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First Department on Unitrin again

Priority Med. Diagnostics, P.C. v New York Cent. Mut. Fire, Ins. Co., 2015 NY Slip Op 50538(U)(App. Term 1st Dept. 2015)
“The defendant-insurer made a prima facie showing of entitlement to summary judgment dismissing the plaintiff-provider’s claim for first-party no-fault benefits by es

Mailing again

Healthy Way Acupuncture, P.C. v One Beacon Ins. Co., 2015 NY Slip Op 50537(U)(App. Term 1st Dept. 2015)
This time, the Court does not focus so much on the jural relationship between the parties, but the court is focusing on when the person commenced employment with the entity at issue.
“The a

Exhaustion of benefits – strict priority of payment regimen is somewhat abrogaded

Harmonic Physical Therapy, P.C. v Praetorian Ins. Co., 2015 NY Slip Op 50525(U)(App. Term 1st Dept. 2015)
“The defendant-insurer made a prima facie showing of entitlement to summary judgment dismissing the action for first-party no-fault benefits.  The evidentiary proof submitted by defendan

  1. Alan M. Elis says:

    The decision explicitly specifies “that such payments were made in compliance with the priority of payment regulation.” Harmonic did not argue that its claims were received first (harmonic “failed to raise a triable issuE”). It just argued that later payments were “precluded.”

Failure to provide proof of Medicare status kills post-verdict interest

Torres v Visto Realty Corp., 2015 NY Slip Op 03255 (1st Dept. 2015)
“Order, Supreme Court, Bronx County (Lizbeth Gonzalez, J.), entered April 4, 2014, which upon defendant’s motion, vacated the portions of the judgment, same court and Justice, entered November 21, 2013, awarding plainti

Missing features

Hi.  We are currently putting back the comments for full viewing.  I was unaware that the comments were not fully functional until an arbitrator yesterday said something.  If there is anything else missing or that you want on here, let me know.  I only know things are amiss when I am told.

Alrof again…

EMC Health Prods., Inc. v Travelers Ins. Co., 2015 NY Slip Op 50475(U)(App. Term 2d Dept. 2015)
Another Alrof sighting…
“Consequently, plaintiff’s motion for summary judgment was properly denied. However, defendant’s cross motion should also have been denied, as defendant fai

EUO time-frame according to the Appellate Term Second Department

O & M Med., P.C. v Travelers Indem. Co., 2015 NY Slip Op 50476(U)(App. Term 2d Dept. 2015)
“Pursuant to the No-Fault Regulations, “any additional verification required by the insurer to establish proof of claim shall be requested within 15 business days of receipt of the [NF-3]&#8221

Objective basis need not be proven

Metro Psychological Servs., P.C. v 21st Century N. Am. Ins. Co., 2015 NY Slip Op 50470(U)(App. Term 2d Dept. 2015)

Again, the Court states that the failure to provide an objective basis for the performance of EUOs need not be proven to deem the request reasonable.
“Contrary to the determinati

Defaults – the right to notice

Paulus v Christopher Vacirca, Inc.,  2015 NY Slip Op 02944 (2d Dept. 2015)
For the procedural nuts out there, this case holds that notice of the entry of a default judgment must always be on motion to someone who appears in an action.  When is this relevent?  When an answer is stricken; when an a

Cost of doctor for aborted trial not reimbursable

“This negligence action seeks damages for injuries sustained by decedent when she fell on defendants’ premises in the City of Binghamton, Broome County. On the morning that the trial was scheduled to commence, defendants’ counsel appeared and requested an adjournment on the ground