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Case Law Database

Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. 26 NY3d 107 (2016)
Regular Panel Decision
Jun 09, 2016

S.B. v. A.C.C.

This case addresses the definition of "parent" under Domestic Relations Law § 70 (a) for purposes of custody and visitation for unmarried couples. The New York Court of Appeals overrules its 1991 decision in Matter of Alison D. v Virginia M., which had limited parental standing to biological or adoptive parents. The Court now holds that a non-biological, non-adoptive partner has standing if they can show by clear and convincing evidence that the parties agreed to conceive and raise a child together. In Matter of Brooke S.B. v Elizabeth A.C.C., the Appellate Division's order is reversed and the matter remitted for further proceedings under this new standard. In Matter of Estrellita A. v Jennifer L.D., the Appellate Division's order is affirmed, upholding standing based on judicial estoppel. This decision aims to address the unworkability of the Alison D. rule in light of evolving familial relationships, particularly for same-sex couples, and to protect the best interests of children.

Parental RightsCustodyVisitationSame-Sex CouplesNontraditional FamiliesEquitable EstoppelJudicial EstoppelPre-Conception AgreementDomestic Relations LawOverruling Precedent
References
28
Case No. MISSING
Regular Panel Decision

Mordkofsky v. V.C.V. Development Corp.

Plaintiff Norman J. Mordkofsky, a contract-vendee, sustained injuries when a deck at his custom-built home construction site collapsed. He sued defendant V.C.V. Development Corp., alleging negligence and violations of Labor Law §§ 200 and 241. While the Supreme Court dismissed the Labor Law claim, the Appellate Division reinstated it, broadening the protection of these statutes to anyone lawfully frequenting a construction site. However, the higher court reversed the Appellate Division's decision, clarifying that Labor Law §§ 200 and 241 are primarily intended to protect employees and workers, not contract-vendees or the general public. The court concluded that Mordkofsky did not fall within the protected class as he was neither an employee nor hired to work at the site.

Labor Law §§ 200 and 241Construction Site InjuryContract-VendeeEmployee ProtectionStatutory InterpretationScope of Labor LawAppellate ReviewSafe Place to WorkWorkers' RightsPersonal Injury
References
14
Case No. 2024 NY Slip Op 00599 [224 AD3d 428]
Regular Panel Decision
Feb 06, 2024

Matter of New Millennium Pain & Spine Medicine, P.C. v. Garrison Prop. & Cas. Ins. Co.

This case involves two appeals by New Millennium Pain & Spine Medicine, P.C. against Garrison Property & Casualty Insurance Company and GEICO Casualty Company. New Millennium sought to vacate master arbitration awards that denied its claims for no-fault benefits for medical services. The Supreme Court denied these applications. The Appellate Division, First Department, affirmed the Supreme Court's decisions, stating that an arbitrator's award will not be set aside unless it is irrational. The court also addressed the argument regarding a 20% wage offset in no-fault benefits, finding it unavailing under Insurance Law § 5102 (b). Ultimately, New Millennium was not entitled to attorneys' fees as it was not the prevailing party.

No-fault benefitsarbitration awardvacaturinsurance lawwage offsetappellate reviewmedical servicesno-fault policy exhaustionattorneys' feesCPLR Article 75
References
8
Case No. 2014-1942 K C
Regular Panel Decision
Sep 22, 2017

AL Acupuncture, P.C. v. Geico Ins. Co.

This case, AL Acupuncture, P.C. v Geico Ins. Co., concerns an appeal from a Civil Court order regarding assigned first-party no-fault benefits. The plaintiff, AL Acupuncture, P.C., sought summary judgment for services rendered, while defendant Geico Insurance Company cross-moved for dismissal. The Appellate Term modified the lower court's order. It denied the plaintiff's motion for summary judgment on claims from September 8 to September 25, 2008, citing the plaintiff's failure to prove the claim was not timely denied and issues with IME scheduling evidence. Conversely, the court granted the defendant's cross-motion, dismissing claims for services from July 8 to September 5, 2008, as Geico demonstrated timely denial and payment under the workers' compensation fee schedule. The order was affirmed as modified.

No-fault benefitsSummary judgmentIndependent medical examinationsTimely denialWorkers' compensation fee scheduleAcupuncture servicesAppellate TermProvider actionAssigned claimsCivil Court order
References
5
Case No. MISSING
Regular Panel Decision

People v. Milton C. Johnson Co.

Milton O. Johnson Company, a corporation, and its president, Walter Gemmill, were charged with violating Labor Law sections 191(1)(a) and 198-c for failing to pay employee wages and vacation benefits. The company abruptly ran out of funds on October 14, 1970, after its factoring company, Armstrong, ceased financial support. Gemmill, who had intimate knowledge of the company's precarious financial state, informed employees there were no funds for their wages or benefits. The court found the corporation strictly liable for the malum prohibitum violations. Regarding Gemmill, despite his defense that he could not have knowingly permitted the violation due to the unforeseeable action by Armstrong, the court determined that his deep involvement and awareness of the company's financial instability meant he "knew or should have known" of the risk of non-payment. Citing precedents like People v. Trapp and People v. Ahrend Co., the court concluded that the risk of such an event rests with the employer and its managers, not the employees. Consequently, both the corporation and Walter Gemmill were found guilty beyond a reasonable doubt of violating the specified Labor Law sections.

