No-Fault Case Law

The court considered several key facts in this case, including that GEICO Insurance Company filed a lawsuit against MV Contract Transportation Inc., Manage Transit Corp., and James J. Boynton due to a vehicle collision on October 6, 2017, which resulted in significant personal injury claims and property damage. MV Contract sought a default judgment against the codefendants, MTC and Boynton, who had not responded or appeared in the action. The main issues decided by the court revolved around whether MV Contract properly served the cross-claims to the defaulting parties and if they had a legal obligation to respond to those claims. Ultimately, the court held that MV Contract failed to effectuate proper service as required by law, and thus the motion for a default judgment was denied since the defaulting parties' obligation to respond was never triggered.

In this case, the court considered the facts surrounding an incident in which Franklin Bermeo was struck by a vehicle identified as an e-bike while crossing an intersection in New York. Bermeo sought uninsured motorist benefits from his insurance provider, Government Employees Insurance Company, which denied the claim on the grounds that the e-bike did not qualify as a motor vehicle under the policy terms. The primary issues addressed included whether the vehicle involved constituted a motor vehicle as defined by the insurance policy and whether the petitioner had met the burden of proof necessary to justify a stay of arbitration. The court ultimately held that the evidence presented, including a police report stating that no motor vehicles were involved, supported the petitioner's claim and denied Bermeo’s request for arbitration for the uninsured motorist benefits. The court's decision adhered to its original ruling after reargument, thus affirming the permanent stay of arbitration.

In this case, the court considered relevant facts concerning the timing of when the plaintiff, ZZ Acupuncture, P.C., filed for recovery of assigned first-party no-fault benefits and the corresponding denial of claims by the defendant, Kemper Insurance Company. The main issues addressed were whether the statute of limitations had expired for the causes of action due to overdue claims and whether the defendant properly established the timing of the denial of claims. The court held that the first and second causes of action were indeed barred by the statute of limitations, as these claims were filed after the six-year limit had elapsed. However, it determined that the third, fourth, fifth, and sixth causes of action were timely, given that they were filed within the appropriate timeframe, absent proof of any earlier denials from the defendant. The order was modified to grant the defendant’s motion to dismiss the first and second causes of action while affirming the remaining parts of the order.

The court examined a case in which a medical provider sought to recover no-fault insurance benefits, asserting that the claims were filed timely despite the insurer’s argument that the statute of limitations had lapsed. The main issues centered around whether the claims became overdue and the appropriate calculation of the statute of limitations based on the timing of claimed denials by the insurance company. The court determined that the first and second causes of action had indeed expired, as the claims had become overdue more than six years before the lawsuit was initiated, based on the receipt date of the claims by the insurer. However, it ruled that the remaining causes of action were not barred by the statute of limitations, as they were timely filed and no evidence was presented that the insurance company issued earlier denials. Ultimately, the court modified the previous order to dismiss the first and second causes of action while affirming the continuation of the others.

The court considered several relevant facts, including the original accident date (September 28, 2017), the issuance of a declaratory judgment declaring the incident a "Staged Accident," and the subsequent default judgments against both the plaintiff and his assignor. The main issues decided involved the application of res judicata and collateral estoppel based on the prior default judgments obtained by "National General Insurance Online, Inc." and whether the defendant was the proper insurer. The court concluded that the default judgment from the earlier action did not have res judicata effect against the plaintiff since the defendant was not the party who obtained the prior judgment, and the plaintiff did not have a fair opportunity to litigate the issue. Furthermore, the court denied the plaintiff's motion for summary judgment due to his failure to demonstrate that the claim form had been received by the defendant, ultimately modifying the order to deny the defendant's cross-motion for summary judgment and affirming the denial of the plaintiff's motion.

In this case, the court considered the failure of the plaintiff’s assignor to appear for three scheduled examinations under oath (EUOs), specifically on May 17, 2019, June 17, 2019, and June 20, 2019. The main issues decided included whether the defendant had appropriately notified the assignor of the rescheduling of the EUO and whether the assignor's absence justified the denial of the no-fault claim. The court found that the assignor had requested to reschedule the June 17 EUO to June 20 and that sufficient oral notice of the new date, time, and location was provided. As a result, the court held that the defendant was entitled to summary judgment dismissing the complaint, as the assignor's failure to appear for the EUOs constituted a valid basis for denying the claim.

In this case, the court considered relevant facts surrounding the plaintiff's assignor's failure to appear for three scheduled examinations under oath (EUOs) related to a no-fault insurance claim. The main issues addressed included whether the notices for the EUOs were adequately communicated and whether the claim was timely denied. The court found that the defendant had provided sufficient notice regarding the rescheduled EUO on June 20, 2019, and that the assignor's absence from the earlier EUOs on May 17, 2019, and June 20, 2019, justified the denial of the claim. Ultimately, the court held that the defendant was entitled to summary judgment, dismissing the complaint based on the assignor's failure to appear at the scheduled EUOs.

In this case, the court evaluated whether the defendant, an insurance company, timely denied a claim from the plaintiff, a diagnostic imaging service. The central issue was whether the plaintiff complied with verification requests required by insurance regulations within 120 days, as well as whether the defendant acted timely in denying the claim. The court found that the defendant had properly requested additional verification within the regulatory timeline and, despite a brief delay in doing so, did not forfeit its right to deny the claim. Ultimately, the court held that the denial was timely and appropriate, granting the defendant's motion for summary judgment and dismissing the plaintiff's complaint.

The court considered the procedural history of an arbitration decision where an arbitrator awarded Excell Clinical Lab $3,129.75 in No-Fault benefits related to a motor vehicle accident. American Transit Insurance Company sought to vacate the arbitration award, arguing that Excell had not established the medical necessity of the disputed services, as they failed to provide an Independent Medical Examination (IME) report or peer review evidence of their own. The key issues addressed included whether the arbitrators' decision was final and definite, as well as whether the award should be vacated under the grounds outlined in CPLR 7511(b). The court ultimately denied the petition to vacate the arbitration award, concluding that the arbitrators had made a rational decision based on the evidence presented and that the award was sufficiently final and definitive.

The court considered several relevant facts, including the procedural history of the case, which involved UGP Acupuncture, P.C. seeking reimbursement from Progressive Northern Insurance Company for medical services rendered following a motor vehicle accident. The initial action was settled between the parties, leading to a Stipulation of Settlement and Discontinuance which was executed on July 23, 2021, and resulted in the case being deemed disposed. The plaintiff then attempted to amend the complaint to substitute Country Wide Insurance Company as the new defendant, arguing that the original index number was preserved for this purpose. The court decided that the index number was extinguished as a result of the prior settlement, and since the motion to amend was moot, the court vacated its earlier interim order related to this motion. Ultimately, the court held that the motion to amend was deemed moot, affirming that the case had been properly settled and disposed of through the Stipulation of Settlement and Discontinuance.