No-Fault Case Law

The court considered the fact that the plaintiff was seeking first-party no-fault benefits for health services provided to two individuals injured in an automobile accident, and that the defendant denied the claims for payment. The main issue decided was whether the defendant's denial of the claims was valid, as the plaintiff argued the claims were not timely denied as required by Insurance Law. The holding of the case was that the court affirmed the lower court's decision to deny the plaintiff's motion for summary judgment, as the defendant was able to rebut the plaintiff's prima facie case by showing that the plaintiff did not submit completed proof of claim and did not timely respond to requests for verification. The defendant also raised an additional issue of fact regarding fraud in the claim, further supporting the denial of the motion for summary judgment.

The court considered the defendant insurer's motion for summary judgment to dismiss the complaint in a lawsuit to recover payments for medical services rendered under No-Fault. The main issues decided were the validity of the complaint, the authorization of the individual physicians named as plaintiffs, and the obstruction of discovery by one of the plaintiffs. The court held that the verification of the complaint was defective, but that the defendant failed to act with due diligence to treat it as a nullity. It was also held that the causes of action pertaining to Drs. Schur, Casson, and Choi should be dismissed due to lack of authorization by their counsel. Additionally, the court granted the motion to dismiss the causes of action asserted by Dr. Abraham due to willful obstruction of discovery.