No-Fault Case Law

The relevant facts considered by the court in this case were that the plaintiff commenced the action to recover assigned first-party no-fault benefits, and the defendant moved to consolidate the present action with four other actions pending before the court. The defendant's appeal was based on a motion made in June 2018 to consolidate the present action with four other actions and to have the Clerk of the Civil Court deemed the appeal to be an appeal of the within joined actions, and to accept an undertaking pertaining to all of the actions. The main issue decided by the court was whether the defendant's motion to consolidate the actions and to have the appeal deemed to be an appeal of the within joined actions should be granted. The court held that the appeal should be dismissed because the action was no longer a viable pending action with which to consolidate any other actions. Therefore, the appeal was dismissed. Ultimately, the holding of the court was that the appeal was dismissed, and the action was no longer a viable pending action with which to consolidate any other actions.

The main facts considered by the court in this case were that the plaintiff had commenced an action to recover assigned first-party no-fault benefits as an assignee. After issue was joined, the defendant failed to appear for trial, resulting in the court granting the plaintiff's application to mark the case "inquest clerk" and hold the defendant in default. The defendant then sought to consolidate this action with four other actions pending in the Civil Court and, upon consolidation, to open its defaults in appearing for trial. The Civil Court denied the defendant's motion to open its defaults in appearing for trial, finding that the defendant had failed to proffer a reasonable excuse for the failure by its incoming counsel to provide proper proof of its legal representation of the defendant. The main issue decided by the court was whether the defendant had provided a reasonable excuse for its failure to appear for trial, and whether it should be allowed to open its defaults in appearing for trial. The holding of the court was that, in light of the stay issued by the Supreme Court, the appeal has been rendered academic as any determination on this appeal would not have a direct effect upon the parties. Therefore, the appeal was dismissed.

The case involved a dispute between Active Care Medical Supply Corp. and Titan Insurance Co. over the distribution of medical supplies and the standing of Active Care to bring the action. The main issue decided was whether Active Care had the necessary license to distribute the medical supplies at issue. The court held that there was insufficient evidence to demonstrate the absence of any material issues of fact regarding Active Care's licensing, as the evidence showed that Active Care had obtained a license with the New York City Department of Consumer Affairs before the supplies were provided. Therefore, the branch of the defendant's motion seeking summary judgment dismissing the complaint on the ground that Active Care lacked a license to distribute the medical supplies at issue was denied, and the matter was remitted to the Civil Court to determine the remaining branches of the defendant's motion.

The main issue in the case was whether the Civil Court properly denied the defendant's motion to vacate a default order, which granted the plaintiff's motion for summary judgment. The parties had entered into a stipulation setting a briefing schedule for the motion, and the defendant failed to serve its opposing papers and cross motion in a timely manner, leading to the default order being granted in favor of the plaintiff. The Court considered whether the stipulation setting the briefing schedule was necessary for the consideration of the questions involved and whether the defendant had a reasonable excuse for its default. The holding of the case was that the Civil Court properly denied the defendant's motion to vacate the default order, as the stipulation was necessary for the consideration of the questions involved, and the defendant failed to establish a reasonable excuse for its default. Therefore, the order denying the defendant's motion to vacate was affirmed.

The court considered the provider's action to recover assigned first-party no-fault benefits in the amount of $2,738.52. The main issue decided was whether the Civil Court had jurisdiction over the case and whether the defendant's policy provided for no-fault coverage. The holding of the case was that the Civil Court did have jurisdiction over the matter because the action sought to recover a sum of less than $25,000. Additionally, the defendant failed to demonstrate that its policy did not provide for such coverage, so they did not demonstrate their entitlement to judgment as a matter of law. Therefore, the order denying the defendant's motion for summary judgment dismissing the complaint was affirmed.

The court considered a master arbitrator's award issued by the Civil Court and determined that it should be set aside because the arbitrator had exceeded his power by issuing an award that was beyond the policy limits. Respondent argued that its claims were complete before the policy issued by petitioner was exhausted, but the court found that the claims were never verified as the healthcare provider failed to appear for an examination under oath as requested by the insurer. The court also concluded that the Appellate Term had the power to remand to Civil Court for a framed issue hearing, after which the respondent was not entitled to the attorneys' fees it requested. Therefore, the Appellate Division affirmed the order of the Appellate Term without costs.

The relevant facts that the court considered in Montvale Surgical Center, LLC. v State Farm Mut. Auto. Ins. Co. included the plaintiff seeking reimbursement of No-Fault benefits for medical and surgical services rendered to a New York claimant at its New Jersey surgical center. The defendant moved to dismiss the complaint on the ground that the plaintiff lacks legal capacity to sue in New York, and alternatively moved to compel discovery and a deposition of the plaintiff. The main issues decided by the court were whether the plaintiff was a foreign corporation doing business in New York, and whether the plaintiff had failed to demonstrate a prima facie case in support of summary judgment. The holding of the case was that the defendant's motion to dismiss the complaint was denied, with prejudice, as the court found that the defendant failed to prove that the plaintiff was doing business in New York. Additionally, the court denied the defendant's alternative motion to compel discovery and a deposition of the plaintiff, and denied the plaintiff's cross-motion for summary judgment.

The main issue in this case was whether the Civil Court should have vacated a default order and granted summary judgment to the defendant in a dispute over first-party no-fault benefits. The defendant argued that the default order should be vacated due to a potentially meritorious defense to the action, as evidenced by a prior order granting summary judgment to the defendant. The court held that the prior order should not have been relied upon to grant summary judgment to the defendant, as it had already been conclusively determined by the prior grant of summary judgment to the plaintiff. The court reversed the prior order and remitted the case back to the Civil Court for a new determination regarding the defendant's motion to vacate the default order.

The court considered a case in which a provider's claims for assigned first-party no-fault benefits had been denied based on allegations of "improper kickbacks," "improper fee splitting," "improper fee scheduling" and "billing for services not rendered." The provider submitted the claims to arbitration pursuant to Insurance Law § 5106 (b) and the arbitrator found in favor of the provider. The insurer appealed the award to the master arbitrator, who vacated the arbitrator's award and remitted the matter for a new hearing. The provider then commenced a proceeding to vacate the master arbitrator's award, and the District Court found that there was a rational basis for the original arbitrator's award and vacated the master arbitrator's award. The main issue was whether the master arbitrator exceeded his power in vacating the original award, and the court held that there was a rational basis for the original arbitrator's award and thus the master arbitrator had exceeded his authority. The court affirmed the order to vacate the master arbitrator's award and remit the matter for further proceedings, and also remitted the matter to the District Court to determine the provider's reasonable attorney's fees for the appeal.

The case involved a dispute between Country-Wide Insurance Company and TC Acupuncture P.C., as the assignee of Corey Crichlow, over attorney's fees in connection with a no-fault arbitration award. The main issue considered by the court was whether TC Acupuncture was entitled to attorney's fees in the article 75 proceeding reviewing the arbitration award in its favor. The court held that TC Acupuncture was indeed entitled to additional attorney's fees for its motion to modify the order and its opposition to Countrywide's motion to reargue that order. The court also found that TC Acupuncture was entitled to the attorney's fees incurred in the appeal to this Court of the order issued in the article 75 proceeding. The judgment of Supreme Court was therefore modified to remand the matter for a determination of TC Acupuncture's reasonable attorney's fees incurred in the proceeding and its appeal.