Matter of Lam Quan MD, P.C. v LM Gen. Ins. Co. (2025 NY Slip Op 03328)

Reported in New York Official Reports at Matter of Lam Quan MD, P.C. v LM Gen. Ins. Co. (2025 NY Slip Op 03328)

Matter of Lam Quan MD, P.C. v LM Gen. Ins. Co. (2025 NY Slip Op 03328)
Matter of Lam Quan MD, P.C. v LM Gen. Ins. Co.
2025 NY Slip Op 03328
Decided on June 4, 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 June 4, 2025 SUPREME COURT OF THE STATE OF NEW YORK Appellate Division, Second Judicial Department
MARK C. DILLON, J.P.
PAUL WOOTEN
BARRY E. WARHIT
LILLIAN WAN, JJ.


2023-02960
(Index No. 610473/22)
[*1]In the Matter of Lam Quan MD, P.C., etc., appellant,

v

LM General Insurance Company, respondent.

Roman Kravchenko, Melville, NY, for appellant.

DECISION & ORDER

In a proceeding pursuant to CPLR article 75 to vacate an award of a master arbitrator dated July 19, 2022, the petitioner appeals from a judgment of the Supreme Court, Nassau County (Conrad D. Singer, J.), entered January 27, 2023. The judgment, insofar as appealed from, (1) awarded the petitioner interest on its recovery of overdue no-fault insurance benefits in the sum of only $39.40, (2) failed to award the petitioner attorneys’ fees pursuant to 11 NYCRR 65-4.6(d), (3) awarded the petitioner attorneys’ fees for services rendered in the Supreme Court in the sum of only $1,000, and (4) failed to award the petitioner the amount of a 3% surcharge imposed by the Office of Court Administration on the petitioner’s credit card transactions.

ORDERED that the judgment is modified, on the law, (1) by deleting the provision thereof awarding the petitioner interest, and (2) by adding a provision thereto awarding the petitioner attorneys’ fees pursuant to 11 NYCRR 65-4.6(d); as so modified, the judgment is affirmed insofar as appealed from, without costs or disbursements, and the matter is remitted to the Supreme Court, Nassau County, (1) for a recalculation of the award of interest, (2) for a determination of the amount of attorneys’ fees to be awarded to the petitioner pursuant to 11 NYCRR 65-4.6(d), and (3) for an award of additional attorneys’ fees to the petitioner for this appeal pursuant to 11 NYCRR 65-4.10(j)(4), and for the entry of an appropriate amended judgment thereafter.

The petitioner, Lam Quan MD, P.C., is the assignee of a claim for no-fault benefits in the amount of $1,002.74 for treatment it rendered to Edwin Pierre-Pierre in October 2020. After the respondent denied the claim, the petitioner submitted the claim to arbitration and the arbitrator denied the claim. In an award dated July 19, 2022, a master arbitrator affirmed the arbitrator’s award.

Thereafter, the petitioner commenced this proceeding pursuant to CPLR article 75 to vacate the master arbitrator’s award. The respondent did not oppose the petition. In an order entered January 5, 2023, the Supreme Court, inter alia, granted the petition. A judgment was entered on January 27, 2023, which, among other things, awarded the petitioner interest on the overdue claim in the sum of only $39.40 and failed to award the petitioner attorneys’ fees pursuant to 11 NYCRR 65-4.6(d). The petitioner appeals.

Pursuant to Insurance Law § 5106(a) and 11 NYCRR 65-3.9(a), interest accrues on overdue no-fault insurance claims at a rate of 2% per month (see Matter of B.Z. Chiropractic, P.C. v Allstate Ins. Co., 197 AD3d 144, 155-156; Hempstead Gen. Hosp. v Insurance Co. of N. Am., 208 [*2]AD2d 501). Such interest is to be “calculated on a pro-rata basis using a 30-day month” (11 NYCRR 65-3.9[a]). “The interest which accrues on overdue no-fault benefits . . . is a statutory penalty designed to encourage prompt adjustments of claims and inflict a punitive economic sanction on those insurers who do not comply” (East Acupuncture, P.C. v Allstate Ins. Co., 61 AD3d 202, 210 [citations omitted]; see Matter of B.Z. Chiropractic, P.C. v Allstate Ins. Co., 197 AD3d at 155). Here, the Supreme Court failed to properly calculate the amount of interest to which the petitioner was entitled on the overdue claim in accordance with Insurance Law § 5106(a) and 11 NYCRR 65-3.9(a). Therefore, we remit the matter to the Supreme Court, Nassau County, for a recalculation of the award of interest.

