Reported in New York Official Reports at Omega 18 Inc. v Global Liberty Ins. Co. of N.Y. (2020 NY Slip Op 50235(U))
against
Global Liberty Insurance Company of New York, Defendant-Appellant.
Defendant appeals from so much of an order of the Civil Court of the City of New York, Bronx County (Naita A. Semaj, J.), entered April 2, 2019, that denied, in part, its motion for summary judgment dismissing the complaint.
Per Curiam.
Order (Naita A. Semaj, J.), entered April 2, 2019, insofar as appealed from, reversed, without costs, motion granted, and the complaint dismissed. The Clerk is directed to enter judgment accordingly.
The defendant insurer made a prima facie showing of entitlement to judgment as a matter of law dismissing the underlying first-party no-fault action. The proof submitted by defendant, including the affirmed peer review report of its physician, set forth a factual basis and medical rationale for the conclusion that the medical supplies plaintiff provided to its assignor, including a portable whirlpool, heat lamp and massager, were not medically necessary (see Triangle R Inc. v New York Cent. Mut. Fire Ins. Co., 32 Misc 3d 143[A], 2011 NY Slip Op 51663[U] [App Term, 1st Dept 2011]). The report explained that the assignor was already receiving physical, acupuncture and chiropractic therapy for her injuries and that the equipment at issue was either unnecessary or redundant (see Enko Enters. Intl., Inc. v Clarendon Natl. Ins. Co., 30 Misc 3d 127[A], 2010 NY Slip Op 52267[U] [App Term, 1st Dept 2010]).
Plaintiff’s opposition, consisting of an attorney’s affirmation, prescription and various claim forms, was unaccompanied by any medical evidence or other competent proof of medical necessity, and failed to raise a triable issue (see TC Acupuncture, P.C. v Tri-State Consumer Ins. Co., 52 Misc 3d 131[A], 2016 NY Slip Op 50978[U] [App Term, 1st Dept 2016]; Karina K. Acupuncture, P.C. v AIG Centennial Ins. Co., 51 Misc 3d 132[A], 2016 NY Slip Op 50415[U] [App Term, 1st Dept 2016]; Cortland Med. Supply, Inc. v 21st Century Centennial Ins. Co., 46 Misc 3d 136[A], 2014 NY Slip Op 51886[U] [App Term, 1st Dept 2014]).
THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.
I concur I concur I concur
Decision Date: February 19, 2020
Reported in New York Official Reports at Matter of GEICO v National Ind. Truckers (2020 NY Slip Op 01163)
| Matter of GEICO v National Ind. Truckers |
| 2020 NY Slip Op 01163 [180 AD3d 900] |
| February 19, 2020 |
| Appellate Division, Second Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
[*1]
| In the Matter of GEICO,
Respondent, v National Independent Truckers, Appellant. |
Ginsberg, Becker & Weaver, LLP, New York, NY (Robert D. Becker of counsel), for appellant.
In a proceeding pursuant to CPLR article 75 to vacate an arbitration award dated June 1, 2017, National Independent Truckers appeals from an order of the Supreme Court, Putnam County (James T. Rooney, J.), dated February 22, 2018. The order granted the petition to vacate the award and denied National Independent Truckers’ cross petition to change venue. The appeal brings up for review so much of an order of the same court dated September 14, 2018, as denied that branch of National Independent Truckers’ motion which was for leave to renew its cross petition and its opposition to the petition (see CPLR 5517 [b]).
Ordered that the order dated February 22, 2018, is affirmed, without costs or disbursements; and it is further,
Ordered that the order dated September 14, 2018, is affirmed insofar as reviewed, without costs or disbursements.
On October 19, 2012, a vehicle insured by the petitioner, GEICO, and operated by Edward Murphy, and a vehicle insured by National Independent Truckers (hereinafter NIT) were involved in a motor vehicle accident. Murphy commenced a personal injury action against the operator and owner of the vehicle insured by NIT. GEICO separately commenced a subrogation action against the operator and owner of the vehicle insured by NIT to recover for the property damage to Murphy’s vehicle (hereinafter the property damage action). GEICO also filed, pursuant to Insurance Law § 5105, a demand for mandatory inter-company arbitration against NIT, seeking reimbursement of no fault payments it had paid on behalf of Murphy.
After a trial in the property damage action, the jury rendered a verdict finding that the operator of the vehicle insured by NIT was not negligent. GEICO thereafter moved pursuant to CPLR 4404 (a) to set aside the jury verdict. During court conferences, the Supreme Court advised the parties that it planned to grant GEICO’s motion.
While GEICO’s motion to set aside the jury verdict remained pending before the Supreme Court, the arbitration between GEICO and NIT proceeded to a hearing. NIT argued, among other things, that GEICO was not entitled to be reimbursed since NIT’s insured had obtained a defense verdict in the property damage action. The arbitrator issued an award in favor of NIT, determining that the jury verdict finding that NIT’s insured was not negligent in the property damage action was “res judicata for this forum.” It is undisputed that the arbitrator was not made aware of GEICO’s pending motion to set aside the verdict or the court’s attempts to facilitate a resolution between the parties given its opinion regarding the strength of GEICO’s motion.
