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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Yklik Medical Supply, Inc. v. Allstate Insurance

Plaintiff Yklik Medical Supply, Inc., a medical supply provider, sued Allstate Insurance Company to recover $317 in unpaid medical bills for equipment supplied to its assignor, Tammy Agosto. Yklik moved for summary judgment, asserting proper bill submission and Allstate's failure to timely pay or deny the claim. Allstate argued that the charges exceeded the Workers' Compensation fee schedule and that a partial payment had been made. The court found that Yklik established a prima facie case. The central issue was whether Allstate's fee schedule defense was precluded due to its failure to issue a timely denial within 30 days as mandated by Insurance Law § 5106 (a) and 11 NYCRR 65-3.5. The court ruled that since Allstate waited 56 days to send its denial, it was precluded from raising the fee schedule defense, and therefore, summary judgment was granted to the plaintiff.

No-fault insurancesummary judgmenttimely denialfee schedulepreclusion ruleinsurance lawmedical supplybilling practicespersonal injury protectionassignor
References
19
Case No. MISSING
Regular Panel Decision
Oct 19, 1994

Comer v. Titan Tool, Inc.

Plaintiffs Delores Comer and Patricia Edelson, as personal representatives of Michael Comer's estate, brought a diversity action for wrongful death against Titan Tool, Inc., the manufacturer of a paint sprayer Michael Comer was using when he died. Titan Tool, Inc. then filed a third-party complaint seeking contribution from Rock & Waterscape Systems, Inc. (R&W), Comer's employer. R&W moved for summary judgment, arguing that under Florida workers’ compensation law, a death benefit payment to Delores Comer barred further liability. The court, applying New York's choice of law rules and interest analysis, found no basis for applying Florida law as R&W is a California domiciliary. The court denied R&W's motion for summary judgment, stating that triable issues remained regarding the choice of law question between New York and California, as Florida law could not control the case.

wrongful deathsummary judgmentchoice of lawdiversity jurisdictionworkers' compensationdomicileloss allocationtort lawemployer liabilityproduct liability
References
37
Case No. MISSING
Regular Panel Decision
Mar 21, 1995

Lewis v. Summit Office Supply, Inc.

The plaintiff, an employee of Manhattan Transfer, Inc., was injured by a forklift operated by defendant Vincent Carbone, an employee of Summit Office Supply, Inc. The plaintiff filed a negligence action against the defendants. The defendants asserted an affirmative defense, arguing that workers' compensation was the plaintiff's sole remedy. The Supreme Court granted the defendants' cross-motion for summary judgment, finding that Vincent Carbone was a special employee of Manhattan Transfer, Inc. The appellate court affirmed the Supreme Court's order, concluding that Vincent Carbone was a coemployee of the plaintiff, making workers' compensation the exclusive remedy under Workers’ Compensation Law § 29 [6].

Personal InjuryNegligenceSummary JudgmentSpecial EmployeeWorkers' Compensation LawCo-employee LiabilityAffirmative DefenseAppellate Court DecisionForklift AccidentEmployment Relationship
References
2
Case No. MISSING
Regular Panel Decision

Khan v. Douglas MacHine & Tool Co., Inc.

Subhan Khan sued Douglas Machine & Tool Company, Inc. and TurboCombustor Technology, Inc. for failure to pay sums due under a debenture. Defendants moved for summary judgment, arguing Khan violated a Subordination Agreement by attempting to collect on a junior debt without the senior creditor's consent. Khan cross-moved for summary judgment, asserting the Subordination Agreement was invalidly assigned or that the senior debt had been paid. The court found the Subordination Agreement validly assigned and in force, and that Khan failed to provide sufficient admissible evidence that the senior debt was extinguished. Consequently, the court granted defendants' motion for summary judgment and dismissed Khan's action, while denying Khan's cross-motion.

Summary JudgmentDebentureSubordination AgreementContract LawAssignment of ContractCorporate Veil PiercingOhio LawNew York LawDiversity JurisdictionFederal Rules of Civil Procedure
References
24
Case No. MISSING
Regular Panel Decision

Tower Insurance v. Mike's Pipe Yard & Building Supply Corp.

An insurer (Plaintiff) filed a motion for summary judgment to disclaim coverage for an underlying personal injury action, citing the insured's (Mike’s Pipe Yard and Building Supply) failure to provide timely notice of an occurrence as stipulated in the liability insurance policy. The insured had initially informed its broker about the incident, assuming the broker acted as the insurer's agent; however, no such principal-agent relationship existed. The trial court initially denied the plaintiff's motion, but the appellate court unanimously reversed this decision, granting the plaintiff's motion and declaring that the plaintiff had no duty to defend or indemnify in the underlying action due to the untimely notification.

Insurance Coverage DisputeTimely Notice ProvisionDisclaimer of CoverageSummary JudgmentAppellate ReviewInsurance Broker AgencyDuty to DefendDuty to IndemnifyPersonal Injury Action
References
1
Case No. 2018 NY Slip Op 02232 [159 AD3d 1321]
Regular Panel Decision
Mar 29, 2018

Matter of Larosa v. ABC Supply Co., Inc.

