Reported in New York Official Reports at Matter of Bay Needle Care Acupuncture, P.C. v Country Wide Ins. Co. (2019 NY Slip Op 07061)
| Matter of Bay Needle Care Acupuncture, P.C. v Country Wide Ins. Co. |
| 2019 NY Slip Op 07061 [176 AD3d 695] |
| October 2, 2019 |
| Appellate Division, Second Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
[*1]
| In the Matter of Bay Needle Care Acupuncture, P.C.,
Appellant, v Country Wide Insurance Company, Respondent. |
Gary Tsirelman, P.C., Brooklyn, NY (Stefan Belinfanti and David M. Gottlieb of counsel), for appellant.
Jaffe & Velazquez, LLP, New York, NY (Jean H. Kang of counsel), for respondent.
In a proceeding pursuant to CPLR article 75, the petitioner appeals from an order of the Supreme Court, Kings County (Bernard J. Graham, J.), dated March 1, 2018. The order denied the petition to vacate the award of a master arbitrator dated September 6, 2017.
Ordered that the order is affirmed, with costs.
The petitioner commenced a no-fault arbitration proceeding seeking to recover from the respondent insurer for acupuncture treatments provided to the petitioner’s assignor. After a no-fault arbitration hearing, an arbitrator determined that the respondent failed to establish its defenses, and awarded the petitioner the sum of $649.74, plus interest and an attorney’s fee award, in effect, pursuant to 11 NYCRR 65-4.6 (b). The petitioner appealed the arbitrator’s award to a master arbitrator, contending that the attorney’s fee award was incorrect as a matter of law. On September 6, 2017, the master arbitrator issued an award affirming the arbitrator’s award.
By notice of petition dated October 30, 2017, the petitioner sought to vacate the master arbitrator’s award pursuant to CPLR 7511. By order dated March 1, 2018, the Supreme Court denied the petition. The petitioner appeals.
The petitioner contends that the master arbitrator’s award must be vacated because an attorney’s fee should have been awarded pursuant to 11 NYCRR 65-4.6 (c), rather than 11 NYCRR 65-4.6 (b). The “role of the master arbitrator is to review the determination of the arbitrator to assure that the arbitrator reached his [or her] decision in a rational manner, [and] that the decision was not arbitrary and capricious, incorrect as a matter of law, in excess of the policy limits or in conflict with other designated no-fault arbitration proceedings” (Matter of Petrofsky [Allstate Ins. Co.], 54 NY2d 207, 212 [1981] [citations omitted]). This power “does not include the power to review, de novo, the matter originally presented to the arbitrator” (Matter of Allstate Ins. Co. v Keegan, 201 AD2d 724, 725 [1994]).
Since arbitration under the no-fault law is compulsory, the scope of review of the master arbitrator’s award is whether it “was arbitrary and capricious, irrational or without a plausible basis” (Matter of Farrell [Allstate Ins. Co.], 232 AD2d 934, 935 [1996] [internal quotation marks omitted]; accord Matter of Steinauer [New York Cent. Mut. Fire Ins. Co.], 272 AD2d 771, 772 [2000]; see Matter of Petrofsky [Allstate Ins. Co.], 54 NY2d at 211; Matter of Mercury Cas. Co. [Patient Care Assoc.], 134 AD3d 1204, 1205 [2015]).
Here, the master arbitrator determined that the petitioner was not entitled to an attorney’s fee award pursuant to 11 NYCRR 65-4.6 (c) because, among other things, it failed to support its attorney’s fee request with “documentation such as time sheets.” Inasmuch as an attorney fee award under subdivision (c) of 11 NYCRR 65-4.6 is set at an hourly rate, and the petitioner’s attorney submitted no time sheets or other documentation to establish how many hours he spent on the matter, the master arbitrator’s affirmance of the attorney’s fee award based upon 11 NYCRR 65-4.6 (b) was not irrational, or arbitrary and capricious. On questions of substantive law, the determination of the master arbitrator must be upheld if, as here, there is a rational basis for the determination (see Matter of Furstenberg [Aetna Cas. & Sur. Co.—Allstate Ins. Co.], 49 NY2d 757, 759 [1980]; Matter of Liberty Mut. Ins. Co. v Spine Americare Med., 294 AD2d 574, 577 [2002]).
Accordingly, we agree with the Supreme Court’s determination denying the petition.
The petitioner did not demonstrate its entitlement to an award of an attorney’s fee for this appeal, as the master arbitrator did not make a finding that the subject claims were “overdue” (Insurance Law § 5106 [a]; see Matter of Fast Care Med. Diagnostics, PLLC/PV v Government Empls. Ins. Co., 161 AD3d 1149, 1151 [2018]). Mastro, J.P., Rivera, Miller and Christopher, JJ., concur.
