Active Care Med. Supply Corp. v Titan Ins. Co. (2020 NY Slip Op 50183(U))

Reported in New York Official Reports at Active Care Med. Supply Corp. v Titan Ins. Co. (2020 NY Slip Op 50183(U))

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

Active Care Medical Supply Corp., as Assignee of Pierre, Miraclea, Appellant,

against

Titan Insurance Co., Respondent.

The Rybak Firm, PLLC (Damin J. Toell and Richard Rozhik of counsel), for appellant. Mccormack & Mattei, P.C. (Jamila Shukry and Erin O’Neill of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Joy F. Campanelli, J.), entered February 7, 2018. The order granted the branch of defendant’s motion seeking summary judgment dismissing the complaint on the ground that plaintiff lacked a license to distribute the medical supplies at issue, and implicitly denied plaintiff’s cross motion for summary judgment.

ORDERED that the order is modified by providing that the branch of defendant’s motion seeking summary judgment dismissing the complaint on the ground that plaintiff lacked a license to distribute the medical supplies at issue is denied; as so modified, the order is affirmed, without costs, and the matter is remitted to the Civil Court to determine the remaining branches of defendant’s motion.

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, among others, that plaintiff lacked standing to bring the action because it did not possess a license to distribute the products at issue. Plaintiff opposed the motion and cross-moved for summary judgment. By order entered February 7, 2018, the Civil Court granted the branch of defendant’s motion seeking summary judgment dismissing the complaint on the ground that plaintiff lacked standing to bring the action, and implicitly denied plaintiff’s cross motion. The court stated that defendant’s licensing defense is not precludable and noted that, in two separate orders in a declaratory judgment action, the Supreme Court, Nassau County, had found that plaintiff herein lacked a license to distribute its products. The Civil Court did not reach the remaining branches of defendant’s motion, which sought summary judgment dismissing the complaint on the grounds that plaintiff had failed to appear for duly scheduled examinations under oath and that the limits of the insurance policy had been exhausted.

“The proponent of a summary judgment motion must make a prima facie showing of [*2]entitlement to judgment as a matter of law, tendering sufficient evidence to demonstrate the absence of any material issues of fact” (Winegrad v New York Univ. Med. Ctr., 64 NY2d 851, 853 [1985]). In an affidavit in support of the branch of defendant’s motion seeking summary judgment on the ground that plaintiff lacked the required license to distribute the supplies at issue, defendant’s medical investigator admitted that plaintiff had obtained a license with the New York City Department of Consumer Affairs on October 12, 2011, and the affidavit of defendant’s claims specialist demonstrated that the supplies had been provided after that date. Thus, defendant’s evidence was insufficient to demonstrate the absence of any material issues of fact (see id.) regarding plaintiff’s licensing. Furthermore, to the extent that the Civil Court considered prior determinations by the Supreme Court, Nassau County, in the declaratory judgment action, as the Supreme Court’s orders pertained to supplies that had been distributed before October 12, 2011, the Civil Court’s reliance on the orders of the Supreme Court was misplaced, and the branch of defendant’s motion based on plaintiff’s alleged lack of a license should have been denied.

Contrary to plaintiff’s assertion, plaintiff was not entitled to summary judgment, as the proof submitted by plaintiff failed to establish that the claims at issue had not been timely denied (see Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co., 25 NY3d 498 [2015]), or that defendant had issued timely denial of claim forms that were conclusory, vague or without merit as a matter of law (see Westchester Med. Ctr. v Nationwide Mut. Ins. Co., 78 AD3d 1168 [2010]; Ave T MPC Corp. v Auto One Ins. Co., 32 Misc 3d 128[A], 2011 NY Slip Op 51292[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2011]).

Accordingly, the order is modified by providing that the branch of defendant’s motion seeking summary judgment dismissing the complaint on the ground that plaintiff lacked a license to distribute the medical supplies at issue is denied, and the matter is remitted to the Civil Court to determine the remaining branches of defendant’s motion.

WESTON, J.P., ALIOTTA and SIEGAL, JJ., concur.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: January 31, 2020
Super Acupuncture & Herbology, P.C. v Global Liberty Ins. Co. of N.Y. (2020 NY Slip Op 50178(U))

Reported in New York Official Reports at Super Acupuncture & Herbology, P.C. v Global Liberty Ins. Co. of N.Y. (2020 NY Slip Op 50178(U))

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

Super Acupuncture and Herbology, P.C., as Assignee of Hernando Llorente, Respondent,

against

Global Liberty Insurance Company of New York, Appellant.

