Source: https://bruteforcelawyer.com/2012/09/11/no-fault-since-may/
Timestamp: 2019-04-24 04:45:52+00:00

Document:
Automobile Insurance Company, her insurer, seeking to arbitrate her uninsured motorist claim.
Texas, Byron was hauling a trailer owned by a Texas corporation, and Byron resides in Texas.
is to be interpreted in accordance with Royal Indem. Co. v Providence Washington Ins.
Byron under that state's law.
prior to the accident date (see Matter of Mercury Ins. Group v Ocana, 46 AD3d 561).
in the termination of coverage being invalid as to third parties (see Matter of Progressive [*2]Northeastern Ins. Co. v Barnes, 30 AD3d 523; Matter of Progressive N. Ins. Co. v White, 23 AD3d 477).
(see Matter of Chubb Group of Ins. Co. v Williams, 14 AD3d 561).
rather was covered under a different GEICO policy, number 4124247364.
motion. Nationwide appeals and we reverse.
that GEICO policy were not covered under the Policy (see York Restoration Corp. v Solty's Constr., Inc., 79 AD3d 861, 863; see also Government Empls. Ins. Co. v Kligler, 42 NY2d 863, 864-865). In opposition, the plaintiffs failed to raise a triable issue of fact (see Zuckerman v City of New York, 49 NY2d 557, 562).
never existed (see Matter of Worcester Ins. Co. v Bettenhauser, 95 NY2d at 188).
claims sounding in fraud (see e.g. Binyan Shel Chessed, Inc. v Goldberger Ins. Brokerage, Inc., 18 AD3d 590).
time in reply papers (see Kearns v Thilburg, 76 AD3d 705, 708).
of fact in opposition (see Parrott v Coopers & Lybrand, 95 NY2d 479, 483-484).
policy" (Markevics v Liberty Mut. Ins. Co., 97 NY2d 646, 648).
limitation of coverage" (Matter of Transportation Ins. Cos. v Sellitto, 267 AD2d 462, 463; see City of New York v St. Paul Fire & Mar. Ins. Co., 21 AD3d 978, 981). Accordingly, the Supreme Court properly determined that GEICO was under a duty to disclaim coverage in a timely manner.
possible (see Matter of American Express Prop. Cas. Co. v Vinci, 18 AD3d 655, 656; Moore v Ewing, 9 AD3d 484, 488; Matter of Colonial Penn Ins. Co. v Pevzner, 266 AD2d 391), and therefore GEICO is not entitled to rely on the "business pursuits" exclusion of its policy.
policies" (State Farm Fire & Cas. Co. v LiMauro, 65 NY2d 369, 375-376; see Stout v 1 E. 66th St. Corp., 90 AD3d 898).
Here, the GEICO policy states that it is "excess over any insurance,"
insurance, whether primary, excess, contingent or on any other basis."
the GEICO policy must be exhausted first (see State Farm Fire & Cas. Co. v LiMauro, 65 NY2d at 375-376; Vassar Coll. v Diamond State Ins. Co., 84 AD3d 942, 945).
Business Law § 349 (see Wilner v Allstate Ins. Co., 71 AD3d at 167).
Kirtane, 73 AD3d 728 ; Lampkin v Chan, 68 AD3d 727 ).
Bristol Harbour Assoc. v Home Ins. Co., 244 AD2d 885 ).
at bar, with the test employed being "usefulness and reason" (Allen v Crowell-Collier Publ.
review of the allegedly privileged documents.
commencing the proceeding, and unjustifiably failed to do so (see Matter of Government Empls. Ins. Co.
; Matter of New York Cent. Mut.
Fire Ins. Co. v Gershovich, 1 AD3d 364, 365 ; Matter of Government Empls.
Ins. Co. v Rosenfarb, 306 AD2d 478, 478-479 ).
tests to be applied are "common speech" (Ace Wire & Cable Co. v Aetna Cas. & Sur.
Wai Kun Lee v Otsego Mut. Fire Ins. Co., 49 AD3d at 865).
the sufficiency of the plaintiffs' opposition papers (see Winegrad v New York Univ. Med.