Reported in New York Official Reports at Actual Chiropractic, P.C. v State Farm Ins. (2019 NY Slip Op 51552(U))
| Actual Chiropractic, P.C. v State Farm Ins. |
| 2019 NY Slip Op 51552(U) [65 Misc 3d 129(A)] |
| Decided on September 27, 2019 |
| Appellate Term, Second Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
| This opinion is uncorrected and will not be published in the printed Official Reports. |
Decided on September 27, 2019
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, BERNICE D. SIEGAL, JJ
2018-650 K C
against
State Farm Insurance, Respondent.
Zara Javakov, P.C. (Zara Javakov of counsel), for appellant. Rivkin Radler, LLP, for respondent (no brief filed).
Appeal from an order of the Civil Court of the City of New York, Kings County (Odessa Kennedy, J.), entered November 16, 2017. The order granted defendant’s 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, plaintiff appeals from an order of the Civil Court which granted defendant’s motion for summary judgment dismissing the complaint on the ground that plaintiff had failed to appear for duly scheduled examinations under oath (EUOs).
Contrary to plaintiff’s contention, defendant was not required to set forth objective reasons for requesting the EUOs in order to establish its prima facie entitlement to summary judgment, as an insurer need only demonstrate “as a matter of law that it twice duly demanded an [EUO] from the [provider] . . . that the [provider] twice failed to appear, and that the [insurer] issued a timely denial of the claim[]” (Interboro Ins. Co. v Clennon, 113 AD3d 596, 597 [2014]; see Parisien v Metlife Auto & Home, 54 Misc 3d 143[A], 2017 NY Slip Op 50208[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2017]; Palafox PT, P.C. v State Farm Mut. Auto. Ins. Co., 49 Misc 3d 144[A], 2015 NY Slip Op 51653[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2015]).
Accordingly, the order is affirmed.
PESCE, P.J., ALIOTTA and SIEGAL, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: September 27, 2019
Reported in New York Official Reports at Satya Drug Corp. v Global Liberty Ins. Co. of N.Y. (2019 NY Slip Op 51505(U))
| Satya Drug Corp. v Global Liberty Ins. Co. of N.Y. |
| 2019 NY Slip Op 51505(U) [65 Misc 3d 127(A)] |
| Decided on September 20, 2019 |
| Appellate Term, First Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
| This opinion is uncorrected and will not be published in the printed Official Reports. |
Decided on September 20, 2019
PRESENT: Shulman, P.J., Cooper, Edmead, JJ.
570002/19
against
Global Liberty Insurance Company of New York, Defendant-Appellant.
Defendant appeals from an order of the Civil Court of the City of New York, New York County (Debra R. Samuels, J.), entered November 27, 2018, which denied its motion for summary judgment dismissing the complaint.
Per Curiam.
Order (Debra R. Samuels, J.), entered November 27, 2018, affirmed, with $10 costs.
Defendant-insurer’s motion for summary judgment dismissing the underlying first-party no-fault action was properly denied, inasmuch as it failed to submit competent evidence of the assignor’s nonappearance at scheduled independent medical examinations (IMEs) (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720, 721 [2006]). The conclusory affirmation of defendant’s IME doctor lacked probative value, since he failed to adequately state the basis of his recollection, some 16 months later, that the assignor did not appear on the scheduled IME dates (see Utica Acupuncture P.C. v Amica Mut. Ins. Co., 55 Misc 3d 126[A], 2017 NY Slip Op50331[U][App Term, 1st Dept 2017]; Five Boro Med. Equip., Inc. V Praetorian Ins. Co., 53 Misc 3d 138[A], 2016 NY Slip Op 51481[U] [App Term, 1st Dept 2016]). Nor was personal knowledge of the assignor’s nonappearance established by the affidavit from the IME schedulingvendor. “The ‘mere fact that the recording of [the] third-party statements [of nonappearances] by the [IME doctor] might be routine, imports no guarantee of the truth, or even reliability, of those statements’ (Matter of Leon RR, 48 NY2d 117, 123 [1979]; cf. Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co., 25 NY3d 498, 508 [2015]” (Metro 8 Med. Equip., Inc. v ELRAC, Inc., 50 Misc 3d 140[A], 2016 NY Slip Op 50174[U][App Term, 1st Dept 2016]).
THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.
I concur I concur I concur
Decision Date: September 20, 2019
Reported in New York Official Reports at ACH Chiropractic P.C. v Geico Ins. Co. (2019 NY Slip Op 51439(U))
ACH Chiropractic
P.C., a/a/o CENEVIL, DAVID, Plaintiff,
against Geico Ins. Co., Defendant. |
744329/16
Attorney for Plaintiff
Oleg Rybak, Esq.