Law Office of Jason Tenenbaum, P.C. (Jason Tenenbaum and Talia Beard of counsel), for appellant. Petre and Associates, P.C. (Damin Toell of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Mary V. Rosado, J.), entered December 14, 2017. The order denied defendant’s motion to vacate an order of that court dated January 20, 2017 granting plaintiff’s motion for summary judgment upon defendant’s failure to timely serve its opposing papers and cross motion as provided for in a stipulation of settlement.

ORDERED that the order entered December 14, 2017 is affirmed, with $25 costs.

Plaintiff commenced this action to recover assigned first-party no-fault benefits and subsequently moved for summary judgment. In a stipulation dated April 4, 2016, the parties agreed, among other things, that plaintiff’s summary judgment motion would be adjourned to January 17, 2017, and that “Opposition to the within motion and all cross-motions must be served on or before August 17, 2016. Any cross-motions served beyond this date will be deemed untimely.” On December 16, 2016, defendant served plaintiff with its cross motion, which included its opposition to plaintiff’s motion. Plaintiff opposed the cross motion. By order dated January 20, 2017, the Civil Court granted plaintiff’s motion upon defendant’s default in timely serving its cross motion “as per the stipulation.” Thereafter, defendant moved to, among other things, vacate the January 20, 2017 default order. Plaintiff opposed the motion. By order entered December 14, 2017, the Civil Court denied defendant’s motion, finding that the “motion [is] incomplete” since “defendant[‘s] papers are missing the adjournment stipulation which set up the briefing schedule for the original motion.”

In support of defendant’s appellate contention that its motion to vacate should have been granted, defendant argues that, pursuant to the April 4, 2016 stipulation, its opposition papers and cross motion had to be served on or before “October 16, 2016” [sic], and it is of no consequence [*2]that a copy of the stipulation was not annexed to its papers submitted in support of its motion to vacate the January 20, 2017 order, since the contents of the stipulation are uncontroverted. However, CPLR 2214 (c) clearly provides that “The moving party shall furnish all other papers not already in the possession of the court necessary to the consideration of the questions involved.” As the stipulation was most certainly “necessary to the consideration of the questions involved,” the Civil Court properly denied defendant’s motion to vacate (see CPLR 2214 [c]; Cripps v Dibisceglie, 172 AD3d 1305, 1306 [2019]; Wells Fargo Home Mtge., Inc. v Mercer, 35 AD3d 728 [2006]; Rudzinski v Jonathan L. Glashow, MD, PC, 55 Misc 3d 1215[A], 2017 NY Slip Op 50583[U], *3 [Sup Ct, Kings County 2017]). In any event, defendant failed to establish a reasonable excuse for its default based on law office failure (see CPLR 2005), as it did not “submit supporting facts in evidentiary form sufficient to justify the default” (Incorporated Vil. of Hempstead v Jablonsky, 283 AD2d 553, 554 [2001]).

In view of the foregoing, we pass on no other issue.

Accordingly, the order entered December 14, 2017 is affirmed.

WESTON, J.P., ELLIOT and SIEGAL, JJ., concur.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: January 31, 2020
Charles Deng Acupuncture, P.C. v Windhaven Ins. Co. (2020 NY Slip Op 50176(U))

Reported in New York Official Reports at Charles Deng Acupuncture, P.C. v Windhaven Ins. Co. (2020 NY Slip Op 50176(U))

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

Charles Deng Acupuncture, P.C., as Assignee of Jackson, Vicki, Respondent,

against

Windhaven Insurance Company, Appellant.

Lawrence N. Rogak, LLC (Lawrence N. Rogak of counsel), for appellant. The Rybak Firm, PLLC (Damin J. Toell and Karina Barska of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Harriet L. Thompson, J.), entered June 15, 2017. The order denied 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 in the amount of $2,738.52, defendant appeals from an order of the Civil Court which denied defendant’s motion for summary judgment dismissing the complaint.

On appeal, defendant argues that the Civil Court lacked “jurisdiction” because defendant is not covered by the provisions of New York Insurance Law § 5107. To the extent that the argument goes to subject matter jurisdiction, it lacks merit. As the complaint seeks to recover a sum of less than $25,000, this action falls within the subject matter jurisdiction of the Civil Court (see CCA 202).