Further, having determined that the denial of the claim was improper, the Supreme Court should have awarded the petitioner attorneys’ fees pursuant to 11 NYCRR 65-4.6(d) (see St. Clare’s Hosp. v Allstate Ins. Co., 215 AD2d 641). Moreover, the petitioner is entitled to attorneys’ fees for this appeal pursuant to 11 NYCRR 65-4.10(j), to be fixed by the court (see Matter of Bay Needle Care Acupuncture v Country-Wide Ins. Co., 176 AD3d 806, 807; see also Matter of GEICO Ins. Co. v AAAMG Leasing Corp., 148 AD3d 703, 706). Therefore, we remit the matter to the Supreme Court, Nassau County, for a determination of the amount of attorneys’ fees to be awarded to the petitioner pursuant to 11 NYCRR 65-4.6(d) and for this appeal pursuant to 11 NYCRR 65-4.10(j).

The petitioner’s remaining contentions are not properly before this Court.

Accordingly, we modify the judgment and remit the matter to the Supreme Court, Nassau County, for further proceedings in accordance with the foregoing, and the entry of an appropriate amended judgment thereafter.

DILLON, J.P., WOOTEN, WARHIT and WAN, JJ., concur.

ENTER:

Darrell M. Joseph

Clerk of the Court

American Tr. Ins. Co. v Brooklyn Med. Practice, PC (2025 NY Slip Op 50897(U) [86 Misc 3d 1208(A)])

Reported in New York Official Reports at American Tr. Ins. Co. v Brooklyn Med. Practice, PC (2025 NY Slip Op 50897(U) [86 Misc 3d 1208(A)])

[*1]
American Tr. Ins. Co. v Brooklyn Med. Practice, PC
2025 NY Slip Op 50897(U) [86 Misc 3d 1208(A)]
Decided on May 22, 2025
Supreme Court, New York County
Lebovits, 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 May 22, 2025
Supreme Court, New York County


American Transit Insurance Company, Petitioner,

against

Brooklyn Medical Practice, PC, Respondent.




Index No. 652228/2025



Larkin Farrell LLC, New York, NY (Joshua Mak and Anthony R. Troise of counsel), for petitioner.

The Beynenson Law Firm, P.C., Franklin Square, NY (Alek Beynenson of counsel), for respondent.


Gerald Lebovits, J.

Petitioner, American Transit Insurance Company, moves under CPLR article 75 to vacate a no-fault arbitration award in favor of respondent, Brooklyn Medical Practice, P.C. Respondent cross-moves to confirm and for an award of fees. The motion is denied. The cross-motion granted in part and denied in part.

1. On its motion, American Transit argues that the arbitrator (and the reviewing master [*2]arbitrator) failed to follow settled law, rendering the award subject to vacatur. This argument is unpersuasive.

The arbitrator held (and the master arbitrator agreed) that American Transit’s basis for denying the claim was foreclosed on issue-preclusion grounds. (See NYSCEF No. 3 at 2; NYSCEF No. 4 at 2-3.) In challenging this determination, American Transit contends that the arbitrator erred as a matter of law in (implicitly) concluding that the “issue previously litigated was necessary to support a valid and final judgment on the merits.” (NYSCEF No. 1 at ¶ 59.) In particular, American Transit says, the arbitral record does not reflect whether “the decision that the Arbitrator relied upon was confirmed in Court” or “converted into a judgment,” and, “therefore, necessary to support a valid and final judgment on the merits.” (Id. [internal quotation marks omitted].) But an arbitral award may be entitled to issue-preclusive effect in a later proceeding whether or not it has been judicially confirmed or converted into a judgment.[FN1] (See Allstate Ins. Co. v Toussaint, 163 AD2d 444, 445 [2d Dept 1990].)

American Transit also argues that there is “no evidence to show that the Petitioner did not file a de novo action, which would render the prior award a nullity.” (NYSCEF No. 1 at ¶ 61.) This court disagrees with American Transit’s position that affording issue-preclusive effect to the prior award was error in these circumstances.

The party seeking the benefit of issue preclusion must meet an initial burden to show “that the decisive issue was necessarily decided in the prior action against a party, or one in privity with a party.” (Buechel v Bain, 97 NY2d 295, 304 [2001].) American Transit cites no authority for the proposition that the party seeking issue preclusion must then also provide evidence ruling out the possibility that the decision in the prior proceeding had been vacated. To the contrary, it makes much more sense to place the burden of showing that the prior determination was no longer in force on the party opposing preclusion—just as that party must “demonstrate[e] the absence of a full and fair opportunity to contest the prior determination.” (Id.; see American Transit Ins. Co. v U.S. Med Supply Corp., 2023 NY Slip Op 50560[U], at *11-12 [Sup Ct, Kings County 2023] [reaching the same conclusion].) That is particularly true in the no-fault context, where it is not difficult to ascertain whether a prior arbitral award has been vacated by a master arbitrator or upon a de novo action. Absent a showing that the prior arbitral determination had been vacated, the arbitrator did not err in affording that determination issue-preclusive effect.