Ctr., 64 NY2d 851, 853 ).
Assur. Co. of Am., 304 AD2d 731 ).
Countrywide Ins. Co., 44 AD3d 729, 730-731 ; Westchester Med. Ctr. v Liberty Mut. Ins.
P.C. v GEICO Ins. Co., 24 Misc 3d 542, 545 ; Rockman v Clarendon Natl.
claim within the requisite 30-day period (see Hospital for Joint Diseases v Travelers Prop.
Cas. Ins. Co., 9 NY3d [*2]312, 318 ; Central Gen.
Misc 3d 138[A], 2009 NY Slip Op 51584[U] [App Term, 2d Dept 2009]).
subject policy upon learning, after the accident occurred, that Pemberton had died in 2003.
that the cancellation of a contract pursuant to its provisions may only be effected prospectively.
Metlife Auto & Home v Agudelo, 8 AD3d 571, 572 ; Matter of Integon Ins.
Co. v Goldson, 300 AD2d 396, 397-398 ).
Mut. Auto. Ins. Co. v Fernandez, 23 AD3d 480, 481 ; Matter of Aetna Cas. & Sur.
pending the hearing and determination.
at least some degree of permanence and intention to remain" (Vela v Tower Ins. Co. of NY, 83 AD3d 1050, 1051 , quoting Matter of Allstate Ins. Co. [Rapp], 7 AD3d 302, 303 ). The mere intention to reside at certain premises is not sufficient (see Vela v Tower Ins. Co. of NY, 83 AD3d at 1051).
36 AD3d 763, 765 ), failed to raise a triable issue of fact.
or otherwise (see Pardo v Central Coop. Ins. Co., 223 AD2d 832, 833 ).
the accident (see Pomona Med. Diagnostic v MVAIC, 30 Misc 3d 132[A],2011 NY Slip Op 50042[U][App Term, 1st Dept 2011]).
insurers (see Fair Price Med. Supply Corp. v Travelers Indem. Co., 42 AD3d 277, 285 , affd 10 NY3d 556 ).
30 Misc 3d 132[A],2011 NY Slip Op 50042[U][App Term, 1st Dept 2011]).
York Univ. Med. Center, 64 NY2d 851, 853 ; Center Candy, Inc. v CJB Food Mart, Inc., 50 AD3d 723 ).
NY Slip Op 50042[U][App Term, 1st Dept 2011]).
of the sufficiency of plaintiff's opposition (see Alvarez v Prospect Hosp., 68 NY2d 320, 324 ).
3d 127[A], 2011 NY Slip Op 51835[U] [App Term, 2d Dept 2011]).
assignor's obligation to provide notice of the accident "to a police, peace or judicial officer"
v Motor Veh. Acc. Indem. Corp., 82 AD3d 1102 ).
underlying notices (see Unitrin at 560).
factual basis for what amounts to, at best, mere suspicions" (Devore v Pfizer Inc., 58 AD3d 138, 144 , lv denied 12 NY3d 703 ).
(see Nassau Ins. Co. v Murray, 46 NY2d 828, 829-830 ).
from the record of counsel's representation letter.
We note plaintiff's failure to file a respondent's brief on appeal.
plaintiff's assignor's intoxication at the time of the accident (see generally Westchester Med. Ctr. v Progressive Cas. Ins. Co., 51 AD3d 1014; Rodriguez v Triborough Bridge & Tunnel Auth., 276 AD2d 769 ; LaDuke v State Farm Ins. Co., 158 AD2d 137 ).
2008 NY Slip Op 52046[U] [App Term, 9th & 10th Jud Dists 2008]).
before this court as they are raised for the first time on appeal (see Joe v Upper Room Ministries, Inc., 88 AD3d 963 ).
summary judgment (Ave T MPC Corp. v Auto One Ins. Co., 32 Misc 3d 128[A], 2011 NY Slip Op 51292[U] [App Term, 2d, 11th & 13th Jud Dists 2011]; see also Westchester Med. Ctr. v Nationwide Mut. Ins. Co., 78 AD3d 1168 ).
