IME no-show upheld based upon DJ case law **correction**
Court upholds IME no-show defense using declaratory judgment case law precedent in New York no-fault insurance litigation, demonstrating retroactive claim denial rights.
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February 2014 Articles
25 articles published in February 2014
Stay not granted in declaratory judgment action
Court denies stay in declaratory judgment action due to insufficient overlap between parties in separate proceedings under CPLR 2201.
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Summary judgment is limited to what is pleaded upon the moving papers
Court ruling clarifies that summary judgment motions are limited to specific pleadings, requiring defendants only address claims actually raised in no-fault cases.
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Disclosure
Court ruling on discovery scope in personal injury cases, covering physician-patient privilege waiver limits and proper use of reply papers in motion practice.
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Discontinuance without prejudice
Court rules on voluntary discontinuance without prejudice in insurance case, discussing plaintiff's right to forum shopping and procedural requirements under CPLR 3217.
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Waiver of right to arbitrate
Court ruling on waiver of arbitration rights through litigation conduct, including counterclaims and participation factors in New York insurance disputes.
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Trial De Novo granted and declaration of non-coverage granted
Nassau County court grants trial de novo and declares no coverage in Allstate v. Phelps case, finding stroke treatment unrelated to motor vehicle accident.
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General non-cooperation denial held to be timely despite it being issued quite untimely
Court upholds insurer's general non-cooperation denial despite untimely issuance when insured showed pattern of sporadic cooperation mixed with obstruction.
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The vague and conclusory denial again
Court ruling on no-fault insurance denial defects: minor errors in claim amounts don't invalidate NF-10 denials, peer review reports not required at time of denial.
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Late motion to strike note of issue can be considered
Court rules that late motions to strike note of issue can still be considered when certificate of readiness contains material misstatements or good cause is shown.
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Lost wage claim requires affirmative proof of disability
Lost wage claims in NY no-fault insurance require medical testimony proving disability and non-speculative income evidence. Court analysis of Gordon v Chubb case.
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Existence of insurance coverage does not defeat summary judgment motion
New York court ruling confirms insurance coverage existence doesn't defeat summary judgment motions in medical debt cases, establishing patient liability principles.
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EUO no show substantiated
Natural Therapy Acupuncture v State Farm: Court upholds EUO no-show denial when insurer proves proper notice and attorney confirms plaintiff's failure to appear.
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Another peer hearsay case
New York court upholds admission of doctor's peer review testimony on medical necessity despite hearsay objections in no-fault insurance case.
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An account stated requires admissible evidence of the account that is stated
Court ruling clarifies that account stated claims require admissible evidence and proper foundation, marking shift from earlier no-fault insurance precedent.
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Staten Island Chiro – what a web you weaved and what a great investigation we did
Staten Island Chiropractic case reveals successful EUO investigation uncovering fee splitting violations and cooperation failures in New York no-fault insurance claims.
Read More →![Peer report is sufficient to prima facie prove lack of serious injury (Ins Law Sec. 5102[d])](https://cdn.jtnylaw.com/blog/peer-report-is-sufficient-to-prima-facie-prove-lack-of-serious-injury-ins-law-sec-5102d.avif)
Peer report is sufficient to prima facie prove lack of serious injury (Ins Law Sec. 5102[d])
Fourth Department ruling confirms peer review expert reports can establish prima facie defense against serious injury claims under NY Insurance Law Section 5102(d).
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Attorney drafted 3101(d) in malpractice action insufficient to defeat summary judgment
First Department Court rejects attorney-drafted expert disclosure in medical malpractice case, highlighting the need for proper evidentiary foundation in summary judgment motions.
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A chiropractor may manipulate areas other than the vertebral column?
NY court ruling on chiropractor scope of practice beyond spinal manipulation in no-fault insurance cases. Impact on Willets Point precedent and treatment coverage.
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No personal knowledge of the practice and procedure to mail the suspension notice results in vacatur of conviction
Court vacates aggravated unlicensed operation conviction due to insufficient proof of proper DMV mailing procedures and lack of personal knowledge testimony.
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Another Prima facie again
Court ruling demonstrates how insurance companies waive their right to challenge claim form deficiencies if not raised during initial claims process.
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A formulation of a prima facie case
Court ruling shows how healthcare providers can establish prima facie cases in no-fault insurance disputes by proving proper billing submission and insurer's failure to respond.
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Another prima facie case – refining Etienne
Court case refines prima facie requirements for no-fault insurance claims, clarifying medical providers don't need business records exception proof in NY.
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Notice of Trial stricken
Court strikes Notice of Trial due to false certificate of readiness and denies protective order motion filed after discovery certification was complete.
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MVAIC should have sought the information through verification
MVAIC case establishes insurers must seek coverage information through verification before challenging qualified person status in NY no-fault claims
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