American Transit’s motion to vacate is denied.

2. On respondent’s cross-motion, respondent seeks not only to confirm the arbitral decision, but also to obtain an additional award of attorney fees. For the reasons discussed above, the arbitral determination is confirmed. Respondent’s fee request is granted in part and denied in part.

In addition to the sums awarded by the arbitrator in principal, interest, and attorney fees, respondent also asks this court to award fees incurred in this proceeding, under 11 NYCRR 65-4.10 (j) (4). Under that provision, the amount to be awarded in fees to a party prevailing in a CPLR article 75 proceeding “shall be fixed by the court adjudicating the matter.” Respondent seeks to recover $850 in fees for 1.7 hours of attorney time billed at $500 an hour. (See NYSCEF No. 11 at ¶¶ 22-23.)

In opposition, American Transit contends that respondent’s attorney fee must be limited to the hourly rate (and maximum fee) permitted by 11 NYCRR 65-4.6 (d). (See NYSCEF No. 16 at ¶¶ 45-46.) This contention is without merit. Section 65-4.6 (d) governs only attorney fees incurred in the underlying arbitration, not also an ensuing CPLR article 75 proceeding to confirm (or vacate) an arbitral award. (See Country-Wide Ins. Co. v TC Acupuncture P.C., 172 AD3d 598, 598 [1st Dept 2019].) This court is also unpersuaded by American Transit’s alternative suggestion that § 65-4.6 (d)’s hourly-rate restrictions necessarily establish the normal billing rate for no-fault attorneys. (NYSCEF No. 16 at ¶ 47.) American Transit does not attempt to show that the capped rate corresponds to the typical no-fault billing rate (either as of the enactment of this regulation or today). And treating § 65-4.6 (d) as setting the maximum rate that a court may properly award under § 65-4.10 (j) (4) would significantly undermine the latter provision’s conferral on courts of discretion to fix a proper attorney fee for CPLR article 75 proceedings. (See Country-Wide Ins. Co. v Bay Needle Care Acupuncture, P.C., 220 AD3d 461, 462 [1st Dept 2023] [“[T]he amount of attorney’s fees awarded pursuant to 11 NYCRR 65—4.10(j)(4) is left to the court’s discretion.”].)

At the same time, respondent has not shown that it is entitled to $850 in fees. Respondent’s counsel’s fee affirmation states only that $500 an hour is his usual hourly billing rate; and that the total billable time spent on this proceeding was 1.7 hours. (See NYSCEF No. 12 at ¶¶ 4-5.) The affirmation does not offer any other information—such as the typical going rate for experienced no-fault attorneys, or what time was spent on which tasks. (Cf. Gamache v Steinhaus, 7 AD3d 525, 527 [2d Dept 2004] [describing criteria for determining hourly rates when awarding fees].) Additionally, some of the time billed is not compensable at all, because that time was spent on preparing respondent’s fee request itself. (See Matter of GEICO Ins. Co. v AAAMG Leasing Corp., 148 AD3d 703, 706 [2d Dept 2017] [holding that “fees on fees” are not available under 11 NYCRR 65-4.6 [j] [4]].) This court concludes that respondent is entitled to $345 in fees, representing 1.15 hours of attorney time at $300 an hour, rather than the $850 claimed.

Accordingly, it is

ORDERED AND ADJUDGED that American Transit Insurance Company’s petition to vacate the underlying arbitral award is denied, and the branch of Brooklyn Medical Practice, P.C.’s cross-petition to confirm the arbitral award is granted; and it is further

ORDERED AND ADJUDGED that the branch of Brooklyn Medical Practice, P.C.’s cross-petition for an award of attorney fees incurred in this proceeding is granted in part and denied in part; and it is further

ORDERED AND ADJUDGED that Brooklyn Medical Practice, P.C. is awarded a [*3]judgment against American Transit Insurance Company for (i) the principal amount owed in first-party benefits of $3,936, with interest on that sum running at the statutory rate of 2% monthly simple interest, from June 11, 2024; plus (ii) the $40 arbitral filing fee; plus (iii) $787.20 in attorney fees awarded in the underlying arbitral proceeding, with interest on that sum running at the statutory rate of 2% monthly simple interest, from June 11, 2024; plus (iv) additional attorney fees incurred in this proceeding of $345; plus (v) costs and disbursements as taxed by the Clerk upon the submission of an appropriate bill of costs; and it is further

ORDERED that respondent serve a copy of this order with notice of its entry on petitioner and on the office of the County Clerk (using the NYSCEF filing event “Notice to the County Clerk – CPLR § 8019 (c)”), which shall enter judgment accordingly.

