No-Fault Case Law

The case involved an appeal from an order of the Civil Court of Queens County that granted the plaintiff's motion to recalculate an award of statutory no-fault interest from a simple rate to a compound rate in a judgment entered on January 31, 2017. The plaintiff, a provider of assigned first-party no-fault benefits, had submitted claims to the defendant in March 2001, stemming from an accident in December 2000, which was settled in January 2015. The defendant did not pay the settlement amount, resulting in a judgment entered in 2017 that awarded statutory no-fault interest at a simple rate. The plaintiff moved to have the interest recalculated again based on pre-2002 regulations that required interest to be calculated at a compound rate. The court affirmed the order, stating that the interest should be recalculated at a compound rate, and also found that the defendant's remaining contention was not properly before the court.

The relevant facts considered in this case involved a dispute over first-party no-fault benefits arising from a motor vehicle accident. American Independent Ins. Co. (AIIC) sought summary judgment based on the doctrine of collateral estoppel, citing two previous determinations by the Supreme Court. The first determination, entered in 2014, held that AIIC was not obligated to pay first-party benefits to certain parties due to the accident being staged, but did not name Gentlecare Ambulatory Anesthesia Services as one of the parties. The second determination, in 2016, directed a judgment to be settled on notice, and a judgment was signed and entered in 2016 barring Gentlecare from seeking reimbursement for claims pertaining to the accident. The main issue decided was whether AIIC had established its defense of collateral estoppel based on the previous determinations, and whether Gentlecare had a full and fair opportunity to litigate the issue in the earlier action. The court held that AIIC failed to establish that it was not obligated to pay first-party benefits to Gentlecare based on the 2014 order, and that the 2016 judgment barred Gentlecare from seeking reimbursement for claims pertaining to the accident. The court affirmed the order granting AIIC's motion for summary judgment.

The court considered that the defendant had moved for summary judgment to dismiss the complaint on the ground that the action was barred under collateral estoppel due to two determinations in the Supreme Court, Kings County. The first determination, from May 13, 2014, stated that the defendant was not obligated to pay first-party benefits based on a staged accident, but did not name the appellant as one of the parties affected. The second determination, from March 8, 2016, resulted in a judgment being settled and entered on August 23, 2016, which barred the appellant from seeking reimbursement for claims pertaining to the accident in question. The main issue decided was whether the defendant established its collateral estoppel defense based on the two determinations from the Supreme Court. The holding was that the defendant had not established that it was not obligated to pay first-party benefits to the appellant based on the May 13, 2014 determination, but that the judgment entered on August 23, 2016 clearly barred the appellant from seeking reimbursement for claims pertaining to the accident in question, so the order granting the defendant's motion for summary judgment was affirmed.

The court considered an action by a provider to recover assigned first-party no-fault benefits. The defendant moved to dismiss the complaint on the ground that the action should have been commenced in New Jersey, where the accident had occurred. The plaintiff opposed this motion on the ground that the defendant had failed to establish where the accident had occurred and cross-moved for summary judgment. The court found that the defendant failed to demonstrate any potential hardship to proposed witnesses if the action is heard in New York and failed to otherwise establish with admissible evidence that "in the interest of substantial justice the action should be heard in another forum". The court also found that the plaintiff failed to demonstrate its entitlement to judgment as a matter of law. The holding of the court was that the branch of defendant's motion seeking to dismiss the complaint on the ground of forum non conveniens should have been denied and the matter was remitted to the Civil Court to determine the remainder of defendant's motion.