To the extent that defendant asserts lack of personal jurisdiction, there is no need to consider defendant’s claimed lack of contacts with New York since, pursuant to CPLR 3211 (e), an objection to personal jurisdiction is waived unless it is raised in the answer or in a pre-answer motion to dismiss the complaint, whichever comes first (see Hatch v Tu Thi Tran, 170 AD2d 649 [1991]; see also Parasconda v Club Mateem, Inc., 33 Misc 3d 141[A], 2011 NY Slip Op 52201[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2011]). “Absent the pursuit of either course, a defendant’s voluntary participation in litigation in which the point can be raised, in and of itself, constitutes a submission to the jurisdiction of the courts” (Gager v White, 53 NY2d 475, 488 [1981]). Here, defendant first appeared by interposing its answer, in which it raised the affirmative defense that the summons was not properly served, but was silent on the issue of personal jurisdiction due to a lack of a jurisdictional basis for the service. Thus, it waived all personal jurisdiction defenses other than the actual service of process (see Hatch, 170 AD2d at [*2]649; Osserman v Osserman, 92 AD2d 932 [1983]).

Even if we view defendant’s argument on appeal as a claim that, on the merits, there is no liability here because defendant is exempt from Insurance Law § 5107, which requires certain insurers to provide no-fault coverage, defendant failed to demonstrate that its policy did not, in fact, provide for such coverage (see Masigla v Windhaven Ins. Co., 64 Misc 3d 137[A], 2019 NY Slip Op 51169[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2019]). Consequently, defendant did not demonstrate its entitlement to judgment as a matter of law.

Accordingly, the order is affirmed.

WESTON, J.P., ELLIOT and SIEGAL, JJ., concur.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: January 31, 2020
Spine Surgery of Buffalo Niagara v GEICO Cas. Co. (2020 NY Slip Op 00789)

Reported in New York Official Reports at Spine Surgery of Buffalo Niagara v GEICO Cas. Co. (2020 NY Slip Op 00789)

Spine Surgery of Buffalo Niagara v GEICO Cas. Co.
2020 NY Slip Op 00789 [179 AD3d 1547]
January 31, 2020
Appellate Division, Fourth Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
As corrected through Wednesday, March 11, 2020


[*1]
  Spine Surgery of Buffalo Niagara, Appellant,
v
GEICO Casualty Company, Respondent.

The Morris Law Firm, P.C., Buffalo (Daniel K. Morris of counsel), for plaintiff-appellant.

Rivkin Radler LLP, Uniondale (J’Naia L. Boyd of counsel), for defendant-respondent.

Appeal from an order of the Supreme Court, Erie County (Mark A. Montour, J.), entered January 8, 2019. The order granted the motion of defendant to dismiss the complaint and dismissed the complaint with prejudice.

It is hereby ordered that the order so appealed from is unanimously modified on the law by providing that the complaint is dismissed without prejudice and as modified the order is affirmed without costs.

Memorandum: Plaintiff, as the assignee of certain claims for no-fault benefits, commenced this action asserting a single cause of action for prima facie tort and seeking, inter alia, punitive damages. Defendant moved to dismiss the complaint pursuant to CPLR 3211 (a) (7), and Supreme Court granted the motion. Plaintiff appeals. For the reasons set forth in our decision in Greater Buffalo Acc. & Injury Chiropractic, P.C. v Geico Cas. Co. (175 AD3d 1100, 1101-1102 [4th Dept 2019]), which involved an identical complaint against defendant, we conclude that the court properly granted defendant’s motion, and we do not consider documents submitted by plaintiff that were not considered by the court in determining the motion (see id.; Tuchrello v Tuchrello, 233 AD2d 917, 918 [4th Dept 1996]). Nevertheless, we agree with plaintiff that the dismissal of the complaint should have been without prejudice (see CPLR 205 [a]; Herrmann v Bank of Am., N.A., 170 AD3d 1438, 1442 [3d Dept 2019]; Clark v New York State Off. of Parks, Recreation & Historic Preserv., 288 AD2d 934, 935 [4th Dept 2001]), and we therefore modify the order accordingly. Present—Centra, J.P., Carni, Lindley, Curran and Winslow, JJ.

Charles Deng Acupuncture, P.C. v Hertz Co. (2020 NY Slip Op 50182(U))

Reported in New York Official Reports at Charles Deng Acupuncture, P.C. v Hertz Co. (2020 NY Slip Op 50182(U))

[*1]
Charles Deng Acupuncture, P.C. v Hertz Co.
2020 NY Slip Op 50182(U) [66 Misc 3d 144(A)]
Decided on January 31, 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 January 31, 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
2018-1134 K C

Charles Deng Acupuncture, P.C., as Assignee of Davis-Vaughan, Felecia, Respondent,

against

Hertz Co., Appellant.


Robyn M. Brilliant, P.C. (Robyn M. Brilliant and Barry Montrose of counsel), for appellant. The Rybak Firm, PLLC (Damin J. Toell of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Joy F. Campanelli, J.), entered January 24, 2018. The order, insofar as appealed from, denied defendant’s motion for summary judgment dismissing the complaint and, upon denying plaintiff’s cross motion for summary judgment, made, in effect, CPLR 3212 (g) findings in plaintiff’s favor.