After the arbitrator issued her award, the Supreme Court granted GEICO’s motion to set aside the jury verdict. GEICO thereafter filed a petition pursuant to CPLR 7511 (b) (1) (i) to vacate the arbitration award on the basis that it was procured by misconduct or fraud. NIT opposed the petition and filed a cross petition to change venue from the Supreme Court, Putnam County, to the Supreme Court, New York County. The Supreme Court granted the petition and denied the cross petition. NIT appeals. The appeal brings up for review so much of an order of the same court dated September 14, 2018, as denied that branch of NIT’s motion which was for leave to renew its cross petition and its opposition to GEICO’s petition (see CPLR 5517 [b]).
A court may vacate an arbitration award pursuant to CPLR 7511 (b) (1) (i) if the court finds that the rights of the moving party were prejudiced by corruption, fraud, or misconduct in procuring the award. Although a party and its counsel’s “lack of candor” in disclosing information material to the arbitration “may fall short of outright fraud, it does constitute the type of misconduct that warrants further proceedings before the arbitrator” (Matter of Kalgren [Cent. Mut. Ins. Co.], 68 AD2d 549, 553 [1979]; see Bevona v Supervised Cleaning & Maintenance Co., 160 AD2d 605, 606 [1990]; Matter of Science Dev. Corp. [Schonberger], 156 AD2d 253, 254 [1989]).
Here, GEICO demonstrated that the arbitrator was not informed of the status of the property damage action, including the pending motion to vacate the jury verdict and the Supreme Court’s attempts to resolve the matter based on its opinion regarding the strength of the motion. It is undisputed that NIT failed to disclose this material information to the arbitrator, despite the fact that it relied upon the jury verdict in the property damage action to support its position at the arbitration. Accordingly, we agree with the court’s determination to vacate the arbitration award as the record established that, had this information been disclosed to the arbitrator, it is likely that she would have reached a different result.
Pursuant to CPLR 7502 (a) (i), a special proceeding to vacate an arbitration award shall be brought “in the county where at least one of the parties resides or is doing business or where the arbitration was held or is pending.” NIT argues that New York County, the location of the arbitration hearing, is the proper venue for the instant proceeding because GEICO does not have an office in Putnam County, and NIT does not have any offices in the State of New York. As NIT did not present any evidence in support of its contention that venue was improper, i.e., that GEICO was not “doing business” in Putnam County, we agree with the Supreme Court’s determination denying NIT’s cross petition to change the venue to New York County.
We further agree with the Supreme Court’s determination to deny that branch of NIT’s motion which was for leave to renew its cross petition and its opposition to GEICO’s petition (see CPLR 2221 [e]). NIT did not meet its burden of providing new facts or demonstrating a change in the law that would alter the court’s decision to grant the petition and deny NIT’s cross petition to change venue. Scheinkman, P.J., Rivera, Balkin and Leventhal, JJ., concur.
Medcare Supply, Inc. v Global Liberty Ins. (2020 NY Slip Op 50231(U))Reported in New York Official Reports at Medcare Supply, Inc. v Global Liberty Ins. (2020 NY Slip Op 50231(U))
| Medcare Supply, Inc. v Global Liberty Ins. |
| 2020 NY Slip Op 50231(U) [66 Misc 3d 146(A)] |
| Decided on February 14, 2020 |
| 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 February 14, 2020
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MICHELLE WESTON, J.P., THOMAS P. ALIOTTA, BERNICE D. SIEGAL, JJ
2018-2322 K C
against
Global Liberty Insurance, Appellant.
Law Office of Jason Tenenbaum, P.C. (Jason Tenenbaum and Shaaker Bhuiyan of counsel), for appellant. Law Offices of Ilona Finkelshteyn, P.C., for respondent (no brief filed).
Appeal from an order of the Civil Court of the City of New York, Kings County (Sharon Bourne-Clarke, J.), entered October 16, 2018. 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.
In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from an order of the Civil Court which granted plaintiff’s motion for summary judgment, and denied defendant’s cross motion which had sought summary judgment dismissing the complaint on the ground that plaintiff’s assignor had failed to appear for duly scheduled independent medical examinations (IMEs).
Defendant’s moving papers demonstrated, prima facie, that defendant had timely mailed both the IME scheduling letters and the denial of claim form (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]), and that plaintiff’s assignor had failed to appear for the duly scheduled IMEs (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 [2006]). In opposition, plaintiff proffered an affirmation by its assignor’s counsel, who did not assert that she possessed personal knowledge of [*2]the facts. Consequently, plaintiff failed to raise a triable issue of fact in opposition to defendant’s motion (see Zuckerman v City of New York, 49 NY2d 557 [1980]).
Accordingly, the order is reversed, plaintiff’s motion for summary judgment is denied and defendant’s cross motion for summary judgment dismissing the complaint is granted.
WESTON, J.P., ALIOTTA and SIEGAL, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: February 14, 2020
Reported in New York Official Reports at Metro Health Prods., Inc. v Maryland Auto Ins. Fund (2020 NY Slip Op 50229(U))
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
against
Maryland Auto Insurance Fund, Respondent.
