New York Law Watch
Insurance: 2026 decisions
Insurance coverage and payment disputes are filed here, including decisions on policy language, exclusions, notice and no-fault benefits.
For Insurance, 2026 decisions, Law Watch lists 40 indexable decisions dated February 13, 2026 to November 12, 2026 across 14 decision weeks.
45 decision records: 40 meet the substance floor; 5 records are held from search listings.
Week ending November 14, 2026
Browse the week ending November 14, 2026
- Sanchez v Hanne2026 NY Slip Op 06585
The court affirmed summary judgment dismissing the plaintiff’s claims for serious injury because the defendants established that the plaintiff’s left knee injury was not causally related to the accident. The plaintiff failed to raise an issue of fact as his medical records were uncertified and his expert report was unaffirmed, leaving the defendants’ radiologist’s findings of chronic degeneration unrefuted.
Week ending October 31, 2026
Browse the week ending October 31, 2026
- Seneca Ins. Co. Inc. v Cobleskill Enter., LLP2026 NY Slip Op 06366
The court granted summary judgment to the insurer, declaring it not obligated to cover the fire because the insured breached the policy’s protective safeguards endorsement by failing to maintain operational smoke detectors in common areas. The court also dismissed the insurer’s fraud and negligent misrepresentation claims against the broker, finding no fiduciary duty and unreasonable reliance, and dismissed the insured’s third-party claims against the broker as moot.
- Matter of Progressive Direct Insurance Company v Wilmar Cifuentes Vargas2026 NY Slip Op 06393
The Appellate Division reversed the permanent stay of arbitration, remanding the matter for a hearing to determine if physical contact occurred and if the 24-hour reporting requirement was met. The court found that conflicting evidence regarding the accident and the reporting compliance necessitated a framed issue hearing rather than a definitive stay.
- Hofstra University, et al., Plaintiffs-Appellants-Respondents, v United Educators, Defendant-Respondent-Appellant.2026 NY Slip Op 06384
The term ‘funds’ in the insurance policy exclusion includes tuition and fees, but dismissal of the complaint is premature because the underlying class actions seek damages beyond the return of money paid. The insurer’s duty to pay defense costs is triggered because the underlying claims raise the possibility of coverage for other damages.
Week ending October 24, 2026
Browse the week ending October 24, 2026
- Williams v Dia2026 NY Slip Op 06232
The court affirmed summary judgment in favor of the plaintiff regarding liability against the defendant driver, finding him negligent as a matter of law, but reinstated the complaint against the other driver because the first driver’s negligence did not preclude comparative fault by the second. The court also held that the plaintiff raised a triable issue of fact on causation through her expert’s opinion.
- Osei v Polanco-Puello2026 NY Slip Op 06207
The court affirmed the dismissal of the complaint because the plaintiff failed to establish a serious injury under Insurance Law § 5102(d). The plaintiff’s expert failed to provide a causation opinion regarding the MRI findings, which defeated both the permanent limitation and 90/180-day claims.
- Matter of American Tr. Ins. Co. v Midland Pharm. Yonkers Corp.2026 NY Slip Op 06193
The Appellate Division modified the lower court’s order to affirmatively confirm the arbitration award and remanded the matter to fix the amount of attorneys’ fees owed to the respondent. The court held that the respondent was entitled to fees under Insurance Law § 5106(a) and that the trial court must review evidence to set a reasonable fee or determine it in its discretion if evidence is insufficient.
- Kolli v Kaleida Health2026 NY Slip Op 06167
The Court held that the physician was covered under the hospital’s self-insurance plan and that the plan constituted an insurance policy subject to ‘other insurance’ clauses. Consequently, the hospital’s coverage was determined to be excess to the primary insurer, with the hospital and excess insurer sharing responsibility on a pro rata basis.
- Reyes v Chapman2026 NY Slip Op 06156
The Appellate Division reversed the lower court’s grant of summary judgment because the defendants failed to meet their prima facie burden of proving the plaintiff did not sustain a serious injury under Insurance Law § 5102(d). The defendants’ expert failed to adequately explain why the plaintiff’s significant limitations in range of motion were voluntary, and the submissions failed to eliminate triable issues regarding causation and the 90/180-day category.
- Matter of United Financial Casualty Company v Sharon A. Jack, et al.2026 NY Slip Op 06124
The court affirmed the dismissal of the petition to stay arbitration because the petitioner failed to submit admissible evidence raising a triable issue of fact regarding whether the accident was staged. The vague allegations in the disclaimer letter and the late submission of an investigator’s affidavit were insufficient to justify a framed-issue hearing.