DATE 5/22/2025

Footnotes


Footnote 1:To the extent American Transit is also arguing that it is settled law that an arbitrator in a later arbitration lacks capacity or authority to determine the issue-preclusive effect of an arbitral award in an earlier arbitration (see NYSCEF No. 1 at ¶ 63), American Transit provides no authority for that proposition. American Transit relies on a passage from Rembrandt Industries, Inc v Hodges International, Inc. (38 NY2d 502, 504 [1976). But that passage holds only that when a party asks a court to afford issue-preclusive effect in litigation to an earlier arbitral determination, the scope of that determination for issue-preclusion purposes must be decided by the court, not delegated back to the arbitrators who rendered the determination at issue. (See Matter of Weinberger v Friedman, 41 AD2d 620, 620 [1st Dept 1973].) That principle has no application here, because the later proceeding in which issue preclusion was raised was itself an arbitration.



Burke 2 Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50840(U))

Reported in New York Official Reports at Burke 2 Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50840(U))

[*1]
Burke 2 Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co.
2025 NY Slip Op 50840(U) [86 Misc 3d 128(A)]
Decided on May 16, 2025
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 May 16, 2025
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : CHEREÉ A. BUGGS, J.P., LISA S. OTTLEY, JOANNE D. QUIÑONES, JJ
2023-1102 K C

Burke 2 Physical Therapy, P.C., as Assignee of Garcia, Alfredo, Appellant,

against

State Farm Mutual Automobile Ins. Co., Respondent.


The Rybak Firm, PLLC (Oleg Rybak and Richard Rozhik of counsel), for appellant. Rivkin Radler, LLP (Stuart M. Bodoff of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Sandra E. Roper, J.), dated September 8, 2023. The order, insofar as appealed from as limited by the brief, granted defendant’s cross-motion for summary judgment dismissing the complaint.

ORDERED that the order, insofar as appealed from, is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals, as limited by the brief, from so much of an order of the Civil Court (Sandra E. Roper, J.) dated September 8, 2023 as granted defendant’s cross-motion for summary judgment dismissing the complaint on the ground that plaintiff had failed to provide requested verification.

For the reasons stated in Burke Physical Therapy, P.C., as Assignee of Brown, Wildex v State Farm Mut. Auto. Ins. Co. (— Misc 3d —, 2025 NY Slip Op _____ [appeal No. 2023-1091 K C], decided herewith), the order, insofar as appealed from, is affirmed.

BUGGS, J.P. and QUIÑONES, JJ., concur.

OTTLEY, J., taking no part.

ENTER:
Paul Kenny
Chief Clerk
Decision Date: May 16, 2025



Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50841(U))

Reported in New York Official Reports at Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50841(U))

[*1]
Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co.
2025 NY Slip Op 50841(U) [86 Misc 3d 128(A)]
Decided on May 16, 2025
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 May 16, 2025
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : CHEREÉ A. BUGGS, J.P., LISA S. OTTLEY, JOANNE D. QUIÑONES, JJ
2023-1151 K C

Burke Physical Therapy, P.C., as Assignee of Rivera, Alexandra, Appellant,

against

State Farm Mutual Automobile Ins. Co., Respondent.


The Rybak Firm, PLLC (Oleg Rybak and Richard Rozhik of counsel), for appellant. Rivkin Radler, LLP (Stuart M. Bodoff of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Sandra E. Roper, J.), dated September 8, 2023. The order, insofar as appealed from as limited by the brief, granted defendant’s cross-motion for summary judgment dismissing the complaint.

ORDERED that the order, insofar as appealed from, is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals, as limited by the brief, from so much of an order of the Civil Court (Sandra E. Roper, J.) dated September 8, 2023 as granted defendant’s cross-motion for summary judgment dismissing the complaint on the ground that plaintiff had failed to provide requested verification.

For the reasons stated in Burke Physical Therapy, P.C., as Assignee of Brown, Wildex v State Farm Mut. Auto. Ins. Co. (— Misc 3d —, 2025 NY Slip Op _____ [appeal No. 2023-1091 K C], decided herewith), the order, insofar as appealed from, is affirmed.

BUGGS, J.P. and QUIÑONES, JJ., concur.

OTTLEY, J., taking no part.

ENTER:
Paul Kenny
Chief Clerk
Decision Date: May 16, 2025



Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50845(U))

Reported in New York Official Reports at Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50845(U))

[*1]
Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co.
2025 NY Slip Op 50845(U) [86 Misc 3d 128(A)]
Decided on May 16, 2025
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 May 16, 2025
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : CHEREÉ A. BUGGS, J.P., LISA S. OTTLEY, JOANNE D. QUIÑONES, JJ
2024-334 K C

Burke Physical Therapy, P.C., as Assignee of Calderon Sanchez, Elmina, Appellant,

against

State Farm Mutual Automobile Ins. Co., Respondent.