The Rybak Firm, PLLC
1810 Voorhies Ave., 3rd Floor, Ste. 7
Brooklyn, NY 11235
(718) 975-2035
Attorney for Defendant
Katherine A. Hazelton, Esq.
Law Office of Goldstein
& Flecker
2 Huntington Quadrangle, Ste. 2N01
Melville, NY 11747
(516)
714-7927
Consuelo Mallafre-Melendez, J.
The court’s Decision and Order is based upon consideration of the following papers:
CPLR 2219(a) RecitationNOTICE OF MOTION & AFFIDAVITS ANNEXED 1
OPPOSITION/CROSS-MOTION 2
REPLY/OPPOSITION TO CROSS-MOTION 3
SUR REPLY
This is an action by Plaintiff medical provider to recover assigned first-party no-fault benefits for treatment provided to its assignor, David Cenevil (Injured Party). Plaintiff argues that it met its prima facie burden and requests that summary judgment be granted in its favor pursuant to CPLR 3212. Defendant opposes Plaintiff’s motion and cross moves for dismissal on grounds that the injuries were the result of an intentional assault when the insured, Bernard Foy (Insured), used his vehicle as a weapon to deliberately strike the Injured Party. Accordingly, Defendant asserts that the Injured Party’s injuries were not the result of an accident, but an intentional act which is not a covered loss under 11 N.Y.C.R.R. § 65-2.2(a). This court agrees.
In New York, an insurer must provide no-fault insurance benefits for injuries resulting from an accident. 11 N.Y.C.R.R. § 65-2.2(a), requires coverage for “personal injuries caused by an accident arising out of the use or operation of a motor vehicle” (emphasis added). In order for an insurer to be relieved of its obligation to cover a loss, it must come forward with evidence to demonstrate that the injuries were a result of an intentional or deliberate action (State Farm Mut. Auto. Ins. Co. v. Langan, 16 NY3d 349 [2011]; Liberty Mut. Ins. Co. v. Goddard, 29 AD3d 698 [2d Dept. 2006]). An insurer must establish its “founded belief” that the incident was an intentional act by a preponderance of the evidence (A.B. Med. Services PLLC v. Eagle Ins. Co., 3 Misc 3d 8, 9 [2d Dept. 2003]; V.S. Med. Servs., P.C. v. Allstate Ins. Co., 25 Misc 3d 39 [2d Dept. 2009]), and can meet its burden with circumstantial evidence (State Farm Mut. Auto. Ins. Co., v. Laguerre, 305 AD2d 490 [2d Dept. 2003]).
Here, Defendant has met its burden through substantial documentary evidence including a police accident report, a criminal complaint an arrest report and an affidavit from Defendant’s Special Investigation Unit (SIU) investigator Doug Pfleging. These documents consistently support a clear finding that the incident which lead to the Injured Party’s injuries was a result of an intentional act. According to the police accident report, the Insured deliberately hit the Injured Party with his vehicle: “At TPO witness stated that deft had a verbal dispute with his step son [sic]. Witness stated that deft (step father) used his vehicle to hit c/v and fled the accident scene” (Deft. Exh. B). Pursuant to the arrest report, the Insured was subsequently arrested on several charges including felony assault with intent to cause serious physical injury and felony assault for using his vehicle as a weapon (Deft. Exh. C).
In New York, to determine whether an event was accidental “it is customary to look at the casualty from the point of view of the insured, to see whether or not it was unexpected, unusual and unforeseen'” (State Farm Mut. Auto. Ins. Co. v. Langan, 16 NY3d at 355 quoting Miller v. Continental Ins. Co., 40 NY2d 675, 677 [1976]). The view point of the injured party is not considered “[b]ecause an injury is always fortuitous to a non-consenting victim” (State Farm Mut. Auto. Ins. Co. v. Langan, 16 NY3d at 355 quoting Michaels v. City of Buffalo, 85 NY2d [*2]754, 759 [1995]). The same is true when the injured party seeks benefits under the policy’s uninsured motorist endorsement (Castillo v. Motor Vehicle Indemnification Corp., 161 AD3d 937 [2d Dept. 2018]; Utica Mut. Ins. Co. v. Burrous, 121 AD3d 910 [2d Dept. 2014]). Here, both the witness’ statement and the testimony from the Injured Party are consistent with a finding that from the Insured’s perspective, the incident was a deliberate act meant to cause injury (Deft. Exh. D; see generally McCarthy v. Motor Vehicle Indemnification Corp., 12 NY2d 922 [1963]).