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, defendant moved for summary judgment dismissing the complaint on the ground that there was no coverage due to the fact that the assignor, a resident of New York, was not an eligible injured person since she had been a passenger in a rental car which had been involved in a motor vehicle accident in New Jersey and neither the assignor, nor any member of her household, owned a vehicle in New York. Plaintiff cross-moved for summary judgment. Defendant appeals from so much of an order of the Civil Court dated January 24, 2018 as denied defendant’s motion and, upon denying plaintiff’s cross motion, made, in effect, CPLR 3212 (g) findings in plaintiff’s favor.

The papers that defendant submitted in support of its motion failed to establish, as a matter of law, that the assignor was not entitled to receive benefits pursuant to Insurance Law § 5103 (a) (3) and, therefore, the Civil Court properly denied defendant’s motion for summary judgment.


Moreover, defendant failed to articulate a sufficient basis to strike the Civil Court’s findings in plaintiff’s favor (see EMC Health Prods., Inc. v Geico Ins. Co., 43 Misc 3d 139[A], 2014 NY Slip Op 50786[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2014]).

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

WESTON, J.P., ALIOTTA and SIEGAL, JJ., concur.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: January 31, 2020Matter of Ameriprise Ins. Co. v Kensington Radiology Group, P.C. (2020 NY Slip Op 00500)

Reported in New York Official Reports at Matter of Ameriprise Ins. Co. v Kensington Radiology Group, P.C. (2020 NY Slip Op 00500)

Matter of Ameriprise Ins. Co. v Kensington Radiology Group, P.C.
2020 NY Slip Op 00500 [179 AD3d 563]
January 23, 2020
Appellate Division, First Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
As corrected through Wednesday, March 11, 2020

[*1]

 In the Matter of Ameriprise Insurance Company, Respondent,
v
Kensington Radiology Group, P.C., as Assignee of Zoila McBean, Appellant.

Gary Tsirelman, P.C., Brooklyn (Stefan M. Belinfanti of counsel), for appellant.

Bruno, Gerbino & Soriano, LLP, Melville (Nathan M. Shapiro of counsel), for respondent.

Rivkin Radler, LLP, Uniondale (Barry I Levy of counsel), for amici curiae.

Order, Appellate Term, First Department, entered January 2, 2018, which reversed an order of the Civil Court, New York County (Erika M. Edwards, J.), entered on or about November 30, 2016, denying the petition to vacate a master arbitrator’s award and confirming the award, and remanded the matter to Civil Court for a framed issue hearing on whether the policy limit was exhausted before petitioner became obligated to pay respondent’s claims, unanimously affirmed, without costs.

Generally, courts will not set aside an award where “there is a rational view to support it” (Country-Wide Ins. Co. v May, 282 AD2d 298, 298 [1st Dept 2001]; see also Matter of Carty v Nationwide Ins. Co., 212 AD2d 462 [1st Dept 1995]). However, in addition to irrationality, an award may be vacated if the arbitrator exceeds his or her power (see CPLR 7511 [b] [1] [iii]). An arbitrator exceeds his/her power if the award is “beyond the policy limits” (Matter of Brijmohan v State Farm Ins. Co., 92 NY2d 821, 823 [1998]; see also e.g. Countrywide Ins. Co. v Sawh, 272 AD2d 245 [1st Dept 2000]).

Respondent contends that its claims were complete before the policy issued by petitioner was exhausted. This argument is unavailing. The Court of Appeals has interpreted the word “claims” in 11 NYCRR 65-3.15 to mean “verified claims” (Nyack Hosp. v General Motors Acceptance Corp., 8 NY3d 294, 300 [2007]), i.e., claims as to which the healthcare provider has submitted additional information requested by the insurer (see id. at 297-298, 300-301). Petitioner requested verification in the form of an examination under oath (EUO). Since respondent never appeared for an EUO, its claims were never verified. The defense that an award exceeds an arbitrator’s power is so important that a party may introduce evidence for the first time when the other party tries to confirm the award (see Brijmohan, 92 NY2d at 822-823).

Respondent may also raise on appeal the purely legal argument that Appellate Term lacked the power to remand to Civil Court for a framed issue hearing (see generally Branham v Loews Orpheum Cinemas, Inc., 31 AD3d 319, 323 n 2 [1st Dept 2006], affd 8 NY3d 931 [2007]). On the merits, however, this argument is unavailing (see Allstate Prop. & Cas. Ins. Co. v Northeast Anesthesia & Pain Mgt., 51 Misc 3d 149[A], 2016 NY Slip Op 50828[U] [App Term, 1st Dept 2016]; Allstate Ins. Co. v DeMoura, 30 Misc 3d 145[A], 2011 NY Slip Op 50430[U] [App Term, 1st Dept 2011]).

