No-Fault Case Law
Biotech Surgical Supply, Inc. v Country Wide Ins. Co. (2019 NY Slip Op 52143(U))
December 31, 2019
The court considered the facts of a case in which a provider had settled a claim for first-party no-fault benefits in February 2003, but the defendant did not pay the settlement amount, resulting in a judgment entered on January 30, 2017. The main issue decided by the court was whether a sua sponte stay of the accrual of no-fault interest was appropriate. The holding of the court was that the order of the Civil Court was reversed, and the portion of the order which stayed the accrual of statutory no-fault interest from February 3, 2003 to February 14, 2017 was vacated. The court found that once the case was settled, the defendant was obligated to pay the agreed-upon amount to the plaintiff, and there was no evidence that the plaintiff had prevented the defendant from doing so, so the Civil Court was in error in tolling the accrual of interest.
Family One Chiropractor, P.C. v Country-Wide Ins. Co. (2019 NY Slip Op 52142(U))
December 31, 2019
The court considered the fact that a settlement for first-party no-fault benefits was reached in February 2008, but the defendant did not pay the settlement amount. A judgment was entered in January 2017 pursuant to CPLR 5003-a. The main issue decided was whether the Civil Court erred in staying the accrual of no-fault statutory interest from February 20, 2008 through February 22, 2017. The holding of the court was that the Civil Court erred in tolling the accrual of interest, and therefore, the order was reversed, and the portion of the order that stayed the accrual of statutory no-fault interest from February 20, 2008 to February 22, 2017 was vacated. The appeal was dismissed.
Repwest Ins. Co. v Hanif (2019 NY Slip Op 09047)
December 18, 2019
The court considered an action for certain declaratory relief to determine whether Repwest Insurance Company had a duty to provide insurance coverage for a collision between a livery vehicle insured by Hereford Insurance Company and a vehicle driven by Nazim Hanif and insured by Repwest. Hereford Insurance Company filed a counterclaim against Repwest for loss transfer pursuant to Insurance Law § 5105 (a). The main issue in this case was whether or not the supreme court had subject matter jurisdiction over the counterclaim. The holding was that the counterclaim for loss transfer was subject to mandatory arbitration and therefore, the supreme court had no subject matter jurisdiction over the counterclaim. The counterclaim of the nominal defendant Hereford Insurance Company was dismissed for lack of subject matter jurisdiction. Therefore, the order of the supreme court was reversed.
Comprehensive Care Physical Therapy, P.C. v GEICO Ins. Co. (2019 NY Slip Op 52070(U))
December 13, 2019
The relevant facts of the case involved an action by a provider to recover assigned first-party no-fault benefits. The plaintiff had failed to appear for duly scheduled examinations under oath. The main issue decided was whether the plaintiff's failure to appear for scheduled examinations under oath warranted the denial of their motion for summary judgment and the granting of the defendant's cross-motion for summary judgment dismissing the complaint. The holding of the case was that the order denying plaintiff's motion for summary judgment and granting defendant's cross motion for summary judgment dismissing the complaint was affirmed, with $25 costs. This decision was based on the plaintiff's failure to appear for scheduled examinations under oath, similar to the reasoning in another case decided with this one.
Comprehensive Care Physical Therapy, P.C. v GEICO Ins. Co. (2019 NY Slip Op 52069(U))
December 13, 2019
The court considered an order denying the plaintiff's motion for summary judgment and granting the defendant's cross motion for summary judgment, based on the plaintiff's failure to appear for scheduled examinations under oath. The main issue decided was whether the plaintiff's failure to appear for scheduled examinations under oath justified the denial of their motion for summary judgment. The holding of the case was that the order denying the plaintiff's motion for summary judgment and granting the defendant's cross motion for summary judgment was affirmed, as the plaintiff had failed to appear for duly scheduled examinations under oath.
Active Care Med. Supply Corp. v American Tr. Ins. Co. (2019 NY Slip Op 52068(U))
December 13, 2019
The relevant facts in this case are that the plaintiff, a medical supply company, was seeking to recover first-party no-fault benefits from the defendant insurance company. The plaintiff appealed an order from the Civil Court, which denied their motion for summary judgment and granted the defendant's cross motion for summary judgment dismissing the complaint. The main issue decided by the court was whether the plaintiff had failed to appear for duly scheduled examinations under oath (EUOs) as required by the defendant. The holding of the court was that the defendant had established that the EUO scheduling letters had been timely mailed and that the plaintiff had indeed failed to appear for the scheduled EUOs, and as a result, the order from the Civil Court was affirmed.
Omphil Care, Inc. v GEICO Ins. Co. (2019 NY Slip Op 52065(U))
December 13, 2019
The case involved a dispute between Omphil Care, Inc., as the assignee of Shereen Small, and GEICO Ins. Co. over recovering assigned first-party no-fault benefits. GEICO had filed a motion for summary judgment, claiming that Omphil Care had failed to appear for examinations under oath (EUOs). The Civil Court of New York granted GEICO's motion for summary judgment and denied Omphil Care's cross motion for summary judgment. The court found that the evidence submitted by GEICO was sufficient to establish that Omphil Care had failed to appear for the EUOs, based on the timely mailing of scheduling letters and denial of claim forms. Therefore, the court affirmed the order granting GEICO's motion for summary judgment.
Aries Chiropractic, P.C. v Ameriprise Ins. Co. (2019 NY Slip Op 52064(U))
December 13, 2019
The court considered the motion for summary judgment by the defendant in an action by a provider to recover assigned first-party no-fault benefits. The main issue decided was whether the defendant's denial of claim form needed to set forth the dates of the scheduled examinations under oath (EUOs) for which the plaintiff had failed to appear. The court held that the defendant's denial of claim form did not need to specify the dates of the EUOs for which the plaintiff had failed to appear, as it was not required by the Department of Financial Services. Therefore, the order granting the defendant's motion for summary judgment dismissing the complaint was affirmed.
SS Med. Care, P.C. v 21st Century Ins. Co. (2019 NY Slip Op 52057(U))
December 13, 2019
The facts of the case involved SS Medical Care, P.C. seeking to recover no-fault benefits for medical services provided as a result of a motor vehicle accident. After SS Medical moved for summary judgment, 21st Century Insurance Company failed to submit any opposition. The Civil Court granted the motion and ordered SS Medical to enter judgment if 21st Century failed to obtain a stay from the Supreme Court within 60 days. Despite a stay being granted by the Supreme Court, SS Medical still entered judgment before the expiration of the 60 days. 21st Century moved to vacate the judgment, citing that they had been in the process of filing a declaratory judgment action in the Supreme Court. The court ultimately held that 21st Century failed to establish a reasonable excuse for its default in opposing the motion for summary judgment, and therefore denied 21st Century's motion to vacate the judgment.
Pavlova v Nationwide Ins. (2019 NY Slip Op 52056(U))
December 13, 2019
The court considered whether to vacate an order granting summary judgment on default in a case involving a provider seeking to recover first-party no-fault benefits. The main issue decided was whether the plaintiff had demonstrated a reasonable excuse for the default and the existence of a meritorious defense to the motion, pursuant to CPLR 5015 (a) (1). The holding of the court was that the Civil Court did not improvidently exercise its discretion in finding that the plaintiff had failed to demonstrate a reasonable excuse for its default, and therefore the order denying plaintiff's motion to vacate the previous order was affirmed.