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February 13, 2025

Allstate Ins. Co. v Kapeleris (2025 NY Slip Op 00839)

https://www.beynensonlaw.com/case-law/allstate-ins-co-v-kapeleris-2025-ny-slip-op-00839/

Court
Appellate Division, Second Department
Decided
February 13, 2025
Citation
2025 NY Slip Op 00839
Posture
Trial
Outcome
Insurer prevailed
Issues
Fee schedule Interest and attorney fees
Legal questions
Attorney's fees: article 75 and appeals (see the maps)
Cite as
Allstate Ins. Co. v Kapeleris, 2025 NY Slip Op 00839 (2d Dept 2025)

Posture, outcome, issues and treatment by other decisions are Beynenson Law’s classification. Treatment labels are assigned by a language model reading the citing decision; negative and appeal-history labels are checked by a second reader.

Summary

Editorial summary by Beynenson Law, not part of the court’s decision.

The injured claimant's no-fault recovery was limited to the amount paid to settle medical bills, rather than the original billed amount. The Appellate Division, Second Department, affirmed the judgment, insofar as appealed from, following a nonjury trial in the insurer's de novo action under Insurance Law § 5106 (c). The claimant challenged the adequacy of the benefits and attorney-fee awards. Having paid $25,109.88 to settle directly billed medical expenses, the claimant incurred reasonable treatment expenses in that amount and was not responsible for the original bills. The court also upheld the $76,856.67 attorney-fee award as a provident exercise of discretion under Insurance Law § 5106 (a) and 11 NYCRR 65-4.10 (j) (4).

Reported in New York Official Reports at Allstate Ins. Co. v Kapeleris (2025 NY Slip Op 00839)

Allstate Ins. Co. v Kapeleris
2025 NY Slip Op 00839
Decided on February 13, 2025
Appellate Division, Second Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
This opinion is uncorrected and subject to revision before publication in the Official Reports.


Decided on February 13, 2025 SUPREME COURT OF THE STATE OF NEW YORK Appellate Division, Second Judicial Department
VALERIE BRATHWAITE NELSON, J.P.
HELEN VOUTSINAS
CARL J. LANDICINO
JAMES P. MCCORMACK, JJ.

2021-09241
(Index No. 605068/15)

[*1]Allstate Insurance Company, respondent,

v

Stacey Kapeleris, appellant.




The Law Office of Jason Tenenbaum, P.C., Melville, NY, for appellant.

Law Office of Peter C. Merani, P.C., New York, NY (Adam J. Waknine of counsel), for respondent.



DECISION & ORDER

In an action pursuant to Insurance Law § 5106(c) for a de novo determination of claims for no-fault insurance benefits, the defendant appeals from a judgment of the Supreme Court, Nassau County (Diccia T. Pineda-Kirwan, J.), dated December 10, 2021. The judgment, insofar as appealed from, upon a decision of the same court dated November 19, 2021, made after a nonjury trial, is in favor of the defendant and against the plaintiff on the defendant’s counterclaim in the principal sum of only $25,109.88 and awarding the defendant attorneys’ fees in the sum of only $76,856.67.

ORDERED that the judgment is affirmed insofar as appealed from, with costs.

The facts underlying this action are summarized in our decision and order on a prior appeal (see Allstate Ins. Co. v Kapeleris, 183 AD3d 626). After a nonjury trial, a judgment dated December 10, 2021, was entered in favor of the defendant and against the plaintiff on the defendant’s counterclaim for no-fault insurance benefits in the principal sum of $25,109.88 and awarding the defendant attorneys’ fees in the sum of $76,856.67. The defendant appeals, contending that the awards are inadequate.

“‘In reviewing a trial court’s findings of fact following a nonjury trial, this Court’s authority is as broad as that of the trial court and includes the power to render the judgment it finds warranted by the facts, taking into account in a close case the fact that the trial judge had the advantage of seeing the witnesses'” (Gelaj v Gelaj, 216 AD3d 1082, 1083, quoting O’Brien v Dalessandro, 43 AD3d 1123, 1123; see Northern Westchester Professional Park Assoc. v Town of Bedford, 60 NY2d 492, 499).

The evidence in the record establishes that the amount of the Supreme Court’s award on the defendant’s counterclaim for no-fault insurance benefits in the principal sum of $25,109.88 was proper. Since the defendant, after being billed directly by her medical providers, reached a settlement with them and paid them the total sum of $25,109.88 to satisfy the medical bills, she incurred reasonable expenses for medical treatment in the total sum of $25,109.88 and was not responsible for the original amount billed to her (see Allstate Ins. Co. v Kapeleris, 183 AD3d at 627-629; cf. Todaro v GEICO Gen. Ins. Co., 46 AD3d 1086).

Further, the award of attorneys’ fees in the sum of $76,856.67 was a provident exercise of discretion (see Insurance Law § 5106[a]; Ins Dept Regs [11 NYCRR] § 65-4.10[j][4]).

