood.

The court considered two actions by a provider to recover assigned first-party no-fault benefits. After a consolidated nonjury trial, each complaint was dismissed on the ground of lack of medical necessity. The main issues decided were whether there was a lack of medical necessity for the services at issue, specifically for manipulation under anesthesia (MUA), and whether the evidence provided by defendant's expert impermissibly went beyond the scope of the peer review report. The holding of the court was that the judgments were affirmed, as the defendant's expert provided a factual basis and medical rationale for the conclusion that there was no medical necessity for the services at issue, and the court was entitled to credit that testimony. The court also found that the plaintiff's witness's testimony was less credible and failed to sufficiently rebut the defendant's expert's testimony.

The court considered a case involving GPM Chiropractic, P.C. as the appellant and State Farm Mutual Insurance Co. as the respondent. The appellant sought to recover no-fault statutory interest for services rendered in 2001, and the issue was joined in December 2002. The Civil Court initially denied the respondent's cross motion for summary judgment dismissing the complaint, and upon reargument, adhered to its prior determination. The court ultimately ruled that the accrual of interest is tolled from November 26, 2005 to April 13, 2018, as the appellant took no meaningful action to prosecute the case after the court's decision on the respondent's motion. The holding of the case was that the accrual of interest is tolled within the specified timeframe.

The main issue in this case was whether the accrual of no-fault statutory interest should be tolled due to plaintiff's delay in prosecuting the action. The court considered the fact that the action was commenced in 2002 to recover assigned first-party no-fault benefits for services allegedly rendered in 2001. The court noted that issue was joined in July 2002, a motion for summary judgment was denied in December 2004, and plaintiff filed a notice of trial in July 2017, showing a lack of meaningful action to prosecute the case after the motion was denied. The holding of the court was that the Civil Court properly tolled the no-fault interest until July 12, 2017, as the plaintiff unreasonably delayed the action after the motion for summary judgment was denied. The court also rejected plaintiff's assertion that defendant's failure to serve responses to discovery demands was a basis to find that defendant unreasonably delayed the action.

The main issue in this case was whether the Civil Court should have denied defendant's motion to dismiss the complaint pursuant to CPLR 3216. The court considered the fact that the plaintiff did not dispute receipt of the 90-day demand and did not make the required showing of prejudice. Furthermore, the plaintiff did not file a notice of trial within 90 days after receiving the 90-day demand and had not moved prior to vacate the demand or to extend the 90-day period. The holding of the court was that defendant's motion to dismiss the complaint pursuant to CPLR 3216 should have been granted. The court found that plaintiff's claim of law office failure did not rise to the level of a justifiable excuse, and therefore, it was unnecessary to consider whether the plaintiff demonstrated the existence of a meritorious cause of action.