Thomas M. Bona, P.C.

Attorneys At Law

Liberal Interpretation:

Court of Appeals Lowers Barrier Against No-Fault Dismissals


As part of our continuing commitment to provide outstanding representation and to serve as an information resource, we wish to inform you of a recent case by the Court of Appeals interpreting the New York No-Fault Law.


Most adjusters who handle New York automobile cases are familiar with the requirement that a plaintiff must sustain a "serious injury", within the meaning of the No-Fault Law, in order to seek compensation for personal injuries. The goal of the No-Fault threshold was to require that a plaintiff meet certain criteria which would theoretically prevent less serious cases from becoming lawsuits. The hope was that with a threshold, only serious cases would remain in the court system. Obviously, this has not worked out as the legislature had intended, and the Court of Appeals has interpreted the No-Fault Law so as to attempt to balance the objectives of the No-Fault Law with the requirement of a threshold for bringing suit.


One of the requirements the Court of Appeals has required is that where the plaintiff claiming a serious injury has terminated treatment, the plaintiff must offer some reasonable explanation. Although the Court of Appeals did not require particular proof regarding an explanation, it did recognize that the purpose of the No-Fault Law is "to separate cases which may proceed to court from the mountains of other auto accident claims which may not".


In Ramkumar v. Grand Style Transportation Enterprises, Inc., the Court of Appeals was presented with an opportunity to clarify what would be a reasonable explanation for terminating treatment. In Ramkumar the plaintiff, at his deposition, was asked when he last treated and he testified that "they cut me off like five months". The defense moved for summary judgment arguing that the plaintiff had not produced any documentary evidence or any indication that would constitute a reasonable explanation for terminating treatment, and the lower court dismissed the complaint. The Appellate Division affirmed the dismissal. The Appellate Division held that the "bare assertion that insurance coverage for medically required treatment was exhausted is unavailing without any documentary evidence of such or, at least, an indication as whether an injured claimant can afford to pay for the treatment out of his or her own funds." The plaintiff appealed to the Court of Appeals.


The Court of Appeals reversed and reinstated the complaint. The Court of Appeals found that the record raised a triable issue of fact as to whether the plaintiff had offered some reasonable explanation for the cessation of physical therapy treatment for his injury. The Court of Appeals found that the Appellate Division's requirement was an unwarranted expansion of the Court of Appeals prior holding. The Court found that plaintiff's testimony at this deposition that "they cut me off" and that he did not have medical insurance at the time of the accident, was sufficient. The Court of Appeals noted that it would have been preferable for plaintiff to submit an affidavit in opposition to the motion for summary judgment explaining why the no-fault insurer terminated his benefits, and that he did not have medical insurance to pay for the treatment. However, the Court of Appeals agreed that plaintiff had come forward with the bare minimum required to raise an issue of fact. The Court found that the bare statement of the plaintiff that "they cut me off" was sufficient to defeat a motion for summary judgment.


Clearly, this is a major victory for the plaintiffs' bar who can now be expected to coach their clients to testify just as the plaintiff did in Ramkumar. The Court of Appeals, by taking a liberal interpretation of the No-Fault Statute, has guaranteed that the trial courts will be filled with even more minor automobile accident cases.


Should you have any questions, please call.


Thomas M. Bona