February 5, 2021

Allay Med. Servs., P.C. v Nationwide Ins. (2021 NY Slip Op 50087(U))

https://www.beynensonlaw.com/case-law/allay-med-servs-p-c-v-nationwide-ins-2021-ny-slip-op-50087u/

Court: Appellate Term, Second Department
Decided: February 5, 2021
Citation: 2021 NY Slip Op 50087(U)
Posture: Summary judgment
Outcome: Insurer prevailed
Later treatment: Followed in 1 later decision (see Cited by)
Issues: Declaratory judgment, res judicata
Legal questions: Effect of insurer's declaratory judgment (see the maps)

Cite as

Allay Med. Servs., P.C. v Nationwide Ins., 2021 NY Slip Op 50087(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2021)

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 insurer's motion for summary judgment dismissing the provider's claims on res judicata grounds was granted on appeal. The insurer relied on a default declaratory judgment stating that it had no obligation to pay the identified claims. The Appellate Term, Second Department, reversed the order, insofar as appealed from, for the reasons stated in the companion appeal decided the same day, No. 2019-1180 K C.

Reported in New York Official Reports at Allay Med. Servs., P.C. v Nationwide Ins. (2021 NY Slip Op 50087(U))

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

Allay Medical Services, P.C., as Assignee of Miller, Nichole, Respondent,
against
Nationwide Ins., Appellant.

Hollander Legal Group , P.C. (Allan S. Hollander of counsel), for appellant. The Rybak Firm, PLLC (Damin J. Toell and Karina Barska of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Odessa Kennedy, J.), entered May 31, 2019. The order, insofar as appealed from as limited by the brief, denied defendant’s motion for, in effect, summary judgment dismissing the complaint.

ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and defendant’s motion for, in effect, summary judgment dismissing the complaint is granted.

Plaintiff Allay Medical Services, P.C. (Allay) commenced this action on June 1, 2016 to recover assigned first-party no-fault benefits for injuries sustained by “Miller, Nichole” in an accident on October 31, 2015, the complaint stating that claim number 363323-GC had been assigned to the matter. Defendant Nationwide Ins. (Nationwide) served an answer and, thereafter, moved to dismiss the complaint pursuant to CPLR 3211 (a) (5), contending that plaintiff’s action was barred, insofar as is relevant, under the doctrine of res judicata, by an order and judgment in a Supreme Court declaratory judgment action. The Supreme Court order and judgment, entered April 25, 2016 upon the default of Allay in opposing a motion by Nationwide, declared that Nationwide was “under no obligation to pay any of the claims identified in Exhibit 1 to the Complaint.” Among other things, Exhibit 1 identified claim number 363323-GC and an accident on October 31, 2015, and listed the eligible injured person as having the initials N.M. Plaintiff opposed defendant’s motion in the Civil Court. As limited by its brief, defendant appeals from so much of an order of the Civil Court entered May 31, 2019 as denied the motion.

For the reasons stated in Allay Med. Servs., as Assignee of Diop, Gregoria v Nationwide Ins. (— Misc 3d &mdash, 2021 NY Slip Op _____ [appeal No. 2019-1180 K C], decided herewith), the order, insofar as appealed from, is reversed, and defendant’s motion for, in effect, summary judgment dismissing the complaint is granted.

WESTON, J.P., ELLIOT and TOUSSAINT, JJ., concur.

ENTER:
Paul Kenny
Chief Clerk
Decision Date: February 5, 2021

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.

Effect of insurer's declaratory judgment

Open the full map

Does an insurer’s no-coverage declaratory judgment, or pending declaratory action, bar or stay a no-fault claimant’s action?

This decision: The DJ is given preclusive effect and bars every claim in the action that the court considered

Granted dismissal under res judicata based on a default DJ declaring the insurer owed nothing on the listed claims, which identified this claim number and accident, applying the reasoning of the companion appeal.

Barred by DJBarred in partNot bound: partiesDJ does not reachStayed pending DJStay deniedThis decisionCites it or cited by itCited or followed

Of the 164 decisions on this question in the Second Department courts and the Court of Appeals, 101 (this one included) are in the same category.

Cited by

A label shows how the later decision treated this one.

Neighborhood Med. Health Care, P.C. v State Farm Mut. Auto. Ins. Co. PIP/BI Claims (2026 NY Slip Op 51600(U)) FollowedThe provider's claim was barred by a declaratory judgment because corroborating identifiers established the same claim and assignor.

Similar decisions

Allay Med. Servs., P.C. v National Liab. & Fire Ins. Co. (2021 NY Slip Op 50442(U))The provider's billing-clerk affidavit raised a factual issue as to receipt of the claim despite the insurer's proof of nonreceipt.
JPF Med. Servs., P.C. v Nationwide Ins. (2020 NY Slip Op 51122(U))The insurer failed to prove policy exhaustion because its payment log lacked a sufficient business-record foundation.
Island Life Chiropractic Pain Care, PLLC v Nationwide Ins. (2021 NY Slip Op 50765(U))The insurer's motion for summary judgment dismissing the provider's claims based on EUO nonappearance was denied.
Medical Supply of NY Corp. v Nationwide Ins. Co. (2022 NY Slip Op 51253(U))The provider's claims were barred by res judicata because the insurer established that they concerned the accident covered by a prior declaration.
JSJ Anesthesia Pain Mgt., PLLC v Nationwide Ins. Co. (2024 NY Slip Op 50203(U))The insurer failed to prove policy exhaustion because its claim specialist did not lay a sufficient foundation for the payment log.