The Rybak Firm, PLLC (Oleg Rybak and Richard Rozhik of counsel), for appellant. Rivkin Radler, LLP (Stuart M. Bodoff of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Sandra E. Roper, J.), dated September 8, 2023. The order, insofar as appealed from as limited by the brief, granted defendant’s cross-motion for summary judgment dismissing the complaint with prejudice.

ORDERED that the order, insofar as appealed from, is reversed, without costs, defendant’s cross-motion for summary judgment dismissing the complaint with prejudice is denied and, upon searching the record, the complaint is dismissed without prejudice.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals, as limited by the brief, from so much of an order of the Civil Court (Sandra E. Roper, J.) dated September 8, 2023 as granted defendant’s cross-motion for summary judgment dismissing the complaint on the ground that plaintiff had failed to provide requested verification.

Plaintiff argues on appeal that the order, insofar as appealed from, should be reversed and the matter remitted to the Civil Court for consideration of what plaintiff denominated as amended opposition to defendant’s cross-motion, which the court declined to consider. The court rejected that submission as an improper sur-reply. In the alternative, plaintiff argues that defendant’s cross-motion should be denied.

Contrary to plaintiff’s contention, it was not improper for defendant to seek, during the claim verification stage, information—such as management agreements, W-2 forms, business-related bank records and lease agreements—for the purpose of determining whether [*2]plaintiff was ineligible to collect no-fault benefits due to a failure to meet licensing requirements (see 11 NYCRR 65-3.16 [a] [1]; State Farm Mut. Auto. Ins. Co. v Mallela, 4 NY3d 313 [2005]; Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co., 85 Misc 3d 130[A], 2025 NY Slip Op 50196[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2025]).

Plaintiff also argues that the instant action cannot be maintained, as collateral estoppel effect should be given to an order of the Supreme Court, Nassau County, denying defendant’s motion for summary judgment in a declaratory judgment action brought by defendant in that court. However, the denial of such a motion “has no preclusive effect on this case, as it was not a final determination on the merits” (Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co., 83 Misc 3d 41, 45 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2024]).

Furthermore, nothing in the record supports plaintiff’s contention that it was improper for the Civil Court to decline to consider plaintiff’s amended opposition to defendant’s cross-motion, nor does plaintiff demonstrate that consideration of the amended opposition would warrant a different outcome.

However, at oral argument, defendant noted that the denial of claim form at issue in this case was issued more than 150 days after the issuance of the initial request for verification. Thus, that denial of claim form is a nullity and, upon searching the record, we conclude that the action is premature and the complaint should be dismissed without prejudice (see Chapa Prods. Corp. v MVAIC, 66 Misc 3d 16 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2019]).

Plaintiff’s remaining contentions lack merit.

Accordingly, the order, insofar as appealed from, is reversed, defendant’s cross-motion for summary judgment dismissing the complaint with prejudice is denied and, upon searching the record, the complaint is dismissed without prejudice.

BUGGS, J.P. and QUIÑONES, JJ., concur.

OTTLEY, J., taking no part.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: May 16, 2025



MSB Physical Therapy, P.C. v Nationwide Ins. (2025 NY Slip Op 50829(U))

Reported in New York Official Reports at MSB Physical Therapy, P.C. v Nationwide Ins. (2025 NY Slip Op 50829(U))

[*1]
MSB Physical Therapy, P.C. v Nationwide Ins.
2025 NY Slip Op 50829(U) [86 Misc 3d 127(A)]
Decided on May 16, 2025
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 May 16, 2025
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : WAVNY TOUSSAINT, P.J., CHEREE A. BUGGS, LISA S. OTTLEY, JJ
2021-476 K C

MSB Physical Therapy, P.C., as Assignee of Bright, Sayquan U, 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 Richard Rozhik of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Richard Tsai, J.; op 72 Misc 3d 1215[A], 2021 NY Slip Op 50750[U] [2021]), dated July 13, 2021. The order, insofar as appealed from, denied the branches of defendant’s motion seeking summary judgment dismissing the first through fifth causes of action and granted the branches of plaintiff’s cross-motion seeking summary judgment on the first through fifth causes of action. Justices Buggs and Ottley have been substituted for former Justices Aliotta and Weston.

ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, the branches of defendant’s motion seeking summary judgment dismissing the first through fifth causes of action are granted and the branches of plaintiff’s cross-motion seeking summary judgment on the first through fifth causes of action are denied.

