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Renelique v National Liab. & Fire Ins. Co., 2016 NY Slip Op 50254(U)(App. Term 2d Dept. 2016) “With respect to defendant’s cross motion, “[t]he proponent of a summary judgment motion must make a prima facie showing of entitlement to judgment as a matter of law, tendering sufficient evidence to eliminate any material issues of fact from […]
EMC Health Prods., Inc. v National Liab. & Fire Ins. Co., 2016 NY Slip Op 50132(U)(App. Term 2d Dept, 2016) “However, in opposition to the cross motion, plaintiff submitted an affidavit from plaintiff’s employee, which affidavit was sufficient to give rise to a presumption that the requested verification had been mailed to, and received by, defendant […]
Contact Chiropractic, P.C. v New York City Tr. Auth., 2016 NY Slip Op 00325 (2d Dept. 2016) “The Appellate Term correctly determined that an action by an injured claimant, or his or her assignee, to recover first-party no-fault benefits from a defendant who is self-insured, is subject to a six-year statute of limitations, since the claim […]
Gutierrez v Tri State Consumers Ins. Co., 2015 NY Slip Op 51703(U)(App. Term 2d Dept. 2015) “Defendant demonstrated that the assignor, who was also the insured under the insurance policy in question, had misrepresented, among other things, his use of the subject vehicle when he had submitted his application for insurance to defendant. However, defendant failed to […]
Compas Med., P.C. v American Tr. Ins. Co., 2015 NY Slip Op 51675(U)(App. Term 2d Dept. 2015) “Indeed, the application for no-fault benefits form, which was signed by plaintiff’s assignor under penalty of perjury, states that the assignor was in the course of his employment when he was injured, an admission that is sufficient to raise […]
Austin Diagnostic Med., P.C. v Mercury Cas. Co., 2015 NY Slip Op 51680(U)(App. Term 2d Dept. 2015) (1)”Plaintiff commenced this action to recover first-party no-fault benefits as assignee of nine individuals. The complaint alleged separate causes of action for each assignor. Defendant moved, pursuant to CPLR 603, to sever the second through ninth causes of action […]
Johnson v Robertson, 2015 NY Slip Op 06658 (2d Dept. 2015). Moreover, “[p]roof of damages may be based solely on oral testimony as long as the witness has knowledge of the actual costs” (Electronic Services. Intl. v. Silvers, 284 A.D.2d 367, 368, 726 N.Y.S.2d 441). The record demonstrates that the Robertson defendants, who had 20 years […]
Want to cancel a policy that insures against proper damage?  Material misrepresentation will do it.   A policy that of insurance that insures against death or personal injury?  3105 will not apply and all cancellations will be prospective at best. Against this reality came the lack of reality that is SS Med. Care, PC v USAA […]
Gutierrez v United Servs. Auto. Assn., 2015 NY Slip Op 50797(U)(App. Term 2d Dept. 2015) “Plaintiff correctly argues that defendant failed to demonstrate that it is not precluded from asserting its proffered defense—that the insurance policy at issue was fraudulently procured—as it failed to establish that it had timely denied plaintiff’s claim on that ground (see […]
Castlepoint Ins. Co. v Jaipersaud, 2015 NY Slip Op 02839 (1st Dept. 2015) “Thus, we are constrained to find that plaintiff is under no duty to defend or indemnify defendant insureds, in the personal injury action brought against them by defendant Fernando, notwithstanding the inherent inequity of Castlepoint’s acceptance and retention of premiums paid by defendants […]
Matter of Liberty Mut. Ins. Co. v Young, 2015 NY Slip Op 00377 (2d Dept. 2015) “A deliberate collision by an insured is not a covered event under an insurance policy (see Matter of Liberty Mut. Ins. Co. v Goddard, 29 AD3d 698, 699; State Farm Mut. Auto. Ins. Co. v Laguerre, 305 AD2d 490, 491;Matter of […]