The court considered a motion by the defendant to dismiss the complaint on the ground of forum non conveniens, arguing that the action should have been commenced in New Jersey, where the accident had occurred. The defendant relied on a New Jersey police crash investigation report to establish that the accident had occurred in New Jersey and that the plaintiff's assignor lived in Texas. The court held that the police report was inadmissible hearsay and defendant had failed to demonstrate the location of the underlying accident or the assignor's residence. The court found that the Civil Court erred in determining that defendant's evidence had sufficiently demonstrated a lack of significant contacts to New York. The court also held that the plaintiff had failed to demonstrate its prima facie entitlement to summary judgment, as the proof submitted failed to establish that the claim at issue had not been timely denied or that the defendant had issued a timely denial of claim form that was conclusory, vague, or without merit as a matter of law. Therefore, the order was modified to deny the defendant's motion to dismiss the complaint on the ground of forum non conveniens, and the matter was remitted to the Civil Court to determine the remainder of defendant's motion.

The relevant facts considered by the court were that a provider sought to recover assigned first-party no-fault benefits that were settled in April 2008, but which the defendant did not pay. A judgment was subsequently entered on January 30, 2017, and the plaintiff moved to correct the judgment by recalculating the interest. The Civil Court granted the motion but, sua sponte, stayed the accrual of statutory no-fault interest from April 9, 2008 through February 22, 2017. The main issue decided by the court was whether the portion of the order which tolled the accrual of interest was appealable, as it did not address a demand for relief made on notice and was, therefore, sua sponte. The holding of the case was that the portion of the order which tolled the accrual of interest did not address a demand for relief made on notice and was, therefore, sua sponte, and was not appealable as of right, so the appeal was dismissed.

The court considered whether a provider could recover assigned first-party no-fault benefits. The insurance company moved for summary judgment, claiming that it had timely denied the claims and that the amounts sought exceeded the workers' compensation fee schedule. The court found that the insurance company demonstrated it had timely mailed initial and follow-up requests for verification but had not received the requested verification. However, the provider's affidavit was sufficient to give rise to a presumption that the requested verification had been mailed to and received by the insurance company. Therefore, there was a triable issue of fact as to whether the provider provided the requested verification. Additionally, the court found a triable issue of fact regarding the insurance company's fee schedule defense. As a result, the judgment was reversed, the part of the order granting summary judgment to the plaintiff was vacated, and plaintiff's cross motion for summary judgment was denied.

The court considered the fact that the plaintiff, Metro Medical Diagnostics, P.C., as assignee of Miroslaw Bazan, filed a lawsuit to recover assigned first-party no-fault benefits that were settled in July 2010. Defendant, Country Wide Insurance Company, did not pay the settlement amount, and a judgment was subsequently entered on January 31, 2017. Plaintiff then moved to correct the judgment by recalculating the interest, and the Civil Court granted the motion but also stayed the accrual of statutory no-fault interest from July 26, 2010 through February 14, 2017. The main issue decided was whether the portion of the order which tolled the accrual of interest was appealable as of right, and the holding of the court was that it was not appealable as of right because it was sua sponte. Therefore, the court dismissed the appeal.

The court considered a case where Health Value Medical, P.C. was seeking to recover no-fault benefits from Country Wide Insurance Company for claims submitted in 2000, arising from an accident in 1999. The case was settled in 2008, but the defendant did not pay the settlement amount, leading to a judgment being entered in 2017 awarding statutory no-fault interest at a simple rate. Health Value Medical, P.C. moved to have the interest recalculated at a compound rate according to pre-2002 regulations, and the court denied the motion. The main issue was whether the interest should be recalculated at a compound rate based on the former regulations. The holding of the case was that plaintiff's motion to recalculate the interest from a simple rate to a compound rate was granted, as the claims in question were governed by the former regulations providing for compound interest.

The main issue that the court decided in this case was whether statutory no-fault interest in a judgment should be recalculated from a simple rate to a compound rate. This case involved a provider seeking to recover assigned first-party no-fault benefits for claims submitted to the insurance company in January 2001, which arose from an accident in November 2000. The defendant had not paid the settlement amount, and a judgment was entered on January 12, 2017, awarding statutory no-fault interest at a simple rate. The court granted the plaintiff's motion to have the interest recalculated pursuant to the pre-2002 regulations, which required no-fault interest to be calculated at a compound rate. The court affirmed the order, holding that the former regulations providing for compound interest should apply to the claims in question.