The Rybak Firm, PLLC (Damin J. Toell of counsel), for appellant. Jeffrey G. Lerman, P.C. (Jeffrey G. Lerman of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Robin S. Garson, J.), entered June 25, 2018. The order granted defendant’s motion, pursuant to, among other things, CPLR 3211 (a) (8), to dismiss the complaint for lack of personal jurisdiction and denied plaintiff’s “cross motion” for summary judgment.
ORDERED that the order is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, defendant moved, pursuant to, among other things, CPLR 3211 (a) (8), to dismiss the complaint. Plaintiff opposed defendant’s motion and “cross-moved” for summary judgment. In support of its motion, defendant alleged, among other things, that it conducts no business in the State of New York, including that it does not issue insurance policies here and has no sales representative or agent within the State, and is not licensed to transact business within the State of New York. In an order entered June 25, 2018, defendant’s motion was granted and plaintiff’s cross motion was denied.
Upon defendant’s prima facie showing that the Civil Court lacked personal jurisdiction over this nonresident on the ground that there was no jurisdictional basis for suit in the Civil Court of the City of New York (see CCA 404), the burden shifted to plaintiff, which purported to have effectuated service by mail to the out-of-state defendant, to establish that it had a jurisdictional basis for the service, as plaintiff “carries the ultimate burden of proof on that issue” [*2](Opticare Acquisition Corp. v Castillo, 25 AD3d 238, 243 [2005]; see also Sanchez v Major, 289 AD2d 320 [2001]; Brandt v Toraby, 273 AD2d 429 [2000]; Cushley v Wealth Masters Intl., 29 Misc 3d 144[A], 2010 NY Slip Op 52221[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2010]). In determining whether a plaintiff has met its burden, a court must construe the pleadings, affidavits and other evidentiary materials in a light most favorable to plaintiff, and must resolve all doubts in favor of jurisdiction (see Brandt, 273 AD2d at 430). Here, plaintiff failed to meet its burden. Plaintiff’s opposition papers consisted only of the affidavit of its owner attesting to the mailing policies and procedures of plaintiff, and the affirmation of its counsel, who had no personal knowledge of the underlying facts (see Carte v Parkoff, 152 AD2d 615 [1989]). Plaintiff failed to produce evidence showing a jurisdictional basis for the service (see CCA 404; Matter of New York Cent. Mut. Ins. Co. v Johnson, 260 AD2d 638 [1999]; see also Matter of Hereford Ins. Co. v American Ind. Ins., 136 AD3d 551 [2016]).
In view of the foregoing, we do not consider plaintiff’s other arguments.
Accordingly, the order is affirmed.
WESTON, J.P., ELLIOT and SIEGAL, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: February 14, 2020
Reported in New York Official Reports at Rockaway Med. & Diagnostic, P.C. v State Farm Mut. Ins. Co. (2020 NY Slip Op 50238(U))
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
against
State Farm Mutual Insurance Co., Respondent.
Law Office of David O’Connor, P.C. (David O’Connor of counsel), for appellant. Rivkin Radler, LLP (Stuart M. Bodoff and Cheryl F. Korman of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Queens County (Phillip Hom, J.), entered July 3, 2018. The order granted the branch of defendant’s motion seeking to dismiss the complaint on the ground of laches.
ORDERED that the order is reversed, without costs, the branch of defendant’s motion seeking to dismiss the complaint on the ground of laches is denied, and the matter is remitted to the Civil Court for a determination of the remaining branches of defendant’s motion.
Insofar as is relevant to the appeal in this action by a provider to recover assigned first-party no-fault benefits, defendant moved to, among other things, dismiss the complaint on the ground of laches, based on plaintiff’s delay in prosecuting the action. The Civil Court granted this branch of defendant’s motion and found that the remaining branches of the motion were moot.
“[A] court ‘ha[s] no power whatsoever’ to dismiss an action for gross laches or failure to prosecute in the absence of a 90-day demand to serve and file a [notice of trial]” (Arroyo v Board of Educ. of City of NY, 110 AD3d 17, 20 [2013], quoting Hodge v New York City Tr. Auth., 273 AD2d 42, 43 [2000]; see also Chase v Scavuzzo, 87 NY2d 228 [1995]; General Assur. Co. v Lachmenar, 45 Misc 3d 134[A], 2014 NY Slip Op 51722[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2014]), and “the doctrine of laches does not provide an alternate basis to dismiss a complaint where there has been no service of a 90-day demand pursuant to CPLR 3216 (b)” (Arroyo, 110 AD3d at 20; see also Montalvo v Mumpus Restorations, Inc., 110 AD3d 1045 [2013]). As defendant does not claim to have served a demand pursuant to CPLR 3216, it was error for the Civil Court to grant the branch of defendant’s motion seeking to dismiss the complaint based on laches.
In light of this court’s determination, the matter must be remitted to the Civil Court for a determination of the remaining branches of defendant’s motion, as they are no longer moot.
Accordingly, the order is reversed, the branch of defendant’s motion seeking to dismiss [*2]the complaint on the ground of laches is denied, and the matter is remitted to the Civil Court for a determination of the remaining branches of defendant’s motion.