Nationwide Gen. Ins. Co. v Pontoon, 2014 NY Slip Op 09001 (2d Dept. 2014) “The referee incorrectly concluded that GEICO was required to submit evidence that Pontoon was involved in staging the collision in order to support a disclaimer of coverage. Contrary to the referee’s conclusion, if GEICO can prove that the collision was staged by […]
Boris Kleyman Physician, P.C. v IDS Prop. Cas. Ins. Co., 2014 NY Slip Op 51810(U)(App. Term 2d Dept. 2014) “Defendant’s contention that plaintiff did not establish that it has standing to receive reimbursement of the first-party no-fault benefits to which its assignor is entitled because plaintiff failed to annex a copy of the assignment of benefits […]
Matter of Utica Mut. Ins. Co. v Burrous, 2014 NY Slip Op 06986 “From the eyes of the decedent” “Contrary to the Supreme Court’s determination, Utica is not entitled to a permanent stay of arbitration, and that branch of its petition should have been denied. In State Farm Mut. Auto. Ins. Co. v Langan (16 NY3d 349), the […]
Okslen Acupuncture P.C. v Unitrin Advantage Ins. Co., 2014 NY Slip Op 51290(U)(App. Term 1st Dept. 2014) “The defendant-insurer failed to demonstrate entitlement to depositions relating to its excessive treatment and fee schedule defenses, in the absence of any affirmative showing that it preserved those defenses by timely denying plaintiff’s 2006 first-party no-fault claim (see Triangle […]
Optimal Well-Being Chiropractic, P.C. v Utica Mut. Ins. Co., 2014 NY Slip Op 51233(U)(App. Term 2d Dept, 2014) “While defendant sought summary judgment on the grounds that plaintiff’s assignor had failed to appear for independent medical examinations and that plaintiff was seeking to recover for treatment which the assignor swore he never received, defendant failed to […]
Dyckman Med. Diagnostic/Treatment, P.C. v Granite State Ins. Co., 2014 NY Slip Op 51026(U)(App. Term 2d Dept. 2014) (1) “A defendant seeking summary judgment dismissing a complaint on statute of limitations grounds bears the initial burden of establishing, prima facie, that the time in which to commence the action had expired (see 6D Farm Corp. v […]
Delta Diagnostic Radiology, P.C. v Infinity Group, 2014 NY Slip Op 50602(U)(App. Term 2d Dept. 2014) The EUO was sufficient to raise an issue of fact as to the fraudulent procurement issue.  Now, you need to subpoena the assignor for trial and have the Civil Court enforce a judicial subpoena.  I feel pains even thinking about […]
V.S. Med. Servs., P.C. v State Farm Mut. Ins. Co., 2014 NY Slip Op 50615(U)(App. Term 2d Dept. 2014) “Prior to trial, the parties stipulated that the sole question for the jury’s determination was whether the motor vehicle collision at issue was the result of an intentionally caused event. An investigator from defendant’s Special Investigation Unit […]
Doctrinally, a fraudulent procurement defense should not be bound by the 30-day pay or deny rule.  This is so since the Appellate Division in Kaplun specifically held that an insurance carrier can seek recompense from an EIP for monies paid out due to this fraud and, therefore, the defense can be raised at an time. […]
Universal Health Chiropractic, P.C. v Infinity Prop. & Cas. Co., 2014 NY Slip Op 50350(U)(App. Term 2d Dept. 2014) No preclusion here. “The vehicle involved in the accident at issue was, at the time of the accident, insured by defendant under a Florida automobile insurance policy issued to plaintiff’s assignor. After an investigation into the accident […]
Great Health Care Chiropractic, P.C. v Lancer Ins. Co., 2014 NY Slip Op 50340(U) All that is required is: “[a] triable issue as to whether plaintiff’s assignor had been acting in the course of his employment at the time of the accident and that, therefore, workers’ compensation benefits might be available.” A triable issue of fact […]
Country-Wide Ins. Co. v Preferred Trucking Servs. Corp., 2014 NY Slip Op 01099 (2014) “The present appeal, on the other hand, involves disclaimer for noncooperation by an insured. A determination as to whether such a disclaimer was made within a reasonable time is more complex because “an insured’s noncooperative attitude is often not readily apparent” (Continental […]