2011]). Plaintiff's remaining contentions on appeal lack merit (see e.g. Urban Radiology, P.C. v Tri-State Consumer Ins. Co., 27 Misc 3d 140[A], 2010 NY Slip Op 50987[U] [App Term, 2d, 11th & 13th Jud Dists 2010]).
office (see Residential Holding Corp. v Scottsdale Ins. Co., 286 AD2d 679 ; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 [App Term, 2d & 11th Jud Dists 2007]).
2009]). In light of the foregoing, we reach no other issue.
judgment dismissing the complaint is granted.
those claims (see Raz Acupuncture, P.C. v AIG Indem. Ins. Co., 28 Misc 3d 127[A], 2010 NY Slip Op 51177[U] [App Term, 2d, 11th & 13th Jud Dists 2010]).
of fact as to whether verification is outstanding.
for the supplies at issue (compare Delta Diagnostic Radiology, P.C. v Integon Natl. Ins. Co., 24 Misc 3d 136[A], 2009 NY Slip Op 51502[U] [App Term, 2d, 11th & 13th Jud Dists 2009]; Delta Diagnostic Radiology, P.C. v American Tr. Ins. Co., 18 Misc 3d 128[A], 2007 NY Slip Op 52455[U] [App Term, 2d & 11th Jud Dists 2007]), defendant's cross motion was properly denied.
assignors had failed to appear for the IMEs scheduled with each of them.
assignors' nonappearance is conclusory and unsupported by the record.
services rendered (see Insurance Department Regulations [11 NYCRR] § 65-1.1).
Med., P.C. v Mercury Cas.
Dists 2009]) and that there was an unmet personal injury protection deductible.
Hosp. Med. Ctr. of Queens v Motor Veh. Acc. Indem. Corp., 12 AD3d 429 ).
to submit an affidavit or affirmation from a medical professional (see Total Equip., LLC v Praetorian Ins.
2012]; Total Equip., LLC, 34 Misc 3d 141[A], 2012 NY Slip Op 50078[U]).
50601[U] [App Term, 2d, 11th & 13th Jud Dists 2010]; Park Slope Med. & Surgical Supply, Inc. v New York Cent. Mut. Fire Ins.
Hosp. v New York Cent. Mut. Fire Ins. Co., 24 AD3d 492 ).
[App Term, 2d, 11th & 13th Jud Dists 2011]).
the injured person] to make such a report or that it was made as soon as was reasonably possible"
2009 NY Slip Op 50440[U] [App Term, 2d, 11th & 13th Jud Dists 2009]).
Assur. Co., 21 Misc 3d 45 [App Term, 2d & 11th Jud Dists 2008]).
it is required to produce all of the information sought therein.
16 [App Term, 2d & 11th Jud Dists 2007]).
granted the motion. We reverse.
party, to the prior arbitration proceeding, the doctrine of collateral estoppel is inapplicable (see Alev Med. Supply, Inc. v Allstate Prop.
[App Term, 2d & 11th Jud Dists 2005]).
133[A], 2010 NY Slip Op 51338[U] [App Term, 2d, 11th & 13th Jud Dists 2010]).
provided MVAIC with a written justification for its untimely submission of the claim form.
135[A], 2011 NY Slip Op 52018[U] [App Term, 2d, 11th & 13th Jud Dists 2011]).
term applicant' as a generic reference to both provider/assignees and injured persons" (East Acupuncture, P.C. v Allstate Ins.
Co., 61 AD3d 202, 210 ).
answer should have been denied.
motion to open its default and compel the acceptance of its late answer is denied.
dismissing the complaint should not have been granted.
Maryland Cas. Co., 90 NY2d 274, 282 ).
131[A], 2006 NY Slip Op 51871[U], *2 [App Term, 2d & 11th Jud Dists 2006]).
67A NY Jur 2d, Injunctions § 213; 12A Carmody-Wait 2d § 78:230, at 441-442).
dismissal of the complaint was required pursuant to CPLR 3215 (c).