WESTON, J.P., ALIOTTA and SIEGAL, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: February 7, 2020
Reported in New York Official Reports at Nationwide Affinity Ins. Co. of Am. v PFJ Med. Care, P.C. (2020 NY Slip Op 00972)
| Nationwide Affinity Ins. Co. of Am. v PFJ Med. Care, P.C. |
| 2020 NY Slip Op 00972 [180 AD3d 1381] |
| February 7, 2020 |
| Appellate Division, Fourth Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
[*1]
| Nationwide Affinity Insurance Company of America et
al., Appellants, v PFJ Medical Care, P.C., Respondent. Nationwide Affinity Insurance Company of America et al., Appellants, v FJL Medical Services, P.C., Respondent. |
Hollander Legal Group, P.C., Melville (Allan S. Hollander of counsel), for plaintiffs-appellants.
Appeal from an order of the Supreme Court, Onondaga County (Donald A. Greenwood, J.), entered April 24, 2019. The order denied plaintiffs’ motions for leave to renew their motions seeking summary judgment.
It is hereby ordered that the order so appealed from is unanimously reversed on the law without costs, the motions for leave to renew are granted and, upon renewal, the motions for summary judgment are granted, and judgment is granted in favor of plaintiffs as follows:
It is adjudged and declared that plaintiffs are under no obligation to pay or reimburse any of the subject claims.
Memorandum: Defendants are medical professional corporations that were assigned claims for no-fault benefits by individuals who purportedly received treatment for injuries allegedly sustained in motor vehicle accidents. Defendants submitted bills for the services they purportedly rendered, along with the assignment of benefit forms, to the insurance carrier plaintiffs (Nationwide plaintiffs) seeking reimbursement pursuant to the No-Fault Law and regulations (see Insurance Law art 51; 11 NYCRR part 65). The Nationwide plaintiffs commenced these declaratory judgment actions after defendants failed to appear at requested examinations under oath (EUOs), alleging that each defendant had breached a material condition precedent necessary to coverage. The Nationwide plaintiffs then moved in both actions for summary judgment declaring that, as a result of such breach, they were under no obligation to pay or reimburse any of the subject claims. Supreme Court denied the motions without prejudice to renew upon completion of discovery. After the Nationwide plaintiffs moved for leave to renew those motions and defendants filed opposition thereto, we issued a decision on an appeal in a related case in which we held that a defense based on nonappearance at an EUO is subject to the preclusion remedy and that, therefore, the Nationwide plaintiffs were required to establish that they issued timely denials on that ground (Nationwide Affinity Ins. Co. of Am. v Jamaica Wellness Med., P.C., 167 AD3d 192, 198 [4th Dept 2018] [Jamaica Wellness]). The Nationwide plaintiffs were thus limited to raising that decision in their reply papers, and the court denied the motions. Thereafter, the Nationwide plaintiffs moved for leave to renew the motions pursuant to CPLR 2221 (e) in light of our intervening decision in Jamaica Wellness and submitted, inter alia, a detailed affidavit of a claims specialist, the subject denial of claim forms, and affidavits of the operations manager of their third-party claims processor. The court denied the motions for leave to renew, and the Nationwide plaintiffs now appeal.
We agree with the Nationwide plaintiffs that the court abused its discretion in denying the motions for leave to renew. A motion for leave to renew “shall be based upon new facts not offered on the prior motion that would change the prior determination or shall demonstrate that there has been a change in the law that would change the prior determination” (CPLR 2221 [e] [2]). “Although a court has discretion to ‘grant renewal, in the interest of justice, upon facts which were known to the movant at the time the original motion was made’ . . . , it may not exercise that discretion unless the movant establishes a ‘reasonable justification for the failure to present such facts on the prior motion’ ” (Robinson v Consolidated Rail Corp., 8 AD3d 1080, 1080 [4th Dept 2004]; see CPLR 2221 [e] [3]). Here, to establish their entitlement to summary judgment by making the requisite showing with respect to their defense to payment of the subject claims based upon defendants’ nonappearance at the EUOs, the Nationwide plaintiffs submitted facts that were known to them but not offered on the prior motions for summary judgment (see CPLR 2221 [e] [2]). The Nationwide plaintiffs also established a reasonable justification for failing to present such facts on the prior motions inasmuch as this Court, in our intervening decision in Jamaica Wellness, held for the first time and in contrast to established precedent in another department that the defense based on nonappearance at an EUO is subject to the preclusion remedy and, therefore, that an insurance carrier seeking a declaration that it is not obligated to pay claims due to such nonappearance must establish, inter alia, that it issued timely and proper denials (167 AD3d at 197-198; see generally Foxworth v Jenkins, 60 AD3d 1306, 1307 [4th Dept 2009]).
We further agree with the Nationwide plaintiffs that they are entitled to summary judgment. Upon our review of the record, we conclude that the Nationwide plaintiffs met their burden as movants and that defendants failed to raise a triable issue of fact (see Nationwide Affinity Ins. Co. of Am. v Beacon Acupuncture, P.C., 175 AD3d 1836, 1837 [4th Dept 2019]). Present—halen, P.J., Peradotto, Troutman and Bannister, JJ.
Reported in New York Official Reports at Nationwide Affinity Ins. Co. of Am. v Jamaica Wellness Med., P.C. (2020 NY Slip Op 00971)
| Nationwide Affinity Ins. Co. of Am. v Jamaica Wellness Med., P.C. |
| 2020 NY Slip Op 00971 [180 AD3d 1379] |
| February 7, 2020 |
| Appellate Division, Fourth Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
[*1]
| Nationwide Affinity Insurance Company of America et
al., Appellants, v Jamaica Wellness Medical, P.C., Respondent. |
Hollander Legal Group, P.C., Melville (Allan S. Hollander of counsel), for plaintiffs-appellants.
