No-Fault Case Law

The main issue in this case was whether the defendant's motion for summary judgment to dismiss the complaint should be granted. The court considered the fact that the plaintiff, as an assignee of a provider, was seeking to recover first-party no-fault benefits, and that the defendant had appealed from an order of the Civil Court denying its motion which had sought summary judgment on the ground that the plaintiff's assignor had failed to appear for scheduled independent medical examinations. The court ultimately held that the defendant's motion for summary judgment should be granted, reversing the lower court's decision and ruling in favor of the defendant. Therefore, the complaint was dismissed in favor of the defendant.

The relevant facts considered by the court included a provider seeking to recover first-party no-fault benefits and an order of the Civil Court granting the defendant's motion for summary judgment dismissing the complaint. The main issue decided in the case was whether the insured vehicle had been involved in the alleged accident in question. The holding of the case was that the order granting defendant's motion for summary judgment was affirmed, as the court found that the insured vehicle had not been involved in the accident, and denied the plaintiff's cross motion for summary judgment.

The court considered an appeal from an order of the Civil Court that denied the defendant's cross motion for summary judgment dismissing the complaint. The main issue decided was whether the plaintiff had failed to appear for duly scheduled examinations under oath and if this constituted grounds for dismissing the complaint. The holding of the court was that the order denying the defendant's motion was reversed, and the defendant's cross motion for summary judgment dismissing the complaint was granted. This decision was based on the reasoning provided in a similar case, Right Aid Med. Supply Corp., as Assignee of Kusi Comfort v Ameriprise Auto & Home. The appellate court judges all concurred with this decision.

The court considered whether additional verification requested by the insurance company remained outstanding. The main issue in the trial was whether the requested verification that was mailed to the plaintiff remained outstanding. The judgment was reversed and the matter was remitted to the Civil Court for a new trial on the issue of whether the requested verification remains outstanding. The court specifically stated that the requests were mailed, and the finding that they were timely mailed was implicit in the court's order. So, the main legal issue in this case was whether the requested verification remained outstanding, and the holding of the court was that the matter needed to be remitted to the Civil Court for a new trial to address this issue.

The court considered the fact that the defendant's motion for summary judgment dismissing the complaint was granted on the grounds that the plaintiff's assignor had failed to appear for scheduled examinations under oath (EUOs) and that the plaintiff's cross motion for summary judgment was denied. The main issue decided was whether the defendant had established that its time to pay or deny the claims at issue was tolled, and whether the delay letters submitted were sufficient to toll the defendant's time to pay or deny the claims. The holding of the case was that the order granting the defendant's motion for summary judgment was affirmed, as the plaintiff's contention that the defendant failed to established that its time to pay or deny the claims was tolled was found to lack merit and the remaining contention was not properly before the court. Ultimately, the court held that the plaintiff failed to establish the defendant's time to pay or deny the claims was tolled, and as such, the order granting the defendant's motion for summary judgment was affirmed.

The court considered whether a provider could recover first-party no-fault benefits when the assignor failed to appear for duly scheduled examinations under oath. The main issue was whether the provider, Nica Acupuncture, P.C., could recover assigned first-party no-fault benefits after its assignor, Maxim Savelyev, failed to appear for scheduled examinations under oath. The court held that the provider could not recover the benefits and affirmed the lower court's order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion for summary judgment. The court's decision was based on the same reasoning as another case, Ocean One Physical Therapy, P.C. v 21st Century Centennial Ins. Co., which was decided at the same time.

The court considered the fact that NL Quality Medical, P.C. was seeking to recover assigned first-party no-fault benefits and that the complaint was dismissed on the grounds that the assignor had failed to appear for scheduled examinations under oath. The main issue decided was whether the provider could recover assigned first-party no-fault benefits when the assignor failed to appear for scheduled examinations under oath. The holding of the court was that the order granting the defendant's motion for summary judgment and dismissing the complaint was affirmed, and the plaintiff's cross-motion for summary judgment was denied. The court's decision was based on the reasoning stated in a similar case, Ocean One Physical Therapy, P.C., as Assignee of Maxim Savelyev v 21st Century Centennial Ins. Co., and the decision was made by P.J. Pesce, and Judges Weston and Aliotta.

The court considered a case where SS Medical Care, P.C. sued 21st Century Insurance Company to recover assigned first-party no-fault benefits for medical services provided after a motor vehicle accident. SS Medical had been granted summary judgment after 21st Century failed to oppose their motion, and a judgment was entered. 21st Century then filed a declaratory judgment action in Supreme Court against SS Medical and its assignor regarding the accident. 21st Century later moved in civil court to vacate the judgment and dismiss the complaint, stating they had been in the process of filing the declaratory judgment action at the time of their default. The main issue was whether a reasonable excuse was present for 21st Century's default in opposing SS Medical's motion for summary judgment. The court held that the excuse provided by 21st Century was not reasonable and, therefore, denied their motion.

The relevant facts considered by the court were that SS Medical Care, P.C. had sought to recover first-party no-fault benefits for medical services provided due to a motor vehicle accident, and had been granted summary judgment due to the lack of opposition from 21st Century Insurance Company. 21st Century subsequently commenced a declaratory judgment action in the Supreme Court, which later granted its motion to temporarily stay any lawsuits against 21st Century regarding the health care services in question. 21st Century then moved to stay the execution of the judgment in favor of SS Medical, vacate the judgment, and dismiss the complaint, claiming it had been in the process of filing the declaratory judgment action at the time of the original summary judgment. The main issue decided was whether 21st Century had a reasonable excuse for its default in opposing the original motion for summary judgment, and whether the judgment was valid in light of the subsequent declaratory judgment. The court held that 21st Century's excuse was insufficient, and the judgment in favor of SS Medical was valid.

The relevant facts considered by the court were that the plaintiff, Sure Way NY, Inc., had filed a lawsuit seeking to recover assigned first-party no-fault benefits from the defendant, Travelers Insurance Company. The defendant had filed a motion for summary judgment to dismiss the complaint on the grounds that the plaintiff had failed to appear for duly scheduled examinations under oath. The main issue decided by the court was whether the defendant was entitled to summary judgment based on the plaintiff's failure to appear for scheduled exams. The holding of the court was that the order granting the defendant's motion for summary judgment was reversed, and the defendant's motion was denied, with the plaintiff being awarded costs of $30. The court's decision was based on the reasoning stated in a related case, Zen Acupuncture, P.C., as Assignee of Figueroa Lizzette v Ameriprise Ins. Co.