No-Fault Case Law

The relevant facts the court considered were that Lotus Acupuncture, P.C. brought an action to recover first-party no-fault benefits and was awarded the principal sum of $4,915 after a nonjury trial. The main issue decided was whether the judgment in favor of the plaintiff should be reversed, as no testimony was taken in this action and a new trial should be held. The holding of the case was that the judgment was reversed and the matter was remitted to the Civil Court for a new trial, as no testimony was taken as to this action and a new trial should be held.

The relevant facts considered by the court in this case were that Healthy Way Acupuncture, P.C. was seeking to recover first-party no-fault benefits as the assignee of Nieves Jason. The case involved seven claims, totaling $6,940, and was consolidated for a nonjury trial with five other actions. The main issues decided were whether the plaintiff had established its prima facie case for the seven claims and whether the defendant had properly and timely denied three of the claims on the ground that the assignor had failed to appear for independent medical examinations (IMEs). The holding of the case was that the judgment award was reduced to the principal sum of $5,695, as the defendant had proven that the assignor had violated a condition precedent to coverage and the plaintiff was not entitled to recover on those specific bills. The matter was remitted to the Civil Court for a recalculation of statutory interest and the entry of an appropriate amended judgment.

The court considered the fact that the plaintiff had commenced an action in March 2011 to recover assigned first-party no-fault benefits and the defendant served a 90-day written demand pursuant to CPLR 3216 in November 2016. The main issue was whether the plaintiff's delay in responding to the defendant's 90-day notice was willful or contumacious, and whether it evidenced an intent to abandon the action. The holding of the case was that the court reversed the order and granted the defendant's motion to dismiss the complaint pursuant to CPLR 3216, based on the reasons stated in a similar case.

The court considered the fact that the plaintiff had commenced the action to recover no-fault benefits in March 2011 and that the defendant had interposed an answer in April 2011. In November 2016, over five years later, the defendant served a 90-day written demand pursuant to CPLR 3216 (b) (3). Despite this, the plaintiff did not serve the defendant with a notice of trial until March 29, 2017. The main issue decided was whether the defendant's motion to dismiss the complaint pursuant to CPLR 3216 should be granted. The holding of the case was that the order of the District Court denying the motion was reversed, and the defendant's motion to dismiss the complaint pursuant to CPLR 3216 was granted. Therefore, the plaintiff's delay in responding to the 90-day notice was found to be sufficient to grant the defendant's motion to dismiss the complaint.

The court considered the fact that the plaintiff had filed a complaint to recover no-fault benefits and that the defendant had served a 90-day written demand pursuant to CPLR 3216. The main issue decided was whether the plaintiff's delay in responding to the 90-day notice constituted a justifiable excuse, and whether the plaintiff had a meritorious cause of action. The court held that the plaintiff's delay in responding to the 90-day notice did not establish a justifiable excuse, and therefore, reversed the order and granted the defendant's motion to dismiss the complaint pursuant to CPLR 3216.

The relevant facts considered by the court were that A & S Medical Supply, Inc., as the assignee of Abram Aranbayev, was seeking first-party no-fault benefits from Motor Vehicle Accident Indemnification Corporation (MVAIC), and the issue was whether A & S had exhausted its remedies. The only witness at trial was an employee of the New York Liquidation Bureau (NYLB), who testified that they seized records of Long Island Insurance Company (LIIC) after LIIC had been placed into liquidation by the Supreme Court. The court held that the NYLB witness was unable to establish that the records were admissible as business records, but MVAIC had sustained its burden of proving "that there was potential coverage." The main issue decided was whether the records seized from LIIC by the NYLB were admissible as business records, and whether MVAIC was required to prove the existence of an insurance policy or coverage at the time of the accident. The court held that the NYLB records were admissible, and MVAIC had sustained its burden of proving that there was potential coverage. Therefore, the judgment was reversed, and the case was remitted to the Civil Court for the entry of a judgment in favor of MVAIC dismissing the complaint.

The court considered the facts that a provider sought to recover no-fault benefits from an insurance company, and that the insurance company had been served with the summons and complaint at their Brooklyn office. The insurance company failed to appear or answer, and a default judgment was entered against them. The main issue decided was whether the insurance company had a reasonable excuse for their default and a potentially meritorious defense to the action. The holding of the case was that the insurance company did not provide sufficient evidence to rebut the proof of proper service, and their claim representative's assertion of improper service lacked detail and did not demonstrate a reasonable excuse for the default. Therefore, the branches of the insurance company's motion to vacate the judgment and compel the provider to accept their answer were denied, and the case was remitted to the trial court to determine the remaining branches of the insurance company's motion.

The court considered the issue of whether an insurance company was entitled to summary judgment in a case where a healthcare provider sought to recover unpaid no-fault benefits. The healthcare provider argued that it had established its entitlement to recovery, while the insurance company argued that the provider's assignor had failed to appear for scheduled Examinations Under Oath (EUOs) and that the accident was an intentional loss and therefore not covered. The court held that the insurance company's denials were untimely, as they were issued after the deadline, and that the evidence of a purposeful collision was insufficient to support the insurance company's defense. Therefore, the insurance company's motion for summary judgment was denied, and the healthcare provider's cross-motion for summary judgment was granted. The provider was entitled to recover the unpaid amount, along with statutory interest, attorneys' fees, and costs.

The relevant facts in this case were that the defendant-insurer, Global Liberty Insurance Company, attempted to invoke the primary jurisdiction of the Workers' Compensation Board (WCB) in two first-party no-fault actions nearly seven years after the issue was raised as an affirmative defense and during the trial. The main issue decided was whether the trial court properly denied the defendant's belated attempt to invoke the primary jurisdiction of the WCB. The holding of the case was that the trial court's decision to deny the defendant's attempt was affirmed, as the defendant's belated invocation of the primary jurisdiction of the WCB was seen as an attempt to further delay the litigation, and therefore was not allowed under these particular circumstances.

The court considered the date of entry of the judgment, the period for which postjudgment interest was sought, and the actions of both the plaintiff and defendant in making payment. The main issues decided were whether the defendant was entitled to stop the accrual of postjudgment interest and if the plaintiff's delay had caused the interest to accrue. The holding of the court was that the defendant was not entitled to stop the accrual of all postjudgment interest and that the matter was remitted to the Civil Court for a new determination of the branch of the defendant's motion seeking an order directing the clerk to enter a satisfaction of judgment. The court also emphasized that the plaintiff is only entitled to receive simple interest at the statutory rate of nine percent per year from the date of the entry of the judgment through the date of the payment of the judgment.