Kopelevich & Feldsherova, P.C., Brooklyn (David Landfair of counsel), for defendant-respondent.
Appeal from an order of the Supreme Court, Onondaga County (Donald A. Greenwood, J.), entered March 29, 2019. The order denied plaintiffs’ motion for summary judgment and granted in part defendant’s cross motion to compel discovery.
It is hereby ordered that the order so appealed from is unanimously reversed on the law without costs, the motion is granted, the cross motion is dismissed, and judgment is granted in favor of plaintiffs as follows:
It is adjudged and declared that plaintiffs are under no obligation to pay or reimburse any of the subject claims.
Memorandum: As we explained in a prior appeal (Nationwide Affinity Ins. Co. of Am. v Jamaica Wellness Med., P.C., 167 AD3d 192 [4th Dept 2018]), defendant is a medical professional corporation that was assigned claims for no-fault benefits by individuals who purportedly received treatment for injuries allegedly sustained in motor vehicle accidents. Defendant submitted bills for the services it purportedly rendered, along with the assignment of benefit forms, to the insurance carrier plaintiffs (Nationwide plaintiffs) seeking reimbursement pursuant to the No-Fault Law and regulations (see Insurance Law art 51; 11 NYCRR part 65). The Nationwide plaintiffs commenced this declaratory judgment action after defendant failed to appear at repeatedly requested examinations under oath (EUOs), alleging that defendant had breached a material condition precedent necessary to coverage. The Nationwide plaintiffs then moved for summary judgment declaring that, as a result of such breach, they were under no obligation to pay or reimburse any of the subject claims. Supreme Court granted the motion, declared, among other things, that defendant breached a condition precedent to coverage by failing to appear at the scheduled EUOs, and determined that the Nationwide plaintiffs therefore had the right to deny all claims retroactively to the date of loss, regardless of whether they had issued timely denials.
We reversed the judgment insofar as appealed from, denied the Nationwide plaintiffs’ motion, and vacated the declarations. We held that a defense based on nonappearance at an EUO is subject to the preclusion remedy and that, therefore, the Nationwide plaintiffs were required to establish that they issued timely denials on that ground. We determined that the Nationwide plaintiffs failed to establish their prima facie entitlement to judgment as a matter of law on the issue of their timely and proper denial of coverage inasmuch as the assertions in the affidavit of their claims specialist that they issued timely denial forms to defendant for nonappearance at the EUOs were conclusory and unsupported by any such denial forms (Nationwide Affinity Ins. Co. of Am., 167 AD3d at 198).
The Nationwide plaintiffs subsequently filed a second motion for summary judgment on the complaint and submitted, inter alia, a detailed affidavit of the claims specialist, the subject denial of claim forms, and affidavits of the operations manager of their third-party claims processor. Defendant cross-moved pursuant to CPLR 3124 to compel discovery. Supreme Court denied the motion on the ground that it was an improper successive motion for summary judgment and granted in part the cross motion. The Nationwide plaintiffs now appeal.
We agree with the Nationwide plaintiffs that the court erred in refusing to entertain their second summary judgment motion. “Although successive summary judgment motions generally are disfavored absent newly discovered evidence or other sufficient cause . . . , neither Supreme Court nor this Court is precluded from addressing the merits of such a motion” (Giardina v Lippes, 77 AD3d 1290, 1291 [4th Dept 2010], lv denied 16 NY3d 702 [2011]; see Putrelo Constr. Co. v Town of Marcy, 137 AD3d 1591, 1593 [4th Dept 2016]). Here, our intervening decision in the prior appeal, which clarified that the defense based on nonappearance at an EUO is subject to the preclusion remedy and that the Nationwide plaintiffs were therefore required to establish that they issued timely denials on that ground, constitutes sufficient cause to entertain the motion (see Pludeman v Northern Leasing Sys., Inc., 106 AD3d 612, 616 [1st Dept 2013]).
We further agree with the Nationwide plaintiffs that they are entitled to summary judgment. Contrary to defendant’s contentions, we conclude upon our review of the record that the Nationwide plaintiffs met their burden as movant and that defendant failed to raise a triable issue of fact (see Nationwide Affinity Ins. Co. of Am. v Beacon Acupuncture, P.C., 175 AD3d 1836, 1837 [4th Dept 2019]). In addition, defendant’s “ ’mere hope or speculation’ that further discovery will lead to evidence sufficient to defeat [the Nationwide plaintiffs’] motion is insufficient to warrant denial thereof” (Kaufmann’s Carousel, Inc. v Carousel Ctr. Co. LP, 87 AD3d 1343, 1345 [4th Dept 2011], lv dismissed 18 NY3d 975 [2012], rearg denied 19 NY3d 938 [2012]; see Austin v CDGA Natl. Bank Trust & Canandaigua Natl. Corp., 114 AD3d 1298, 1301 [4th Dept 2014]; see generally CPLR 3212 [f]). In light of our determination, defendant’s cross motion to compel discovery is dismissed as moot (see Clark C.B. v Fuller, 59 AD3d 1030, 1031 [4th Dept 2009]). We therefore reverse the order by granting the motion, dismissing the cross motion, and granting judgment in favor of the Nationwide plaintiffs declaring that they are under no obligation to pay or reimburse any of the subject claims. Present—Whalen, P.J., Peradotto, Troutman and Bannister, JJ.