In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from so much of an order of the Civil Court as denied the branches of defendant’s motion seeking summary judgment dismissing the first through fifth causes of action on the ground that plaintiff failed to appear for duly scheduled examinations under oath, and granted the branches of plaintiff’s cross-motion seeking summary judgment on the first through fifth causes of action.

For the reasons stated in MSB Physical Therapy, P.C., as Assignee of Bright, Sayquan U v Nationwide Ins. (— Misc 3d —, 2025 NY Slip Op ___ [Appeal No. 2021-478 K C], decided herewith), the order (72 Misc 3d 1215[A], 2021 NY Slip Op 50750[U] [Civ Ct, Kings County 2021]), insofar as appealed from, is reversed, the branches of defendant’s motion seeking [*2]summary judgment dismissing the first through fifth causes of action are granted and the branches of plaintiff’s cross-motion seeking summary judgment on the first through fifth causes of action are denied.

The decision and order of this court dated December 23, 2022 (77 Misc 3d 140[A], 2022 NY Slip Op 51377[U] is hereby recalled and vacated (see motion decided simultaneously herewith).

TOUSSAINT, P.J., BUGGS and OTTLEY, JJ., concur.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: May 16, 2025



MSB Physical Therapy, P.C. v Nationwide Ins. (2025 NY Slip Op 50830(U))

Reported in New York Official Reports at MSB Physical Therapy, P.C. v Nationwide Ins. (2025 NY Slip Op 50830(U))

[*1]
MSB Physical Therapy, P.C. v Nationwide Ins.
2025 NY Slip Op 50830(U) [86 Misc 3d 127(A)]
Decided on May 16, 2025
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 May 16, 2025
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : WAVNY TOUSSAINT, P.J., CHEREE A. BUGGS, LISA S. OTTLEY, JJ
2021-478 K C

MSB Physical Therapy, P.C., as Assignee of Bright, Sayquan U, 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 Richard Rozhik of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Richard Tsai, J.), dated July 12, 2021. The order denied defendant’s motion for summary judgment dismissing the complaint and granted plaintiff’s cross-motion for summary judgment. Justices Buggs and Ottley have been substituted for former Justices Aliotta and Weston.

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

In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from an order of the Civil Court which denied defendant’s motion which had sought summary judgment dismissing the complaint on the ground that plaintiff failed to appear for duly scheduled examinations under oath (EUOs), and granted plaintiff’s cross-motion for summary judgment.

Defendant demonstrated that a letter scheduling an initial EUO of plaintiff had been mailed before receipt of the claims at issue, and that defendant issued timely follow-up EUO scheduling requests after each failure to appear by plaintiff, thus tolling defendant’s time to pay or deny the claims (see Stracar Med. Servs. v State Farm Mut. Auto. Ins. Co., 61 Misc 3d 150[A], 2018 NY Slip Op 51759[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2018]; ARCO Med. NY, P.C. v Lancer Ins. Co., 34 Misc 3d 134[A], 2011 NY Slip Op 52382[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2011]). Defendant further established that plaintiff [*2]failed to appear for each of the scheduled EUOs, and that defendant then issued “timely and proper denial[s] of the claims following [plaintiff’s] failure to appear at the last scheduled EUO” (Quality Health Supply Corp. v Nationwide Ins., 216 AD3d 1013, 1014 [2023], revg 69 Misc 3d 133[A], 2020 NY Slip Op 51226[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2020]). As plaintiff failed to raise a triable issue of fact in response to defendant’s prima facie showing, defendant’s motion should have been granted and plaintiff’s cross-motion denied.

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

The decision and order of this court dated December 23, 2022 (77 Misc 3d 140[A], 2022 NY Slip Op 51378[U]) is hereby recalled and vacated (see motion decided simultaneously herewith).

TOUSSAINT, P.J., BUGGS and OTTLEY, JJ., concur.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: May 16, 2025



MSB Physical Therapy, P.C. v Nationwide Ins. (2025 NY Slip Op 50831(U))

Reported in New York Official Reports at MSB Physical Therapy, P.C. v Nationwide Ins. (2025 NY Slip Op 50831(U))

[*1]
MSB Physical Therapy, P.C. v Nationwide Ins.
2025 NY Slip Op 50831(U) [86 Misc 3d 127(A)]
Decided on May 16, 2025
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 May 16, 2025
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : WAVNY TOUSSAINT, P.J., CHEREE A. BUGGS, LISA S. OTTLEY, JJ
2021-623 K C

MSB Physical Therapy, P.C., as Assignee of Shuler, Azyzah, Appellant,

against

Nationwide Ins., Respondent.


