December 2, 2015

Best Touch PT, P.C. v American Tr. Ins. Co. (2015 NY Slip Op 51789(U))

https://www.beynensonlaw.com/case-law/best-touch-pt-p-c-v-american-tr-ins-co-2015-ny-slip-op51789u/

Court: Appellate Term, Second Department
Decided: December 2, 2015
Citation: 2015 NY Slip Op 51789(U)
Posture: Summary judgment
Outcome: Insurer prevailed
Issues: Declaratory judgment, res judicata
Legal questions: Effect of insurer's declaratory judgment (see the maps)

Cite as

Best Touch PT, P.C. v American Tr. Ins. Co., 2015 NY Slip Op 51789(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2015)

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.

A default declaratory judgment barring no-fault payment is a conclusive final determination for res judicata purposes. Before the provider commenced its benefits action, the insurer sued the assignor and providers, including this provider, seeking a declaration of no payment obligation based on IME nonappearance. Supreme Court subsequently granted the insurer declaratory relief on default. The insurer relied on that order in an unopposed cross motion for summary judgment in the benefits action. A contrary judgment could destroy or impair rights established by the declaratory order, which remained conclusive despite the default. The Appellate Term, Second Department, reversed, denied the provider's summary judgment motion and granted the insurer's cross motion dismissing the complaint.

Reported in New York Official Reports at Best Touch PT, P.C. v American Tr. Ins. Co. (2015 NY Slip Op 51789(U))

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

Best Touch PT, P.C. as Assignee of Emely Cordero, Respondent,
against
American Transit Ins. Co., Appellant.

Appeal from an order of the Civil Court of the City of New York, Kings County (Carol Ruth Feinman, J.), entered April 29, 2014. The order granted plaintiff’s motion for summary judgment and denied defendant’s cross motion for summary judgment dismissing the complaint.

ORDERED that the order is reversed, with $30 costs, plaintiff’s motion for summary judgment is denied and defendant’s cross motion for summary judgment dismissing the complaint is granted.

On February 11, 2013, plaintiff commenced this action in the Civil Court, Kings County, to recover from defendant American Transit Ins. Co. (ATIC) assigned first-party no-fault benefits for services plaintiff had provided to its assignor, Emely Cordero, as a result of injuries sustained in a motor vehicle accident on October 23, 2011. Prior to the commencement of this action, ATIC had commenced a declaratory judgment action in the Supreme Court, Bronx County, against Emely Cordero and various providers, including plaintiff herein, alleging that, because Cordero had failed to appear at duly scheduled independent medical examinations, ATIC had no obligation to pay any claims for first-party no-fault benefits which had been submitted to ATIC by the various providers named in that action who had treated Cordero as a result of the October 23, 2011 accident. By order dated May 22, 2013, the Supreme Court (Julia I. Rodriguez, J.) granted ATIC’s motion for entry of a declaratory judgment, on default, declaring that ATIC was not obligated to pay any claims for no-fault benefits submitted by the parties named as defendants in the declaratory judgment action.

In August 2013, plaintiff herein moved for summary judgment. Defendant cross-moved for summary judgment dismissing the complaint, contending that this action was barred by virtue of the May 22, 2013 order of the Supreme Court. Plaintiff did not oppose defendant’s cross motion. By order entered April 29, 2014, the Civil Court granted plaintiff’s motion and denied defendant’s cross motion.

Based upon the May 22, 2013 order of the Supreme Court, this action is barred under the doctrine of res judicata (see Vital Meridian Acupuncture, P.C. v Republic W. Ins. Co., 46 Misc 3d 147[A], 2015 NY Slip Op 50222[U] [App Term, 2d, 11th & 13th Jud Dists 2015]; EBM Med. Health Care, P.C. v Republic W. Ins., 38 Misc 3d 1 [App Term, 2d, 11th & 13th Jud Dists 2012]; Ava Acupuncture, P.C. v NY Cent. Mut. Fire Ins. Co., 34 Misc 3d 149[A], 2012 NY Slip Op 50233[U] [App Term, 2d, 11th & 13th Jud Dists 2012]). To hold otherwise could result in a [*2]judgment in this action which would destroy or impair rights established by the Supreme Court’s order in the declaratory judgment action (see Schuylkill Fuel Corp. v Nieberg Realty Corp., 250 NY 304, 306-307 [1929]; Vital Meridian Acupuncture, P.C. v Republic W. Ins. Co., 46 Misc 3d 147[A], 2015 NY Slip Op 50222[U]). Moreover, the Supreme Court’s order is a conclusive final determination, notwithstanding that it was entered on default (see Lazides v P & G Enters., 58 AD3d 607 [2009]; Matter of Allstate Ins. Co. v Williams, 29 AD3d 688 [2006]; Matter of Eagle Ins. Co. v Facey, 272 AD2d 399 [2000]; Vital Meridian Acupuncture, P.C. v Republic W. Ins. Co., 46 Misc 3d 147[A], 2015 NY Slip Op 50222[U]; EBM Med. Health Care, P.C. v Republic W. Ins., 38 Misc 3d 1; Ava Acupuncture, P.C. v NY Cent. Mut. Fire Ins. Co., 34 Misc 3d 149[A], 2012 NY Slip Op 50233[U]).

Accordingly, the order of the Civil Court is reversed, plaintiff’s motion for summary judgment is denied and defendant’s cross motion for summary judgment dismissing the complaint is granted.

Elliot, J.P., Pesce and Solomon, JJ., concur.

Decision Date: December 02, 2015

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

Held the action barred by res judicata because the default order in the insurer's prior declaratory judgment action declared it owed nothing to the named providers for the assignor's accident.

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 in this decision

Vital Meridian Acupuncture, P.C. v Republic W. Ins. Co. (2015 NY Slip Op 50222(U))A default declaratory judgment conclusively determining no obligation to pay no-fault benefits bars a contrary recovery under res judicata.
EBM Med. Health Care, P.C. v Republic W. Ins. (2012 NY Slip Op 22300)An unvacated default declaratory judgment has res judicata effect in a provider's pending no-fault action.
Ava Acupuncture, P.C. v NY Cent. Mut. Fire Ins. Co. (2012 NY Slip Op 50233(U))An unvacated default declaratory order barring no-fault benefits is a final determination that can preclude a provider's action under res judicata.

Similar decisions

Vital Meridian Acupuncture, P.C. v American Tr. Ins. Co. (2016 NY Slip Op 51007(U))An unvacated default order declaring noncoverage is a conclusive final determination that can bar a provider's action under res judicata.
Active Care Med. Supply Corp. v American Commerce Ins. Co. (2016 NY Slip Op 51813(U))An unvacated default declaratory judgment order can bar a provider's no-fault action under res judicata without a notice of entry.
Greenway Med. Supply Corp. v American Tr. Ins. Co. (2018 NY Slip Op 50039(U))A default declaratory order that has not been vacated may bar a provider's no-fault action under res judicata.
Daily Med. Equip. Distrib. Ctr., Inc. v American Tr. Ins. Co. (2015 NY Slip Op 51897(U))A declaratory judgment denying a provider's accident-related no-fault entitlement has preclusive effect even if entered on default.
Ultimate Health Prods., Inc. v American Tr. Ins. Co. (2015 NY Slip Op 50906(U))The provider's benefits action was barred by res judicata under an unvacated default declaratory order denying no-fault coverage.