Reported in New York Official Reports at Ellen Sue Ginsberg D.O.P.C. v Hertz Claim Mgt. Corp. (2020 NY Slip Op 50191(U))
[*1]| Ellen Sue Ginsberg D.O.P.C. v Hertz Claim Mgt. Corp. |
| 2020 NY Slip Op 50191(U) [66 Misc 3d 1220(A)] |
| Decided on February 5, 2020 |
| Civil Court Of The City Of New York, Bronx County |
| Soto, 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 February 5, 2020
Ellen Sue Ginsberg
D.O.P.C. A/A/O Vernalee Reid, Plaintiff(s),
against Hertz Claim Management Corp. D/B/A Hertz Rent a Car and Hertz Corporation, Defendant(s). |
707603/17
Baker Sanders, LLC Attorneys for Plaintiff
Robyn M. Brilliant, P.C. Attorneys for the Defendant
Marissa Soto, J.
Papers considered in the review of this Motion:
Notice of Motion and Affidavits Annexed: 1
Affirmation in Opposition: 2
Reply Affirmation: 3
In this action by a provider to recover assigned first-party No-Fault benefits for ELLEN SUE GINSBERG D.O.P.C. as Assignee of VARNALEE REID (“Plaintiff”), HERTZ CLAIM MANAGEMENT CORP. D/B/A HERTZ RENT A CAR AND HERTZ CORPORATION (“Defendant”), Defendant moves for summary judgment pursuant to CPLR §3212 dismissing Plaintiff’s Complaint arguing that (i) Plaintiff has been paid in full for dates of service 01/05/15-01/07/15 in the amount of $225.00, and (ii) Plaintiff failed to submit proof of claim or bills to Defendant for dates of service 1/12/15- 1/23/15, or reasonable justification for its failure to submit said claims, as mandated by the no-fault regulation. Plaintiff opposes Defendant’s motion arguing that (i) Defendant’s proof of payment is insufficient to establish that the bill for dates of service 01/05/15-01/07/15 in the amount of $225.00 was paid in full, and (ii) Defendant’s allegation that it did not receive claims or bills for dates of service 1/12/15-1/23/15 is not supported by any affidavit from someone with personal knowledge and it lacks merit. Defendant’s reply challenges Plaintiff’s representations and asserts that (i) Plaintiff’s opposition is insufficient to raise triable issues of fact, and (ii) failed to rebut Defendant’s documentary proof. Defendant’s motion is denied in part and granted in part.
It is well established that summary judgment may be granted only when it is clear that no triable issue of fact exists. Alvarez v. Prospect Hospital, 68 NY2d 320 (1986). The burden is upon the moving party to make a prima facie showing that he or she is entitled to summary judgment as a matter of law by presenting evidence in admissible form demonstrating the absence of material facts. Giuffrida v. Citibank Corp., 100 NY2d 72 (2003). Moreover, NY [*2]C.P.L.R. 3212(b) provides, that a summary judgment motion must be supported by an affidavit from a person with knowledge of the facts, setting forth all material facts as well as other admissible evidence. A conclusory affidavit or an affidavit by an individual without personal knowledge of the facts does not establish the proponent’s prima facie burden. In addition, the failure to oppose a motion for summary judgment alone does not justify the granting of summary judgment. Instead, the court must still assess whether the moving party has fulfilled its burden of demonstrating that there is no genuine issue of material fact and its entitlement to judgment as a matter of law. Weingrad, et al., v New York University Medical Center, 64 NY2d 851 (1985); Liberty Taxi Mgt., Inc. v. Gincherman, 32 AD3d 276 (1st Dep’t 2006).
The nonmoving party must establish, by admissible evidence, the existence of a factual issue requiring a trial to determine the dispute. Zuckerman v City of New York, 49 NY2d 492 (1980). The nonmoving party cannot provide conclusory allegations of fact or law to defeat a summary judgment application. Id. at 562; Century Center Ltd. v Davis, 100 AD2d 564 (2nd Dept. 1984). The function of the court on a motion for summary judgment is issue finding rather than issue determination, and the court must evaluate whether the alleged factual issues presented are genuine or unsubstantive. Sillman v Twentieth Century Fox Film Corp., 3 NY2d 394 (1957).
Payment for services of 01/05/15-01/07/15 in the amount of $225.00
It is undisputed that Plaintiff submitted a bill for services rendered to the Assignor for dates of service 01/05/15-01/07/15, in the amount of $225.00, and that said bill was received by Defendant. However, Defendant avers that they paid Plaintiff the total amount of said bill, as part of a payment to Plaintiff in the amount of $565.14. Defendant attached to his motion, as evidence, a payment screen and cancelled check (Exhibit B), as well as “a copy of the additional bills included in the 4/22/16 payment totaling $565.14 and the PIP log.” (Exhibit C).
