Courtside by Larry Rogak brings to the fore cases and decisions of relevance to doing insurance business. Some of the results are, in a word, “unbelievable”.
Maxford, Inc. v Erie Ins. Co. of N.Y. Edited by Lawrence N. Rogak In this No-Fault suit, the insurer moved for summary judgment on the grounds that plaintiff misrepresented her true home address on the insurance application. Civil Court denied the motion. The Appellate Term held that the insurer’s burden is not only to prove […]
T & S Med. Supply Corp. v Ocean Harbor Cas. Ins. Co. Edited by Lawrence N. Rogak In this suit for NY no-fault benefits against a Florida insurer, the insurer moved for summary judgment based upon its retroactive voiding of the policy due to material misrepresentation. Reversing Civil Court’s grant of summary judgment, the Appellate […]
In the Matter of the Arbitration between: St. Lukes Roosevelt Hospital Center and New Jersey Manufacturers Insurance Co Edited by Lawrence N. Rogak The claimant had a New Jersey auto policy in which he elected to have his own health insurance be primary for his medical expenses. The claimant was a pedestrian in New York and was struck […]
Contact Chiropractic, P.C. v New York City Tr. Auth. Edited by Lawrence N. Rogak Resolving a long-standing split between the First and Second Departments, the Court of Appeals holds that the statute of limitations on a No-Fault claim against a self-insured entity is three years from the date of loss. This decision is a boon […]
Eagle Surgical Supply, Inc. v Country-Wide Ins. Co. Edited by Lawrence N. Rogak At the conclusion of trial in 2015 in this PIP suit filed in 2007, Defendant requested that interest be tolled because of the long delay in bringing the case to trial. The Appellate Term held that interest does not get tolled in […]
Forest Park Acupuncture, P.C. v NYCT MABSTOA Edited by Lawrence N. Rogak In this PIP suit, both plaintiff and defendant moved for summary judgment. The motion was resolved, as often happens, with an order stating that the plaintiff’s motion was only “granted to the extent” that plaintiff had established its prima facie case. The usual […]
In this no-fault suit, the Appellate Term holds that where the insurer’s defense is that the plaintiff failed to respond to verification requests, the burden of proof at trial is on the insurer to show that the verification remains outstanding.—LNR
Medex Pharmacy v State Farm Mutual Automobile Insurance Company Edited by Lawrence N. Rogak ?The crucial issue in this PIP arbitration is whether a claimant must respond to an insurer’s request for verification, when the items requested are not in the claimant’s possession. The Applicant seeks $1,350.67 for a compound cream dispensed to the injured claimant. According […]
Value Care Pharmacy, Inc and Allstate Insurance Company AAA Case No. 17-17-1053-2955 (Eileen Casey, arbitrator) Award date: 02/28/2018 The issue in this PIP arbitration was: Whether Applicant is entitled to no-fault reimbursement for compound pain cream denied based on a peer review? The original amount claimed was $2,077.47 for compound pain cream provided on October […]
In the Matter of the Arbitration of Certain Controversies between TECHNOLOGY INSURANCE COMPANY against PROGRESSIVE MAX INSURANCE COMPANY Edited by Lawrence N. Rogak This action to vacate an intercompany arbitration award arose from a collision between a school bus and a private car. A passenger on the school bus was an employee of the bus […]
A Beacon International Group, Ltd. Member
