No-Fault Case Law

The case involved a dispute between Pierre J. Renelique, M.D., P.C., as the assignee of Ligene, Joanel, and American Independent Ins. Co. regarding the recovery of assigned first-party no-fault benefits. American Independent Ins. Co. appealed from an order of the Civil Court, which denied their motion to dismiss the complaint. The appellate court reversed the order and granted the defendant's motion to dismiss the complaint. The main issue decided was whether the complaint should be dismissed pursuant to CPLR 3211 (a) (8) and the court held that the motion to dismiss the complaint should be granted.

The court considered an appeal from an order denying the defendant's motion to dismiss a complaint in a no-fault benefits action. The main issue was whether the complaint should be dismissed pursuant to CPLR 3211 (a) (8). The court held that the order denying the defendant's motion to dismiss the complaint was reversed, and the defendant's motion to dismiss the complaint was granted. The decision was based on the reasoning stated in a previous case, Pierre J. Renelique, M.D., P.C., as Assignee of Vernizier, Jean Willy v American Ind. Ins. Co., which was decided along with the current case. The decision was concurred by the presiding judges.

The court considered an appeal from an order of the Civil Court, which denied the defendant's motion to dismiss a complaint brought by Pierre J. Renelique, M.D., P.C., as Assignee of Acevedo, Constantino, seeking to recover assigned first-party no-fault benefits from American Independent Ins. Co. The main issue decided was whether the complaint should be dismissed pursuant to CPLR 3211 (a) (8). The court ultimately held that the order denying the defendant's motion to dismiss the complaint was reversed and that the defendant's motion to dismiss the complaint was granted. Therefore, the defendant's motion to dismiss the complaint was ultimately successful.

The court considered an appeal from an order of the Civil Court of the City of New York, Kings County, which denied the defendant's motion to dismiss the complaint brought by Pierre J. Renelique, M.D., P.C., as Assignee of Joseph, Marie Willene, to recover assigned first-party no-fault benefits from American Independent Ins. Co. The main issue decided was whether the complaint should be dismissed pursuant to CPLR 3211 (a) (8). The holding of the court was that, for the reasons stated in another case involving the same parties, the order denying the motion to dismiss the complaint was reversed, and defendant's motion to dismiss the complaint was granted. Therefore, the order of the Civil Court was reversed and the defendant's motion to dismiss the complaint was granted.

The relevant facts the court considered were whether or not the defendant, a Pennsylvania company, had transacted business in New York and whether the New York courts had jurisdiction over the defendant. The main issue decided was whether the court had jurisdiction over the defendant in a case pertaining to first-party no-fault benefits. The holding of the case was that the court granted the defendant's motion to dismiss the complaint, ruling that the plaintiff did not make a sufficient showing that jurisdiction could exist, and therefore their assertion of a jurisdictional predicate was not deemed frivolous. The court reversed the denial of the defendant's motion and granted the motion to dismiss the complaint.

The relevant facts the court considered were that the plaintiff mailed the summons and complaint to the defendant by certified mail, return receipt requested, but failed to properly serve the defendant with a copy of the summons and complaint by first-class mail, as required by CPLR 312-a. The main issue decided by the court was whether the plaintiff's failure to properly serve the defendant with the summons and complaint deprived the court of personal jurisdiction over the defendant. The court held that in the absence of proper service, no personal jurisdiction was acquired over the defendant, and therefore the branch of the defendant's motion seeking to dismiss the complaint was granted. The court also noted that even if the plaintiff had properly served the defendant, the complaint would have been dismissed pursuant to CPLR 3211 (a) (8) for other reasons.

The case involves an appeal from an order of the Civil Court which granted defendant's motion for summary judgment dismissing the complaint and denied plaintiff's cross motion for summary judgment. The defendant denied the plaintiff's claims on the ground that the services at issue were not medically necessary and that the fees charged exceeded the amount permitted by the workers' compensation fee schedule. The court found that the defendant failed to establish that the services provided lacked medical necessity, but it was established that the amount sought exceeded the amount permitted by the workers' compensation fee schedule. The holding of the court was that defendant's motion for summary judgment dismissing the complaint is granted only to the extent of dismissing so much of the complaint as sought to recover in excess of $425.88 upon each of the claims at issue.

The court considered an appeal from an order of the Civil Court which granted the plaintiff's motion for summary judgment in an action by a provider to recover assigned first-party no-fault benefits. The main issue decided was whether the plaintiff's motion for summary judgment should have been denied, as the proof submitted by the plaintiff failed to establish that the claim had not been timely denied or that the defendant had issued a timely denial of claim form that was conclusory, vague or without merit. The holding of the court was that the order granting plaintiff's motion for summary judgment was reversed and the motion for summary judgment was denied.

The relevant facts the court considered in this case involved an action to recover assigned first-party no-fault insurance benefits arising from an accident that occurred on November 30, 2015 in New Jersey. The defendant moved for summary judgment based on a lack of New York insurance coverage and for a determination that New Jersey law applied to the action. The plaintiff, a New York corporation, opposed the motion and cross-moved for summary judgment seeking payment of bills submitted in the amount of $3,745.37. The main issues decided by the court were whether the defendant's policy covered the subject incident and whether New York or New Jersey law should apply. The holding of the case was that the defendant's motion was denied, as they failed to establish their policy did not cover the incident, and the plaintiff's cross-motion was granted to the extent that they had proven timely submission of bills and no denial was issued. The court also held that a triable issue of fact existed as to whether New Jersey law should apply, and the plaintiff would bear the burden of proving the medical necessity of the services if the defendant proved at trial that its policy contained only a New Jersey no-fault endorsement.

The court considered the motion to sever the first cause of action seeking to recover upon a claim for services rendered to Shavkat Djalilov from the remaining cause of action in an action by a provider to recover first-party no-fault benefits assigned to it by two assignors. The main issue decided was whether the first cause of action should be severed from the remaining causes of action. The holding of the court was that the motion to sever the first cause of action from the remaining cause of action should have been granted, as the claims arose out of two separate accidents which occurred on two different dates, and the facts relating to each claim were likely to raise few, if any, common issues of fact. Therefore, the order of the Civil Court denying defendant's motion to sever the first cause of action was reversed, and defendant's motion to sever the first cause of action from the remaining causes of action was granted.