Plaintiff’s opposition asserts that Defendant’s proof of payment fails to establish that the bill was in fact paid in full. Plaintiff argues that the check fails to indicate the dates of service, was issued one (1) year after receipt of the bill, that the payment ledger attached to Defendant’s motion indicated $0 payment for this bill, and that there is no affidavit to support any payment. Defendant’s reply states that the payment screen identifies the Assignee as the claimant “for date of service ‘1/5/15-3/10/16’and that check number as ‘3606667’ was issued on ‘4/22/16’. This payment screen also indicted that this check was cashed .by GINSBERG on ’04/27/16′, more than a year prior to the filing of the instant action.” (Exhibit B).
While the Defendant includes the Rothenberg Affidavit, infra, in its papers; the Rothenberg Affidavit doesn’t address the payment procedure. Instead, Defendant relies exclusively on its attorney affirmation to explain and admit the proof of the alleged payment. Such affirmation is clearly not based on personal knowledge. The documents alone do not substantiate the claims made by Defendant, as evidenced by Defendant’s attempt to clarify the writing on the payment screen to include the “for dates of service” notation, which is missing from the payment screen, in his affirmation (see Defendant Reply Affirmation p. 3). Affirmations by themselves cannot present evidence in an “admissible form sufficient to require a trial of material questions of fact” Zuckerman, 49 NY2d at 562. “Opposition to summary judgment must be made by a person with personal knowledge” and in failing to do so is of no probative value. Marinelli v. Shifrin, 260 AD2d 227, 228-229 (1st Dep’t 1999). Accordingly, the Court finds that the Defendant did not prove its prima facie case by admissible evidence as to payment for dates of service 01/05/15-01/07/15, in the amount of $225.00.
Failure to submit proof of claim or bills for dates of service 01/12/15-01/23/15
Defendant avers that they never received a claim and/or bill from Plaintiff for dates of service 01/12/15-01/23/15 in the amount of $225.00. Defendant’s motion contains an affidavit from Jeremy Rothenberg, No-fault Claims Adjuster at HERTZ (“Rothenberg Affidavit”), in which Mr. Rothenberg affirms that he “was in charge of this No-Fault file at the time the bills (which are the subject of this litigation) were submitted to HERTZ,” and was personally responsible for overseeing, reviewing, processing and examining this No-Fault file and this claim (Exhibit D). Rothenberg’s Affidavit described his familiarity with the procedure for processing claims, approving payment or denial of claim as a matter of standard procedure in the ordinary course of business at Hertz, that based upon his personal knowledge, a careful and thorough review of this claim and No-Fault file, including the mailing of verification requests and maintaining mailing logs, which are kept in the ordinary course of business and are created contemporaneously. Finally, Mr. Rothenberg attested that “the bills for dates of service 01/12/15-01/15/15 in the amount of $225.00 and 01/20/15-01/23/15 in the amount of $225 were never received by Hertz.” (Exhibit D). Based on the proof submitted, Defendant has met his prima facie burden of proving that the claim and/or bills for dates of service 01/12/15-01/23/15 were not received.
Plaintiff’s opposition papers attempt to rebut Mr. Rothenberg’s sworn statement merely by providing two (2) copies of screens as proof of timely mailed bills for the dates of service in question and claiming that “each screen provides a tracking number specific for each mailing.” (Exhibit 1). Both arguments were presented through attorney affirmation only without any affidavit based on personal knowledge. As discussed above, affirmations not based on personal knowledge are insufficient to oppose a summary judgment motion. Marinelli, 260 AD2d at 228-229. Plaintiff has not established whether the bills were received by Defendant as a triable factual issue.
In conclusion, Defendant’s motion for summary judgment on the payment of bills for dates of service 01/05/15-01/07/15 is denied and granted on the non-receipt of the claim or bills to HERTZ for dates of service 01/12/15-01/23/15. The case may procced to trial on the one remaining triable issue in dispute. The matter is hereby set down for trial on August 31, 2020 at 9:30 a.m. in room 505.
This constitutes the Decision and Order of the Court.
Dated: February 5, 2020
Hon. Marissa Soto
Justice NYC Civil CourtActual Chiropractic, P.C. v Global Liberty Ins. Co. of N.Y. (2020 NY Slip Op 50189(U))
Reported in New York Official Reports at Actual Chiropractic, P.C. v Global Liberty Ins. Co. of N.Y. (2020 NY Slip Op 50189(U))
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
against
Global Liberty Insurance Company of New York, Appellant.
Law Office of Jason Tenenbaum, P.C. (Jason Tenenbaum and Shaaker Bhuiyan of counsel), for appellant. Zara Javakov, P.C. (Zara Javakov, Esq.), for respondent (no brief filed).
Appeal from an order of the Civil Court of the City of New York, Kings County (Michael Gerstein, J.), entered December 12, 2018. The order denied defendant’s motion to consolidate four other actions pending before that court with the instant action and, upon consolidation, to compel the Clerk of the Civil Court to, in effect, deem the notice of appeal filed in the instant action to be a notice of appeal of the consolidated action and to accept an undertaking in the consolidated action.
ORDERED that the appeal is dismissed.
