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Nationwide Affinity Insurance Company of America v. Gwendolyn Fox, et. al.

Nationwide Affinity Insurance Company of America v. Jamaica Wellness Medical, P.C.

Nationwide Affinity Insurance Company of America v. Iesha George, et. al.

Nationwide Affinity Insurance Company of America v. Winston Jackson, et. al.

Nationwide Agribusiness Insurance Company v. Angel Rojas

Nationwide Mutual Insurance Company v. HMP Orthropedics, P.C. a/a/o Christopher Jackson

Nationwide Affinity Insurance Company of America v. Sherry Ann Layne et. al.

W. Joseph Gorum, M.D., P.C. a/a/o Carlos Taveras v. Lancer Insurance Company

 

 

 

 

 

 

 

 

 

 

 

Nationwide Affinity Insurance Company of America v. Gwendolyn Fox, et. al.

Index No. 159374/2016

Supreme Court: New York - New York County

 

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After oral argument, Allan S. Hollander secured summary judgment in favor of Nationwide in an action involving the noticing of three (3) claimants involved in a suspect motor vehicle incident to appear for an examination under oath (EUO). Nationwide commenced the action seeking a declaration from the Supreme Court, New York County, that Nationwide was under no obligation to reimburse the healthcare provider defendants as their assignors failed to appear for an EUO, a condition precedent to coverage under the policy of insurance and the No-Fault regulation. After oral argument and a review of the papers, the Honorable Jennifer G. Schecter determined Nationwide established timely noticing of the EUOs in accordance with the No-Fault Regulation. Nationwide was further able to establish the non-appearance of the assignors at multiple EUOs, and Nationwide properly denied the claims.

 

 

 

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Nationwide Affinity Insurance Company of American v. Jamaica Wellness Medical, P.C.

Index No. 2017EF200

Supreme Court:  New York- Onondaga County

 

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View Renewal Order

 

In an action venued in Supreme Court, Onondaga County, Allan S. Hollander and Brian E. Kaufman obtained summary judgment on behalf of Nationwide and defeated the defendant’s motion to renew. This matter involved the failure of the defendant to appear for an examination under oath (EUO) after counsel for the defendant objected to Nationwide’s basis for the request.  After hearing arguments on Nationwide’s motion for summary judgment and defendant’s motion to renew and reviewing the motion papers, which included affidavits from Nationwide investigators, the Honorable Donald A. Greenwood ruled that Nationwide was able to establish it had a valid basis for the EUO requests, that the defendant failed to appear at examinations under oath after being properly noticed, and Nationwide properly denied the claims submitted by the defendant.

 

 

 

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Nationwide Affinity Insurance Company of America v. Iesha George, et. al

Index No. 605673/2016

Supreme Court: New York - Nassau County

 

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In an action involving the noticing of claimants involved in a suspect motor vehicle incident to appear for an examination under oath (EUO), Allan S. Hollander and Brian E. Kaufman persuaded the Supreme Court, Nassau County, to grant Nationwide summary judgment. Nationwide commenced the action seeking a declaration that it was under no obligation to reimburse the healthcare provider defendants for services rendered based upon the failure of their assignors to appear for an EUO. The great challenge of this case was Allan and Brian overcoming an affidavit submitted by counsel for the assignors, which stated he was present at the EUO and his clients intended to also appear.

 

 

 

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Nationwide Affinity Insurance Company of America v. Winston Jackson, et. al

Index No. 604911/2017

Supreme Court: New York - Nassau County

 

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In a recent decision out of the Supreme Court, Nassau County, Allan S. Hollander was successful in obtaining a judgment that relieved Nationwide of its obligation to provide No-Fault and Liability coverage on a suspect loss. After Nationwide’s preliminary investigation revealed possible indicia of fraud, it retained Allan to assist in its investigation into whether the motor vehicle loss in question was a staged and/or intentional loss. Along with the information obtained from Nationwide’s field investigation, Allan conducted the examinations under oath (EUOs) of the vehicle’s three (3) occupants. When Nationwide reviewed all the evidence, including but not limited to the multiple discrepancies in the EUO testimony, it made the decision to deny personal injury protection and liability coverage. To validate its denial of coverage, Allan commenced a declaratory judgment action on behalf of Nationwide. After being presented with all evidence, the Court determined the motor vehicle incident in question was a staged and/or intentional loss and as such, Nationwide was relieved of its obligations to provide No-Fault and Liability coverage.