Contact Chiropractic, P.C. v New York City Tr. Auth., 2013 NY Slip Op 23410 (App. Term 2d Dept. 2013) “Defendant contended therein that, since it does not maintain an insurance [*2]policy, its obligation to provide no-fault benefits is statutorily imposed (Insurance Law § 5103; see Insurance Department Regulations [11 NYCRR] § 65-2.1) and governed by […]
Great Health Care Chiropractic, P.C. v Omni Indem. Co., 2013 NY Slip Op 51450(U)(App. Term 2d Dept. 2013) “In support of its motion, defendant submitted affidavits of its litigation manager and the claims litigation manager of American Independent Insurance Company (AIIC) which sufficiently established defendant’s lack of coverage defense” “Notably, the AIIC claims litigation manager […]
Wexford Med., P.C. v Commerce Ins. Co., 2013 NY Slip Op 51193(U)(App. Term 2d Dept. 2013) “The complaint alleges that “health services” were rendered to the assignor on January 9, 2003, that a bill for such services was “timely received” by defendant insurer, and that defendant failed to properly deny the bill within 30 days […]
Central Radiology Servs., P.C. v First Am. Ins., 2013 NY Slip Op 51031(U)(App. Term 2d Dept. 2013) [There was some discussion regarding procedural issues.  All I would note that is you are seeking to dismiss based upon a personal jurisdiction defense, make sure that is the relief that you seek; not for leave to to […]
Jian Kang, Inc. v New York Cent. Mut. Fire Ins. Co., 2013 NY Slip Op 50851(U)(App. Term 2d Dept. 2013) (1) In this action by a provider to recover assigned first-party no-fault benefits, defendant denied plaintiff’s claims on the ground of “material misrepresentation” because plaintiff had billed for a heating pad which defendant had determined had […]
Urban Radiology, P.C. v GEICO Gen. Ins. Co., 2013 NY Slip Op 50850(U)(App. Term 2d Dept. 2013) (1) Law requiring AOB “The Civil Court dismissed the complaint, finding that plaintiff had not established a prima facie case because it had not offered into evidence an assignment of benefits. While the claim forms at issue did not […]
Parkway Pain Mgt., PLLC v American Tr. Ins. Co., 2013 NY Slip Op 50521(U)(App. Term 2d Dept. 2013) “We find that defendant’s proof, including the police accident report, was sufficient to raise a question of fact as to whether plaintiff’s assignor had been acting as an employee at the time of the accident, which issue must […]
Ideal Med. Supply v Mercury Cas. Ins. Co., 2013 NY Slip Op 23068 (App. Term 1st Dept. 2013) “Although plaintiff’s assignor was a named party in the prior action, plaintiff cannot be deemed to be in privity with its assignor, since the declaratory judgment action was commenced after the assignment” Perhaps the concurrence is more […]
United States v. Leslie Dantes Theodore (11 CR 829)(SDNY 2013)   MR. BELL: Your Honor, not for the purposes of the allocution. I will note that at the bottom of page 4 of the plea agreement, three lines from the bottom, there is a provision that does not frequently occur, but it may be worth […]
W & Z Acupuncture, P.C. v Unitrin Auto & Home Ins. Co., 2012 NY Slip Op 52400(U)(2d Dept. 2012) Insurance carrier sought an EBT of the medical provider based upon the “independent contractor” defense.  Until three months ago, this defense escaped preservation.  Not so anymore.   The Court was therefore constrained to reverse the Civil Court: […]
New York Hosp. Med. Ctr. of Queens v Utica Mut. Ins. Co., 2012 NY Slip Op 52388(U)(App. Term 2d Dept. 2012) In this case, the Plaintiff Assignor jumped on a parked car and walked away and the complaint was dismissed “In support of its cross motion, defendant submitted an affidavit by its insured who stated […]
Ural v Encompass Ins. Co. of Am.,  2012 NY Slip Op 05407 (2d Dept. 2012) This was a rough opinion.  I am glad not to be on the receiving end of this one.  Here are the pertinent parts: “However, after a year of attempting to negotiate a settlement, and after receiving what he considered inadequate […]