- Matter of Erie Ins. Co. v Rodriguez2026 NY Slip Op 06115
Supplemental underinsured motorist (SUM) coverage is not triggered when the bodily injury liability limits of the tortfeasor’s insurance policies are greater than the third-party liability limits of the policy under which the claimant seeks SUM benefits. The court affirmed the stay of arbitration because the State Farm limits exceeded the Erie policy limits.
- Matter of American Tr. Ins. Co. v Pfeffer2026 NY Slip Op 06113
The Appellate Division reversed the lower court’s award of $1,000 in attorneys’ fees because the Supreme Court failed to state the evidentiary basis for that specific determination. The matter was remitted for a new determination of the fee amount with a required statement of the evidentiary basis.
- Indian Harbor Insurance Company v SP & K Construction, Inc.2026 NY Slip Op 06104
The insurer failed to demonstrate entitlement to rescind the policy because it did not present documentation showing its underwriting practices would have prohibited issuance had the true facts been disclosed. The court affirmed the dismissal of the complaint but modified the judgment to award the defendants costs and attorneys’ fees.
- American Transit Insurance Company v Bliss Acupuncture, P.C.2026 NY Slip Op 06081
The dismissal of a de novo action due to the plaintiff’s failure to comply with discovery demands revives the underlying master arbitration award, making it binding on the parties. Consequently, the defendant is entitled to confirmation of that award and an award of reasonable attorneys’ fees for services performed in connection with the de novo action and the appeal.
Week ending October 17, 2026
Browse the week ending October 17, 2026
- Sowah v Oueteouakam2026 NY Slip Op 06035
The Appellate Division affirmed the summary judgment dismissing the complaint because the plaintiff failed to demonstrate a serious injury to her cervical and lumbar spine under Insurance Law § 5102(d). The plaintiff’s experts did not sufficiently address or rule out the chronic, degenerative changes identified by the defendant’s expert radiologist as the cause of her symptoms.
- Jacober v Madan2026 NY Slip Op 05911
The court affirmed the dismissal of the plaintiffs’ claims, finding that the complaint failed to plead fraudulent and negligent misrepresentation with sufficient particularity and that the transaction was not consumer-oriented under General Business Law § 349. Consequently, the claim against MassMutual based on respondeat superior also failed because the underlying claims against the brokers were properly dismissed.
Week ending October 10, 2026
Browse the week ending October 10, 2026
- Jenkins v City of Utica2026 NY Slip Op 05872
The court affirmed summary judgment dismissing the complaint regarding permanent and significant limitation of use, finding that the plaintiff’s injuries were preexisting and unsupported by objective evidence. However, the court modified the order to reinstate the complaint regarding the 90/180-day category of serious injury because the defendants failed to meet their initial burden of proof on that specific category.
- Vinasco v Kuzam2026 NY Slip Op 05868
The Appellate Division affirmed the dismissal of the plaintiff’s complaint, finding that defendants established prima facie that the plaintiff did not suffer a serious injury as defined by Insurance Law § 5102(d). The court held that the plaintiff failed to raise a triable issue of fact because her medical records were unaffirmed and she failed to offer an expert opinion to the contrary.
- USMMA Sailing Found., Inc. v Hilb Group of N.Y., LLC2026 NY Slip Op 05824
The court reversed the lower court’s order and granted the defendant’s motion to dismiss the General Business Law § 349 cause of action and the associated request for attorneys’ fees. The court determined that the plaintiff’s allegations described a private contract dispute unique to the parties rather than conduct with a broad impact on consumers at large.
- Fritz v Kurmel Brokerage, Ltd.2026 NY Slip Op 05769
The court affirmed summary judgment dismissing the plaintiff’s negligence and breach of contract claims against the insurance broker because the plaintiff failed to make a specific request for the additional coverage he later claimed was missing. The broker had no continuing duty to advise the client on updated coverage absent a specific request or a special relationship.
- Alarcon v Otsego Mut. Fire Ins. Co.2026 NY Slip Op 05757
The court affirmed the dismissal of the plaintiff’s breach of contract claim and the entry of a declaratory judgment that the insurance policies were void ab initio. The insurer established that the plaintiff made a material misrepresentation by stating the property was a one-family dwelling when it was structurally a three-family dwelling, and the insurer would not have issued the policy had the correct information been disclosed.
