Declaratory Judgment Granted on Default Serves as Res Judicata of Previously Commenced Provider Recovery Claim

NO-FAULT  – DECLARATORY JUDGMENT  – DEFAULT  JUDGMENT  –  RES JUDICATA Daily Med. Equip. Distrib. Ctr., Inc. v. American Tr. Ins. Co. (App. ...

"Not It" Affidavit Sufficient to Merit Summary Judgment on Lack of Coverage Defense

NO-FAULT  – LACK OF COVERAGE DEFENSE New Way Med. Supply Corp. v. Dollar Rent A Car (App. Term, 2nd Dept., decided 12/8/2015) In support of ...

'Twas The Risky Night Before Christmas -- How an Insurance Professional Reads the Classic (Reprised)

[Those of you who have been reading this blog for at least the past five years will recognize this.  Reprised for our more recent and curren...

86-Day Delayed Notice of an Approximately $200,000 Claimed Theft Loss Found Inexcusable as a Matter of Law

PROPERTY  – RENTERS POLICY  –  PERSONAL ARTICLES POLICY  – THEFT  – LATE NOTICE   – LATE NOTICE EXCUSES  –  PREJUDICE Minasian v. IDS Prop. ...

Provider's Fee Splitting With Billing Company Does Not Constitute a Defense to Provider's No-Fault Claim for Payment

NO-FAULT – PROVIDER FEE SPLITTING WITH BILLING COMPANY  – SPECIAL PROCEEDING TO VACATE MASTER ARBITRATION AWARD  – LICENSING REQUIREMENTS   ...

Primary vs. Umbrella -- No Duty, No Standing, No Suit

PERSONAL AUTO  – PRIMARY POLICY  – UMBRELLA POLICY  – STANDING   – EQUITABLE SUBROGATION  – VOLUNTARY PAYMENT Government Employees Ins. Co. ...

Replacement Cost Coverage Denied to Insured Who Did Not Replace the Dwelling Within Two Years or Show That His Actual Repair/Replacement Costs Exceeded the Insurer's ACV Payment

PROPERTY  – HOMEOWNERS – TWO-YEAR REPAIR/REPLACEMENT DEADLINE  – REPLACEMENT COST COVERAGE   Mateyunas v. Cambridge Mut. Fire Ins. Co. (Sup....

9 Assignees + 6 MVAs + 2 Defenses = 9 Separate Actions -- Severance Granted

NO-FAULT  – MOTION TO SEVER – MEDICAL NECESSITY & FEE SCHEDULE DEFENSES    Austin Diagnostic Med., P.C. v Mercury Cas. Co. (App. Term, 2...

No-Fault Insurer Establishes EUO No-Show Defense on Summary Judgment Motion

NO-FAULT  – SUMMARY JUDGMENT SHOWING OF EUO NO-SHOW DEFENSE  – DISCOVERY ON REASONABLE OF EUO REQUESTS    Palafox PT, P.C. v State Farm Mut....

Not UM and SOL

UM – MEANING OF "UNINSURED" – STATUTE OF LIMITATIONS    Matter of American Transit Ins. Co. v. Rosario (1st Dept., decided 11/17/2...

Form Over Substance Does Matter -- Having Not Asserted Collateral Estoppel as an Affirmative Defense, No-Fault Insurer Is Denied Dismissal of Provider's Recovery Action

NO-FAULT – COLLATERAL ESTOPPEL – MALLELA DEFENSE   Downtown Acupuncture PC v. State Wide Ins. Co. (NYC Civ. Ct., Kings Co., decided 10/22/2...

Denial of Personal Auto Liability Coverage Based on Bodily Injury to Resident Relative of Insured Exclusion Upheld

PERSONAL AUTO – BODILY INJURY TO RESIDENT RELATIVE OF INSURED EXCLUSION – UNBORN CHILD   Harrell v. State Farm Ins. Co. (3rd Dept., decided ...

Bodily Injury Recovery from Non-Motor Vehicle Defendant Reduces SUM Coverage Recovery

SUM – OFFSET FOR BODILY INJURY RECOVERY – NON-DUPLICATION CONDITION  – MAXIMUM SUM PAYMENT  Redeye v. Progressive Ins. Co. (4th Dept., decid...

I'm Legal, So to Speak

Twenty-one years ago today I unlocked the door of a single room on the 21st floor of the Rand Building and began the (ad)venture that has be...

Defending the Insured's Default Without Disclaiming Dooms the Declaratory Judgment Action

COMMERCIAL LIABILITY – LATE NOTICE – PREJUDICE  – UNTIMELY DISCLAIMER Montpelier US Ins. Co. v. 240 Mt. Hope Realty Co. (SDNY, decided 10/22...

Health Care Provider's Voluntary Discontinuance Without Prejudice Conditioned on Payment of No-Fault Insurer's Attorneys' Fees for Defending Discontinued Action

NO-FAULT  – VOLUNTARY DISCONTINUANCE  – CHANGE OF VENUE Walden-Bailey Chiropractic aao Harvey Siegel v. Erie Ins. Co. (App. Term, 2nd Dept.,...

"Continuous Input" Not Required for Public Adjuster Who Provided "Valuable Services"

COMMERCIAL PROPERTY – PUBLIC ADJUSTER COMPENSATION – "VALUABLE SERVICES" Public Adjustment Bureau, Inc. v. Greater New York Mut. I...

New Jersey Automobile Medical Fee Schedule Held to Apply to New York No-Fault Claim

NO-FAULT – NEW JERSEY FEE SCHEDULE – PREVAILING FEE IN THE GEOGRAPHIC LOCATION OF THE PROVIDER  – EXCESSIVE FEE DEFENSE PRECLUSION Surgicare...

George Campbell Painting Reprised

CGL – BLANKET ADDITIONAL INSURED – EMPLOYEE INJURY EXCLUSION – UNTIMELY DISCLAIMER – INSURANCE LAW § 3420(D)(2)         Endurance Am. Specia...