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

Case No. 2019 NY Slip Op 08951 [178 AD3d 525]
Regular Panel Decision
Dec 12, 2019

Matter of Global Liberty Ins. Co. of N.Y. v. North Shore Family Chiropractic, PC

The Appellate Division, First Department, affirmed the dismissal of a petition by Global Liberty Insurance Company of New York, which sought to vacate an arbitration award denying their claim. Global Liberty had argued that workers' compensation benefits were available to the assignor, Ramon Martinez, and thus their denial of the no-fault insurance claim to North Shore Family Chiropractic, PC (Martinez's assignee) was proper. The court found that Global Liberty failed to prove Martinez was injured in the course of his employment. The order was modified to remand the matter for a determination of attorneys' fees owed to North Shore Family Chiropractic, PC, including those for the appeal.

Insurance DenialNo-Fault BenefitsArbitration AwardAttorneys' FeesWorkers' Compensation CoverageEmployment StatusAppellate ReviewRemandBurden of ProofAssignor
References
4
Case No. MISSING
Regular Panel Decision
Jul 26, 2012

Mangione v. Jacobs

The case addresses whether a plaintiff's elective surgery, performed before court-ordered independent medical examinations (IMEs), constitutes spoliation of evidence. Plaintiff Susanna Mangione, involved in a 2009 taxi accident, failed to appear for multiple court-ordered IMEs despite prior personal injury lawsuits. She underwent spinal surgery on February 27, 2012, without notifying the court or defendants and without providing medical justification for the urgency. The court found this act to be intentional spoliation of evidence, irreparably prejudicing the defendants' ability to assess causation and defend against claims of exacerbated prior injuries. Consequently, the court denied defendants Ramabel Limo, Inc. and Glener V Simbana's motion for summary judgment on liability but granted defendant Jules J. Jacobs' motion to dismiss the complaint, dismissing the action against all defendants.

Spoliation of evidenceIndependent medical examinationPersonal injury lawsuitSummary judgment motionMotion to dismissElective surgeryCourt orders violationPlaintiff's misconductIrreparable prejudiceLitigation sanctions
References
58
Case No. 2021 NY Slip Op 03590
Regular Panel Decision
Jun 09, 2021

Matter of Isabela P. (Jacob P.)

In this case, Jacob P., the father, appealed an order of disposition from the Family Court, Queens County, which found that he neglected his child, Isabela P. The Administration for Children's Services initiated the proceeding, alleging the father failed to provide adequate supervision and guardianship. The Family Court's finding of neglect was based on evidence that the father repeatedly made false reports of sexual abuse against the mother in the child's presence and encouraged the child to corroborate these allegations. The Appellate Division, Second Department, affirmed the Family Court's order, concluding that the father's actions created an imminent danger of emotional impairment to the child, thus failing to meet the minimum degree of parental care.

Child NeglectParental MisconductFalse AllegationsFamily Court Act Article 10Appellate ReviewEmotional ImpairmentPreponderance of EvidenceJudicial DeferenceChild WelfareCustody Dispute
References
7
Case No. 2014-1527 Q C
Regular Panel Decision
Dec 08, 2017

AVM Chiropractic, P.C. v. American Tr. Ins. Co.

This case concerns an appeal from an order of the Civil Court of the City of New York regarding assigned first-party no-fault benefits. Plaintiff, AVM Chiropractic, P.C., sought to recover benefits from American Transit Ins. Co. The Civil Court initially granted some branches of the defendant's motion for summary judgment and reduced claims based on a fee schedule defense. The Appellate Term modified the order, denying summary judgment for the defendant on specific causes of action (second, third, and sixth through eighth) and vacating findings on others (ninth and tenth). The court found that the defendant did not adequately demonstrate appropriate reductions in accordance with workers' compensation Ground Rules for several claims.

No-Fault BenefitsSummary JudgmentWorkers' Compensation Fee ScheduleAppellate ReviewInsurance ClaimsAssigneeFirst-Party BenefitsCivil ProcedureGround RulesNew York Law
References
1
Case No. 2014-1568 S C
Regular Panel Decision
Jul 20, 2016

Chirocare Chiropractic Assoc. v. State Farm Mut. Auto. Ins. Co.

This case involves a provider, Chirocare Chiropractic Associates, as assignee of Antoneta Mertiri, seeking first-party no-fault benefits from State Farm Mutual Automobile Insurance Company. The District Court initially granted State Farm's motion for summary judgment, dismissing the complaint based on a workers' compensation fee schedule defense. The Appellate Term reversed this order, finding that the District Court erred by dismissing the entire complaint on this ground, as the fee schedule defense only applied to amounts in excess of the schedule. Furthermore, the District Court failed to address State Farm's primary defense of lack of medical necessity, which could have been dispositive of the whole action. The matter was remitted to the District Court for a new determination addressing the medical necessity defense first.

No-fault insuranceAutomobile insuranceSummary judgmentAppellate reversalRemittiturMedical necessity defenseWorkers' compensation fee scheduleFirst-party benefitsAssignee claimChiropractic care
References
2
Case No. 2015-1649 Q C
Regular Panel Decision
Jan 20, 2017

Flatbush Chiropractic, P.C. v. American Tr. Ins. Co.

