July 14, 2015

Vital Meridian Acupuncture, P.C. v American Tr. Ins. Co. (2015 NY Slip Op 51078(U))

https://www.beynensonlaw.com/case-law/vital-meridian-acupuncture-p-c-v-american-tr-ins-co-2015-ny-slip-op-51078u/

Court: Appellate Term, Second Department
Decided: July 14, 2015
Citation: 2015 NY Slip Op 51078(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

Vital Meridian Acupuncture, P.C. v American Tr. Ins. Co., 2015 NY Slip Op 51078(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.

An unvacated default declaratory judgment barring a provider's recovery of no-fault benefits precludes its action for those benefits under res judicata. The insurer obtained a default judgment in Supreme Court, New York County, declaring that the provider and others were not entitled to benefits arising from the accident. A judgment for the provider in the benefits action would impair rights established by that declaration. Following EBM Med. Health Care, P.C. v Republic W. Ins., the default declaration was a conclusive final determination because it had not been vacated. The Appellate Term, Second Department, affirmed denial of the provider's summary judgment motion and grant of the insurer's cross motion dismissing the complaint.

Reported in New York Official Reports at Vital Meridian Acupuncture, P.C. v American Tr. Ins. Co. (2015 NY Slip Op 51078(U))

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

Vital Meridian Acupuncture, P.C. as Assignee of JOSE FERNANDEZ PEREZ, Appellant,
against
American Transit Ins. Co., Respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Robin S. Garson, J.), entered May 1, 2013. The order denied plaintiff’s motion for summary judgment and granted defendant’s cross motion for summary judgment dismissing the complaint.

ORDERED that the order is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits for services rendered to its assignor, who had allegedly sustained injuries in a motor vehicle accident on April 25, 2011, plaintiff moved for summary judgment and defendant cross-moved for summary judgment dismissing the complaint, contending that plaintiff’s cause of action is barred by virtue of a default judgment in a Supreme Court declaratory judgment action. Plaintiff appeals from an order of the Civil Court denying its motion and granting defendant’s cross motion.

The record indicates that defendant commenced a declaratory judgment action in Supreme Court, New York County, against plaintiff and a number of other providers, as well as the allegedly injured assignor. In a judgment entered on default on December 4, 2012, the Supreme Court declared that plaintiff, among others, was not entitled to recover no-fault benefits arising out of the accident on April 25, 2011. In light of the default declaratory judgment, the present action is barred under the doctrine of res judicata (see 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]), as any judgment in favor of plaintiff in the instant action would destroy or impair rights or interests established by the Supreme Court judgment (see SZ Med., P.C. v Erie Ins. Co., 24 Misc 3d 126[A], 2009 NY Slip Op 51221[U] [App Term, 2d, 11th & 13th Jud Dists 2009]). “[A] declaratory judgment is a conclusive final determination, notwithstanding that it was entered on default, since res judicata applies to a judgment taken by default which [as in the present case] has not been vacated” (EBM Med. Health Care, P.C. v Republic W. Ins., 38 Misc 3d at 3).

Accordingly, the order is affirmed.

Weston, J.P., Aliotta and Elliot, JJ., concur.

Decision Date: July 14, 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 unvacated default declaratory judgment declared the provider not entitled to benefits for the accident, and a default judgment is a conclusive final determination.

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

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

EBM Med. Health Care, P.C. v Republic W. Ins. (2012 NY Slip Op 22300) FollowedAn 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)) FollowedAn unvacated default declaratory order barring no-fault benefits is a final determination that can preclude a provider's action under res judicata.
SZ Med., P.C. v Erie Ins. Co. (2009 NY Slip Op 51221(U)) FollowedThe providers' no-fault action was barred by res judicata because a prior declaratory judgment resolved coverage for the same accident.

Similar decisions

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.
Great Health Care Chiropractic, P.C. v Progressive Ins. Co. (2015 NY Slip Op 51077(U))The provider's no-fault action was barred by res judicata under an unvacated default declaratory judgment denying benefits from the accident.
Best Touch PT, P.C. v American Tr. Ins. Co. (2015 NY Slip Op 51789(U))A default declaratory judgment barring no-fault payment is a conclusive final determination for res judicata purposes.
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.
GBI Acupuncture, P.C. v Nationwide Ins. (2015 NY Slip Op 51048(U))An unvacated default declaratory order denying no-fault coverage bars a provider's benefits action under res judicata.