In view of the foregoing, respondent is not entitled to the attorneys’ fees it requested. Concur—Gische, J.P., Mazzarelli, Webber, Gesmer, JJ. [Prior Case History: 58 Misc 3d 144(A), 2017 NY Slip Op 51911(U).]

Montvale Surgical Ctr., LLC. v State Farm Mut. Auto. Ins. Co. (2020 NY Slip Op 50106(U))

Reported in New York Official Reports at Montvale Surgical Ctr., LLC. v State Farm Mut. Auto. Ins. Co. (2020 NY Slip Op 50106(U))



Montvale Surgical Center, LLC., a/a/o YOUNG SOOK YI, Plaintiff,

against

State Farm Mutual Automobile Insurance Co., Defendant.

CV-6239-18/HU
C. Stephen Hackeling, J.

Upon the following papers numbered 1 to 20 read on this motion to dismiss plaintiff’s complaint by Notice of Motion/Order to Show Cause and supporting papers 1,2,6; Notice of Cross Motion and supporting papers 7,8,13; Answering Affidavits and supporting papers 7,8,13; Replying Affidavits and supporting papers 14-18,20; Filed papers; Other exhibits: 3-5,9-12,19; (and after hearing counsel in support of and opposed to the motion), it is,

ORDERED that the motion by defendant to dismiss plaintiff’s complaint pursuant to CPLR 3211(a)(3), on the ground that plaintiff lacks legal capacity to sue in the State of New York, pursuant to BCL §1312(a), is denied, with prejudice; and it is further

ORDERED that the alternative motion by defendant to compel discovery and a deposition of plaintiff, is denied; and it is further

ORDERED that the cross-motion by plaintiff for summary judgment pursuant to CPLR 3212, and plaintiff’s request for an order pursuant to CPLR 3212(g), are both denied.

Plaintiff health service provider, a limited liability corporation,[FN1] seeks reimbursement of No-Fault benefits in the sum of $7,943.11, as assignee of a New York No-Fault claimant, for medical and surgical services rendered to its Brooklyn assignor, at its New Jersey surgical center on 05/04/2018, stemming from an automobile accident of 1/08/2018.

Plaintiff lists its address as 6 Chestnut Ridge Road, Montvale, New Jersey 07645 on the summons, and the submitted, uncertified medical records (see CPLR 4518) not objected to by defendant, show the same address as the location of the surgery rendered on 5/04/2018.

Defendant now moves for dismissal pursuant to CPLR 3211(a) (3), arguing that plaintiff lacks standing to bring this action in the State of New York, because plaintiff has failed to register with the Secretary of State in New York to operate as a foreign corporation authorized to do business in New York, pursuant to BCL §1312(a). Defendant asserts plaintiff is a New Jersey corporation whose business activities within New York State are so systematic and regular as to manifest continuity of activity,[FN2] and contends that online data activity demonstrates that plaintiff has over 627 pending cases against insurance companies in the New York State court system.

Alternatively, defendant moves pursuant to CPLR 3101 for an order compelling plaintiff to appear for deposition, to address the issue of plaintiff’s legal capacity to sue in the State of New York.[FN3]

In opposition to the motion to dismiss, plaintiff denies it qualifies as a foreign corporation required to register with the New York Secretary of State to operate as a foreign corporation doing business in New York, stating its contact with the State of New York is “incidental” and not “systematic” as claimed by defendant. Plaintiff asserts a denial of its right to sue in a New York State Court, based upon an assignment of a New York No-Fault claim, is a violation of the interstate commerce clause of the U.S. Constitution.

Plaintiff further contends that plaintiff’s assignor is a New York resident (living in Brooklyn), who assigned his New York No-Fault contract to plaintiff, who brought the instant suit to collect for unpaid medical services rendered to plaintiff’s assignor at its New Jersey medical facility.

In addition, plaintiff cross-moves for summary judgment for the sums delineated in the complaint, contending it timely provided its claim to defendant, thirty days have since transpired, and defendant has not paid or denied the claim.

In the alternative, plaintiff seeks an order pursuant to CPLR 3212(g), stating that plaintiff [*2]has met its prima facie case in the event of trial.

In opposition to plaintiff’s motion for summary judgment, defendant contends that contrary to plaintiff’s statement, defendant has denied the claim within 30 days of its receipt, and attaches documents of proof in support of this contention.

