No-Fault Case Law

New Horizon Surgical Ctr., L.L.C. v Travelers Ins. (2019 NY Slip Op 50282(U))

The main issues that were decided in this case were whether the defendant's motion seeking summary judgment dismissing the complaint should be granted, and whether the action was premature due to the plaintiff's alleged failure to provide requested verification. The court considered the fact that the action was brought by a provider to recover assigned first-party no-fault benefits. The holding of the case was that the order, insofar as appealed from, was reversed and the branch of defendant's motion seeking summary judgment dismissing the complaint was granted. The court reversed the denial of the branch of defendant's motion and granted summary judgment dismissing the complaint.
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New Horizon Surgical Ctr., L.L.C. v Travelers Ins. (2019 NY Slip Op 50281(U))

The main issues in the case were whether the plaintiff had provided all requested verification in an action to recover assigned first-party no-fault benefits, and whether the action was premature due to the failure to provide requested verification. The court considered the fact that the defendant had timely mailed initial and follow-up verification requests, and that the plaintiff submitted an affidavit stating that all verification requested was provided. However, plaintiff failed to provide a signed informed consent form executed by the assignor, as requested by the defendant. The holding of the court was that the plaintiff failed to raise an issue of fact as to whether it had provided all of the requested verification, and therefore the branch of defendant's motion seeking summary judgment dismissing the complaint was granted.
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New York Infinity Health Care, LCSW, P.C. v Global Liberty Ins. Co. of N.Y. (2019 NY Slip Op 50278(U))

The court considered an appeal from an order denying the defendant's motion to sever the first cause of action seeking to recover upon a claim for services rendered to Shavkat Djalilov from the remaining causes of action in an action by a provider to recover assigned first-party no-fault benefits. The main issue was whether the defendant's motion to sever the first cause of action should be granted pursuant to CPLR 603. The court held that the order denying the defendant's motion to sever was affirmed, with the reasoning to be provided in a separate case. The main holding of the case was that the defendant's motion to sever the first cause of action was properly denied.
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Unique Physical Rehab, PT, P.C. v Global Liberty Ins. Co. of N.Y. (2019 NY Slip Op 50277(U))

The court considered the motion to sever the first cause of action seeking to recover upon a claim for services rendered to Victor Agnest from the remaining causes of action in an action by a provider to recover assigned first-party no-fault benefits. The main issue was whether the defendant's motion to sever the first cause of action should be granted. The court held that the order, insofar as appealed from, is affirmed and denied the defendant's motion to sever the first cause of action seeking to recover upon a claim for services rendered to Victor Agnest from the remaining causes of action. The decision was based on the reasons stated in a similar case, Himalayans Acupuncture, P.C., as Assignee of Davron Khuseynov, et al. v Global Liberty Ins. Co. of NY.
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Himalayans Acupuncture, P.C. v Global Liberty Ins. Co. of N.Y. (2019 NY Slip Op 50276(U))

The court considered an appeal from an order of the Civil Court of the City of New York, Kings County that denied the defendant's motion to sever the first cause of action seeking to recover upon a claim for services rendered to Davron Khuseynov from the remaining causes of action. The main issue decided was whether the causes of action arising from two different accidents and the multiple defenses interposed in the answer justified severance under CPLR 603. The court held that the decision to grant severance is an exercise of judicial discretion and should not be disturbed on appeal in the absence of a party showing prejudice to a substantial right. The court determined that the assignors being injured in separate accidents and the interposition of 48 defenses did not demonstrate that resolution of the claims for services rendered to each assignor would involve different questions of law and fact, affirming the denial of the defendant's motion.
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Parisien v 21st Century Ins. Co. (2019 NY Slip Op 50275(U))

The court considered the facts of a case where a provider was seeking first-party no-fault benefits and had moved for summary judgment, while the defendant cross-moved for summary judgment dismissing the complaint. The main issues decided were the denial of the claim based on the defendant not receiving the underlying claim form, the payment being made in accordance with the workers' compensation fee schedule, and the provider failing to appear for examinations under oath. The holding of the court was that the summary judgment for the denial of the second and fifth causes of action was denied, as there was a triable issue of fact as to whether the claim form was timely mailed, and the follow-up scheduling letters for the examinations under oath were untimely. Additionally, the proof submitted in support of the motion failed to establish that the claim had not been timely denied or that the denial issued by the defendant was conclusory, vague, or without merit as a matter of law. As a result, the branches of the cross motion seeking summary judgment dismissing the second and fifth causes of action were denied.
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Fu-Qi Acupuncture, P.C. v Travelers Ins. Co. (2019 NY Slip Op 50273(U))

The relevant facts of the case involved Fu-Qi Acupuncture, P.C. suing Travelers Insurance Company to recover assigned no-fault benefits. Travelers Insurance Company served an answer in January 2015, accompanied by a notice to take deposition, and in February 2015, Fu-Qi Acupuncture, P.C. served a notice of trial and certificate of readiness. The main issue decided was whether Fu-Qi Acupuncture, P.C. had completed discovery, as represented in the certificate of readiness. The holding of the court was that the notice of trial and certificate of readiness should have been vacated, as Fu-Qi Acupuncture, P.C. had not completed discovery, despite the representation made in the certificate of readiness, and therefore, Travelers Insurance Company's motion to vacate the notice of trial and certificate of readiness was granted.
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Fu-Qi Acupuncture, P.C. v Travelers Ins. Co. (2019 NY Slip Op 50272(U))

The court considered a motion to vacate a notice of trial and certificate of readiness in a first-party no-fault benefits case. The main issue decided was whether the defendant's motion to vacate the notice of trial and certificate of readiness should be granted. The court held that, for the same reasons stated in a related case (Fu-Qi Acupuncture, P.C., as Assignee of Gomez, Osiris v Travelers Ins. Co.), the order is reversed and defendant's motion to vacate the notice of trial and certificate of readiness is granted. Therefore, the order denying defendant's motion was reversed and the defendant's motion to vacate the notice of trial and certificate of readiness was granted.
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Gordon v Geico Ins. Co. (2019 NY Slip Op 29072)

The court considered the fact that defendant Geico Insurance Company failed to appear for a conference, leading the court to dismiss the plaintiff's complaint for failure to meet the burden of proof. The main issue decided in the case was whether the plaintiff met the burden of proof in the absence of the defendant at the conference. The court held that the plaintiff did not meet the burden of proof and dismissed the complaint.
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Sheepshead Bay Oral Surgery, PLLC v Unitrin Direct Ins. Co. (2019 NY Slip Op 51058(U))

The relevant facts considered by the court were that the plaintiff, a provider, was seeking to recover first-party no-fault benefits as the assignee of Joiliette Davis, and the defendant, an insurance company, moved to dismiss the complaint. The main issue decided was whether the action was timely, as the six-year statute of limitations for contract actions was applicable, and the cause of action accrued 30 days after the insurer's receipt of the claim. The holding of the court was that the action was not timely, as the defendant established that it received all of the claim forms at issue no later than June 6, 2008, and the action was commenced over six years later. As a result, the defendant's motion to dismiss the complaint was granted.
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