No-Fault Case Law

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.

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.

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.

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.

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.

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.

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.

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.

The relevant facts considered by the court in this case were that the plaintiff, Neptune Medical Care, P.C., sought to recover first-party no-fault benefits, and the defendant, Praetorian Insurance Company, denied the claims on the grounds that the assignors of the plaintiff failed to appear for examinations under oath (EUOs) and independent medical examinations (IMEs). Both parties filed motions for summary judgment, and the Civil Court denied both motions, finding that the only triable issues were whether the EUO and IME scheduling letters had been timely and properly mailed. The main issue decided by the court was whether the defendant had timely and properly scheduled the EUOs and IMEs, and whether the plaintiff's assignors had failed to appear at duly scheduled appointments. The court held that the defendant failed to establish that the initial and follow-up letters scheduling the EUOs and IMEs had been timely mailed, and as a result, they failed to demonstrate that the appointments had been properly scheduled. Therefore, the defendant was not entitled to summary judgment dismissing the complaint, and the order was affirmed, with costs.

The main issue in the case was whether the plaintiff, Mag Medical, P.C., as the assignee of Nadezda Emelianova, was entitled to recover assigned first-party no-fault benefits from the defendant, Kemper Insurance Company. The defendant had filed a motion for summary judgment to dismiss the complaint, claiming that they had timely mailed the denial of claim forms and that there was a lack of medical necessity for the services at issue. In support of their motion, the defendant submitted an affirmed peer review report, but the plaintiff did not submit any medical evidence in opposition. The court ultimately reversed the order of the Civil Court, granting the defendant's motion for summary judgment and dismissing the complaint, as the plaintiff had failed to rebut the defendant's prima facie showing of lack of medical necessity.