The rambling man does not meet burden of lack of medical necessity at trial
Court rejects insurance company's confused medical expert testimony in no-fault case, showing that unopposed evidence must still meet basic quality standards.
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March 2014 Articles
19 articles published in March 2014
Declaratory judgment action given preclusive effect
Court ruling demonstrates how declaratory judgments can preclude subsequent no-fault insurance claims arising from the same accident, establishing binding legal precedent.
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Another Civil Kings Judge gets reversed for deciding that Great Wall does not apply
Kings County judge reversed again for rejecting Great Wall acupuncture fee schedule ruling. Appellate Term upholds chiropractor rate limitations for acupuncture services.
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“Defendant is mistaken”
Court ruling shows insurance companies can't use IME no-shows as defense if they failed to timely deny claims, highlighting procedural requirements in no-fault cases.
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Comp defense succeeds but medical necessity defense falters
Court rules fee schedule defense succeeds with employee affidavit but medical necessity defense fails when plaintiff submits sworn letter from treating chiropractor
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Mailing challenge unpreserved
Court dismisses mailing challenge raised for first time on appeal in no-fault insurance case, emphasizing importance of preserving legal arguments at trial level.
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Premature summary judgment motion
Court rules defendant's summary judgment motion premature when plaintiff lacks discovery needed to oppose medical necessity denial in no-fault insurance case.
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Interesting? Snooze and Lose
NY appellate court rules that no-fault providers who delay lawsuits 7+ years lose statutory interest windfall, ending "snooze and lose" practice.
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Prima Facie post Etienne
Eagle Surgical Supply v Allstate case establishes methods for proving prima facie cases in NY no-fault insurance claims using NF-10 denial forms as evidence.
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Material misrepresentation – via Florida law
Florida court case on material misrepresentation in no-fault insurance applications and ab initio policy cancellation requirements under Florida law.
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No jurisdiction
New York courts lack jurisdiction over out-of-state insurance carriers not licensed or authorized to conduct business in the state, as demonstrated in this appellate case.
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A re-submission will not get you anywhere
New York court confirms that resubmitting the same no-fault insurance claim does not restart the 30-day payment deadline, rejecting a common provider strategy.
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Workers Compensation Primacy
New York court clarifies that only a triable issue of fact regarding employment status is needed to refer workers compensation cases to the Workers Compensation Board.
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Fraudulent procurement and preclusuion
New York no-fault insurance law addresses when carriers can raise fraudulent procurement defenses and timing requirements under the 30-day pay or deny rule.
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EUO no show not timely
Court rules insurance carrier failed to prove timely EUO requests, highlighting critical procedural requirements in no-fault insurance defense cases.
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Marked off and cannot be dismissed on motion
New York Civil Court cases marked off the calendar cannot be dismissed under CPLR 3404, but may remain dormant indefinitely without revival options.
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Biomechanical Engineer allowed to testify
Landmark 2014 Vargas v Sabri case allows biomechanical engineers to testify on motor vehicle accident causation without medical credentials in New York courts.
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EBT denied
Appellate Term First Department rules CPLR doesn't apply to no-fault EBTs, reviving Zlatnick precedent that limits insurer discovery rights in medical provider cases.
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2309(c) – dead for now (maybe?) and the out of state insurer issue
Analysis of CPLR 2309(c) certificate of conformity requirements for out-of-state affidavits in New York no-fault insurance litigation and recent court decisions.
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