No-Fault Case Law

The court considered the fact that the defendant-insurer had mailed notices for independent medical examinations (IMEs) to plaintiff's assignor, and that the assignor failed to appear. The main issue decided was whether the defendant was entitled to summary judgment dismissing the action for first-party no-fault benefits. The holding of the court was that the defendant-insurer had made a prima facie showing of entitlement to summary judgment by establishing that it had timely and properly mailed the IME notices, and that the assignor failed to appear. The court also found that the plaintiff did not raise a triable issue in opposition to the defendant's evidence, and therefore granted the defendant's motion for summary judgment dismissing the complaint.

The main issues in this case involved an arbitration in which respondent New Century Acupuncture P.C. sought reimbursement from petitioner Country-Wide Insurance Company for healthcare services provided to an assignor, William Dew, following a motor vehicle accident. Country-Wide alleged that New Century was fraudulently incorporated and actually owned or controlled by an individual who had pleaded guilty to conspiracy to commit mail fraud and health care fraud. Arbitrator Rosenberger issued an Arbitration Award in favor of New Century, but Country-Wide argued that the award should be vacated based on the arbitrator's failure to disclose a relationship with New Century and its attorneys. The court held that the failure of the arbitrator to disclose his connection to New Century's attorneys mandated vacatur of the Arbitration Award, and granted the petition to vacate the award.

The court considered the fact that the offending vehicle in a no-fault arbitration was insured by Global Liberty Insurance of New York subsequent to the respondent's coverage. It was determined that the subsequent coverage terminated the respondent's coverage of the same vehicle as of the effective date and hour of Global's coverage, irrespective of whether the respondent had otherwise complied with the cancellation requirements of the Vehicle and Traffic Law. The main issues decided were that the respondent failed to demonstrate that it had properly cancelled its policy, and that the arbitration award was in excess of the arbitrator's authority. The holding of the case was that the arbitration award in favor of the petitioner was vacated, and the respondent's cross petition seeking to vacate the arbitration award was granted.

The main facts considered by the court were that defendant moved for summary judgment dismissing the complaint, and plaintiff cross-moved for summary judgment. The main issue to be decided was whether the first cause of action should have been dismissed as premature. The holding of the court was that the 30-day period within which defendant was required to pay or deny the claim did not begin to run, and thus the first cause of action should have been dismissed as premature. The court ultimately reversed the order and granted the branch of defendant's motion seeking summary judgment dismissing the first cause of action.

The court considered whether a provider could recover assigned first-party no-fault benefits from an insurance company. The main issue was whether the action was premature since the provider had not responded to the insurance company's requests for additional verification. The court held that the action was indeed premature because the provider had not provided all the verification requested by the insurance company, and therefore the 30-day period within which the insurance company was required to pay or deny the claims did not begin to run. The court also found that the provider's remaining contention was not properly before the court and declined to consider it. Therefore, the court affirmed the denial of the provider's motion for summary judgment and granted the insurance company's cross motion for summary judgment dismissing the complaint.

The court considered a motion to dismiss a complaint by a provider seeking to recover assigned first-party no-fault benefits, on the ground that the Civil Court lacked personal jurisdiction over the defendant insurance company. The defendant provided affidavits stating that they were a Pennsylvania company not licensed to do business in New York, with no offices, bank accounts, agents, or real property in New York, and did not contact or solicit business in New York. The plaintiff's opposition to the motion consisted of only an unverified complaint and a conclusory affirmation by the plaintiff's counsel. The main issue decided was whether the Civil Court properly granted the defendant's motion to dismiss the complaint based on lack of personal jurisdiction. The holding of the court was that the order granting the defendant's motion to dismiss was affirmed, as the plaintiff did not provide sufficient evidence to warrant jurisdictional discovery, and plaintiff's argument that essential jurisdictional facts might exist was not supported by tangible evidence.

The relevant facts considered by the court were that the plaintiff filed a complaint to recover first-party no-fault benefits and served the defendant, who failed to answer the complaint and defaulted in the action. The plaintiff subsequently moved for leave to enter a default judgment, which was granted. The main issue decided by the court was whether the defendant should be allowed to vacate the default judgment and dismiss the action based on failure to enter a default judgment within one year of the default. The holding of the court was that the defendant's excuses for failing to oppose the motion for entry of a default judgment and for the delay in moving to vacate the default judgment were insufficient, and the court affirmed the denial of defendant's motion to vacate the default judgment. The court also found that the defendant did not demonstrate a potentially meritorious defense to the action and was not entitled to dismissal of the complaint.

The relevant facts considered in this case involved a provider's attempt to recover assigned first-party no-fault benefits from an insurance company. The main issue decided was whether the provider had demonstrated its entitlement to summary judgment, and whether the insurance company had established its defense that the provider had failed to appear for properly scheduled examinations under oath. The holding of the case was that the provider had failed to demonstrate its entitlement to summary judgment, as the affidavit submitted in support of its motion failed to establish that the claim at issue had not been timely denied. However, the insurance company's cross motion for summary judgment dismissing the complaint was also denied, as it failed to establish its defense that the provider had failed to appear for properly scheduled examinations under oath. Therefore, the court modified the order to deny the insurance company's cross motion for summary judgment dismissing the complaint, but affirmed the order in all other respects.

The court considered the plaintiff's appeal from an order of the Civil Court of the City of New York, which granted the defendant's motion to consolidate four related actions and to limit any potential recovery of attorneys' fees in the consolidated action to $850. The main issues decided were whether the $850 limit on attorneys' fees, as provided by Insurance Department Regulations, was properly applied to the claims at issue in the consolidated action and whether the plaintiff's appeal from the portion of the order granting consolidation should be dismissed since the plaintiff had agreed to consolidation. The holding of the court was that the $850 limit on attorneys' fees was properly applied to the claims at issue, and that the plaintiff's appeal from the portion of the order granting consolidation must be dismissed.

The relevant facts in the case were that New Way Medical Supply Corp. as the assignee of Jonathan Trevino appealed from an order of the Civil Court denying plaintiff's motion for summary judgment to recover assigned first-party no-fault benefits from American Transit Ins. Co. The main issue decided was that the plaintiff failed to establish that the defendant had failed to pay or deny the claim within the 30-day period required by Insurance Law, or that the defendant had issued a timely denial of claim that was conclusory, vague, or without merit as a matter of law. As a result, the plaintiff failed to demonstrate its entitlement to summary judgment. The holding of the case was that the order denying plaintiff's motion for summary judgment was affirmed, with $25 costs.