Plaintiff’s arguments concerning its prima facie case and timely denial of the claims are irrelevant. Defendant insurer “is not precluded, despite untimely disclaimer, from raising as a defense its denial of liability on the ground that the services rendered to treat the injuries at issue did not arise from a covered accident” (General Hospital v. Chubb Group of Insurance Companies, 90 NY2d 195, 201 [1997]). Furthermore, Defendant’s “strict compliance with the time requirements of both statute and regulations may be obviated and the preclusion remedy rendered unavailable when denial of claims is premised on a lack of coverage” (General Hospital v. Chubb Group of Insurance Companies, 90 NY2d at199).
Based on the foregoing, Plaintiff’s motion for summary judgment is denied. Defendant’s cross motion to dismiss is granted.
This constitutes the decision and order of this court.
September 4, 2019
Brooklyn, NY
ENTER.
__________________________________
CONSUELO MALLAFRE-MELENDEZ
Judge, Civil Court
Reported in New York Official Reports at Matter of Global Liberty Ins. Co. of N.Y. v Top Q. Inc. (2019 NY Slip Op 06445)
| Matter of Global Liberty Ins. Co. of N.Y. v Top Q. Inc. |
| 2019 NY Slip Op 06445 [175 AD3d 1131] |
| September 3, 2019 |
| Appellate Division, First Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
[*1]
| In the Matter of Global Liberty Insurance Company of New
York, Appellant, v Top Q. Inc., as Assignee of Zurima Cole, Respondent. |
Law Office of Jason Tenenbaum, P.C., Garden City (Jason Tenenbaum of counsel), for appellant.
Order, Supreme Court, Bronx County (Julia I. Rodriguez, J.), entered August 31, 2018, which denied the petition to vacate a master arbitrator’s award, unanimously reversed, on the law, without costs, and the petition granted.
The master arbitrator’s award was arbitrary because it irrationally ignored the controlling law that the no-fault policy issued by petitioner was void ab initio due to respondent’s assignor’s failure to attend duly scheduled independent medical exams (see Hereford Ins. Co. v Lida’s Med. Supply, Inc., 161 AD3d 442, 443 [1st Dept 2018]; Matter of Global Liberty Ins. Co. v Professional Chiropractic Care, P.C., 139 AD3d 645, 646 [1st Dept 2016]; American Tr. Ins. Co. v Lucas, 111 AD3d 423, 424 [1st Dept 2013]). Concur—Sweeny, J.P., Renwick, Manzanet-Daniels, Tom, Oing, JJ.
Reported in New York Official Reports at Matter of Haskins v Motor Veh. Acc. Indem. Corp. (2019 NY Slip Op 51417(U))
[*1]| Matter of Haskins v Motor Veh. Acc. Indem. Corp. |
| 2019 NY Slip Op 51417(U) [64 Misc 3d 1234(A)] |
| Decided on August 30, 2019 |
| Supreme Court, Kings County |
| Rivera, J. |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
| This opinion is uncorrected and will not be published in the printed Official Reports. |
Decided on August 30, 2019
In the Matter of the
Application of Clinton Xavier Haskins, Petitioner,
against Motor Vehicle Accident Indemnification Corporation, Repondent. |
511603/19
Attorney for Plaintiff
Vel Belushin, Esq.
Belushin Law Firm, P.C.
1712 Kings Highway, Suite 2
Brooklyn, New York 11229
(718) 787-4470
Attorney for Defendant
Sheila Ahmed, Esq.
Law Office of Jaime E. Gangemi
100 William Street, 14th Floor
New York, New York 10038
(646) 205-7880
Francois A. Rivera, J.
By order to show cause and petition, filed on May 23, 2019, petitioner Clinton Xavier Haskins (hereinafter petitioner or Haskins), seeks an order, pursuant to New York Insurance Law § 5221, compelling the respondent Motor Vehicle Accident Indemnification Corporation (hereinafter MVAIC) to provide payment of No-fault benefits to the petitioner. This application [*2]is opposed by MVAIC.