Here, the Court determines that defendant has failed to satisfy its burden of demonstrating that plaintiff was a foreign corporation “doing business” in the State of New York, and was thereby subject to the registering conditions placed by BCL §1312 on foreign corporate capacity to sue in New York (see Pergament Home Ctrs. v Net Realty Holding Trust, 171 AD2d 736 [2nd Dept 1991]). Though there is no admissible proof that plaintiff is a New Jersey Corporation, plaintiff asserts in its complaint that it is a LLC. and has a New Jersey address. Plaintiff also asserts its business contact with the State of New York is “incidental” and not “systematic.” In addition, defendant contends that plaintiff is a New Jersey business, which plaintiff does not deny.

Therefore, the Court determines that defendant has failed to overcome the presumption that plaintiff is doing business in its state of incorporation, and not in the State of New York (see Highfill, Inc. v Bruce and Iris, Inc., 50 AD3d 742 [2nd Dept 2008]).

The Court further finds that there is no proof that plaintiff maintains an office or phone listing, or owns real property or has employees or sales reps, in the State of New York (see Uribe v Merchants Bank of New York, 266 AD2d 21, 22 [1st Dept 1999]; see also S & T Bank v Spectrum Cabinet Sales, Inc., 247 AD2d 373 [2nd Dept 1998]).

Indeed, though defendant broadly links over 627 pending cases in the State of New York court system brought by plaintiff against insurance companies, as evidence of plaintiff’s New York systemic activities, the linkage is disingenuous and unavailing. First, defendant’s proof is by inadmissible hearsay. Next, plaintiff’s activities in the State of New York, appear to be limited to collection lawsuits from assignments under New York’s No-Fault law, brought in New York courts for unpaid medical services rendered in its business as a health service provider and surgical center in the State of New Jersey.

Moreover, the instant action does not equate to an assignment of a collection of account receivables for consumer debt purchased by a plaintiff, for enforcement through the New York State court system (see Centurion Capital Corp. v Guarino, 35 Misc 3d 1219[A][Civ Ct, City of New York, 2012]), nor an assignment to recover money for goods sold in New York by an out-of-state (Pennsylvania) corporation (see S & T Bank v Spectrum Cabinet Sales, Inc., supra]).

The Court finds that the undisputed facts remain that plaintiff is a health service provider and surgical center, rendering services at its health care facility located in New Jersey, which requires incidental litigation for collection of its unpaid charging fees in the courts of the State of New York, where entrance as a plaintiff is contemplated through assignments under New York’s No-Fault law. It is not as a corporate entity whose actual business is as a systematic purchaser of assignments for collection enforcement in the courts of the State of New York.

The Court notes that even if plaintiff was required to register as a foreign corporation doing business in the State of New York, it is not a jurisdictional defect, and does not defeat the action, as a plaintiff may cure the failure to obtain a certificate pursuant to BCL §1312 at any time prior to resolution of the action by judgment (see Uribe v Merchants Bank of New York, supra; Hot Roll Mfg. Co. v Cerone Equipment Co., 38 AD2d 339 [3rd Dept, 1972]; see also Virgilio Flores, S.A. v Jerome Radelman, Inc., 567 F. Supp 577 [1982]). As a result, the instant circumstances do not create a true legal incapacity to sue within the meaning of CPLR 3211[a][3] [*3](see Paper Manufacturers Co. v Ris Paper Co., 86 Misc 2d 95 [City of New York, Civ Ct, 1976]).

Accordingly, the motion by defendant to dismiss plaintiff’s complaint pursuant to CPLR 3211(a)(3), on the ground that plaintiff lacks legal capacity to sue in the State of New York pursuant to BCL §1312(a), is denied, with prejudice.

Defendant’s alternative motion to compel discovery and a deposition of plaintiff “if defendant (sic) disputes that it lacks capacity to sue” is denied. The issue of plaintiff’s legal capacity to sue under BCL §1312(a) is now moot, given the Court’s instant ruling, thereby eliminating the need for defendant’s request for discovery and deposition for this purpose. Supervision of discovery and the setting of reasonable terms and conditions rests within the sound discretion of the Court (see Hernandez v City of Yonkers,74 AD3d 1025, 1026 [2nd Dept 2010]). Accordingly, defendant’s alternative motion to compel discovery and a deposition of plaintiff, is denied.

Plaintiff’s cross-motion for summary judgment pursuant to CPLR 3212, upon the grounds that defendant has failed to pay or deny the bills within 30 days of receipt of plaintiff’s claim or properly toll the time, for dates of service on 05/04/18, is denied (see 11 NYCRR 65-3.8[a][1]). Defendant has refuted plaintiff’s contentions with documents demonstrating that it timely provided a denial of claim to plaintiff,[FN4] thereby creating a question of fact on this issue requiring a trial (see Alvarez v Prospect Hospital, 68 NY2d 320, 324 [1986]; Winegrad v New York Univ. Med. Ctr., 64 NY2d 851, 853 [1985]; Zuckerman v City of New York, 49 NY2d 557,562 [1980]).

