No-Fault Case Law

In this case, the court considered the procedural posture of the appeal concerning a no-fault benefits dispute, where Shamrock Medical, P.C., as the assignee of Rexford Bishop, sought to recover benefits from Personal Service Insurance Company. The primary issue resolved was whether the order of the Civil Court, which granted the defendant’s motion to dismiss the complaint in part by setting a traverse hearing, was appealable. The holding determined that no appeal lies as of right from such an order, leading to the dismissal of the appeal. The court referenced relevant case law to support its decision and concluded that leave to appeal was not warranted.

In this case, the court considered the appeal by Personal Service Insurance Company regarding a prior order that granted a motion to dismiss the complaint only to the extent of setting the matter down for a traverse hearing. The main issues involved whether the dismissal of the complaint should be upheld or if the traverse hearing was warranted based on the evidence presented. Ultimately, the court held that the appeal was dismissed, reaffirming the lower court's decision to set the matter for a traverse hearing rather than fully dismissing the complaint. This decision aligns with the precedent established in a related case, indicating the court's commitment to examining the necessary facts before a final resolution.

In this case, the court considered the appeal from a Civil Court order that partially granted the defendant's motion to dismiss the complaint filed by a medical provider seeking to recover assigned no-fault benefits. The main issue was whether the dismissal of the complaint should proceed in full or if a traverse hearing was necessary to evaluate the facts presented. The court ultimately held that the appeal was dismissed, affirming the lower court's decision to set the matter down for a traverse hearing rather than granting a complete dismissal of the complaint. This decision aligns with precedents established in similar cases involving insurance disputes over no-fault benefits.

The court considered the denial of attorney's fees to New York Recovery PT, P.C., after the provider's claims for assigned first-party no-fault benefits were initially denied, leading to an arbitration award in favor of the provider. The main issues addressed were whether the provider was entitled to attorney's fees despite the proceeding primarily involving the confirmation of a master arbitration award rather than resolving a dispute de novo. The court held that the provider was indeed entitled to attorney's fees since the insurer failed to timely pay the arbitration award, as dictated by the regulations governing no-fault claims. Consequently, the appellate court reversed the district court's ruling, granting the provider's motion for attorney's fees and remitting the case for determination of the reasonable fee amount.

In this case, the court considered the relevant facts surrounding an accident involving a vehicle insured by Erie Insurance Company and an attempt by Prompt Medical Group, as an assignee, to recover no-fault benefits. The main issue was whether the vehicle insured by the defendant was involved in the accident, as claimed by the plaintiff. The defendant's motion for summary judgment was based on statements in a police report, but the court found these statements to be inadmissible hearsay, lacking proper exceptions to the hearsay rule. Additionally, the court noted that conflicting accounts regarding the occurrence of the accident raised material issues of fact. Ultimately, the court reversed the lower court’s order, denied the defendant's motion for summary judgment, and ruled that the plaintiff's claims needed to be further examined in court.

In this case, the court evaluated the procedural compliance of the plaintiff, Medtech Medical Supply, Inc., with CPLR 5003-a regarding the tender of a release and a stipulation of discontinuance before entering judgment for no-fault benefits. The main issues addressed included whether the plaintiff had fulfilled its obligations under CPLR 5003-a (a) by properly tendering the necessary documents and whether the defendant, Liberty Mutual Ins. Co., adequately demonstrated noncompliance. The court found that the defendant did not provide sufficient evidence to support its claim that the plaintiff failed to tender the requisite documents in accordance with the statute. Consequently, the court upheld the earlier decision, affirming the order that denied the defendant’s motion to vacate the judgment entered against it.

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.