Notice of Motion
Affirmation in Support
Verified Petition
Exhibits A to D
Affirmation in Opposition
Exhibit A
Reply Affirmation
Exhibit A to D
BACKGROUND
On May 23, 2019, Haskins commenced the instant special proceeding by electronically filing an order to show cause and verified petition with annexed exhibits (hereinafter the commencement papers) with the Kings County Clerk’s office (KCCO). The commencement papers allege the following salient facts. On August 17, 2018, at approximately 2:51 a.m., while Haskins was riding his bicycle on Atlantic Avenue near the intersection of Utica Avenue in Brooklyn, New York, he was struck by a motor vehicle (hereinafter the accident). Haskin alleges that the operator of the vehicle that struck him initially left the scene but returned after being followed by witnesses. That day, the police arrived at the scene, interviewed the petitioner and the operator of the offending vehicle and completed a police accident report or MV-104. According to the MV-104, the offending vehicle was a 2004 Mercury Sedan registered in Texas to Alexander Ikenhi. The driver of the offending vehicle was Emmanuel Daudu. Haskins was transported to Kings County Hospital to treat his injuries. On September 4, 2018, Haskins served a notice of intention to make a claim on MVAIC. Haskins claims that neither he nor his counsel have been able to confirm any insurance information for offending vehicle.
MOTION PAPERS
The petitioner’s papers include an order to show cause, affirmation of counsel, a verified petition and four annexed exhibits labeled A through D. Exhibit A includes a facsimile copy of a FDNY Pre-hospital Care Report Summary dated August 17, 2018; a collection of progress notes titled Kings County Hospital Center Chart Review printout for Clinton Haskins. Exhibit B includes a copy of an unsigned letter to MVAIC dated September 4, 2018; New York Motor Vehicle No-Fault Insurance Law, Application for Motor Vehicle No-Fault Benefits, page 1 of 3 and page 2 of 3; a copy of a letter to MVAIC dated December 11, 2018 signed by Shira McDonald; Affidavit of No Insurance signed by Clinton Haskins on August 17, 2018; Notice of Intention to Make a Claim signed by Clinton Haskins on August 21, 2018. Exhibit C is a letter from Anderson Jean, MVAIC Qualification Processor, to Clinton Haskins dated March 19, 2019. Exhibit D is a copy of a police report dated August 30, 2018.
MVAIC’s opposition consists of an affirmation of counsel and one annexed exhibit labeled A. Exhibit A is a copy of a police report dated August 30, 2018. Exhibit A is a duplicate of petitioner’s exhibit D.
Petitioner’s reply papers consist of an affirmation of counsel and four annexed exhibits labeled A to D. Exhibit A is a printout of a Samba Safety Texas Vehicle Record. Exhibit B is a letter from Jonathan Miles, Assistant Attorney General of Texas, to Nick Lealos, Staff Attorney [*3]Texas Department of Insurance, dated October 25, 2012. It is described as a full printout of Open Records Letter Ruling OR2012-17108. Exhibit C is a printout from the Texassure.com website of Frequently Asked Questions. Exhibit D was previously submitted by petitioner as exhibit D to its moving papers.
LAW AND APPLICATION
In the case at bar the petitioner is not seeking leave to sue MVAIC pursuant to Insurance Law § 5218. Nor is he seeking payment on behalf of any medical provider for services rendered to treat the injuries caused by the subject accident. By seeking an order compelling MVAIC to pay for first party no fault benefits, the petitioner is in effect seeking a judgment declaration that he is a qualified person as defined in Insurance Law
§ 5202 (b).
The commencement papers demonstrate the following facts. On August 17, 2018, petitioner was riding a bicycle on Atlantic Avenue near its intersection with Utica Avenue when he was struck and injured by a vehicle which fled and then returned to the scene. The police arrived, interviewed the petitioner and the driver of the offending vehicle and completed an accident report. Since the police were called to the scene of the accident shortly after its occurrence and made a report of the investigation, the petitioner was not required to make any further report to the police to comply with Insurance Law § 5208 (a) (2) (A) (Daniel, In re, 181 Misc 2d 941, 945 [Civ. Ct. 1999]). In compliance with Insurance Law § 5208 (a) (1), petitioner timely filed a notice of claim with MVAIC dated September 4, 2019.
By letter dated March 19, 2019, MVAIC advised the petitioner that he had not yet complied with the requirements of Article 52 of the Insurance Law to be a “covered person.” In particular, MVAIC stated that it could not provide liability or no fault benefits until it received proof of lack of insurance and a default judgment against the operator and owner of the offending vehicle.
Insurance Law article 52 is intended to provide, inter alia, no-fault benefits for qualified persons for basic economic loss arising out of the use and operation of uninsured motor vehicles (see Insurance Law § 5201). In order to recover first-party no-fault benefits from defendant MVAIC, a plaintiff is required to comply with all the applicable requirements of Insurance Law article 52 (see Insurance Law § 5221 [b] [2]; Ocean Diagnostic Imaging v Motor Vehicle Acc. Indemnification, 8 Misc 3d 137(A) [App Term 2005]).
