No-Fault Case Law
American Chiropractic Care, P.C. v Hereford Ins. Co. (2019 NY Slip Op 51359(U))
August 16, 2019
The relevant facts of the case are that American Chiropractic Care, P.C. was seeking to recover assigned first-party no-fault benefits from Hereford Insurance Company. Hereford Insurance Company had moved for summary judgment dismissing the complaint on the basis that the plaintiff's assignor had failed to appear for independent medical examinations (IMEs). However, the court found that the IME scheduling letter was not sent in a timely manner, and therefore, Hereford Insurance Company was unable to demonstrate its entitlement to summary judgment. The court also found that the plaintiff failed to demonstrate its prima facie entitlement to judgment, as the proof submitted failed to establish that the claims at issue had not been timely denied. As a result, the judgment was reversed, the order granting plaintiff's cross motion for summary judgment was vacated, and plaintiff's cross motion for summary judgment was denied.
Charles Deng Acupuncture, P.C. v Allstate Ins. Co. (2019 NY Slip Op 51358(U))
August 16, 2019
The court considered the fact that the plaintiff had commenced an action to recover first-party no-fault benefits for services provided to its assignor, who was injured in an accident on October 24, 2011. Prior to this action, the defendant had brought a declaratory judgment action in the Supreme Court pertaining to the same accident, and the Supreme Court had granted defendant's motion for summary judgment. The main issue decided was whether the plaintiff's action was barred by the doctrine of res judicata based on the Supreme Court's order. The holding of the court was that the present action was indeed barred under the doctrine of res judicata, as any judgment in favor of the plaintiff in the instant action would destroy or impair rights or interests established by the Supreme Court's order. Therefore, the court affirmed the order granting the defendant's motion for summary judgment.
Lida’s Med. Supply, Inc. v Hereford Ins. Co. (2019 NY Slip Op 51356(U))
August 16, 2019
The main issue in this case was whether Lida's Medical Supply, Inc. was entitled to recover assigned first-party no-fault benefits from Hereford Insurance Co. The court considered the fact that the plaintiff's assignor had failed to appear for duly scheduled independent medical examinations (IMEs) and the timing of the denial of claim forms issued by the defendant. The court held that while the plaintiff's motion for summary judgment should have been denied as the proof submitted failed to establish that the claims had not been timely denied, the defendant's cross motion for summary judgement dismissing the complaint was properly denied as the follow-up IME scheduling letter was not timely. The judgment was reversed, the portion of the order granting the plaintiff's motion for summary judgment was vacated, and plaintiff's motion for summary judgment was denied.
EMC Health Prods., Inc. v Maryland Auto. Ins. Fund (2019 NY Slip Op 51318(U))
August 9, 2019
The court considered an appeal from an order of the Civil Court of the City of New York, Kings County that granted the defendant's motion to consolidate the instant action with two related actions and to dismiss the complaints in all three actions for lack of personal jurisdiction over the defendant. The main issue decided was whether the Civil Court had personal jurisdiction over the defendant in the actions. The holding of the case was that the order was affirmed, with the court finding that the Civil Court lacked personal jurisdiction over the defendant. The court determined that the defendant's motion to consolidate the actions and dismiss the complaints was appropriate based on the lack of personal jurisdiction.
EMC Health Prods., Inc. v Maryland Auto. Ins. Fund (2019 NY Slip Op 51317(U))
August 9, 2019
The court considered the consolidation of three related actions for the purposes of disposition of the motion and the dismissal of the complaints in all three actions, based on the contention that the Civil Court lacked personal jurisdiction over the defendant. The main issue decided was whether the Civil Court had personal jurisdiction over the defendant and if the consolidation and dismissal of the complaints was appropriate. The holding of the case was that for the reasons stated in a related case, the order to consolidate the actions and dismiss the complaints was affirmed.