127[A], 2011 NY Slip Op 51835[U] [App Term, 2d, 11th & 13th Jud Dists 2011]).
provided, and agreed that defendant had the burden of going forward as a result of the stipulation.
section 3103 to prevent abuse." There is nothing in the trial record to indicate that plaintiff moved for a protective order pursuant to CPLR 3103.
new trial limited to the issue of medical necessity.
the acceptance of its late answer should have been denied.
order, had not been made.
benefits had been made in accordance with the Workers' Compensation Law (see e.g.
be dismissed, the order, insofar as appealed from, is affirmed.
disperse medical supplies directly to the patient, and that the practice was followed in this case.
Zuckerman v City of New York, 49 NY2d 557 ).
the cross motion was timely and properly served pursuant to CPLR 2215.
sufficient facts to support such a finding (see CPLR 2103 [b] ).
the cross motion should not have been considered.
Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 ).
one unit of time, i.e., 15 minutes.
opposition to plaintiff's motion was nevertheless insufficient to establish a triable issue of fact.
been shown to be warranted (see A.B.
of the foregoing, defendant did not raise a triable issue of fact in opposition to plaintiff's motion.
trial to the issue of the medical necessity of the supplies provided.
opportunity to establish its defense of lack of medical necessity.
medically necessary. We reject plaintiff's argument.
ground that the services or supplies provided lacked medical necessity.
sufficient to establish that the medical documentation reviewed by Dr.
sustain plaintiff's objection to the admissibility of the records.
the fact of plaintiff's assignor's injuries.
expressly agreed to such request for services.
dismissing plaintiff's claims for the unpaid portions of those bills.
cross motion seeking summary judgment dismissing those claims.
March 9, 2007 IME for March 23, 2007.
City of New York, 49 NY2d 557 ).
NYCRR] § 65-3.5 [a]; Insurance Law 5106 [a]; Westchester Med. Ctr. v Lincoln Gen.
Med. Ctr. v Lincoln Gen. Ins. Co., 60 AD3d at 1046; but see Unitrin Advantage Ins. Co.
that the fees sought were improper.
purpose, they did not need to qualify as business records (see Five Boro Psychological Servs., P.C. v Progressive Northeastern Ins.
141[A], 2010 NY Slip Op 50990[U] [App Term, 2d, 11th & 13th Jud Dists 2010]).
timely mailed (see St. Vincent's Hosp.
2d, 11th & 13th Jud Dists 2011]).
cannot establish its prima facie case.
at issue had been timely mailed (see St.
) and the omitted pages "did not pose any possibility of confusion or prejudice to . . .
Chiropractic & Acupuncture, PLLC v American Employers' Ins. Co. Div. of Onebeacon Am. Ins.
been assigned by the same individual and have arisen from the same accident (see Jamaica Med. Supply, Inc. v NY Cent.
Mut. Fire Ins. Co., 34 Misc 3d 21, 23 [App Term, 2d, 11th & 13th Jud Dists 2011]; A.B. Med. Servs. PLLC v USAA Gen.
that plaintiff failed to comply with a condition precedent to coverage (see Westchester Med. Ctr. v Lincoln Gen.
only against those who were either a party, or in privity with a party, to a prior proceeding (Russell v New York Cent. Mut. Fire Ins.
inapplicable (see Magic Recovery Med.
Tsatskis v State Farm Fire & Cas. Co., 2012 NY Slip Op 51268(U) (App. Term, 9th & 10th Jud. Dists. 2012).
demonstrate that the insurance policy at issue contained an endorsement permitting EUOs.
140[A], 2010 NY Slip Op 51605[U] [App Term, 1st Dept 2010]; Eagle Chiropractic, P.C. v Chubb Indem.
2011 NY Slip Op 52023[U], *1).
[b]; § 65-3.8 [j]; St. Vincent Med.
Care, P.C. v Travelers Ins. Co., 26 Misc 3d 144[A], 2010 NY Slip Op 50446[U]).
