No-Fault Case Law

This case involves a dispute over jurisdiction and whether the Civil Court of the City of New York has the authority to hear a case involving a plaintiff health care provider who is the assignee of no-fault first-party benefits. The vehicle involved in the accident was insured by defendant Republic Western Insurance Company, and was insured by Republic. The main issue is whether the court can use information from a state governmental website and examine and use admissions made by Republic and U-Haul on their internet websites. The court held that it is proper for the court to use the information from public websites and that the relationship between Republic and U-Haul is clear, with Republic insuring all U-Haul vehicles. The court also held that it has the jurisdiction to hear the case.

The court considered a dispute between King's Medical Supply Inc. and Allstate Insurance Company regarding the payment of first-party no-fault benefits for medical supplies provided to injured assignors. King's Medical Supply sought to recover $13,573.32 from Allstate, but the insurer only denied a portion of the claims in a timely manner. The main issue was whether King's Medical Supply was entitled to partial summary judgment for the claims that were not timely denied, and whether it could recover the remaining amount for the supplies it provided. The court held that King's Medical Supply was entitled to partial summary judgment in the amount of $10,002.86, representing the claims that were not denied in a timely manner, and remanded the case for further proceedings to calculate interest and attorney's fees. However, the court also found that there were issues of fact regarding whether King's Medical Supply could recover the remaining amount sought, and confirmed that the assignments were proper and the plaintiff had standing to sue.

The relevant facts considered by the court in this case included a motion for summary judgment by the plaintiff and a claim denial by the defendant based on lack of medical necessity and excessive cost of medical equipment. The main issue decided was whether the plaintiff had established a prima facie case by properly submitting proof of claim, and whether the defendant had provided the requisite proof for the claim denial, as well as the issue of whether the cost of unprescribed medical equipment is a recoverable no-fault benefit. The holding of the court was that the plaintiff's motion for summary judgment was granted to the extent of awarding partial summary judgment in the sum of $1,347.50, and the matter was remanded for a calculation of statutory interest and an assessment of attorney's fees on that amount, as well as for further proceedings on the remaining portion of the claim.

The court considered the fact that the plaintiff was seeking to recover first-party no-fault benefits for medical services rendered to its assignor, as well as statutory interest and attorney's fees, pursuant to Insurance Law § 5101 et seq. The main issue decided was whether the plaintiff had established its prima facie entitlement to summary judgment, as it did not clearly show that the assignor made an assignment to the plaintiff. The court held that the plaintiff failed to establish its prima facie entitlement to summary judgment, as there was a question of fact as to whether the plaintiff is the same entity named in the assignment. The court also found that the defendant's notices for examinations under oath did not toll the statutory period, as there was no provision in the no-fault regulations for such verification at the applicable time. The judgment was reversed without costs, and the matter was remanded to the court below for all further proceedings.

The court considered the motion to vacate a default judgment in favor of the plaintiff, Amaze Medical Supply Inc., against defendant Allstate Insurance Company. The main issue in the case was whether the defendant had established a reasonable excuse for defaulting and a meritorious defense to the action. The court held that in order to vacate a default judgment, the defendant must establish both a reasonable excuse for defaulting and a meritorious defense to the action. The court found that the defendant's employee's affidavit was insufficient to establish a reasonable excuse, as it failed to set forth supporting facts in evidentiary form, and that the defendant failed to establish a meritorious defense to the action. Therefore, the court reversed the order granting the defendant's motion to vacate the default judgment and denied the motion.

The main issue in this case was whether the plaintiff, Damadian MRI in Garden City, P.C., had established its entitlement to summary judgment in a lawsuit against Windsor Group Insurance for first-party no-fault benefits for medical services rendered to an assignor. The court considered whether the assignment made to the plaintiff by the assignor was valid, as the assignment form named the assignee merely as "Damadian MRI" and raised a question of fact as to whether plaintiff was the same entity named in the assignment. The court also addressed whether the defendant's notices for examinations under oath tolled the statutory period, as there was no provision in the no-fault regulations for such verification. The holding of the court was that the plaintiff failed to establish its prima facie entitlement to summary judgment and that its cross motion for summary judgment should have been denied. The court also reversed the judgment, vacated the order granting plaintiff's cross motion, and remanded the matter to the lower court for further proceedings.

Relevant facts considered by the court included a claim by a medical supply company for $2,998.04 in first-party no-fault insurance benefits. All but $780.96 of the claim was denied by the defendant insurer on the grounds that the supplier's prices exceeded the prevailing rates for medical equipment, and that certain items claimed were duplicative. The issue decided was whether the insurer was justified in denying the claim, and the court concluded that the insurer's denial was factually insufficient and that a portion of the claim was recoverable. The holding of the court was that partial summary judgment should have been granted in the amount of $2,598.04, and the matter was remanded to the court below for the calculation of statutory interest and an assessment of attorney's fees, and for all further proceedings on the remaining portion of the claim in accordance with the decision of the court.

In this legal case, Singh appealed the denial of his cross motion to dismiss a petition by his insurer, Nationwide Insurance Company, to permanently stay arbitration of his uninsured motorist claim. Singh had sent a certified letter to his insurer, enclosing an application for no-fault insurance benefits and a notice "with respect to uninsured and/or underinsured motorist benefits." Nationwide sent a letter of disclaimer 10 days later from its Woodbury office since Singh's claim was not notified to them as soon as possible. Singh cross-moved to dismiss the petition on the ground that the proceeding itself was not timely commenced, arguing that the 20-day preclusion was measured from the later demand for arbitration. The Supreme Court initially granted the petition to stay arbitration, holding that the proceeding was timely. However, this decision was reversed, and the court found that the evidence did not support the conclusion that Nationwide was misled into filing an untimely petition, and that Nationwide itself had never raised this issue. Therefore, the Supreme Court erred in denying Singh's cross motion to dismiss and in granting Nationwide's untimely petition to stay arbitration.

The main issue in this case was whether the insurer, New York Central Mutual Insurance Company, properly denied a claim for No-Fault benefits submitted by A.M Medical, P.C. Plaintiff argued that the denials were untimely and insufficient to raise a triable issue of fact, as they were based on an inadmissible "Low Impact Study." Defendant contended that the injuries did not arise from a covered accident and relied on a report prepared by a private consultant, which concluded that the speed of the assignor's vehicle was not sufficient to cause persistent injury. The court held that the defendant's denials were untimely and insufficient, as they were based on an inadmissible report and failed to establish that the accident was deliberate or part of an insurance fraud scheme. The plaintiff's motion for summary judgment was granted, and the plaintiff was given leave to enter judgment against the defendant in the sum of $7,562.00 plus statutory attorneys' fees and interest.

The court considered the fact that the plaintiff, a health care provider and assignee of no-fault benefits, submitted a claim to the defendant, the insurer of the assignor, to recover first party No Fault Law benefits. The defendant's denial of the claim was dated December 2, 2002, which was more than 30 days after the claim was received. The main issue decided was whether the defendant's late denial of the claim precluded them from asserting an affirmative defense. The holding of the case was that the defendant's late denial of the claim precluded them from asserting an affirmative defense, and the plaintiff's motion for summary judgment was granted in the amount of $1,758.40, plus interest and attorneys' fees.