BRATHWAITE NELSON, J.P., VOUTSINAS, LANDICINO and MCCORMACK, JJ., concur.

2021-09241 DECISION & ORDER ON MOTION

Allstate Insurance Company, respondent,

v Stacey Kapeleris, appellant.

(Index No. 605068/15)

Appeal from a judgment of the Supreme Court, Nassau County, dated January 10, 2021. Motion by the appellant to strike stated portions of the respondent’s brief on the ground that they refer to matter dehors the record. By decision and order on motion of this Court dated March 3, 2023, the motion was held in abeyance and referred to the panel of Justices hearing the appeal for determination upon the argument or submission thereof.

Upon the papers filed in support of the motion and the papers filed in opposition thereto, and upon the argument of the appeal, it is

ORDERED that the motion is denied.

BRATHWAITE NELSON, J.P., VOUTSINAS, LANDICINO and MCCORMACK, JJ., concur.

ENTER:

Darrell M. Joseph

Clerk of the Court

Legal questions

A question of no-fault law this decision rules on, from our Legal Questions pages. Bars count the decisions on the question by year and court, coloured by category; circles are this decision and the decisions on the question it cites or that cite it. Point at a bar or circle for details. The categories and summaries are Beynenson Law’s classification, made by a language model and checked by a second reading.

Attorney's fees: article 75 and appeals

Open the full map

How is the applicant’s attorney’s fee fixed for no-fault article 75 proceedings, de novo actions and appeals?

This decision: Court fixes a reasonable amount itself, or upholds the amount fixed below as within its discretion

Upheld a $76,856.67 attorney's fee awarded after a nonjury trial in the insurer's de novo action as a provident exercise of discretion under 5106 (a) and 65-4.10 (j) (4).

  • Appellate DivisionApp Div 44
  • Appellate TermApp Term 3
  • Trial courtsTrial 11
2019, Appellate Division: 4 decisions (3 Fee due; court to fix, 1 No fee recoverable)2018, Appellate Division: 1 decision (1 No fee recoverable)2017, Appellate Division: 1 decision (1 Fee due; court to fix)2016, Appellate Division: 1 decision (1 Limited to regulatory schedule)2025, Appellate Division: 13 decisions (4 Fee due; court to fix, 9 Amount fixed or upheld)2026, Appellate Division: 24 decisions (11 Fee due; court to fix, 3 Amount fixed or upheld, 4 Amount set aside, 6 No fee recoverable)2020, Appellate Term: 1 decision (1 Fee due; court to fix)2025, Appellate Term: 2 decisions (1 Fee due; court to fix, 1 Amount set aside)2023, Trial courts: 7 decisions (2 Amount fixed or upheld, 5 Limited to regulatory schedule)2024, Trial courts: 2 decisions (1 Amount fixed or upheld, 1 No fee recoverable)2026, Trial courts: 1 decision (1 No fee recoverable)2011, Trial courts: 1 decision (1 Fee due; court to fix)This decision
201520202025
Fee due; court to fixAmount fixed or upheldAmount set asideLimited to regulatory scheduleNo fee recoverableThis decision

Of the 58 decisions on this question in the Second Department courts and the Court of Appeals, 15 (this one included) are in the same category.

Cited in this decision

A label shows how this decision treated the case it cites.

  • Allstate Ins. Co. v Kapeleris (2020 NY Slip Op 02645) FollowedThe claimant had standing because direct billing and payment rendered two no-fault assignments ineffectual, and no third assignment existed.
  • Todaro v GEICO Gen. Ins. Co. (2007 NY Slip Op 09863) Contrasted (cf., but see)An insured incurs medical expenses upon treatment, and payment by other sources does not extinguish the no-fault insurer's obligation.

Similar decisions

  • Allstate Fire & Cas. Ins. Co. v Branch Med., P.C. (2022 NY Slip Op 50277(U))An arbitration award directing payment beyond exhausted no-fault policy limits exceeds the arbitrator's power.
  • American Tr. Ins. Co. v Hackensack Surgery Ctr., LLC (2025 NY Slip Op 05787)An order may be resettled to reflect that a dismissal was granted on default when the written order omitted that basis.
  • American Tr. Ins. Co. v Barakat PT PC (2026 NY Slip Op 01750)The provider's attorney fee award was reversed because its basis was unexplained and the record contained conflicting evidence.
  • Bay LS Med. Supplies, Inc. v Allstate Ins. Co. (2015 NY Slip Op 51626(U))The insurer's unrebutted mailing proof warranted dismissal of the first cause of action, while the provider failed to establish entitlement on the second.
  • St. Barnabas Hosp. v Allstate Ins. Co. (2009 NY Slip Op 07824)The insurer failed to establish a meritorious defense because its timely denial misstated the claim amount and gave an invalid reason.
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