- Gomez v Uber Tech., Inc.2026 NY Slip Op 05722
The Appellate Division affirmed summary judgment dismissing the complaint because the defendants established that the plaintiff’s alleged injuries were preexisting degenerative conditions not caused by the collision. The plaintiff failed to raise an issue of fact regarding causation because his medical records were inadmissible and his treating physician did not examine him contemporaneously with the accident.
- Askins v Upstaging Inc.2026 NY Slip Op 05715
The court granted summary judgment dismissing the plaintiff’s serious injury claims because the defendants established that the plaintiff’s injuries were caused by preexisting degenerative conditions rather than the accident. The plaintiff failed to raise an issue of fact by not specifically addressing or ruling out these preexisting conditions in her expert’s opinion.
Week ending October 3, 2026
Browse the week ending October 3, 2026
- Medical Imaging of Bronx, P.C., Inc. v MVAIC2026 NY Slip Op 26160
The court reversed the lower court’s judgment, directing dismissal of the complaint because the plaintiff failed to establish a reasonable justification for the delay in submitting no-fault claims to MVAIC. The Appellate Term held that the lower court lacked authority to disregard strict filing time frames based on public policy considerations.
- Discover Property & Casualty Company v National Football League2026 NY Slip Op 05595
The court held that NFL football does not constitute a ‘product’ under the Products Completed Operations Hazard (PCOH) definition, thereby excluding the claims from the PCOH aggregate limit. Additionally, the court determined that each player’s injury constitutes a separate occurrence, meaning the AGLIC excess policy was not triggered, and found the NFL’s settlement reasonable while rejecting the ‘no loss’ defense based on club indemnification.
- Gersic v Kuehner2026 NY Slip Op 05474
The court reversed the lower court’s denial of summary judgment, finding that the plaintiff failed to raise an issue of fact regarding causation because his experts offered only conclusory opinions that his herniations were traumatic rather than degenerative. The court also granted summary judgment against the individual defendant based on the plaintiff’s failure to meet the serious injury threshold against the other defendant.
Week ending September 26, 2026
Browse the week ending September 26, 2026
- Prospect Auto Sales & Repairs, Inc. v State Farm Mut. Auto. Ins. Co.2026 NY Slip Op 05431
The Appellate Division reversed the lower court’s grant of summary judgment, determining that the complaint properly sought damages for breach of contract rather than a direct statutory violation. The court held that the defendant failed to meet its prima facie burden because its supporting affidavit was based on hearsay and it failed to provide the survey relied upon to justify its payment amount.
- Matter of Hartford Fire Ins. Co. v Villanueva2026 NY Slip Op 05393
The Appellate Division affirmed the denial of the motion to vacate an order staying arbitration, finding that the appellant failed to proffer a reasonable excuse for her default in opposing the petition. The court determined that conclusory assertions regarding missing medical records and police reports did not constitute a reasonable excuse without an explanation of efforts to obtain those documents.
- RVA Leasing Corp. v Nationwide Mut. Ins. Co.2026 NY Slip Op 51527[U]
The court reversed the lower court’s denial of summary judgment, granting the insurer’s motion to dismiss the complaint for first-party no-fault benefits. The insurer established that it timely mailed examination under oath notices and provided specific objective justification for the examinations, while the plaintiff failed to raise any issue of fact regarding their failure to appear.
Week ending September 19, 2026
Browse the week ending September 19, 2026
- Joseph Onorato, M.D., P.C. v Bruck2026 NY Slip Op 05294
The Appellate Division reversed the lower court’s judgment, holding that the plaintiff failed to establish a prima facie entitlement to summary judgment because the defendants, as policyholders, did not assign their rights to the demutualization proceeds. The court further granted the defendants’ cross-motion for summary judgment, declaring that the plaintiff is not entitled to the proceeds from the insurance company’s conversion to a stock company.
- Hassane v Elbakry2026 NY Slip Op 05289
The Appellate Division reversed the lower court’s grant of summary judgment to the defendant because the defendant failed to meet the prima facie burden of showing the plaintiff did not sustain a serious injury under Insurance Law § 5102(d). Additionally, the court denied the plaintiff’s cross-motion for summary judgment on liability on the merits, finding that triable issues of fact remained regarding the cause of the accident and the applicability of the emergency doctrine.