EMC Health Prods., Inc. v Maryland Auto. Ins. Fund (2019 NY Slip Op 51316(U))
August 9, 2019
The main issue in this case was whether the Civil Court of the City of New York had personal jurisdiction over the defendant, Maryland Automobile Insurance Fund. The defendant had moved to consolidate the present case with two related actions and to dismiss all three complaints on the grounds that the court lacked personal jurisdiction. The court found that the defendant had made a prima facie showing that the Civil Court lacked personal jurisdiction, and the burden shifted to the plaintiff to establish that it had acquired jurisdiction. Plaintiff failed to meet this burden, as their opposition papers consisted only of their counsel's affirmation, who had no personal knowledge of the underlying facts and failed to produce evidence showing a jurisdictional basis for the service. As a result, the court affirmed the order to consolidate the actions and dismiss the complaint in the present case.
TAM Med. Supply Corp. v Kemper Ins. Co. (2019 NY Slip Op 51314(U))
August 9, 2019
The court considered the fact that plaintiff Tam Medical Supply Corp. sought to recover first-party no-fault benefits for supplies provided to its assignor following a motor vehicle accident. The defendant insurer, Kemper, had initiated a declaratory judgment action in the Supreme Court, Bronx County, seeking a declaration that it had no obligation to pay any pending or future claims for no-fault benefits arising from the accident. The Supreme Court granted Kemper's motion for summary judgment, finding that it was not obligated to pay the claims pertaining to the accident. Subsequently, Tam moved in the Civil Court for summary judgment and Kemper cross-moved to dismiss the complaint, which the Civil Court granted. The main issue decided was whether the Civil Court's decision to deny Tam's motion for summary judgment and grant Kemper's cross motion to dismiss the complaint was correct, and the court held that it was and affirmed the judgment.
TAM Med. Supply Corp. v Kemper Ins. Co. (2019 NY Slip Op 51313(U))
August 9, 2019
The case involved a dispute over the payment of no-fault benefits for medical supplies provided to an individual injured in a motor vehicle accident. The defendant insurer, Kemper, had sought a declaration in a separate action that they were not obligated to pay for any claims for benefits stemming from the accident, which was granted by the Supreme Court. The plaintiff, TAM Medical Supply Corp., then moved in the Civil Court for summary judgment, while Kemper cross-moved to dismiss the complaint on the basis that the Supreme Court's order granted them summary judgment. The Civil Court denied TAM's motion and granted Kemper's cross motion, leading to the dismissal of the complaint. The Appellate Term affirmed the judgment, holding that TAM's action in the Civil Court was barred by the doctrine of res judicata due to the findings of fact and determination of the merits made by the Supreme Court in granting summary judgment to Kemper.
Bronx Acupuncture Therapy, P.C. v Hereford Ins. Co. (2019 NY Slip Op 06059)
August 7, 2019
The relevant facts of the case were that Bronx Acupuncture Therapy, P.C. commenced an action in Civil Court to recover $727.36 from Hereford Ins. Co. for unpaid healthcare services rendered to Dulce Baez. Hereford had denied payment due to lack of information submitted about the nature, extent, and need of the service. The main issue of the case was whether Hereford was right to have denied the payment based on lack of sufficient information. In a unanimous decision, the court held that Hereford's denial of payment was without merit as a matter of law. An unlisted modality like moxibustion must be justified by report, but the insurer has the burden of requesting additional verification first, which Hereford had failed to do. Therefore, summary judgment in favor of Bronx Acupuncture Therapy, P.C. was proper.
Lida’s Med. Supply, Inc. v Park Ins. Co. (2019 NY Slip Op 51282(U))
August 2, 2019
The court considered the case of Lida's Medical Supply, Inc. as the assignee of George Cortwright, who was seeking to recover first-party no-fault benefits from Park Insurance Company. The main issue decided was whether the defendant's motion for summary judgment, which sought to dismiss the complaint on the grounds that Cortwright had failed to appear for scheduled independent medical examinations, should be granted. The court held that for the same reasons stated in another case, Alleviation Med. Servs., P.C., as Assignee of Hill, Laquan v. Citiwide Auto Leasing, the defendant's motion for summary judgment should be granted. Therefore, the court reversed the order that denied the defendant's motion and granted summary judgment in favor of the defendant.