No-Fault Case Law
Active Care Med. Supply Corp. v American Tr. Ins. Co. (2019 NY Slip Op 50751(U))
May 10, 2019
The case involved an appeal from a denial of a motion for summary judgment by a provider seeking to recover first-party no-fault benefits, as well as a granting of the defendant's cross-motion for summary judgment dismissing the complaint. The court considered the reasons stated in a similar case, Active Care Med. Supply Corp., as Assignee of Wilson, Andrae v American Tr. Ins. Co., and affirmed the order. The main issue was whether the provider was entitled to recover assigned first-party no-fault benefits, and the holding of the court was that the denial of the motion for summary judgment and granting of the defendant's cross-motion for summary judgment was affirmed.
Blackman v Allstate Ins. Co. (2019 NY Slip Op 50750(U))
May 10, 2019
The relevant facts the court considered in this case were that Noel E. Blackman, M.D., as Assignee of Levent, Emek, appealed the denial of his motion for summary judgment and the grant of defendant Allstate Insurance Company's cross motion for summary judgment dismissing the complaint. The main issue decided was whether the provider should recover assigned first-party no-fault benefits, and the holding was that the order was modified to deny defendant's cross motion for summary judgment dismissing the complaint. The court cited a similar case in its decision, Metro Psychological Servs., P.C., as Assignee of Adams Kenneth v Allstate Ins. Co., and ultimately upheld the denial of the defendant's cross motion for summary judgment.
Solution Bridge, Inc. v State Farm Mut. Auto. Ins. Co. (2019 NY Slip Op 50749(U))
May 10, 2019
The relevant facts in this case involved an action brought by a provider to recover assigned first-party no-fault benefits. The appellant, Solution Bridge, Inc., appealed an order of the Civil Court that granted the branch of the defendant's motion seeking summary judgment dismissing the second cause of action. The main issue decided was whether there was a triable issue of fact as to whether the verification had been provided by the appellant, as the affidavit submitted in opposition to defendant's motion was deemed sufficient to give rise to a presumption that the requested verification had been mailed to, and received by, defendant. The holding of the court was that the order, insofar as appealed from, was reversed and the branch of the defendant's motion seeking summary judgment dismissing the second cause of action was denied.
Metro Psychological Servs., P.C. v Allstate Ins. Co. (2019 NY Slip Op 50748(U))
May 10, 2019
The court considered a case in which a provider was seeking to recover assigned first-party no-fault benefits from an insurance company. The main issue decided was whether the insurance company's motion for summary judgment dismissing the complaint should be granted, and whether the provider's cross motion for summary judgment should be denied. The court held that the insurance company's motion for summary judgment dismissing the complaint should be denied, as the company failed to establish that the denial of claim forms had been timely mailed. However, the court also held that the provider's cross motion for summary judgment should be denied, as the provider failed to establish that the claims at issue had not been timely denied, or that the insurance company had issued timely denials of claim that were conclusory, vague or without merit as a matter of law.
Active Care Med. Supply Corp. v American Tr. Ins. Co. (2019 NY Slip Op 50747(U))
May 10, 2019
The court considered an appeal from an order of the Civil Court of New York denying the provider's motion for summary judgment seeking to recover assigned first-party no-fault benefits. The court also granted the defendant's cross motion for summary judgment seeking to dismiss that cause of action. The main issue decided was whether the plaintiff was entitled to summary judgment to recover no-fault benefits, and if the defendant was entitled to summary judgment dismissing the cause of action. 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. Therefore, the plaintiff was not entitled to recover assigned first-party no-fault benefits and the defendant was entitled to dismiss the cause of action.
Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2019 NY Slip Op 50746(U))
May 10, 2019
The main issue in the case was whether the provider was entitled to recover assigned first-party no-fault benefits from the insurance company. The court considered the denial of the plaintiff's motion for summary judgment and the granting of the defendant's cross motion for summary judgment. The court affirmed the lower court's decision to deny the plaintiff's motion and grant the defendant's cross motion, dismissing the complaint. The holding of the case was that the insurance company was not obligated to provide no-fault benefits to the provider, and therefore the lower court's decision was affirmed.
Parisien v Allstate Ins. Co. (2019 NY Slip Op 50745(U))
May 10, 2019
The court considered the denial of the defendant's motion for summary judgment in a case brought by a medical provider to recover assigned first-party no-fault benefits. The main issue decided was whether the defendant's motion for summary judgment should be granted or denied. The holding of the case was that the order denying the defendant's motion for summary judgment was affirmed, with the court concurring. The specific reasons for the decision were not provided in the summary.
Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2019 NY Slip Op 50744(U))
May 10, 2019
The case involved a dispute between Gentlecare Ambulatory Anesthesia Services and GEICO Insurance Company regarding the failure of Gentlecare to appear for scheduled examinations under oath (EUOs) as part of a claim for first-party no-fault benefits. The Civil Court denied Gentlecare's motion for summary judgment and granted GEICO's cross-motion for summary judgment dismissing the complaint. The main issue decided was whether GEICO's proof was sufficient to demonstrate that Gentlecare had failed to appear for the EUOs and whether GEICO was required to set forth objective reasons for requesting the EUOs. The court held that the proof submitted by GEICO was sufficient to establish that Gentlecare had failed to appear for the EUOs and that GEICO was not required to set forth objective reasons for requesting the EUOs in order to establish its entitlement to summary judgment. As a result, the court affirmed the order, with $25 costs.
BQE Acupuncture, P.C. v GEICO Ins. Co. (2019 NY Slip Op 50743(U))
May 10, 2019
The main issue in this case was whether the defendant, GEICO Ins. Co., had properly used the workers' compensation fee schedule applicable to chiropractors to reimburse the plaintiff, BQE Acupuncture, P.C., for the acupuncture services it had rendered. The court considered the evidence presented by both parties and determined that the defendant had fully paid the plaintiff for the services at issue in accordance with the workers' compensation fee schedule for acupuncture services performed by chiropractors. The court found that the defendant had established its entitlement to judgment as a matter of law and granted the defendant's motion for summary judgment, dismissing the complaint. The court also noted that one of the plaintiff's contentions was not properly before the court as it was being raised for the first time on appeal and declined to consider it. Therefore, the court affirmed the order in favor of the defendant, GEICO Ins. Co.
Active Care Med. Supply Corp. v American Tr. Ins. Co. (2019 NY Slip Op 50742(U))
May 10, 2019
The relevant facts considered by the court were that Active Care Medical Supply Corp. was seeking to recover assigned first-party no-fault benefits from American Transit Insurance Company. American Transit had mailed examination under oath (EUO) scheduling letters to Active Care, but Active Care failed to appear for the scheduled EUOs. American Transit was granted summary judgment dismissing the first and third causes of action by the Civil Court. The main issue decided was whether American Transit had established that the EUO scheduling letters had been timely mailed and whether Active Care had failed to appear for the scheduled EUOs. The holding of the case was that the court affirmed the order granting American Transit's motion, as they had shown that the EUO scheduling letters were timely mailed and that Active Care had failed to appear for the scheduled EUOs.