No-Fault Case Law

The main issue in this case was whether the Civil Court properly granted defendant's motion to vacate a judgment entered upon their failure to appear or answer the complaint, and to compel the plaintiff to accept defendant's late answer. The court considered the reasons stated in a similar case and affirmed the order, holding that the judgment was properly vacated and the plaintiff was compelled to accept the defendant's late answer. The relevant facts considered by the court were not explicitly mentioned in the summary, but it can be inferred that the plaintiff had initially been granted a judgment upon the defendant's failure to respond, and the defendant later sought to vacate this judgment and submit a late answer. Ultimately, the court held in favor of the defendant, granting their motion and compelling the plaintiff to accept their late answer.

The Court considered the case of Prompt Medical Supply, Inc. as the assignee of Gladstone Lawrence against State Farm Mutual Auto Ins. Co. The main issue decided was whether the defendant had established a reasonable excuse for not timely answering the complaint and the existence of a potentially meritorious defense to the action. The holding was that the Civil Court did not improvidently exercise its discretion in finding that the defendant had established a reasonable excuse for not timely answering the complaint, as the defendant had reasonably believed that the plaintiff might withdraw the action and had failed to provide requested verification. Therefore, the order was affirmed.

The court considered an appeal from an order of the Civil Court in Kings County denying the defendant's motion to dismiss the complaint on the ground that the court lacked personal jurisdiction over the defendant in a case involving a provider seeking to recover assigned first-party no-fault benefits. The main issue decided was whether the Civil Court had personal jurisdiction over the defendant, American Independent Insurance Co., in the case. The holding of the court was 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 based on the reasons outlined in Pavlova v American Ind. Ins. Co. and previous relevant cases. Therefore, the defendant's motion to dismiss the complaint was ultimately granted.

The court considered the motion to dismiss the complaint pursuant to CPLR 3216 in the case of Pro Health Acupuncture, P.C. v GEICO Insurance. Plaintiff commenced the action to recover assigned first-party no-fault benefits on May 10, 2011, and defendant served a 90-day written demand pursuant to CPLR 3216, which plaintiff failed to respond to or explain the delay. Despite serving a notice of trial and opposing the motion, the court held that plaintiff failed to establish a justifiable excuse for its delay and the existence of a meritorious cause of action, and therefore, the motion to dismiss the complaint was granted. The holding of the case was the reversal of the order, with the decision that defendant's motion to dismiss the complaint pursuant to CPLR 3216 is granted.

The main issue decided in this case was whether the defendant, Metropolitan Group Prop. & Cas. Ins, was entitled to summary judgment based on the plaintiff's alleged failure to appear for an Examination Under Oath (EUO) in an action to recover assigned first-party no-fault insurance benefits. The court found that while the plaintiff did not attend the scheduled EUOs, the defendant failed to establish through admissible evidence that the EUO scheduling letters and denials were properly addressed and mailed to the plaintiff. The court concluded that the defendant did not fulfill the requirements of CPLR 4518(a) and failed to eliminate all triable issues of fact in connection with establishing its proper mailing of the EUO scheduling letters and denials. As a result, the defendant's motion for summary judgment was denied.

The court considered an order from the District Court of Suffolk County which denied the defendant's motion to dismiss 17 of 21 claims for first-party no-fault benefits, and granted the plaintiff's cross motion for summary judgment. The main issue decided was whether the letters scheduling examinations under oath (EUOs) of the plaintiff were defective. The court held that the EUO scheduling letters were not defective, as they properly identified the assignor, the date of the accident, and the defendant's file number. The court also found that the defendant had timely mailed denial of claim forms and that the plaintiff had failed to appear for the scheduled EUOs. As a result, the court modified the order to grant the defendant's motion to dismiss 17 of the claims and denied the plaintiff's cross motion for summary judgment on those 17 claims.

The court considered the no-fault benefits claim for medical expenses filed by the plaintiff after being struck by a motor vehicle owned by George W. Nellen, whose insurance carrier was the defendant. The defendant denied the plaintiff's application for benefits on the grounds that the injuries were not related to the motor vehicle accident. The defendant moved to dismiss the complaint on the basis that the plaintiff had assigned his right to receive no-fault benefits to various medical providers and thus had no standing to bring the action. The main issue decided was whether the defendant was entitled to summary judgment dismissing the complaint, and the court held that the defendant was entitled to judgment as a matter of law because the plaintiff failed to raise a triable issue of fact. Therefore, the court reversed the order denying the defendant's motion and granted the motion for summary judgment dismissing the complaint.

The relevant facts in the case involved a no-fault insurance carrier commencing an action seeking a judgment declaring it was not obligated to pay a claim for no-fault insurance benefits submitted by the defendant on behalf of its assignor John Thomas. The defendant had been awarded more than $5,000 against the plaintiff as a result of a master arbitration award. The plaintiff moved for leave to enter a default judgment against the defendant based upon the defendant's failure to answer the complaint or appear in this action. The Supreme Court denied the plaintiff's motion on the basis that the master arbitration award was supported by evidence in the record and was not arbitrary or capricious. The main issue decided was whether the plaintiff's motion for leave to enter a default judgment against the defendant should have been granted, and whether a judgment should be declared that the plaintiff is not obligated to pay a claim for no-fault insurance benefits submitted by the defendant on behalf of its assignor John Thomas. The holding of the court was that the plaintiff's motion for leave to enter a default judgment against the defendant should have been granted, and since it was a declaratory judgment action, the matter must be remitted to the Supreme Court for the entry of a judgment declaring that the plaintiff is not obligated to pay a claim for no-fault insurance benefits submitted by the defendant on behalf of its assignor John Thomas.

The main issue in this case was whether the plaintiff, RX Warehouse Pharmacy Inc., was entitled to recover assigned first-party no-fault benefits for breach of contract from the defendant, Erie Insurance Exchange. The court considered the defendant's motion to dismiss the action on the grounds of failure to join a necessary party, specifically the insurance carrier for the plaintiff's assignor, Mikhail Soldatov. The defendant argued that it was not the insurer of Soldatov's vehicle and therefore had no duty to provide him with no-fault coverage. The plaintiff, however, claimed that the court lacked subject matter jurisdiction to hear the defense that another insurance carrier was responsible for the plaintiff's claims and argued that the issue must be resolved through arbitration. The court ultimately found in favor of the defendant, granting their motion to interpose an answer within 30 days due to the lack of evidence that Soldatov was an "eligible injured person" under defendant's policy.

The court considered the fact that the provider was seeking to recover assigned first-party no-fault benefits in the amount of $342.01. The main issue decided was whether the defendant had established the proper mailing of the independent medical examination (IME) scheduling letters and whether the plaintiff's assignor had failed to appear for the IMEs. The holding of the court was that the proof submitted by the defendant was sufficient to establish the proper mailing of the IME scheduling letters and that the plaintiff's assignor had failed to appear for the IMEs. The court also found that there was an issue of fact as to whether the defendant had received the claim seeking reimbursement in the amount of $342.01, and as a result, neither party was entitled to summary judgment upon that claim. Therefore, the court modified the order by denying the branch of the defendant's motion seeking summary judgment dismissing the claim in the amount of $342.01.