No-Fault Case Law

The court considered the defendant-insurer’s appeal from an order of the Civil Court of the City of New York, which denied, in part, its motion for summary judgment dismissing the complaint. The main issue decided was whether the defendant-insurer made a prima facie showing of entitlement to judgment as a matter of law by demonstrating that it timely denied the plaintiff's first-party no-fault claims based on an affirmed independent examination report (IME) of its examining orthopedist. The holding of the court was that the defendant-insurer did make a prima facie showing of entitlement to judgment as a matter of law, and therefore, the motion for summary judgment was granted in its entirety, and the complaint was dismissed. The medical affirmation submitted by the plaintiff failed to raise a triable issue since it was not based on an examination of the assignor, nor did it meaningfully rebut the findings of the defendant's examining physician. Additionally, the assignor's subjective complaints of pain did not overcome the objective medical tests detailed in the IME report.

The court considered a case where Nova Chiropractic Services, P.C. as the assignee of Cynthia Guerrero, was seeking to recover first-party no-fault benefits from GEICO General Insurance Company. The main issue was the medical necessity of the services provided by the chiropractic services. The Civil Court precluded the testimony of defendant's expert witness and granted plaintiff's motion for a directed verdict. However, the Appellate Term, Second Department reversed the judgment and remitted the matter to the Civil Court for a new trial. The holding of the case was that the judgment in favor of the plaintiff was reversed, and a new trial was ordered.

The relevant facts the court considered were that Sharp View Diagnostic Imaging, P.C. was seeking to recover assigned first-party no-fault benefits from GEICO General Insurance Company. The main issue decided was the medical necessity of the services in question. The court precluded the testimony of defendant's expert witness and granted plaintiff's motion for a directed verdict, resulting in a judgment in favor of the plaintiff in the principal sum of $1,791.73. The holding of the case was that the judgment was reversed and the matter was remitted to the Civil Court for a new trial, in accordance with the decision in another related case.

In this case, Nova Chiropractic Services, P.C. sued GEICO General Insurance Company to recover assigned first-party no-fault benefits, with the sole issue being the medical necessity of the services provided. The Civil Court precluded the testimony of the defendant's expert witness and granted the plaintiff's motion for a directed verdict, awarding the plaintiff the principal sum of $873.96. On appeal, the Appellate Term, Second Department reversed the judgment and remitted the matter to the Civil Court for a new trial. The decision was made in light of a similar case involving the same parties, where issues related to the medical necessity of the services provided were considered. The Appellate Term held that a new trial was required in this case.

The court considered that plaintiff, Veraso Medical Supply Corp, was seeking to recover assigned first-party no-fault benefits and had filed a motion for summary judgment. However, the defendant, 21st Century Insurance Company, had filed a cross motion for summary judgment dismissing the complaint on the grounds that plaintiff's assignor had failed to appear for examinations under oath. The main issue decided was whether the defendant's cross motion for summary judgment dismissing the complaint should be granted. The holding of the court was that the defendant's cross motion for summary judgment dismissing the complaint was denied.

The court considered a case where Nova Chiropractic Services, P.C. was seeking to recover assigned first-party no-fault benefits from GEICO General Insurance Company. The main issue was the medical necessity of the services provided, and the Civil Court precluded the testimony of GEICO's expert witness, granting Nova Chiropractic's motion for a directed verdict. The judgment in favor of Nova Chiropractic in the amount of $2,184.94 was appealed by GEICO. The Appellate Term reversed the judgment and remitted the matter to the Civil Court for a new trial, citing a similar case as precedent. The holding of the case was that the judgment in favor of Nova Chiropractic was reversed and the matter was sent back for a new trial.

The court considered the fact that the plaintiff, a medical supply company, was seeking to recover first-party no-fault benefits as the assignee of a patient who failed to appear for required examinations under oath. The main issue decided was whether the defendant insurance company could deny the claim based on the assignor's failure to attend the EUOs. The court held that the defendant's cross motion for summary judgment dismissing the complaint should have been denied as the defendant failed to demonstrate that it was not precluded from raising its defense. Additionally, the court found that the plaintiff failed to establish its entitlement to summary judgment, as it did not prove that the claim had not been timely denied, or that the denial of claim form issued by the defendant was conclusory, vague, or without merit as a matter of law. Therefore, the court modified the order by denying the defendant's cross motion for summary judgment.

The main issue in this case was the medical necessity of the services provided by Nova Chiropractic Services, P.C. as the assignee of Glorian Daly, in a claim against GEICO General Insurance Company for first-party no-fault benefits. At a nonjury trial, the Civil Court precluded the testimony of GEICO's expert witness and granted Nova Chiropractic's motion for a directed verdict, awarding them $1,310.90. The Appellate Term, Second Department reversed the judgment and remitted the matter to the Civil Court for a new trial. The decision was based on the reasoning in another case, Nova Chiropractic Servs., P.C., as Assignee of Miguel A. Vizcaino v GEICO Gen. Ins. Co., decided in conjunction with this case. The holding of the court was to reverse the judgment and order a new trial based on the issues raised regarding the preclusion of the defendant's expert testimony.

The main issue in this case was the medical necessity of supplies in a lawsuit for first-party no-fault benefits. The Civil Court precluded the testimony of the defendant's expert witness and granted the plaintiff's motion for a directed verdict, resulting in a judgment in favor of the plaintiff for $1,346.76. On appeal, the Appellate Court reversed the judgment and remitted the matter to the Civil Court for a new trial. The decision was based on a similar case where the judgment was also reversed, and it was decided that a new trial was necessary. Therefore, the holding of this case was that the judgment in favor of the plaintiff was reversed, and the case was remanded for a new trial.

The court considered the judgment of the Civil Court of the City of New York that awarded the plaintiff the principal sum of $2,036.99 after a nonjury trial. The main issue on appeal was the preclusion of the testimony of the defendant's expert witness and the granting of the plaintiff's motion for a directed verdict on the medical necessity of the supplies in question. The court held that the judgment was reversed and the matter was remitted to the Civil Court for a new trial, based on a similar decision in another case. Therefore, the decision of the trial court was overturned and a new trial was ordered in this case as well.