 

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Nationwide Agribusiness Insurance Company v. Angel Rojas, et. al.

Index No. 607259/2017

Supreme Court: New York - Nassau County

 

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In an action involving injures sustained by a motorcyclist allegedly struck by a Nationwide insured vehicle, Allan S. Hollander and Christopher J. Volpe were successful in obtaining a decision relieving Nationwide of its policy obligations. The action arose from an incident involving an individual performing wheelies on a motorcycle who lost control. After the motorcycle slid out from under the cyclist, the motorcycle skidded across the intersection and slid under a Range Rover driven by the Nationwide insured. The motorcyclist claimed the Range Rover struck him thereby causing him to lose control and fall off the motorcycle. Christopher conducted examinations under oath of both the Nationwide insured and the motorcyclist. Based upon the testimony elicited, Nationwide denied the motorcyclist’s claims determining the injuries did not arise out of the “use or operation” of the insured vehicle. To validate its denial of coverage, Allan commenced a declaratory judgment action on behalf of Nationwide. The Supreme Court, Nassau County, found Nationwide presented sufficient evidence to determine the injuries sustained by the motorcyclist did not arise out of the “use or operation” of the insured vehicle.

 

 

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Nationwide Mutual Insurance Company v. HMP Orthropedics, P.C. A/A/O Christopher Jackson

Index No. 152622/2016

Supreme Court: New York - New York County

 

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After receiving unfavorable decisions at arbitration and master review, Allan S. Hollander and Brian E. Kaufman secured a favorable decision upon de novo review in the Supreme Court. Both the lower and master arbitrators held the claim was improperly denied on the basis of EUO no-show where the EUO notice was sent to an improper address of a claimant (although it was sent to the address listed on the claimant’s No-Fault application) and to his attorney. However, after oral arguments in the de novo action, the Judge held the denial was proper as the EUO scheduling letters were sent to the claimant’s attorney.  The claims of the medical provider were subsequently dismissed by the Court.

 

 

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Nationwide Affinity Insurance Company of America v. Sherry Ann Layne et. al.

Index No. 601765/2017

Supreme Court:  New York- Nassau County

 

View Default Order    View Renewal/Reargument Order

 

In an action venued in Supreme Court, Nassau County, Allan S. Hollander and Brian E. Kaufman secured a favorable decision that relieved Nationwide’s obligations under the personal injury protection endorsement and liability portion of a policy of insurance.  Nationwide became suspicious when it received applications for No-Fault benefits from two (2) individuals who were not listed on the police accident report for the subject loss.  Nationwide requested Allan conduct the EUOs of both applicants. Based upon the contradicting testimony elicited, along with the failure to provide the documents requested to substantiate the claims, Nationwide denied both No-Fault and liability coverage. Thereafter, Allan commenced a declaratory action in Supreme Court on Nationwide’s behalf. The defendants filed a late answer, which Nationwide rejected and thereafter moved for a default judgment. Upon a review of the written papers submitted, the Court found the defendants lacked both a reasonable excuse for their failure to timely appear and a meritorious defense to the action. As such, Nationwide was relieved of its obligations under both the No-Fault and liability portions of the policy of insurance.

 

 

 

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W. Joseph Gorum, M.D., P.C. a/a/o Carlos Taveras v. Lancer Insurance Company

Index No. 607953/2016

Supreme Court: New York - Nassau County

 

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In defense of a petition to vacate a favorable arbitration award, Allan S. Hollander was able to convince the Court the arbitrator’s award should be upheld.  Allan was successful in an arbitration of the underlying claims before the American Arbitration Association. Thereafter, the Applicant sought to vacate the arbitration award by filing an action in the Supreme Court, Nassau County.  The claims were denied on the basis they were untimely submitted.  Specifically, the claims at issue were submitted to Lancer 46 days from the date the medical services were performed.  However, the Regulation requires such claims be submitted within 45 days unless the applicant is able to provide a reasonable excuse for not timely submitting the claims. The Applicant did not offer any excuse for its untimely submission of the claim.  As such, the Court upheld the arbitrator’s award finding that the arbitrator’s decision was not arbitrary or capricious.

 

 

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