Claimant Stephen Larosa, a crane operator, sought workers' compensation benefits for a right knee injury in April 2015. The employer, ABC Supply Company, Inc., and its carrier controverted the claim, arguing it did not arise from employment. Both a Workers' Compensation Law Judge and the Workers' Compensation Board found the injury to be work-related. The employer appealed this decision to the Appellate Division, Third Department. The Appellate Division affirmed the Board's decision, concluding that substantial evidence supported the finding that Larosa's injury arose out of and in the course of his employment, despite arguments concerning inconsistent accounts, an idiopathic condition, and insufficient medical evidence.

Workers' Compensation ClaimRight Knee InjuryCausally Related InjuryArising Out of EmploymentCourse of EmploymentPresumption of CompensabilityIdiopathic ConditionPreexisting ConditionSubstantial EvidenceAppellate Review
References
10
Case No. 2014-1081 K C
Regular Panel Decision
Oct 05, 2016

High Quality Med. Supplies, Inc. v. Mercury Ins. Group

This case involves an appeal concerning assigned first-party no-fault benefits sought by High Quality Medical Supplies, Inc., as assignee of Charles Botwee. The defendant, Mercury Ins. Group, appealed an order from the Civil Court that denied its motion for summary judgment to dismiss the complaint. Mercury Ins. Group contended that billing for durable medical equipment not listed in a fee schedule is not compensable. However, the Appellate Term affirmed the lower court's decision, citing 11 NYCRR 68.5, which specifically permits reimbursement for healthcare services not explicitly covered by fee schedules, thereby rejecting the defendant's argument.

No-Fault BenefitsFirst-Party BenefitsDurable Medical EquipmentFee ScheduleSummary JudgmentAppellate TermAssigned BenefitsInsurance LawReimbursementCivil Court
References
3
Case No. 2018-1176 K C
Regular Panel Decision
Nov 01, 2019

Y.A.M. Med. Supply, Inc. v. Global Liberty Ins. Co. of NY

This case involves an appeal from an order of the Civil Court of the City of New York, Kings County, which denied the defendant's cross-motion to hold the action in abeyance. The defendant, Global Liberty Ins. Co. of NY, sought to pause the proceedings pending a determination by the Workers' Compensation Board regarding the plaintiff's assignor's eligibility for workers' compensation benefits. The plaintiff, Y.A.M. Medical Supply, Inc., is a provider seeking assigned first-party no-fault benefits. The Appellate Term affirmed the Civil Court's decision, ruling that the defense of workers' compensation eligibility is subject to preclusion if not timely raised, and the defendant failed to demonstrate a timely denial of the plaintiff's claims.

No-Fault BenefitsWorkers' Compensation LawCross MotionAction in AbeyancePreclusion DefenseTimely DenialAppellate TermCivil CourtFirst-Party BenefitsAssignee
References
2
Case No. 2016-1618 K C
Regular Panel Decision
Mar 22, 2019

Active Care Med. Supply Corp. v. American Tr. Ins. Co.

This case concerns an appeal by Active Care Medical Supply Corp. against American Transit Ins. Co. regarding first-party no-fault benefits. The plaintiff, an assignee of Luciano Ernesto, sought summary judgment, while the defendant cross-moved to either dismiss the complaint or hold the action in abeyance. The defendant argued that Luciano Ernesto might be eligible for workers' compensation benefits, thus requiring a determination from the Workers' Compensation Board. The Civil Court granted the defendant's cross-motion to hold the action in abeyance. The Appellate Term affirmed this decision, reiterating that the Workers' Compensation Board has primary jurisdiction over the applicability of the Workers' Compensation Law and that courts should defer to the Board's determination.

No-Fault BenefitsWorkers' Compensation LawPrimary JurisdictionAbeyanceAppellate TermSummary JudgmentEligibility DisputeFirst-Party BenefitsInsurance CoverageAssignor-Assignee
References
9
Case No. MISSING
Regular Panel Decision

United States v. Doe

This case involves an antitrust investigation into the linen supply industry in the New York Metropolitan area. Grand Jury subpoenas were served on various linen supply companies (Suppliers), their association (Linen Supply Institute of New York), and a union (Laundry Workers International Union, Local 284 AFL). The Suppliers, Association, and Union filed motions to quash or modify these subpoenas, citing unreasonableness, oppressiveness, and jurisdictional doubts. District Judge McGOHEY largely denied these motions, asserting the Grand Jury's broad investigative powers and confirming the reasonableness of the subpoena's scope and timeframe. However, the court did grant limited relief by exempting documents already possessed by the Government and by narrowing certain demands related to the Union's internal financial data.

AntitrustGrand JurySubpoena Duces TecumQuashing SubpoenaModifying SubpoenaLinen Supply IndustryLabor UnionInterstate CommerceJudicial DiscretionDepartment of Justice
References
23
Showing 1-10 of 339 results

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