Week ending September 5, 2026
Browse the week ending September 5, 2026
- Compensation Guidance, Inc. v Aspro Plumbing, Inc.2026 NY Slip Op 05159
The court affirmed the dismissal of the plaintiff’s breach of contract and unjust enrichment claims because the plaintiff was not licensed as an insurance consultant in New York. Consequently, the contract was deemed unenforceable, and the plaintiff could not recover fees for services rendered.
Week ending July 25, 2026
Browse the week ending July 25, 2026
- Adams v Blodgett2026 NY Slip Op 04684
The court affirmed the denial of summary judgment, finding triable issues of fact regarding whether the client made a specific request for coverage and whether a special relationship existed that imposed a continuing duty on the broker. The court determined that the broker’s failure to procure the requested coverage and the client’s failure to read the policy raised credibility and comparative negligence issues for trial rather than warranting dismissal.
- Carrier Corp. v Allstate Ins. Co.2026 NY Slip Op 04610
The court affirmed the determination that subclinical injuries constituted injury-in-fact and that defense costs eroded policy limits, but vacated the award of damages for claims accruing prior to 2017. This modification was necessary because the plaintiffs failed to satisfy a condition precedent by making a definite claim for coverage within 12 months of payment.
- Buffalo City Cemetery v Netherlands Ins. Co.2026 NY Slip Op 04602
The court held that a justiciable controversy existed for declaratory relief regarding the insurer’s duty to defend, as the policy endorsement was susceptible to more than one reasonable interpretation. However, the court modified the lower court’s order to dismiss the plaintiff’s claims for punitive damages and attorneys’ fees, as no independent tort or contractual basis supported such recovery.
Week ending June 27, 2026
Browse the week ending June 27, 2026
- Merced v GEICO Ins. Agency, LLC2026 NY Slip Op 51311[U]
The court affirmed the dismissal of the complaint against the insurer because there is no privity of contract between the injured plaintiff and the tortfeasor’s insurer. Consequently, the plaintiff failed to state a cause of action as the statutory conditions for suing the insurer under Insurance Law § 3420 were not met.
Week ending June 20, 2026
Browse the week ending June 20, 2026
- One RX Chemist, Inc. v Nationwide Mut. Ins. Co.2026 NY Slip Op 51309[U]
The Appellate Term reversed the lower court’s denial of summary judgment, granting the insurer’s motion to dismiss the complaint. The court held that the insurer established a prima facie case by showing the plaintiff failed to appear for scheduled examinations under oath and did not raise a triable issue of fact.
- New Image Chiropractic, P.C. v Kemper Ins. Co.2026 NY Slip Op 51306[U]
The Appellate Term held that a default declaratory judgment against a different insurer had no res judicata or collateral estoppel effect because the plaintiff did not appear in that prior action. Additionally, the court denied the plaintiff’s cross-motion for summary judgment because it failed to submit evidence of the insurer’s address to prove timely mailing of claim forms.
Week ending June 13, 2026
Browse the week ending June 13, 2026
- Big Apple Med. Group Corp. v MVAIC2026 NY Slip Op 51298[U]
The court affirmed the denial of summary judgment because the defendant failed to demonstrate that the vehicle was insured at the time of the accident. The evidence provided only showed insurance coverage at the time of registration, which was two months prior to the incident.
Week ending February 14, 2026
Browse the week ending February 14, 2026
- ENS Med., P.C. v Nationwide Ins. Co.89 Misc 3d 1044
The court held that no-fault arbitration has subject matter jurisdiction over disputes regarding lost earnings incurred by health service providers when attending examinations under oath (EUOs) demanded by insurers. However, the court confirmed the master arbitration award because the arbitrators’ denial of the claim was not irrational, arbitrary, or capricious, and ordered the American Arbitration Association to modify its arbitration request form to accommodate such claims.
Also decided
- Hereford Ins. Co. v Orthopaedics, Spine & Sports Medicine LLP 2026 NY Slip Op 06524 November 5, 2026
- RVA Leasing Corp. v Nationwide Mut. Ins. Co. 2026 NY Slip Op 51528[U] September 22, 2026
- Grand Plus Supply, Inc. v GEICO Indem. Co. 2026 NY Slip Op 51588[U] September 18, 2026
- National Football League et al. v U.S. Specialty Insurance Company et al. 2026 NY Slip Op 05233 September 3, 2026
- Normile v DB Ins. Co., Ltd. 252 AD3d 136 February 11, 2026