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

Appeal from an order of the Civil Court of the City of New York, Kings County (Odessa Kennedy, J.), entered July 29, 2021. The order granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross-motion for summary judgment. Justices Buggs and Ottley have been substituted for former Justices Aliotta and Weston.

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 failed to appear for duly scheduled examinations under oath (EUOs), and denied plaintiff’s cross-motion for summary judgment.

Defendant established prima facie that it timely mailed initial and follow-up EUO scheduling letters (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]; see also 11 NYCRR 65-3.8 [l]); that plaintiff failed to appear for the scheduled EUOs; and that defendant then issued “timely and proper denial[s] of the claims following [plaintiff’s] failure to appear at the last scheduled EUO” (Quality Health Supply Corp. v Nationwide Ins., 216 AD3d 1013, 1014 [2023], revg 69 Misc 3d 133[A], 2020 NY Slip Op 51226[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2020]). As plaintiff failed to raise a triable issue of fact in response to defendant’s prima facie showing, defendant’s motion was properly granted and plaintiff’s cross-motion was properly denied.

Accordingly, the order is affirmed.

The decision and order of this court dated December 23, 2022 (77 Misc 3d 140[A], 2022 NY Slip Op 51382[U]) is hereby recalled and vacated (see motion decided simultaneously herewith).

TOUSSAINT, P.J., BUGGS and OTTLEY, JJ., concur.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: May 16, 2025



GC Chiropractic, P.C. v Allstate Ins. Co. (2025 NY Slip Op 50835(U))

Reported in New York Official Reports at GC Chiropractic, P.C. v Allstate Ins. Co. (2025 NY Slip Op 50835(U))

[*1]
GC Chiropractic, P.C. v Allstate Ins. Co.
2025 NY Slip Op 50835(U) [86 Misc 3d 127(A)]
Decided on May 16, 2025
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 May 16, 2025
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : CHEREÉ A. BUGGS, J.P., WAVNY TOUSSAINT, JOANNE D. QUIÑONES, JJ
2023-1069 K C

GC Chiropractic, P.C., as Assignee of German Tome, Appellant,

against

Allstate Ins. Co., Respondent.


Gary Tsirelman, P.C. (David M. Gottlieb of counsel), for appellant. Peter C. Merani, P.C. (Samuel A. Kamara and Michael Zeleznock of counsel), for respondent.

Appeal from an amended order of the Civil Court of the City of New York, Kings County (Jill R. Epstein, J.), dated May 11, 2023. The amended order, insofar as appealed from, granted the branch of defendant’s motion seeking an order pursuant to CPLR 2606, 2607 and 8010 directing plaintiff to move to recover from the Department of Finance the undertaking deposited by defendant, and, sua sponte, directed plaintiff “to provide Defendant with [a] Satisfaction of Judgment upon receipt of full payment.”

ORDERED that, on the court’s own motion, so much of the notice of appeal as is from so much of the order as, sua sponte, directed plaintiff to provide defendant with a satisfaction of judgment upon plaintiff’s receipt of full payment should be deemed to be an application for leave to appeal from that portion of the order, and leave to appeal is granted (see CCA 1702 [c]); and it is further,

ORDERED that the amended order, insofar as appealed from, is reversed, with $30 costs, the branch of defendant’s motion seeking an order pursuant to CPLR 2606, 2607 and 8010 directing plaintiff to move to recover from the Department of Finance the undertaking deposited by defendant is denied, and so much of the order as, sua sponte, directed plaintiff to provide defendant with a satisfaction of judgment upon plaintiff’s receipt of full payment is vacated.

In this action by a provider to recover assigned first-party no-fault benefits, a default judgment was entered in plaintiff’s favor on July 27, 2016 for the total sum of $3,623.62. On [*2]December 4, 2017, defendant’s motion seeking to vacate the default judgment was denied. Defendant appealed to this court from the December 4, 2017 order and, on January 25, 2018, defendant deposited the sum of $3,623.62 with the New York City Department of Finance (DOF) in connection with the appeal. By decision and order dated November 29, 2019, this court affirmed the order denying defendant’s motion to vacate the default judgment (GC Chiropractic, P.C. v Allstate Ins. Co., 65 Misc 3d 156[A], 2019 NY Slip Op 51954[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2019]). Defendant subsequently moved for, among other things, an order pursuant to CPLR 2606, 2607 and 8010 directing plaintiff to move to recover from the DOF the undertaking deposited by defendant. After plaintiff opposed the motion, the Civil Court (Jill R. Epstein, J.), in an amended order dated May 11, 2023, “[p]ursuant to CPLR 2606, 2607 and 8010 . . . direct[ed] plaintiff to proceed to recover the undertaking from the Department of Finance and to provide Defendant with [a] Satisfaction of Judgment upon receipt of full payment.”

