EUO no-show DJ is successful (for the most part)
Second Department affirms declaratory judgment for insurer after medical provider failed to appear for two examinations under oath, establishing material breach of no-fault policy.
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April 2014 Articles
24 articles published in April 2014
Trial De Novo reqires each award to be equal to or greater than $5000
Trial de novo requires awards of $5,000+ for plenary judicial review in New York no-fault insurance cases, per Insurance Law § 5106(b).
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Non receipt of verification not proven
New York no-fault case: E4 Services v Lincoln General - court rules denial of receipt alone insufficient to rebut mailing presumption, requires proof of improper procedures.
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Add this to the mix of why the “120 day rule” or “60 day rule” should not apply to Civil Court MSJ’
Civil Court decision highlights inconsistency in how pro se litigants are treated under procedural rules, particularly regarding summary judgment motion deadlines.
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How Huntington/Travelers can play out
Legal strategies for defending multiple no-fault insurance cases from the same assignor after Huntington v. Travelers decision, including special interrogatories tactics.
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Alrof citing again – never a good thing
Court cites problematic Alrof precedent again for EUO no-shows, highlighting ongoing issues with personal knowledge requirements in no-fault insurance cases.
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Verdict sustaining that the loss was intentional sustained
NY court upholds jury verdict finding motor vehicle collision was intentionally caused, denying plaintiff's motion for judgment as matter of law in no-fault case.
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Additional verification issue
NY Appellate Term reverses summary judgment in medical provider case, finding triable issues of fact regarding whether additional verification requests were properly responded to.
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Policy can be rescined under PA law; proof insufficient as to particular Assignor
PA law policy rescission case - insufficient proof against assignor in NY no-fault insurance fraud claim. Delta Diagnostic v Infinity Group 2014 decision analysis.
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No-show proved through certified transcripts
Learn how certified EUO transcripts can prove no-shows in New York no-fault insurance cases, as demonstrated in Active Chiropractic v Praetorian Insurance.
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IME no-show denial timely where verification requested after no-show
Court ruling clarifies timing requirements for IME no-show denials when verification is requested after the missed appointment in New York no-fault insurance cases.
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Mr. SK Prime expanded Great Wall
SK Prime Med. Supply case marks first application of Great Wall precedent beyond acupuncture, establishing fee schedule standards for durable medical equipment in no-fault insurance.
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Plaintiff’s medical records are admissible by defendant absent dispute regarding accuracy or veracity
Court ruling establishes that plaintiff's uncertified medical records are admissible when accuracy isn't disputed, offering cleaner evidentiary approach than current hearsay constructs.
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Stipulated to defeat.
Court ruling on medical necessity burden shifting in no-fault insurance case where contemporaneous treatment notes defeat IME testimony in Nassau County trial.
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The articulable need test for a provider EBT on a medical necessity case
New York court ruling shows that provider depositions in no-fault cases require "articulable need" - even minimal disclosure may suffice to block EBT motions.
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Bad faith
Court rules insurer's settlement decision was mistake in judgment, not bad faith, despite significant damages potential in GM case.
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This one is wrong
Court incorrectly applies res judicata in no-fault case where different treatment periods and lack of specific findings should prevent collateral estoppel application.
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It is not a Note of Issue
New York appellate court incorrectly applies CPLR 3212(a) note of issue requirement to Civil Court, where only a notice of trial is filed, creating statutory confusion.
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Mailing from the Court of Appeals – kind of important
Court of Appeals ruling on Preferred Mutual v Donnelly establishes less restrictive test for insurance mailing requirements and proper notice procedures.
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IME no show run amuck
Court ruling on IME no-shows highlights timing issues with claim denials in no-fault insurance cases, showing the complexity of procedural requirements.
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Peer review testimony is admissible and sufficient
Court ruling clarifies that peer review testimony with independent medical record analysis can establish lack of medical necessity in no-fault insurance disputes.
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The 60-day rule that was never published in the law journal
Court applies unpublished 60-day summary judgment rule in Civil Court case, raising procedural questions about timing limits and Second Department review needed.
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IME no-show – Court refused to follow Appellate Division standards
Court refused to follow Appellate Division standards in IME no-show case, incorrectly ruling on mailing requirements and attorney representation burden.
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A prima facie case – not too much needed
Court affirms that third-party biller testimony alone can establish prima facie case in no-fault insurance disputes, following Viviane Etienne precedent.
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