Amendment of 11 NYCRR 68.6 coming soon
New York proposes amending 11 NYCRR 68.6 to limit out-of-state no-fault health service reimbursement to highest NYS fee schedule rates for 2016.
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September 2016 Articles
32 articles published in September 2016
The prejudice rule in action
Court applies prejudice rule when default judgment was vacated before insurer raised timely notice defense under Insurance Law § 3420(c)(2)(B).
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IME no-show affidavit executed 8 years prior to the no show
Court rejected IME no-show affidavits executed 8 years after the missed appointments, emphasizing the need for contemporaneous documentation in no-fault cases.
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EUO no-show substantiated again
Court reinforces proper procedures for proving EUO no-shows in no-fault insurance cases, citing established precedent on certified transcripts and mailing requirements.
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IME no show – complied with Neptune, AT v. Vance and 3.5(b); 3.6(b)
Insurance carriers can successfully deny no-fault claims when patients fail to appear for scheduled IMEs, provided proper procedures are followed for verification requests.
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Notice of intent to cancel – premium finance company
Court ruling highlights insufficient affidavits in no-fault cases where mailing procedures for cancellation notices weren't properly documented by insurers.
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Allstate mailing issues
Pattern of Allstate mailing failures emerges in New York courts, with multiple 2016 cases showing the insurer's inability to prove timely delivery of denial letters.
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Manoo goes up
Appellate Division grants leave to appeal in Mapfre v. Manoo declaratory judgment case, certifying question of law for Court of Appeals review.
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Proof of military status not enough on a material misrepresentation DJ
Court rules that proving military status misrepresentation isn't enough when insurance company fails to timely deny claim in no-fault case.
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Proof insufficient to comply with 65-3.5(b), 65-3.6(b)
Court rules insufficient proof of proper EUO notice and no-show in Liberty Mutual v K.O. Med case, highlighting critical requirements for no-fault insurance denials.
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Affidavit of errors
Understanding affidavit of errors in NY criminal appeals - procedural requirements for town and village court appeals when proceedings aren't stenographically recorded.
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Former Judge Michael Ciaffa has been located
Attorney Jason Tenenbaum reflects on former Judge Michael Ciaffa's transition to private practice and his contributions to no-fault insurance law understanding.
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Jury said the injury was related to a stint in prison
Jury finds no serious injury after plaintiff failed to disclose prison-related pain, affirming verdict against lying plaintiff in NY no-fault case.
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Preliminary injunction denied – the analysis is questionable
Court denies preliminary injunction in Liberty Mutual fraud case, finding insufficient evidence of fraudulent incorporation despite gaps in EUO testimony.
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Supreme Court got it wrong but I saw a tactical error in the EUO
Supreme Court's ruling in State Farm v Thompson highlights strategic missteps in no-fault insurance declaratory judgment cases involving examination under oath procedures.
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What do these cases have in common?
Three 2016 no-fault insurance cases demonstrate how procedural requirements under 11 NYCRR 65-3.5 can derail declaratory judgment actions seeking coverage denials.
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The Court comments on a copy and paste job
Court criticizes insurance carrier's sloppy copy-and-paste affidavit with wrong policyholder name, highlighting importance of careful document preparation in rescission cases.
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Another Article 75 needed to be taken against AAA
Long Island attorney discusses Article 75 petition success against AAA master arbitrator decision in IME no-show case, highlighting systemic issues in no-fault arbitration.
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PL 210.45 verification is a sufficient affidavit
Court accepts Penal Law § 210.45 verified statements as sufficient affidavits to raise factual issues, highlighting New York's antiquated approach to sworn statements.
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Interest when liability is stipulated
Court ruling clarifies that stipulating to liability doesn't trigger prejudgment interest accrual, potentially costing plaintiffs significant money in lengthy cases.
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Failure to check e-mail in e-filed case is a reasonable excuse to a default
First Department rules that failure to regularly check email in e-filed cases can constitute reasonable excuse for vacating defaults, emphasizing particularized explanations.
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Declaratory judgment – ability to oppose the motion en toto?
New York declaratory judgment law: Can defendants oppose motions entirely when multiple parties are named? Analysis of standing requirements and procedural options.
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The missing video
NY court case where plaintiff's belated video disclosure during trial led to complaint dismissal, later reversed on appeal for lack of willful conduct evidence.
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New Jersey arbitration statute requires an application for Article 75 relief
New Jersey arbitration statute requires application for Article 75 relief to compel arbitration in no-fault insurance disputes, as New York procedural law controls over substantive New Jersey law.
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Another unsuccessful 4518(a) challenge
Court rules EUO scheduling letters don't need business records exception when offered to prove mailing, not truth of contents, expanding non-hearsay doctrine.
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Claim rep affidavit sufficient to prove no insurance in effect
New York appellate court ruling shows claim representatives can provide sufficient affidavit evidence to prove no insurance coverage was in effect at time of accident.
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Tolling of interest
New York no-fault insurance law on statutory interest tolling when providers delay prosecution of claims against insurers.
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Unpleaded affirmative defense is sufficient
Court rules unpleaded affirmative defenses of collateral estoppel and res judicata can support summary judgment in no-fault cases without surprise or prejudice.
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MUA with Straniere: Part 2
New Horizon Surgical v Allstate: Court analysis of MUA medical necessity burden of proof and expert witness testimony in New York no-fault insurance disputes.
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A lot here in a Straniere special
New Horizon Surgical Center v Allstate case analysis covering chiropractor MUA procedures, medical necessity burden of proof, and facility fee coverage extensions.
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Discrepancy between the judgment and the decision – decision controls
No-fault insurance case highlights how small-dollar disputes can escalate into costly appeals, raising questions about proportionality in litigation strategy.
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An unincorporated solo practitioner using his own social security number.
Court ruling on proper taxpayer identification requirements for no-fault insurance billing providers and when social security numbers vs EINs must be used.
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