Key Takeaway
Court ruling demonstrates how defendant's affidavits from driver and passenger can establish prima facie case that no contact occurred in no-fault insurance claim.
Understanding No-Contact Defense in No-Fault Insurance Cases
In New York’s no-fault insurance system, medical providers often file lawsuits seeking payment for treatment provided to patients injured in motor vehicle accidents. However, insurance companies can defend against these claims by arguing that no covered incident actually occurred. One of the most straightforward defenses involves establishing that there was no physical contact between the insured vehicle and the injured party.
The recent Appellate Term decision in Compas Med., P.C. v United Servs. Auto. Assn. illustrates how defendants can successfully challenge no-fault insurance claims when they can demonstrate that no contact occurred between their insured vehicle and the allegedly injured person.
Jason Tenenbaum’s Analysis:
Compas Med., P.C. v United Servs. Auto. Assn., 2018 NY Slip Op 50764(U)(App. Term 2d Dept. 2018)
“In support of its motion, defendant proffered an affidavit by its insured, who averred that she had not struck anyone with her vehicle. The insured’s passenger also submitted an affidavit, in which she stated that the insured vehicle had not come into contact with a pedestrian. The affidavits were sufficient to demonstrate, prima facie, that “the alleged injur do[] not arise out of an insured incident” (Central Gen. Hosp. v Chubb Group of Ins. Cos., 90 NY2d 195, 199 ; see Andromeda Med. Care, P.C. v NY Cent. Mut. Fire Ins. Co., 26 Misc 3d 126, 2009 NY Slip Op 52601 ; Midwood Med. [*2]Equip. & Supply, Inc. v USAA Cas. Ins. Co., 25 Misc 3d 139, 2009 NY Slip Op 52379 ). “
Key Takeaway
This decision reinforces that sworn affidavits from both the insured driver and passengers can establish a prima facie defense that no contact occurred. When defendants can substantiate their position with credible witness testimony, the burden shifts to plaintiffs to demonstrate that a covered incident actually took place, making these cases significantly more challenging for medical providers to pursue.