Plaintiff commenced this action to recover assigned first-party no-fault benefits. After issue was joined, defendant moved for an order, pursuant to CPLR 602 (a), to consolidate the present action with four other actions pending before the court and, upon consolidation, to, in effect, open its defaults in appearing at trial. By order entered May 8, 2018, the Civil Court denied the branch of defendant’s motion seeking to, in effect, open its defaults and did not reach the branch seeking consolidation of the actions. Defendant has separately appealed from the May 8, 2018 order (see Actual Chiropractic, P.C., as Assignee of Ruben Rodriguez v Global Liberty Ins. Co. of NY, ___ Misc 3d ___, 2020 NY Slip Op _____ [appeal No. 2018-1857 K C], decided herewith). On that appeal, defendant proffered an order of the Supreme Court, Bronx County, entered February 9, 2018, which held, among other things, that all civil lawsuits, judgments and other proceedings “that have been brought or may be brought by . . . Actual Chiropractic, P.C.” seeking no-fault benefits as assignee of Ruben Rodriguez pertaining to the same accident and under the same claim number as those at bar are “permanently stayed.” This court is dismissing that appeal on the ground that any determination therein would not, under the facts therein, have a direct effect upon the parties.
The instant appeal concerns a motion made by defendant in June 2018, pursuant to CPLR [*2]602 (a), to consolidate the present action with four other actions and, upon consolidation, “to have the Clerk of the Civil Court . . . County of Kings, compelled to deem the appeal [of the instant action] . . . to be an appeal of the within joined actions” and to accept an undertaking pertaining to all of the actions. Plaintiff opposed the motion. Defendant appeals from an order of the Civil Court entered December 12, 2018 denying defendant’s motion.
In view of the dismissal of the appeal in Actual Chiropractic, P.C., as Assignee of Ruben Rodriguez v Global Liberty Ins. Co. of NY, ___ Misc 3d ___, 2020 NY Slip Op _____ [appeal No. 2018-1857 K C], decided herewith), this action is no longer a viable pending action with which to consolidate any other actions.
Accordingly, the appeal is dismissed.
WESTON, J.P., ALIOTTA and SIEGAL, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: January 31, 2020
Reported in New York Official Reports at Actual Chiropractic, P.C. v Global Liberty Ins. Co. of N.Y. (2020 NY Slip Op 50185(U))
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
against
Global Liberty Insurance Company of New York, Appellant.
Law Office of Jason Tenenbaum, P.C. (Jason Tenenbaum and Shaaker Bhuiyan of counsel), for appellant. Zara Javakov, P.C. (Zara Javakov, Esq.), for respondent (no brief filed).
Appeal from an order of the Civil Court of the City of New York, Kings County (Rosemarie Montalbano, J.), entered May 8, 2018. The order denied the branch of defendant’s motion seeking to, in effect, open its default in appearing for trial.
ORDERED that the appeal is dismissed.
Plaintiff commenced this action to recover assigned first-party no-fault benefits as assignee of Ruben Rodriguez, who was allegedly injured in a motor vehicle accident on December 5, 2013. After issue was joined, counsel from The Law Office of Jason Tenenbaum appeared for defendant for trial, but was told by the Civil Court that his office was not counsel of record, and the matter was adjourned. On the adjourned date, April 20, 2017, the court granted plaintiff’s application to mark the case “inquest clerk” and hold defendant in default. By order to show cause dated May 12, 2017, defendant moved to consolidate the present action with four other actions pending in the Civil Court and, upon consolidation, to, in effect, open its defaults in appearing for trial. Defendant supported the motion with a Supreme Court order of substitution entered May 4, 2017 and a notice of appearance dated April 24, 2017, which lists The Law Office of Jason Tenenbaum, P.C., as the attorney appearing for defendant. By order entered May 8, 2018, the Civil Court denied the branch of defendant’s unopposed motion seeking to, in effect, open its defaults in appearing for trial, finding that defendant had failed to proffer a reasonable excuse for the failure by its incoming counsel to provide “proper proof of its legal representation of defendant.” The Civil Court did not reach the branch of defendant’s motion seeking, pursuant to CPLR 602 (a), consolidation.
On the instant appeal, defendant has annexed to its brief an order of the Supreme Court, Bronx County, entered February 9, 2018, which held, among other things, that all civil lawsuits, judgments and other proceedings “that have been brought or may be brought by . . . Actual [*2]Chiropractic, P.C.” seeking no-fault benefits under the same claim number and regarding the same assignor and motor vehicle accident as in the case at bar are permanently stayed. As a court may take judicial notice “on appeal, of reliable documents, the existence and accuracy of which are not disputed” and, generally, “of matters of public record” (Brandes Meat Corp. v Cromer, 146 AD2d 666, 667 [1989]; see Headley v New York City Tr. Auth., 100 AD3d 700 [2012]), this court, in the interest of judicial economy, takes judicial notice of the Supreme Court’s order entered February 9, 2018, which permanently “stays” the parties from proceeding further in the action at bar.
In light of the stay issued by the Supreme Court, this appeal has “been rendered academic as any determination on [this] appeal[ ] would not, under the facts of this case, have a direct effect upon the parties” (Matter of Claudia G. [Ermelio G.], 71 AD3d 894, 895 [2010]).
Accordingly, the appeal is dismissed.
WESTON, J.P., ALIOTTA and SIEGAL, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: January 31, 2020