No-Fault Case Law

In this case, the court considered the failure of the plaintiff, a physical therapy provider, to provide necessary verification requested by the defendant, State Farm Mutual Automobile Insurance Company, during the claim verification process for no-fault benefits. The main issues involved whether the defendant's request for verification documents was appropriate and whether the plaintiff's claims were barred by collateral estoppel based on a previous related declaratory judgment action. The court upheld the lower court's decision granting the defendant's motion for summary judgment, asserting that the plaintiff's lack of compliance with the verification request justified the dismissal of its complaint. Furthermore, the court concluded that the denial of the previous motion for summary judgment in a different court did not carry preclusive effect, as it was not a final determination on the merits. Ultimately, the order was affirmed, confirming the dismissal of the plaintiff's claims.

The court considered a stipulation agreement from 2009 between the parties that allowed the plaintiff to enter a judgment for no-fault benefits without any time limit if payment was not received within 30 days. The plaintiff sought to enter judgment based on this stipulation, which was initially granted. However, the defendant later moved to vacate the judgment, arguing that it had not received the plaintiff's motion and that payments had been made timely. The Civil Court granted the defendant's motion to dismiss the complaint, claiming the plaintiff's action was barred by the six-year statute of limitations. On appeal, the court reversed this decision, ruling that the stipulation allowed the plaintiff to seek a judgment without any time constraints and that there was no applicable statute of limitations for entering a judgment based on the stipulation’s terms. The court denied the motion to dismiss and remitted the case for further proceedings.

In this case, Lam Quan MD, P.C. sought to vacate the award of a master arbitrator which upheld the denial of a no-fault insurance claim for $1,002.74. The primary issues considered by the court included the calculation of interest on the overdue claim and the entitlement to attorneys' fees. The Supreme Court initially awarded the petitioner only a minimal interest of $39.40 and denied the request for attorneys' fees under the applicable regulations. The Appellate Division found that the interest calculation was improper and that the petitioner was entitled to attorneys' fees for both the underlying claim and the appeal. Consequently, the court modified the judgment, eliminated the incorrect interest award, and remitted the matter for a proper recalculation of interest and attorneys' fees.

The court considered the fact that Burke 2 Physical Therapy, P.C. sought to recover assigned first-party no-fault benefits but faced a challenge from State Farm Mutual Automobile Insurance Company regarding the provision of requested verification. The main issue decided was whether the plaintiff had adequately complied with the insurer's verification requests, which the defendant argued was necessary for the claim to proceed. Ultimately, the court held that the plaintiff failed to provide the required verification, resulting in the affirmation of the Civil Court's order that granted State Farm's cross-motion for summary judgment, thus dismissing the complaint. The ruling underscored the importance of meeting verification requirements in no-fault insurance claims.

In this case, the court considered the issue of whether the plaintiff, a medical provider seeking to recover assigned first-party no-fault benefits, had sufficiently provided the requested verification to support its claim. The main issue was the defendant's request for verification, which the plaintiff failed to provide, leading to the defendant's cross-motion for summary judgment. The Civil Court of the City of New York granted the defendant's motion, dismissing the complaint. The Appellate Term affirmed this decision, reinforcing the requirement for proper verification as a necessary condition for claiming benefits under the no-fault insurance scheme. The ruling highlighted the importance of compliance with verification requests in the context of no-fault insurance claims.

The court considered the procedural context of plaintiff Burke Physical Therapy, P.C. attempting to recover assigned first-party no-fault benefits after the Civil Court granted State Farm's cross-motion for summary judgment, citing plaintiff's failure to provide adequate verification of its eligibility for benefits. The main issues involved whether State Farm appropriately requested verification documents and whether the Civil Court erred in rejecting plaintiff's amended opposition to the cross-motion. The court held that State Farm's denial of the claim form was issued too late, rendering it ineffective. As a result, the appellate court reversed the previous order, denied the cross-motion for summary judgment, and dismissed the complaint without prejudice, allowing the plaintiff another opportunity to pursue its claim.

The court considered the facts surrounding a claim for assigned first-party no-fault benefits filed by MSB Physical Therapy against Nationwide Insurance. The main issues centered on whether the plaintiff had failed to comply with the required examinations under oath, which was claimed by the defendant as a basis for dismissing the action. The Civil Court initially denied the defendant's motion for summary judgment and granted the plaintiff's cross-motion for summary judgment. However, upon appeal, the court reversed the Civil Court's order, granting the defendant's motion and denying the plaintiff's cross-motion, thus siding with the defendant's argument regarding the plaintiff's non-compliance with the examination requirements.

In this case, the court considered that the plaintiff, a physical therapy provider, failed to appear for scheduled examinations under oath (EUOs) related to their claims for no-fault insurance benefits. The defendant, Nationwide Insurance, demonstrated that it had sent timely notices for the EUOs before and after the claims were submitted and provided evidence of the plaintiff's repeated failures to attend these examinations. The main issues decided included whether the defendant's motions for summary judgment should be granted based on the plaintiff's non-compliance with the EUO requirements and whether the plaintiff could raise any triable issues of fact. The court ultimately reversed the prior order, granting the defendant's motion for summary judgment and denying the plaintiff's cross-motion, establishing that the plaintiff's failure to comply with the EUO process precluded recovery of the asserted benefits.

The court considered the fact that MSB Physical Therapy, P.C., as the assignee of a patient, failed to attend scheduled examinations under oath (EUOs) required for the processing of no-fault insurance claims. The defendant, Nationwide Insurance, established that it had properly mailed the scheduling letters for the EUOs and demonstrated that plaintiff's non-appearance justified the denial of claims. The main issues decided included whether the plaintiff's non-compliance with the EUO requirements warranted the dismissal of the complaint and the denial of plaintiff's cross-motion for summary judgment. The court held that since the plaintiff did not raise a triable issue of fact against the defendant’s prima facie showing, the motion for summary judgment by Nationwide Insurance was rightly granted, and the plaintiff's cross-motion was denied.

The court considered relevant facts surrounding a default judgment entered in favor of the plaintiff, GC Chiropractic, for no-fault benefits, totaling $3,623.62, and the subsequent appeal by the defendant, Allstate Insurance Company. Allstate deposited the amount with the New York City Department of Finance while appealing the order that denied its motion to vacate the judgment. The main issues addressed included whether the deposit tolled the accrual of interest and whether the plaintiff was obliged to recover the deposited undertaking. The court held that the deposit did not toll interest accrual and that the amount of the deposit alone was insufficient to satisfy the entire judgment. Consequently, the court reversed the lower court's order directing the plaintiff to recover from the Department of Finance and vacated the direction to provide a satisfaction of judgment upon full payment.