Insurance Law § 5221 requires that respondent provide for the payment of first-party benefits to a “qualified person” for basic economic loss arising out of the use or operation in New York of an uninsured motor vehicle. “Qualified person” is defined as “a resident of this state, other than an insured or the owner of an uninsured motor vehicle and his spouse when a passenger in such vehicle, or his legal representative” (Insurance Law § 5202 [b] [I]) (Jones v Motor Vehicle Acc. Indemnification Corp., 172 AD2d 942, 942 [3rd Dept 1991]).
However, when the petitioner knows the identity of the driver or the owner of the offending vehicle, the petitioner must first exhaust against those individuals before seeking relief from MVAIC (Hauswirth v Am. Home Assur. Co., 244 AD2d 528, 529 [2nd Dept 1997]; citing, Matter of Troches v Motor Vehicle Acc. Indem. Corp., 171 AD2d 873 [2nd Dept 1991]; see also, Matter of Frankl v Motor Vehicle Acc. Indem. Corp., 53 AD2d 614 [2nd Dept 1976]). In the event that proceedings against the operator and owner should result in a judgment finding that [*4]neither the owner or operator or their insurer is liable for petitioner’s injuries, the petitioner may then assert a claim against MVAIC pursuant to Insurance Law § 5218 (c) (Bell v Morris, 169 Misc 2d 1062 [App Term 2nd Dept 1996]). Until the plaintiff has exhausted his available remedies against the operator and owner of the offending vehicle, his claims for relief as against MVAIC are premature (Hauswirth, 244 AD2d at 528, 529,; citing Matter of Frankl, 53 AD2d 614).
CONCLUSION
The petition of Clinton Xavier Haskins for an order pursuant to New York Insurance Law § 5221 compelling the respondent Motor Vehicle Accident Indemnification Corporation to provide petitioner with No-fault benefits is denied without prejudice as premature.
The foregoing constitutes the decision and order of this Court.
Enter:
J.S.C.Right Aid Med. Supply Corp. v Travelers Ins. Co. (2019 NY Slip Op 51415(U))
Reported in New York Official Reports at Right Aid Med. Supply Corp. v Travelers Ins. Co. (2019 NY Slip Op 51415(U))
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
against
Travelers Insurance Company, Respondent.
The Rybak Firm, PLLC (Damin J. Toell of Cousnel), for appellant. Law Offices of Aloy O. Ibuzor (Janice A. Robinson of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Robin Kelly Sheares, J.), entered September 28, 2017. The order denied plaintiff’s motion to vacate an order of that court entered August 12, 2016 which, upon plaintiff’s failure to timely submit opposition to defendant’s prior motion for summary judgment dismissing the complaint, granted defendant’s prior motion.
ORDERED that the order entered September 28, 2017 is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment. A stipulation signed by the parties on November 9, 2015 provided that opposition to defendant’s motion “must be served on or before” June 12, 2016, and “[a]ll papers served beyond the within deadline[] shall be deemed null and void.” It is uncontested that plaintiff’s opposition to defendant’s motion was served on July 13, 2016. By order entered August 12, 2016, the Civil Court granted defendant’s motion, noting that it was not considering plaintiff’s late opposition as it had been served beyond the time set therefor in the stipulation, and dismissed the complaint. Thereafter, plaintiff moved, pursuant to CPLR 5015 (a) (1), to vacate the August 12, 2016 order. Plaintiff appeals from an order of the Civil Court entered September 28, 2017 denying plaintiff’s motion.
Where a plaintiff moves, pursuant to CPLR 5015 (a) (1), to vacate an order entered upon the plaintiff’s failure to oppose a motion, “the plaintiff is required to demonstrate both a reasonable excuse for the default and a potentially meritorious opposition to the motion” (Estrada v Selman, 130 AD3d 562, 562—563 [2015]; see also Longevity Med. Supply, Inc. v State Farm Fire & Cas. Co., 54 Misc 3d 136[A], 2017 NY Slip Op 50118[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2017]; D & R Med. Supply, Inc. v American Tr. Ins. Co., 35 Misc 3d [*2]136[A], 2012 NY Slip Op 50785[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2012]). In support of plaintiff’s motion to vacate, plaintiff’s attorney argued that due to law office failure, the “draft [of the opposition papers] was not . . . served on Defendant until one day after it was due to Defendant” (emphasis in the original). The record, however, indicates that plaintiff mailed its opposition papers to defendant on July 13, 2016, which was over a month past the stipulated due date of June 12, 2016. Under the circumstances, we find that plaintiff failed to demonstrate a reasonable excuse for its default and, therefore, we need not consider whether plaintiff offered a potentially meritorious opposition to defendant’s motion (see Wells Fargo Bank, N.A. v Syed, 160 AD3d 914, 915 [2018]).