21st Century Advantage Ins. Co. v Cabral Look, 21st Century did their homework.  Someone admitted to defrauding the insurance companies.  Yet, Mr. All Boro, a distant relative of of Mr. Five Boro felt the need to put in gratuitous opposition to the preliminary injunction motion.  As such, more paper and judicial resources were were wasted […]
W.H.O. Acupuncture, P.C. v Infinity Prop. & Cas. Co., 2012 NY Slip Op 22142 (App. Term 2d Dept. 2012) It was interesting to see a discussion on the nuances of Florida PIP law.  It has been under such lately, especially as they seek to crack down on perceived abuses of the law.  Putting aside the […]
Citibank, N.A. v Van Brunt Props., LLC, 2012 NY Slip Op 03974 (2d Dept. 2012) In the world of multiple assignments, it is sometimes asked whether you can assign a chose of action or an interest in something after the commencement of a lawsuit?  The answer is “yes” and an order concomitantly amending the caption […]
I have here a repository of some of the documents that I either ordered or found on Pacer regarding the following individuals: 1) Defendant Mugerman (Unlimited and Infinity) 2) Defendants Shapiro & Bronshteyn (Bath Medical, Alev Medical) and plea agreement (Shapiro) and plea agreement (Bronshteyn). 3) Defendant Shturman (TriMed Supply, Dorsey Medical Supply) and plea […]
B.Y., M.D., P.C. v Global Liberty Ins. Co. of N.Y., 2012 NY Slip Op 50156(U)(App. Term 2d Dept. 2012) This would normally win the Mr. Five Boro award, but Eagle v. Progressive took that title today.  This comes in a very close second.  Read the first two paragraphs. Point 1: The order, insofar as appealed […]
A.B. Med. Servs., PLLC v American Tr. Ins. Co., 2012 NY Slip Op 50076(U)(App. Term 2d Dept. 2012) This case in many ways represents the shuffelling of too many papers.  There is an interesting take from this case: “The District Court granted leave to renew based on plaintiffs’ purported “new facts.” However, the “new facts” […]
Arzu v NYC Tr. Auth., 2012 NY Slip Op 22008 (Civ. Ct. Kings Co. 2012) The last thorny issue in PIP practice that has not gotten much attention: 65-3.9(d).  This is the toll of interest that applies when a plaintiff lets a case sit in limbo ad finitium. As we all know, interest accrues at […]
EBM Med. Health Care, P.C. v Amica Mut. Ins. Co., 2011 NY Slip Op 51720(U)(App. Term 2d Dept. 2011). How do you lose a statute of limitations case… Well… In the no-fault context, a cause of action accrues when payment of no-fault benefits becomes “overdue” (see Insurance Law § 5106 [a]; see also Benson v […]
New York Cent. Mut. Ins. Co. v McGee,  2011 NY Slip Op 06253 (2d Dept. 2011) Point one: A Malella defense (or cause of action) against different providers, despite different contracts of insurance, should be consolidated. “The Supreme Court improvidently exercised its discretion in, sua sponte, severing the action as to the 12 PCs, and, […]
Health & Endurance Med., P.C. v Travelers Prop. Cas. Ins. Co., 2011 NY Slip Op 51120(U)(App. Term 2d Dept. 2011) Contrary to plaintiff’s contention, defendant was permitted to move to dismiss on the ground that the complaint fails to state a cause of action notwithstanding defendant’s service of an answer (CPLR 3211 [a] [7]; [e]). […]
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What personal information is collected through this website and how is it used?

We collect information about our users in three ways: directly from the user, from our Web server logs and through cookies. We use the information primarily to provide you with a personalized Internet experience that delivers the information, resources, and services that are most relevant and helpful to you. We don’t share any of the information you provide with others, unless we say so in this Privacy Policy, or when we believe in good faith that the law requires it. 

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