Flatbush Chiropractic, P.C., as assignee of Pierre Luxio, appealed an order that granted American Transit Ins. Co.'s motion to dismiss the complaint and denied plaintiff's cross-motion for leave to renew its prior motion for summary judgment. The Civil Court initially denied plaintiff's summary judgment motion and granted defendant's cross-motion, requiring Workers' Compensation Board resolution within 90 days due to an issue of fact regarding the accident occurring in the course of employment. After 21 months, defendant moved to dismiss for non-compliance, and plaintiff cross-moved to renew, presenting an affidavit indicating no record of a workers' compensation application. The Appellate Term affirmed the Civil Court's decision, stating that the alleged 'new facts' would not change the prior determination and plaintiff failed to show good cause against dismissal.

No-Fault BenefitsWorkers' Compensation IssueSummary Judgment MotionMotion to DismissLeave to RenewAppellate ReviewProcedural ComplianceAssignor-AssigneeCivil CourtAppellate Term
References
1
Case No. 2016-329 S C
Regular Panel Decision
Apr 27, 2017

Spineisland for Chiropractic, P.C. v. 21st Century Advantage Ins. Co.

This case involves an appeal by Spineisland For Chiropractic, P.C., acting as an assignee, against 21st Century Advantage Insurance Company concerning first-party no-fault benefits. The plaintiff sought to recover for services billed under CPT code 95831. The District Court of Suffolk County had previously granted the defendant's motion for summary judgment, asserting that the defendant had appropriately paid the plaintiff based on the workers' compensation fee schedule. On appeal, the Appellate Term affirmed the lower court's decision. The Appellate Term found that the defendant had adequately demonstrated the proper application of CPT code 95833 for the services billed under CPT code 95831, and the plaintiff failed to present a triable issue of fact.

No-fault benefitsSummary judgmentCPT codeWorkers' compensation fee scheduleAppellate TermSuffolk CountyAssigneeInsurance disputeChiropractic servicesMedical billing
References
1
Case No. MISSING
Regular Panel Decision
Nov 23, 1981

Malone v. Jacobs

This case involves an appeal by defendants Stephen and John Jacobs from a Supreme Court order denying their motion to dismiss the complaint filed by Daniel and Linda Malone. The Malones sought damages for personal injuries Daniel sustained in an automobile accident with Stephen Jacobs, with both men being volunteer firemen responding to an alarm. The appellate court determined that both were acting in the line of duty, making the Volunteer Firemen’s Benefit Law their exclusive remedy. Consequently, the order was reversed, granting defendants leave to amend their answer to assert this exclusive remedy defense, and summary judgment was granted, leading to the dismissal of the Malones' complaint. The court also affirmed that John Jacobs, as the vehicle owner, could rely on the same defense due to vicarious liability.

Volunteer Firemen's Benefit LawExclusive RemedySummary JudgmentAffirmative DefenseAutomobile AccidentPersonal InjuryLoss of ConsortiumLine of DutyVicarious LiabilityMotion to Dismiss
References
6
Case No. MISSING
Regular Panel Decision

Barrie v. Jacobs

Defendant Peter Jacobs, an attorney, faced three separate actions alleging he aided and abetted securities law violations related to Universal Cosmetics Corporation's stock offering. Jacobs moved to transfer these actions to a Maryland bankruptcy court, asserting jurisdiction due to his intent to seek indemnification from Universal. The court denied this transfer motion, ruling that a potential indemnification claim against a bankrupt entity does not establish the necessary direct effect on the bankruptcy estate, distinguishing it from cases where claims directly intertwine with the estate. Additionally, Jacobs sought to disqualify plaintiffs' attorney, Mr. Maybruck, arguing he was a potential witness. The court also denied this motion, concluding that while Maybruck's testimony might be useful, it was not 'strictly necessary' or 'otherwise unobtainable,' especially as his professional conduct was not directly at issue in the case. Both of defendant's motions were thus denied.

Securities Law ViolationAiding and AbettingIndemnification ClaimBankruptcy JurisdictionTransfer of ActionAttorney DisqualificationAdvocate-Witness RuleProfessional ResponsibilityFederal District CourtMotions Practice
References
6
Case No. MISSING
Regular Panel Decision

Green v. Jacob & Co. Watches, Inc.

William E. Green, an African-American, brought an action against Jacob & Company Watches, Inc., Jacob Arabo, and MG Security Services LLC, alleging racial discrimination and retaliation under Title VII, NYSHRL, NYCHRL, and 42 U.S.C § 1981. Green, formerly Director of Security for Jacob & Co., claimed he was terminated after objecting to racially offensive comments and discriminatory practices, including referring to African-American employees as "monkeys." Defendants moved to dismiss the claims, and Jacob & Co. also challenged the sufficiency of service of process. The Court partially granted and partially denied the motions to dismiss, allowing discrimination, retaliation, and hostile work environment claims to proceed under NYSHRL, NYCHRL, and § 1981, but dismissed Title VII hostile work environment and retaliation claims due to a failure to exhaust administrative remedies. Additionally, Green's cross-motion for an extension of time to serve process was granted.

Employment DiscriminationRacial DiscriminationHostile Work EnvironmentRetaliationTitle VIINYSHRLNYCHRL42 U.S.C. § 1981Motion to DismissService of Process
References
29
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