Criminal LiabilityWage Non-PaymentVacation BenefitsCorporate Officer LiabilityKnowing PermitFinancial DistressMalum ProhibitumLabor Law ViolationEmployer ResponsibilityOfficer Guilt
References
2
Case No. 2013-2706 Q C
Regular Panel Decision
Sep 19, 2016

NYS Acupuncture, P.C. v. State Farm Mut. Auto. Ins. Co.

This case, NYS Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co., concerned an appeal from an order of the Civil Court of the City of New York, Queens County. The plaintiff, NYS Acupuncture, P.C., sought assigned first-party no-fault benefits from State Farm, which had moved for summary judgment arguing full payment according to the workers' compensation fee schedule. The Civil Court initially granted State Farm's motion. On appeal, NYS Acupuncture, P.C. contended that the fee schedule reductions were improper. The Appellate Term, Second Department, affirmed the prior ruling, finding that State Farm adequately demonstrated it had fully compensated the plaintiff for acupuncture services based on the applicable workers' compensation fee schedule for services performed by chiropractors, referencing Great Wall Acupuncture, P.C. v Geico Ins. Co.

Workers' Compensation Fee ScheduleNo-Fault BenefitsAcupuncture ServicesChiropractorsSummary JudgmentAppellate ReviewInsurance DisputeFee Schedule ReductionAssigned BenefitsMedical Billing
References
1
Case No. 2015-1094 K C
Regular Panel Decision
Dec 22, 2017

V.S. Care Acupuncture, P.C. v. NY Cent. Mut. Fire Ins. Co.

This case involves an appeal brought by NY Central Mutual Fire Ins. Co. against V.S. Care Acupuncture, P.C., an assignee, concerning first-party no-fault benefits. The defendant appealed an order from the Civil Court that denied its motion for summary judgment to dismiss claims for services rendered between October 2009 and February 2010. The Appellate Term found that the defendant had properly mailed denial of claim forms and established that the amounts sought by the plaintiff exceeded the applicable workers' compensation fee schedule. Consequently, the Appellate Term reversed the lower court's order and granted the defendant's motion for summary judgment, dismissing the relevant parts of the complaint.

No-Fault BenefitsSummary JudgmentAppellate ReviewFee Schedule DefenseDenial of ClaimWorkers' Compensation Fee ScheduleInsurance LawFirst-Party BenefitsAssignee RightsCivil Court Order
References
1
Case No. 2015-2609 Q C
Regular Panel Decision
Jun 01, 2018

Gl Acupuncture, P.C. v. Allstate Ins. Co.

This case involves an appeal by GL Acupuncture, P.C., as assignee of Dwayne O. Ferguson, against Allstate Insurance Company regarding first-party no-fault benefits. The Civil Court of the City of New York, Queens County, had initially denied plaintiff's motion for summary judgment and granted defendant's cross-motion, dismissing the complaint due to alleged excessive charges. On appeal, the Appellate Term, Second Department, found that Allstate Insurance Company failed to demonstrate timely mailing of denial of claim forms, thus precluding their defense. However, GL Acupuncture, P.C. also failed to establish its entitlement to summary judgment. Therefore, the Appellate Term modified the order by denying the defendant's cross-motion for summary judgment, while affirming the denial of the plaintiff's motion for summary judgment.

No-fault benefitsSummary judgmentDenial of claimTimely mailingStandard office practiceInsurance defenseAppellate reviewPrima facie caseExcess workers' compensation fee scheduleAssignee claims
References
4
Case No. 2017-1180 K C
Regular Panel Decision
Aug 02, 2019

Merrick Med., P.C. v. A Cent. Ins. Co.

The case of Merrick Med., P.C. v A Central Ins. Co. concerned a provider's action to recover assigned first-party no-fault benefits from an insurer. The defendant insurer, A Central Insurance Company, moved for summary judgment to dismiss the complaint, asserting that a portion of the claim exceeded the workers' compensation fee schedule and other claims lacked medical necessity. Initially, the Civil Court denied the defendant's motion in part, making CPLR 3212 (g) findings. However, the Appellate Term, Second Department, modified the Civil Court's order. The appellate court concluded that the defendant's motion for summary judgment dismissing the complaint should have been entirely granted, as the specific claim was properly paid under the fee schedule, and the remaining claims were successfully challenged on medical necessity grounds by the defendant, which the plaintiff failed to rebut.

No-fault benefitsSummary judgment motionWorkers' compensation fee scheduleMedical necessity defenseAppellate Term decisionInsurance litigationAssignee claimCivil procedurePeer review reportIndependent medical examination
References
3
Case No. MISSING
Regular Panel Decision
Jul 10, 2013

Christopher C. v. Bonnie C.

This divorce action between Christopher C. and Bonnie C. addresses equitable distribution, spousal maintenance, and counsel fees. The defendant, Bonnie C., who has a court-appointed guardian due to mental and emotional difficulties, had separated from the plaintiff in 2003 and informally divided marital assets. The court ratified this prior asset division, noting the defendant had dissipated her share. Finding the defendant unable to work and self-support, and the plaintiff capable of employment despite his claims of disability, the court awarded the defendant non-durational permanent maintenance of $2,500 per month and substantial attorney's fees. The plaintiff's motion to suspend or refund temporary maintenance was denied.

DivorceSpousal MaintenanceEquitable DistributionGuardianshipMental Health IssuesAsset DissipationAttorney's FeesFinancial CapacityPermanent MaintenanceMarital Property
References
12
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