No-Fault Case Law

In this case, the respondent sustained injuries in a single-car accident and registered a blood alcohol content of .10% when tested at the hospital. She later pleaded guilty to driving while ability impaired. When she filed for no-fault benefits, her claim was denied by the petitioner due to the policy's intoxication exclusion. As a result, the respondent filed for arbitration while the petitioner sought a stay. The relevant facts in the case included whether the respondent was actually intoxicated at the time of the accident. The court decided that the parties had agreed to arbitrate the dispute and that it was for the arbitrator to address the merits of the dispute. The holding of the case was that the matter would proceed to arbitration, and the court denied the petitioner's motion for a permanent stay and the respondent's cross-motion for summary judgment without costs.

The court considered the fact that plaintiffs were seeking to recover first-party no-fault benefits for chiropractic services they provided to an injured assignor in the sum of $2,603.36. The main issue decided was whether the plaintiffs provided defendant with properly completed claim forms to establish their entitlement to summary judgment. The court held that the affidavit submitted by the plaintiffs' billing manager was insufficient to establish that the claim forms were properly completed, as it did not indicate for which plaintiff she was the billing manager, and thus plaintiffs failed to make out their prima facie entitlement to summary judgment. Therefore, the court affirmed the order denying plaintiffs' motion for summary judgment.

The relevant facts considered by the court in this case were that a medical supply house, plaintiff, sought to recover first-party no-fault benefits for medical equipment furnished to its assignor, submitting claims for $795 and $1,220, and subsequently filing a motion for summary judgment. The main issue decided was whether the plaintiff was entitled to summary judgment on its claims, and the holding of the court was that the plaintiff was entitled to partial summary judgment in the sum of $1,925. The court found that the defendant failed to timely pay or deny the $795 claim, and that the request for the assignor to appear for an examination under oath did not toll the 30-day period within which the defendant was required to pay or deny the $1,220 claim. The court also determined that the plaintiff's compensation should be reduced by the amount billed for an unprescribed medical item. As a result, the matter was remanded to the lower court for further proceedings.

The relevant facts of the case were that Adam's Medical Supplies filed a lawsuit seeking first-party no-fault benefits for medical equipment provided to its assignor. The company also sought statutory interest and attorney's fees. Adam's Medical Supplies moved for summary judgment on various claims, while the defendant, Windsor Group Insurance Company, opposed the motion and also moved for summary judgment dismissing the complaint. The court granted Adam's partial summary judgment on some of its claims, but denied summary judgment on a $120 claim for a "TENS accessory kit." The main issues decided were whether Adam's Medical Supplies established its entitlement to the claims and whether Windsor Group Insurance Company demonstrated a triable issue of fact. The holding of the case was that Adam's Medical Supplies was entitled to partial summary judgment on certain claims, while Windsor Group Insurance Company was awarded partial summary judgment dismissing the $120 claim for the TENS accessory kit.

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.