Furthermore, the Court finds that plaintiff has failed to demonstrate a prima facie case in support of summary judgment, as the necessary element provided by the Assignment of Benefits form submitted by plaintiff’s assignor, states it is for an accident which occurred on 3/19/18, not the subject accident of 1/08/18 (see Alvarez v Prospect Hospital, supra; Winegrad v New York Univ. Med. Ctr.,supra; Zuckerman v City of New York, supra).

Any remaining contentions lack merit.

The foregoing constitutes the decision and order of this Court.

Dated: January 20, 2020

J.D.C.

Footnotes

Footnote 1:Though defendant claims plaintiff is a New Jersey corporation, there is no admissible evidence substantiating this claim.

Footnote 2:Defendant’s papers are contradictory, in that paragraph 10 of the affirmation in support of the motion states plaintiff did not do any business in New York, while paragraph 13 states plaintiff has been doing large amounts of New York business. Furthermore, defendant states in paragraph 18 that plaintiff lists a New York business address, which is clearly false, as demonstrated by the New Jersey address listed in the summons and the lack of any other address listed in any other papers.

Footnote 3:Defendant’s Notice of Motion seeks an order compelling plaintiff to appear for deposition, only, but its affirmation supports discovery of plaintiff (¶ 3) and documentary discovery (¶ 20), on the issue of plaintiff’s legal capacity to sue in the State of New York.

Footnote 4:In paragraph 12 of the Affirmation in Support, Defendant cites Amer-A-Med Health Products, Inc. v GEICO Ins. Co., 2010 NY Slip Op 32258(U)(Sup Ct Nass Cty). However, the correct cite is 2010 NY Slip Op 31032, and the case does not stand for the proposition “that foreign No-Fault providers must comply with BCL §1312(a).”

Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2020 NY Slip Op 50067(U))

Reported in New York Official Reports at Gentlecare Ambulatory Anesthesia Servs. v GEICO Ins. Co. (2020 NY Slip Op 50067(U))

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

Gentlecare Ambulatory Anesthesia Services; Lyonel F. Paul, M.D., as Assignee of Lumene, Erick, Appellant,

against

GEICO Ins. Co., Respondent.

The Rybak Firm, PLLC (Damin J. Toell and Richard Ruzhik of counsel), for appellant. Rivkin Radler, LLP (J’Naia L. Boyd of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Richard J. Montelione, J.), entered November 3, 2017. The order granted defendant’s motion to vacate an order of that court (Robin Kelly Sheares, J.) dated August 12, 2016 granting plaintiff’s prior unopposed motion for summary judgment, and upon such vacatur, to deny plaintiff’s prior motion and grant defendant’s motion for summary judgment dismissing the complaint, to the extent of vacating the August 12, 2016 order and the judgment entered January 10, 2017 pursuant thereto, and, in effect, denying plaintiff’s prior motion and “reinstat[ing]” an October 27, 2016 order of that court (Robin S. Garson, J.) granting defendant’s motion for summary judgment dismissing the complaint.

ORDERED that the order entered November 3, 2017 is reversed, with $30 costs, and the matter is remitted to the Civil Court for a new determination of defendant’s motion to vacate the August 12, 2016 default order, and, upon such vacatur, to deny plaintiff’s prior motion for summary judgment and grant defendant summary judgment dismissing the complaint.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff served a motion for summary judgment on October 7, 2015, returnable on November 9, 2015, which, by stipulation, was adjourned to August 12, 2016. On December 23, 2015, while [*2]plaintiff’s motion was pending, defendant served a motion for summary judgment dismissing the complaint, returnable on January 25, 2016, which, by stipulation, was adjourned to October 26, 2016. On August 12, 2016, despite defendant’s request for an adjournment of plaintiff’s motion to the return date of defendant’s own pending motion for summary judgment, presumably so that the motions could be decided together, the Civil Court (Robin Kelly Sheares, J.) granted plaintiff’s unopposed motion for summary judgment. Three days later, on August 15, 2016, plaintiff served opposition papers to defendant’s still-pending motion for summary judgment, which plaintiff denominated as “Defendant’s cross-motion”; those papers also referenced and purported to further support “plaintiff’s motion for summary judgment.”