We note that, for the first time on appeal, plaintiff states that its counsel “misread the stipulation as providing a due date of July 12, 2016.” However, we do not consider arguments or factual assertions raised for the first time on appeal (see Chimarios v Duhl, 152 AD2d 508 [1989]).
Accordingly, the order entered September 28, 2017 is affirmed.
PESCE, P.J., WESTON and ALIOTTA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: August 23, 2019
Reported in New York Official Reports at Right Aid Med. Supply Corp. v Travelers Ins. Co. (2019 NY Slip Op 51414(U))
| Right Aid Med. Supply Corp. v Travelers Ins. Co. |
| 2019 NY Slip Op 51414(U) [64 Misc 3d 149(A)] |
| Decided on August 23, 2019 |
| Appellate Term, Second Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
| This opinion is uncorrected and will not be published in the printed Official Reports. |
Decided on August 23, 2019
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., MICHELLE WESTON, THOMAS P. ALIOTTA, JJ
2017-2443 K C
against
Travelers Insurance Company, Respondent.
The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Law Offices of Aloy O. Ibuzor (Janice A. Robinson of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Robin Kelly Sheares, J.), entered September 28, 2017. The order denied plaintiff’s motion (1) to vacate an order of that court entered August 12, 2016 which, upon plaintiff’s failure to timely submit opposition to defendant’s prior motion for summary judgment dismissing the complaint and to timely file its cross motion for summary judgment, granted defendant’s prior motion and denied plaintiff’s cross motion and, (2) upon such vacatur, to deny defendant’s prior motion and grant plaintiff’s cross motion.
ORDERED that the order entered September 28, 2017 is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment. A stipulation signed by the parties on November 9, 2015 provided that opposition to defendant’s motion and any cross motion “must be served on or before” June 12, 2016, that any cross motion served later “will be deemed as untimely,” and “[a]ll papers served beyond the within deadlines shall be deemed null and void.” It is uncontested that plaintiff’s opposition to defendant’s motion and plaintiff’s cross motion for summary judgment were served on July 7, 2016. By order entered August 12, 2016, the Civil Court granted defendant’s motion and denied plaintiff’s cross motion, noting that the cross motion had been served beyond the time set therefor in the stipulation, and dismissed the complaint. Thereafter, plaintiff moved to vacate the August 12, 2016 order and, upon such vacatur, to deny defendant’s motion and grant plaintiff’s cross motion on the ground that it had timely served its opposition to defendant’s motion and its cross motion. Plaintiff appeals from an order of the Civil Court entered September 28, 2017 which denied plaintiff’s motion.
In its motion papers, plaintiff asserted, incorrectly, that it had served its opposition to [*2]defendant’s motion and its cross motion in accordance with the time set forth therefor in the stipulation. However, the unequivocal language of the stipulation provided that service of opposition papers and any cross motion must be on or before June 12, 2016 and that any cross motion served beyond June 12, 2016 would be deemed untimely and “null and void.” Consequently, in order to warrant the relief requested, plaintiff was required to demonstrate both a reasonable excuse for its default and a potentially meritorious opposition to defendant’s motion (see CPLR 5015 [a]; Estrada v Selman, 130 AD3d 562 [2015]). Plaintiff failed to provide any excuse for its default in its motion papers.
For the first time on appeal, plaintiff states that its counsel “misread the stipulation as providing a due date of July 12, 2016.” However, we do not consider arguments or factual assertions raised for the first time on appeal (see Chimarios v Duhl, 152 AD2d 508 [1989]).
Accordingly, the order entered September 28, 2017 is affirmed.
PESCE, P.J., WESTON and ALIOTTA, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: August 23, 2019
Reported in New York Official Reports at Santomauro v Allstate Ins. Co. (2019 NY Slip Op 51413(U))
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
against
Allstate Ins. Co., Respondent.
Gary Tsirelman, P.C. (Devon Riley Christian and David M. Gottlieb of counsel), for appellant. Law Offices of Peter C. Merani, P.C. (Edward M. Tobin and Adam Waknine of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Joy F. Campanelli, J.), dated August 30, 2017. The order, insofar as appealed from as limited by the brief, granted the branches of defendant’s motion seeking to vacate a judgment of that court entered July 28, 2016 upon defendant’s failure to appear or answer the complaint, and to compel plaintiff to accept defendant’s answer.
ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and the branches of defendant’s motion seeking to vacate the default judgment and to compel plaintiff to accept defendant’s answer are denied.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals, as limited by her brief, from so much of an order of the Civil Court as granted the branches of defendant’s motion seeking to vacate a judgment of that court, entered July 28, 2016 upon defendant’s failure to appear or answer the complaint, and to compel plaintiff to accept defendant’s answer.
