No-Fault Case Law
Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2018 NY Slip Op 50837(U))
June 1, 2018
The case involved a dispute over first-party no-fault benefits. The plaintiff, a medical provider, appealed from an order of the Civil Court which denied their motion for summary judgment and granted the defendant's cross motion for summary judgment. The basis for the denial of plaintiff's motion and the granting of the defendant's cross motion was that the plaintiff had failed to appear for scheduled examinations under oath (EUOs). The defendant was able to establish that the EUO scheduling letters and denial of claim form had been properly mailed, and that the plaintiff had failed to appear for the scheduled EUOs. The court found that the defendant's proof was sufficient to give rise to a presumption of proper mailing, and therefore affirmed the order, denying the plaintiff's motion and granting the defendant's cross motion.
Acupuncture Healthcare Plaza I, P.C. v Allstate Ins. Co. (2018 NY Slip Op 50835(U))
June 1, 2018
The main issue decided in this case was whether the denial of claim forms at issue had been timely mailed. The court considered the affidavits submitted by the defendant and found that they did not sufficiently set forth a standard office practice or procedure to ensure timely mailing. As a result, the defendant did not demonstrate that it was not precluded from asserting its defense, and therefore was not entitled to summary judgment dismissing the first through fourth causes of action. The holding of the case was that the order of the Civil Court denying the defendant's motion seeking summary judgment was affirmed.
Active Care Med. Supply Corp. v American Tr. Ins. Co. (2018 NY Slip Op 50832(U))
June 1, 2018
The relevant facts considered by the court were that Active Care Medical Supply Corp. was seeking to recover assigned first-party no-fault benefits. The main issue decided was whether the provider was entitled to recover these benefits, and the court ultimately affirmed an order granting the defendant's motion for summary judgment and denying the plaintiff's cross motion for summary judgment. The holding of the case was that the court affirmed the order, with the costs of $25, and that the provider was not entitled to recover the assigned first-party no-fault benefits.
Active Care Med. Supply Corp. v American Tr. Ins. Co. (2018 NY Slip Op 50831(U))
June 1, 2018
The court considered an appeal from an order of the Civil Court granting the defendant's motion for summary judgment and denying the plaintiff's cross motion for summary judgment in a case regarding the recovery of assigned first-party no-fault benefits. The main issue decided was whether the lower court properly granted the defendant's motion for summary judgment and denied the plaintiff's cross motion. The holding of the court was that the order of the Civil Court was affirmed, with the costs of $25, for the reasons stated in a similar case decided at the same time.
Gl Acupuncture, P.C. v Allstate Ins. Co. (2018 NY Slip Op 50830(U))
June 1, 2018
The court considered whether the denial of claim forms had been timely mailed and whether the claims at issue had been timely denied by the defendant. The main issue decided was whether the amounts sought to be recovered by the plaintiff, for services rendered prior to April 1, 2013, were in excess of the workers' compensation fee schedule. The holding of the case was that the defendant's cross motion for summary judgment dismissing the complaint was denied, as the plaintiff's motion for summary judgment was properly denied. Therefore, the order was modified to provide that defendant's cross motion for summary judgment dismissing the complaint was denied.
Gl Acupuncture, P.C. v Allstate Ins. Co. (2018 NY Slip Op 50829(U))
June 1, 2018
The relevant facts the court considered in this case were related to a dispute over whether a provider was entitled to recover assigned first-party no-fault benefits. The main issue decided by the court was whether the amounts sought to be recovered were in excess of the workers' compensation fee schedule. The holding of the court was that the branches of the defendant's cross motion seeking summary judgment dismissing the second through fifth causes of action were denied, as the defendant did not sufficiently demonstrate that it was not precluded from asserting its proffered defense, and the plaintiff also failed to establish that the claims at issue had not been timely denied. Therefore, the order was modified to provide that the branches of defendant's cross motion seeking summary judgment were denied.
Active Care Med. Supply Corp. v American Tr. Ins. Co. (2018 NY Slip Op 50828(U))
June 1, 2018
The court considered an appeal from an order that granted the defendant's motion for summary judgment dismissing the complaint and denied the plaintiff's cross motion for summary judgment in an action to recover assigned first-party no-fault benefits. The main issue was whether the trial court erred in granting defendant's motion for summary judgment and denying plaintiff's cross motion for summary judgment. The holding of the court was that for the reasons stated in a related case, the order granting the defendant's motion for summary judgment was affirmed.
Precious Acupuncture Care, P.C. v GEICO Gen. Ins. Co. (2018 NY Slip Op 50827(U))
June 1, 2018
The court considered an appeal from an order of the Civil Court of the City of New York, Kings County, in a case involving Precious Acupuncture Care, P.C., seeking to recover first-party no-fault benefits from GEICO General Insurance Company. GEICO appealed from an order denying its cross motion for summary judgment dismissing the fourth cause of action based on lack of medical necessity. The main issue decided was whether there was a triable issue of fact regarding the medical necessity of the services at issue. The court held that after reviewing the record, there was indeed a triable issue of fact regarding the medical necessity of the services, and therefore affirmed the order denying GEICO's cross motion for summary judgment.
Active Care Med. Supply Corp. v American Tr. Ins. Co. (2018 NY Slip Op 50825(U))
June 1, 2018
The relevant facts of the case were that the plaintiff, Active Care Medical Supply Corp, sought to recover first-party no-fault benefits as the assignee of a individual. The defendant, American Transit Ins. Co., filed a motion for summary judgment to dismiss the complaint. The main issue decided was whether the plaintiff was entitled to recover assigned first-party no-fault benefits. The holding of the court was that the order granting the defendant's motion for summary judgment was affirmed, and the plaintiff's complaint was dismissed.
Active Care Med. Supply Corp. v American Tr. Ins. Co. (2018 NY Slip Op 50824(U))
June 1, 2018
The court considered the case of Active Care Medical Supply Corp appealing an order from the Civil Court of the City of New York, which granted the defendant's motion for summary judgment dismissing the complaint. The main issue was whether the provider could recover assigned first-party no-fault benefits, and the court affirmed the order, with costs. The holding of the case was that the order granting the defendant's motion for summary judgment was affirmed, for the reasons stated in another similar case.