No-Fault Case Law

The main issues in this case were whether the action by the provider to recover assigned first-party no-fault benefits should be held in abeyance pending a determination by the Workers' Compensation Board of the parties' rights under the Workers' Compensation Law, and whether there is an issue of fact as to whether the plaintiff's assignor had been acting in the course of his employment at the time of the accident and that, therefore, workers' compensation benefits might be available. The Civil Court of the City of New York, Kings County granted the branch of defendant's cross motion seeking to hold the action in abeyance. The court determined that the issue of eligibility for workers' compensation benefits must be resolved in the first instance by the Workers' Compensation Board before the court considers whether the plaintiff is entitled to recover first-party no-fault benefits. Therefore, the order was affirmed.

The relevant facts of the case involve a dispute between Global Liberty Insurance Company and Medco Tech, Inc. regarding a claim for no-fault insurance benefits for medical equipment provided to an individual involved in a motor vehicle accident. Global Liberty Insurance Company relied on a peer review report that concluded the individual's condition was degenerative and not post-traumatic, and therefore the surgery undergone was not medically necessary in relation to the accident. The main issue decided by the court was whether the need for the medical equipment was causally related to the accident. The holding of the court was that the arbitral award must be vacated and a de novo hearing held because, based on the record before them, it would be irrational to conclude that the need for the medical equipment was causally related to the accident. Therefore, the court reversed the judgment against Global Liberty Insurance Company and granted their motion to vacate the award, while denying Medco Tech, Inc.'s motion to confirm the award.

The court considered the facts of the case, including the claimant failing to appear for scheduled independent medical examinations (IME) and the denial of the claim based on those missed appointments. The main issue decided was whether the defendant had established a prima facie case as to the mailing of the denial forms and setting the matter down for a hearing on the issue of IME no show. The holding of the case was that the defendant's motion for summary judgment and motion to dismiss were denied, as the defendant failed to establish that it was entitled to summary judgment, and the documentary evidence submitted by the defendant did not conclusively establish a defense as a matter of law. Additionally, the court found that the plaintiff had adequately pled causes of action pursuant to New York's no-fault regulations, and the court was not bound by an arbitration award against a different plaintiff in a separate matter.

The main facts of this case involve a medical rehabilitation center, Queens-Roosevelt Medical Rehabilitation P.C., seeking to recover first-party no-fault benefits from Response Insurance Company. The insurance company filed a motion to strike the complaint and dismiss the action, but the Civil Court denied the motion. The issue decided by the Appellate Term was whether the complaint should be struck and the action dismissed pursuant to CPLR 3126. The holding of the court was that the order of the Civil Court was reversed, and the insurance company's motion to strike the complaint and dismiss the action was granted. This decision was made based on the reasoning and holding of a related case, Queens-Roosevelt Med. Rehabilitation, P.C., as Assignee of Maria Rodriguez v Response Ins. Co.

The court considered the denial of defendant's motion to strike the complaint and dismiss the action pursuant to CPLR 3126 in an action by a provider to recover assigned first-party no-fault benefits. The main issue was whether the denial of the defendant's motion was proper. The court held that the denial was not proper and reversed the order, granting the defendant's motion to strike the complaint and dismiss the action pursuant to CPLR 3126. The decision was based on the reasons stated in another case, Queens-Roosevelt Med. Rehabilitation, P.C., as Assignee of Maria Rodriguez v Response Ins. Co., decided herewith. The decision was concurred by P.J. Pesce, Weston, and Aliotta, JJ.

The main issue in this case was whether the Civil Court properly denied defendant's motion to strike the complaint and dismiss the action pursuant to CPLR 3126 in an action by a provider to recover assigned first-party no-fault benefits. The relevant facts considered by the court were not explicitly stated in the provided text. The holding of the case was that the order denying defendant's motion was reversed, and defendant's motion to strike the complaint and dismiss the action pursuant to CPLR 3126 was granted. The decision was made by the Appellate Term, Second Department, and the case was decided on March 8, 2019.

The relevant facts considered by the court were that Queens-Roosevelt Medical Rehabilitation, P.C. was seeking to recover assigned first-party no-fault benefits from Response Insurance Company. The main issue decided by the court was whether the lower court erred in denying the defendant's motion to strike the complaint and dismiss the action pursuant to CPLR 3126. The holding of the case was that the order of the Civil Court denying the defendant's motion was reversed, and the defendant's motion to strike the complaint and dismiss the action pursuant to CPLR 3126 was granted. This decision was made for the reasons stated in another related case, Queens-Roosevelt Med. Rehabilitation, P.C., as Assignee of Maria Rodriguez v Response Ins. Co. The judges presiding over the case all concurred with this decision.

The main issue in the case was whether the plaintiff had failed to comply with discovery demands and whether the actions of the plaintiff's owner, Dr. John McGee, constituted a violation of state licensing requirements. The court considered the facts that the plaintiff had refused to answer certain questions during a deposition, that certain claims had already been dismissed based on noncompliance with discovery, and that Dr. McGee had already been deposed twice. The court held that the questions at issue were material and necessary to the defense of the action, and that the plaintiff's refusal to answer the questions may be presumed to be willful and contumacious. As a result, the court reversed the lower court's decision and granted the defendant's motion to strike the complaint and dismiss the action pursuant to CPLR 3126.

The relevant facts of the case included a provider seeking to recover first-party no-fault benefits for services rendered to an assignor. The defendant sought to amend its answer to assert the affirmative defense of collateral estoppel and for summary judgment dismissing the complaint, based on an arbitrator's decision in April 2014 that found the plaintiff was not eligible to recover benefits because it was not a licensed professional medical corporation in the State of New York. The main issues decided were whether the defendant should be granted leave to amend its answer and whether summary judgment should be granted based on the doctrine of collateral estoppel. The court ultimately affirmed the order, determining that the plaintiff had not demonstrated prejudice or surprise as a result of the proposed amendment to the answer and had presented no basis to disturb the branch of defendant's motion seeking summary judgment dismissing the complaint based on collateral estoppel. The holding of the case was that the defendant was granted leave to amend its answer and summary judgment was granted based on the doctrine of collateral estoppel, resulting in the affirmation of the order by the court.

The main issue in this case is whether the provider's action to recover assigned first-party no-fault benefits was premature because the plaintiff had failed to provide requested verification. The court considered the fact that the defendant had appealed from an order of the Civil Court that denied the branch of the defendant's motion seeking summary judgment dismissing the complaint. The court decided that the branch of the defendant's motion seeking summary judgment dismissing the complaint should be granted. The holding of this case is that the order, insofar as appealed from, is reversed, and the branch of defendant's motion seeking summary judgment dismissing the complaint is granted.