3101(d) from the Court of Appeals
Court of Appeals clarifies CPLR 3101(d) expert witness disclosure requirements, timing objections, and trial court discretion in Rivera v Montefiore Medical Center.
Read More → 📅
October 2016 Articles
28 articles published in October 2016
Punted satisfaction case
J.K.M. Med. Care v Interboro Insurance case analysis: provider's satisfaction case involving successive motions and judgment entry timing in no-fault benefits dispute.
Read More →
Judgment in declaratory judgment action does not need to rendered against Assignor to be effective
New York court rules judgment in declaratory action bars assignee recovery without direct order against assignor in no-fault insurance case.
Read More →
A Frye hearing is required where two sides have opposing literature on a contested novel service
Frye hearing required when experts present conflicting literature on novel medical theories. Court analysis of prenatal neuroblastoma detection standards.
Read More →
Causation not proved
Court dismisses personal injury case where plaintiff failed to prove causation between car accident and cervical injuries, distinguishing new trauma from preexisting neck condition.
Read More →
Policy exhaustion and fee schedule concerns
Easy Care Acupuncture v MVAIC case explores policy exhaustion defenses and fee schedule reductions in New York no-fault insurance acupuncture claims disputes.
Read More →
EUO no show is unconditional
Appellate Term reinforces that failing to appear for EUO is unconditional bar to coverage, rejecting Civil Court's attempt to allow second chance for medical provider.
Read More →
Putting the cart before the horse?
Court rejects insurance defense motion due to improper notarization where notary signature preceded the affiant's signature, highlighting critical procedural requirements.
Read More →
Claims representative’s attestation is sufficient to make a prima facie showing
Court ruling establishes that a claims representative's affidavit explaining fee calculations using relative values and conversion factors creates sufficient prima facie evidence.
Read More →
More verification non receipt issues
Multiple 2016 New York appellate cases highlight ongoing disputes over insurance companies' claims of receiving additional verification requests in no-fault insurance disputes.
Read More →
Maya again loses their no show cases
Maya Assurance Company loses three no-show IME cases in 2016, highlighting common defenses used by healthcare providers in no-fault insurance disputes.
Read More →
Lack of coverage: there was no lease for the vehicle
Court affirms no coverage where auto leasing company's employee affidavit proved no policy existed for the vehicle on accident date, establishing prima facie defense.
Read More →
IME scheduling letters: inclusion of an apartment number
Court ruling clarifies that insurance companies can use apartment numbers in IME scheduling letters even if not on original claim forms, with proper affidavit evidence.
Read More →
Rocket docket at the First Department
First Department appeal challenging rocket docket preclusion in no-fault case, examining law office failure standards and interest of justice review procedures.
Read More →
IME no show not upheld
Court rejects insurance carrier's attempt to overturn no-fault arbitration award after failing to include required reimbursement language in IME notices.
Read More →
Default granted but summary judgment motion denied
Global Liberty Ins. Co. v W. Joseph Gorum case analysis: court grants default but denies summary judgment on medical necessity peer review signature issues.
Read More →
Snooze and lose rule – Tremendous consequences
New York's brutal 20-day rule for staying arbitration when there's no coverage - Allstate loses SUM coverage dispute after missing deadline by months
Read More →
Fee Schedule and 8 unit issue
Liberty Chiropractic v 21st Century Insurance case examining fee schedule defenses and 8-unit limitations under NY no-fault law, authentication requirements.
Read More →
EUO loss (again)
Insurance company loses summary judgment motion for failing to provide proper proof of plaintiff's non-appearance at examination under oath hearing.
Read More →
IME no show – reasonableness not enterained
Court finds IME requests reasonable despite patient's prior IME attendance, ruling no-shows bar no-fault benefits regardless of reasonableness objections.
Read More →
The verifications were not mailed
A no-fault insurance case where inadequate affidavits led to defeat, highlighting the importance of learning from legal mistakes and improving documentation strategies.
Read More →
Verification non-receipt – Partial response insufficient
Court rules partial response to verification requests insufficient, requiring complete verification before claim payment or denial under NY no-fault law.
Read More →
Non-receipt defense prevails
Court rules on non-receipt defense in no-fault insurance case where defendant successfully proved they never received claim form, highlighting e-filing benefits.
Read More →
The dates of the EUO’s do not need to be placed in the letters
NY court rules EUO scheduling letter dates need not be included in denial forms. Case law analysis on no-fault insurance EUO notice requirements.
Read More →
The DME equivalent of Robert Physical Therapy plays out
New York court rules that DME not included in fee schedules can still be compensable under 11 NYCRR 68.5, overturning insurance carrier arguments.
Read More →
What’s the over under on this appeal scheduled for the December term
Jason Tenenbaum analyzes a no-fault insurance case heading to appeal, predicting reversal due to insurer's procedural failures in EUO scheduling and discovery tactics.
Read More →
False statement about prior injuries warrants further discovery
Discovery of false statements about prior injuries after case filing can warrant additional examinations under oath, potentially leading to coverage disclaimer.
Read More →
Another arbitrator and master arbitrator get shamed for not following the law
Court vacates master arbitration award for failing to consider IME report despite electronic signature, highlighting CPLR 2106 flexibility in no-fault cases.
Read More →