No-Fault Case Law
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.
Crystal Acupuncture, P.C. v Travelers Ins. (2019 NY Slip Op 52055(U))
December 13, 2019
The court considered an appeal from an order of the Civil Court entered April 17, 2018 granting the plaintiff's motion for summary judgment and denying the defendant's cross motion for summary judgment dismissing the complaint. The main issue decided was whether the defendant's proof was sufficient to support their cross-motion for summary judgment dismissing the complaint. The holding of the court was that the judgment was reversed, with $30 costs, the order entered April 17, 2018 is vacated, plaintiff's motion for summary judgment is denied and defendant's cross motion for summary judgment dismissing the complaint is granted.
Market St. Surgical Ctr. v Autoone Ins. Co. (2019 NY Slip Op 52054(U))
December 13, 2019
The main issue in this case was whether the court should vacate a default judgment in favor of the defendant. The court held that in order to vacate a default in opposing a motion, the moving party must demonstrate both a reasonable excuse for the default and the existence of a meritorious defense to the motion. The court found that the plaintiff failed to demonstrate a meritorious defense to the defendant's motion, and, therefore, the plaintiff's motion to vacate the default judgment should have been denied. As a result, the court reversed the order granting the plaintiff's motion to vacate and reinstated the order granting summary judgment in favor of the defendant.
Compas Med., P.C. v American Tr. Ins. Co. (2019 NY Slip Op 52053(U))
December 13, 2019
The court considered the fact that plaintiff, as an assignee of the injured party, had filed a motion for summary judgment to recover assigned first-party no-fault benefits, while the defendant argued that the assignor had been injured during the course of employment. The main issue decided was whether the plaintiff had complied with a prior order requiring them to make a proper application to the Workers' Compensation Board to determine the parties' rights under the Workers' Compensation Law. The holding of the case was that since the plaintiff did not demonstrate compliance with the prior order, the order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion was affirmed. Additionally, the argument made by the plaintiff that Workers' Compensation Law § 28 rendered any claim for workers' compensation benefits untimely was deemed unavailing.