Supreme Court held that Medicaid fee schedule applies to CPM rental
Supreme Court ruling applies Medicaid fee schedule to CPM rental in no-fault insurance case, potentially ending reasonable and customary charges for providers.
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February 2016 Articles
23 articles published in February 2016
Triable issue of fact as to submission of claim
Court finds triable issue of fact exists when insurance company claims non-receipt of claim form but provider has proof of mailing. Untimely submission alone doesn't warrant dismissal.
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The bad faith boondoggle that we knew was coming
Court ruling on GEICO bad faith insurance claim dismissal - analyzing SUM benefits dispute and insurer's duty to act in good faith under NY law.
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The proof of no-show
New York court ruling highlights the importance of proper documentation when proving IME no-shows in no-fault insurance cases, requiring specific basis of knowledge.
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Personal knowledge from the First Department
New York appellate court clarifies personal knowledge requirements for insurance attorneys in EUO no-show cases, highlighting key differences between departments.
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2106 and a prima facie comment
Court ruling on CPLR 2106 affirmations and prima facie requirements for no-fault insurance claims, including chiropractor limitations and 30-day payment rules.
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Scope of testimony regarding “deviations”
Analysis of testimony standards regarding deviations in no-fault medical necessity cases, examining proper questioning techniques and legal rationale requirements.
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A DJ without a purpose
Court dismisses carrier's declaratory judgment lacking Manhattan nexus when arbitration demands filed, highlighting jurisdictional issues in no-fault cases.
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Substantial compliance satisfied stipulation
Court finds substantial compliance with settlement stipulation sufficient grounds to vacate judgment, demonstrating rare but important exception to strict enforcement rules.
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Verification received? I think not.
Court ruling shows employee affidavits can create legal presumptions about mailed verification documents, raising questions about premature insurance claims.
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Unpreserved argument
Court rejects unpreserved argument on appeal in no-fault declaratory judgment case, highlighting importance of raising all meritorious issues at trial level.
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VTL 313(2)(a) not complied with
Court ruling clarifies VTL 313(2)(a) filing requirements for insurance policy terminations and their impact on third-party claims and benefits.
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Trial de novo summary judgment motion appealed
Appellate Division reverses trial court on no-fault insurance denial mailing practices and medical necessity evidence, establishing prima facie case standards.
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Later conflicting statements are “feigned” issues of fact
New York courts reject contradictory statements made to defeat summary judgment, treating later conflicting versions as "feigned issues of fact" rather than genuine disputes.
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Conditional order striking answer trumps cross-motion for summary judgment
Court properly struck defendant's answer for discovery violations, demonstrating that conditional orders must be followed and cross-motions won't save non-compliant parties.
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“reasonable hypothesis” standard under Ins Law 5105
Court upholds arbitration award under Insurance Law 5105's "reasonable hypothesis" standard, confirming vehicle's commercial use met threshold requirements.
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How much is enough to satisfy 3101(d)?
Conway v Elite Towing case explains CPLR 3101(d) expert disclosure requirements for personal injury litigation, including sufficient detail standards and IME report exceptions.
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Statute of limitations
Appellate Division clarifies that self-insured defendants face six-year statute of limitations for no-fault claims, treating them as contractual rather than statutory matters.
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IDS?
New York appellate court upholds trial court's decision to vacate defendant's default judgment based on reasonable excuse for failing to timely respond to petition.
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CPLR 3211(a)(5) motion converted to CPLR 3212 motion
Discover how a CPLR 3211(a)(5) motion can transform into a CPLR 3212 summary judgment motion. Learn about key procedural requirements and notice exceptions in NY civil practice.
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Choice of law – Florida prevails allowing retroactive recission
Florida law prevails in New York court allowing retroactive policy rescission for material misrepresentation in insurance application under Florida Statutes § 627.409.
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The boilerplate “I mailed the verification letters”
Court ruling shows how strategic affidavits can overcome insurance company defenses in no-fault verification disputes, forcing cases to trial.
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One month delay in posting – reasonable excuse established
Long Island no-fault attorney Jason Tenenbaum explains the challenges of maintaining a legal blog while handling complex trials, depositions, and appeals in active practice.
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