Parochial Bus Sys. v Board of Educ. of City of NY, 60 NY2d 539 ).
plaintiff's assignor to appear at an independent medical examination (see Presbyterian Hosp.
Mut. Auto. Ins. Co. v Hertz Corp., 43 AD3d 907, 908 ; Midisland Med., PLLC v NY Cent. Mut.
Jud Dists 2010]). However, it was subscribed by the parties' attorneys (see CPLR 2104).
Travelers Home & Mar. Ins. Co., 55 AD3d 644 ; Dan Med., P.C. v New York Cent. Mut.
form was mailed to plaintiff, defendant did not show that it had timely denied the claims.
merely asserted that he had insufficient documentation and information (see Midisland Med., PLLC v Allstate Ins.
matter of law (see id.; A.B. Med.
50114[U] [App Term, 2d & 11th Jud Dists 2005]).
stipulation, pursuant to which plaintiff is precluded from offering evidence of its claims.
Consequently, plaintiff cannot make out its prima facie case.
(5) to dismiss the complaint on the ground of collateral estoppel.
664 ; Uptodate Med. Servs., P.C.
made "contact" with plaintiff's assignor, and a copy of the judgment dismissing the prior action.
Gen. Hosp., 90 NY2d at 199).
Term, 2d, 11th & 13th Jud Dists 2009]).
date, and the return receipt was not signed by a recipient and did not indicate a date of delivery.
after the commencement of the action, some three years after the purported mailing.
; Kincade v Kincade, 178 AD2d 510 ).
145[A], 2012 NY Slip Op 50151[U] [App Term, 2d, 11th & 13th Jud Dists 2012]; High Quality Med., P.C. v. Mercury Ins.
145[A], 2012 NY Slip Op 50151[U]; New Millennium Psychological Servs., P.C. v Unitrin Advantage Ins.
AD3d 494 ; Collins v AA Truck Renting Corp., 209 AD2d 363 ).
Consequently, this peer review report failed to meet the requirements of CPLR 2309 (b).
65-3.8 [a] ), and, as a result, defendant's denial of plaintiff's claim was untimely.
which was based upon the defense that plaintiff's assignor had failed to appear for an EUO.
do not pass upon the propriety of the Civil Court's determination with respect thereto.
Liberty Mut. Ins. Co., 31 AD3d 724, 725 ; Matter of State Farm Mut. Auto. Ins.
(see Matter of Auto One Ins. Co. v Forrester, 78 AD3d at 1175; Tobias v Liberty Mut.
Fire Ins. Co., 78 AD3d 928 ).
judgment on the first and second causes of action are denied.
remaining as to the third cause of action is whether verification is still outstanding.
related to the discovery requested.
employee of National Claim Evaluations, Inc. to establish that the IME had been scheduled.
other things, that defendant had hired Transcion Medical, P.C. to schedule IMEs of the assignor.
failed to establish its defense based upon the failure of plaintiff's assignor to appear at an IME.
2010, the Civil Court (Maureen A. Healy, J.) denied the motion.
; cf. Mora v Mora, 39 AD3d 829 ).
83 AD3d 696, 697 ).
52382[U] [App Term, 2d, 11th & 13th Jud Dists 2011]).
11th & 13th Jud Dists 2010]).
papers copies of the medical records which had been reviewed by defendant's peer reviewer (see Elmont Open MRI & Diagnostic Radiology, P.C. v New York Cent.
permissibly placed on the report by the chiropractor who had performed the peer review (see Quality Health Prods. v Geico Gen. Ins.
& 13th Jud Dists 2010]).
light of the foregoing, we reach no other issue.
153[A], 2012 NY Slip Op 50342[U] [App Term, 2d, 11th & 13th Jud Dists 2012]).
summary judgment dismissing the complaint is vacated and the motion is denied.
at issue in the third cause of action.
dismissing the complaint should not have been granted as to that claim.
You're lucky I get this far. I'll post the lower court decisions at my leisure. Probably never.

References: § 349
 § 65
 § 213
 § 78
 § 65
 § 65
 v.