While no appeal as of right lies from the sua sponte portion of the order directing plaintiff to provide defendant with a satisfaction of judgment upon plaintiff’s receipt of full payment, we deem the notice of appeal to be an application for leave to appeal from that portion of the order and grant plaintiff’s application (see CCA 1702 [c]).

Defendant’s contentions that the undertaking it deposited on January 25, 2018 tolled the accrual of interest, that the amount of the undertaking is sufficient to satisfy defendant’s debt, and that it is plaintiff’s burden to move to recover the undertaking lack merit. The deposit of money pursuant to CPLR 5519 in order to obtain a stay of execution of the judgment pending appeal does not toll the accrual of interest (see Purpura v Purpura, 261 AD2d 595; 597 [1999]; see also Wiederhorn v Merkin, 106 AD3d 416 [2013]; Matter of Matra Bldg. Corp. v Kucker, 19 AD3d 496 [2005]). We note that since no-fault interest continues to accrue until the judgment is satisfied (see Matter of Matra Bldg. Corp., 19 AD3d 496; see generally 11 NYCRR 65-3.9 [a]; Matter of B.Z. Chiropractic, P.C. v Allstate Ins. Co., 197 AD3d 144 [2021]), the amount of the undertaking alone will be insufficient to satisfy the judgment.

Accordingly, the amended order, insofar as appealed from, is reversed, and the branch of defendant’s motion seeking an order pursuant to CPLR 2606, 2607 and 8010 directing plaintiff to move to recover from the Department of Finance the undertaking deposited by defendant is denied and so much of the order as, sua sponte, directed plaintiff to provide defendant with a satisfaction of judgment upon plaintiff’s receipt of full payment is vacated.

BUGGS, J.P., TOUSSAINT and QUIÑONES, JJ., concur.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: May 16, 2025

Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50836(U))

Reported in New York Official Reports at Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2025 NY Slip Op 50836(U))

[*1]
Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co.
2025 NY Slip Op 50836(U) [86 Misc 3d 128(A)]
Decided on May 16, 2025
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 May 16, 2025
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : CHEREÉ A. BUGGS, J.P., LISA S. OTTLEY, JOANNE D. QUIÑONES, JJ
2023-1091 K C

Burke Physical Therapy, P.C., as Assignee of Brown, Wildex, Appellant,

against

State Farm Mutual Automobile Ins. Co., Respondent.


The Rybak Firm, PLLC (Oleg Rybak and Richard Rozhik of counsel), for appellant. Rivkin Radler, LLP, (Stuart M. Bodoff of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Sandra E. Roper, J.), dated September 8, 2023. The order, insofar as appealed from as limited by the brief, granted defendant’s cross-motion for summary judgment dismissing the complaint.

ORDERED that the order, insofar as appealed from, is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals, as limited by the brief, from so much of an order of the Civil Court (Sandra E. Roper, J.) dated September 8, 2023 as granted defendant’s cross-motion for summary judgment dismissing the complaint on the ground that plaintiff had failed to provide requested verification.

Plaintiff argues on appeal that the order, insofar as appealed from, should be reversed and the matter remitted to the Civil Court for consideration of what plaintiff denominated as amended opposition to defendant’s cross-motion, which the court declined to consider. The court rejected that submission as an improper sur-reply. In the alternative, plaintiff argues that defendant’s cross-motion should be denied.

Contrary to plaintiff’s contention, it was not improper for defendant to seek, during the claim verification stage, information—such as management agreements, W-2 forms, business-related bank records and lease agreements—for the purpose of determining whether plaintiff was ineligible to collect no-fault benefits due to a failure to meet licensing requirements (see 11 NYCRR 65-3.16 [a] [1]; State Farm Mut. Auto. Ins. Co. v Mallela, 4 NY3d 313 [2005]; Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co., 85 Misc 3d 130[A], 2025 NY [*2]Slip Op 50196[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2025]).

Plaintiff also argues that the instant action cannot be maintained, as collateral estoppel effect should be given to an order of the Supreme Court, Nassau County, denying defendant’s motion for summary judgment in a declaratory judgment action brought by defendant in that court. However, the denial of such a motion “has no preclusive effect on this case, as it was not a final determination on the merits” (Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co., 83 Misc 3d 41, 45 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2024]).

Furthermore, nothing in the record supports plaintiff’s contention that it was improper for the Civil Court to decline to consider plaintiff’s amended opposition to defendant’s cross motion, nor does plaintiff demonstrate that consideration of the amended opposition would warrant a different outcome.

Plaintiff’s remaining contentions lack merit.

Accordingly, the order, insofar as appealed from, is affirmed.

BUGGS, J.P. and QUIÑONES, JJ., concur.

OTTLEY, J., taking no part.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: May 16, 2025