At the outset, we note that the process server’s affidavit constituted prima facie evidence of proper service of process upon defendant pursuant to CPLR 311 (a) (1), by serving a general agent of defendant who was authorized to accept service on its behalf (see Hayden v Southern Wine & Spirits of Upstate NY, Inc., 126 AD3d 673 [2015]; Teitelbaum v North Shore-Long Is. Jewish Health Sys., Inc., 123 AD3d 1006 [2014]; Indymac Fed. Bank FSB v Quattrochi, 99 AD3d 763 [2012]).
A defendant seeking to vacate a default judgment pursuant to CPLR 5015 (a) (1) must demonstrate both a reasonable excuse for the default and a potentially meritorious defense to the [*2]action (see Eugene Di Lorenzo, Inc. v A.C. Dutton Lbr. Co., Inc., 67 NY2d 138, 141 [1986]; Progressive Cas. Ins. Co. v Excel Prods., Inc., 171 AD3d 812 [2019]; Westchester Med. Ctr. v Allstate Ins. Co., 80 AD3d 695 [2011]). Here, we find that the Civil Court improvidently exercised its discretion in determining that defendant had provided a reasonable excuse for its default. Defendant submitted an affidavit by the employee allegedly served. However, the employee did not indicate whether he had in fact been served or even that he could not recall whether he had been served. Instead, he stated only that “[o]ne of my duties is to act as the receptionist” at defendant’s Brooklyn location and then purported to describe defendant’s business practices and procedures in recording receipt of summonses and complaints in its computer system. However, defendant’s employee did not indicate whether he had employed those practices and procedures at the time in question. An affidavit submitted by another of defendant’s employees, its claim representative, asserted conclusorily that defendant had not been served with the summons and complaint, since it did not have a record in its computer system of having received process. These affidavits are insufficient to warrant the relief requested (see Pierre J. Renelique Physician, P.C., as Assignee of Jose Mercado v Allstate Ins. Co., ___ Misc 3d ___, 2019 NY Slip Op 29225 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2019]).
Accordingly, the order, insofar as appealed from, is reversed and the branches of defendant’s motion seeking to vacate the default judgment and to compel plaintiff to accept defendant’s answer are denied.
PESCE, P.J., WESTON and SIEGAL, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: August 23, 2019
Reported in New York Official Reports at Right Aid Med. Supply Corp. v State Farm Mut. Auto. Ins. Co. (2019 NY Slip Op 51409(U))
| Right Aid Med. Supply Corp. v State Farm Mut. Auto. Ins. Co. |
| 2019 NY Slip Op 51409(U) [64 Misc 3d 149(A)] |
| Decided on August 23, 2019 |
| Appellate Term, Second Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
| This opinion is uncorrected and will not be published in the printed Official Reports. |
Decided on August 23, 2019
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, DAVID ELLIOT, JJ
2017-595 K C
against
State Farm Mutual Automobile Ins. Co., Respondent.
The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Richard T. Lau & Associates (Martin Dolitsky of counsel), for respondent.
Appeal from a judgment of the Civil Court of the City of New York, Kings County (Richard J. Montelione, J.), entered March 21, 2016. The judgment, after a nonjury trial, dismissed the complaint.
ORDERED that the judgment is reversed, with $30 costs, and the matter is remitted to the Civil Court for a new trial on the issue of whether the requested verification remains outstanding.
In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint on the ground that the action was premature. By order entered November 19, 2014, the Civil Court found that defendant had established that it had timely requested additional verification, and held, in effect pursuant to CPLR 3212 (g), that the only issue for trial was whether plaintiff had provided the requested verification to defendant. At a nonjury trial held on February 26, 2016, the Civil Court noted that the only issue to be determined was whether plaintiff had provided the requested verification, stated that the burden was on plaintiff, and directed plaintiff to call its first witness. Plaintiff did not call any witnesses, arguing that the burden was on defendant to first establish that it had not received the requested verification. With no testimony having been presented, the Civil Court found for defendant on the ground that plaintiff had failed to demonstrate that it had provided the requested verification. Plaintiff appeals from a judgment entered March 21, 2016, dismissing the complaint.
For the reasons stated in Island Life Chiropractic, P.C. v Travelers Ins. Co. (___ Misc 3d ___, 2019 NY Slip Op 51273[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2019]), the judgment is reversed and the matter is remitted to the Civil Court for a new trial on the issue of whether the requested verification remains outstanding.
PESCE, P.J., ALIOTTA and ELLIOT, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: August 23, 2019