By order to show cause signed on October 20, 2016, defendant moved to vacate the August 12, 2016 order granting plaintiff’s unopposed motion for summary judgment and, upon such vacatur, to deny plaintiff’s prior motion and grant defendant summary judgment dismissing the complaint. While that motion was pending, the Civil Court (Robin S. Garson, J.), by order entered October 27, 2016, granted defendant’s motion for summary judgment dismissing the complaint. On January 10, 2017, a default judgment was entered awarding plaintiff the principal sum of $2,418.95, based upon the August 12, 2016 order. On August 18, 2017, plaintiff served opposition papers to defendant’s October 20, 2016 motion. Defendant subsequently served reply papers, attaching the October 27, 2016 order granting its motion for summary judgment dismissing the complaint. By order entered November 3, 2017, the Civil Court (Richard J. Montelione, J.) granted defendant’s motion to the extent of vacating the August 12, 2016 order and the January 10, 2017 judgment entered pursuant thereto, and, in effect, denying plaintiff’s prior motion and “reinstat[ing]” the October 27, 2016 order granting defendant’s motion for summary judgment dismissing the complaint, giving it “full force and effect.”

In order to vacate a default order or judgment pursuant to CPLR 5015 (a) (1), a defendant must demonstrate both a reasonable excuse for the default and a potentially meritorious defense to the action (see Li Fen Li v Cannon Co., Inc., 155 AD3d 858 [2017]; Aurora Loan Servs., LLC v Ahmed, 122 AD3d 557 [2014]). Here, in the November 3, 2017 order, the Civil Court relied on the October 27, 2016 order, which awarded summary judgment to defendant, to find that defendant had a potentially meritorious defense to the action sufficient to warrant the vacatur of the August 12, 2016 order.

A grant of summary judgment is the procedural equivalent of a trial (see Falk v Goodman, 7 NY2d 87, 91 [1959]; News Am. Mktg., Inc. v Lepage Bakeries, Inc., 16 AD3d 146 [2005]), and an order granting such relief is as final and as conclusively determinative of all issues in an action as is a judgment after trial (see Engel v Aponte, 51 AD2d 989 [1976]; Riley v Southern Transp. Co., 278 App Div 605 [1951]). Here, the grant of summary judgment to plaintiff by order dated August 12, 2016 was a final determination of the action. Therefore, the Civil Court should not have issued its October 27, 2016 order granting defendant’s motion for summary judgment, since it should not even have entertained that motion, as that motion did not seek to vacate the August 12, 2016 order granting plaintiff’s motion for summary judgment upon defendant’s default. Consequently, it was error for the Civil Court, in its November 3, 2017 order, [*3]to rely on the October 27, 2016 order—which purported to award defendant summary judgment after plaintiff had already been awarded summary judgment on August 12, 2016—and to find, by virtue of the October 27, 2016 order, that defendant had established a meritorious defense, in order to grant the branch of defendant’s motion seeking to vacate the August 12, 2016 order (and, in effect, the January 10, 2017 judgment entered pursuant thereto). Rather, the Civil Court should have made its own independent assessment of the merits of the branch of defendant’s motion seeking to vacate the August 12, 2016 order based on the facts submitted in those motion papers in order to determine whether the default should be vacated and, if so, whether upon such vacatur, the branch of defendant’s motion seeking summary judgment should be granted.

Accordingly, the order entered November 3, 2017 is reversed and the matter is remitted to the Civil Court for a new determination of defendant’s motion to vacate the August 12, 2016 default order and, upon such vacatur, to deny plaintiff’s prior motion for summary judgment and grant defendant summary judgment dismissing the complaint.

WESTON, J.P., ALIOTTA and SIEGAL, JJ., concur.



ENTER:
Paul Kenny
Chief Clerk
Decision Date: January 17, 2020
Ancient & Modern Acupuncture, P.C. v MVAIC (2020 NY Slip Op 50011(U))

Reported in New York Official Reports at Ancient & Modern Acupuncture, P.C. v MVAIC (2020 NY Slip Op 50011(U))

[*1]
Ancient & Modern Acupuncture, P.C. v MVAIC
2020 NY Slip Op 50011(U) [66 Misc 3d 1207(A)]
Decided on January 7, 2020
Civil Court Of The City Of New York, New York County
Kraus, 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 January 7, 2020
Civil Court of the City of New York, New York County


Ancient & Modern Acupuncture, P.C. a/a/o CASSANDRA PRICE, Plaintiff

against

MVAIC, Defendant




CV 701498/17/NY



GARY TSIRELMAN, P.C.

Attorneys for Plaintiff

By: Jung F. Pryjma. Esq.

129 Livingston Street – Second & Third Flrs

Brooklyn, New York 11201

718.438.1200 x 169

MARSHALL & MARSHALL

Attorneys for Defendant

By: Alexis Levine, Esq.

30 Jericho Executive Plaza – 100W

Jericho, New York 11753

516.997.6000
Sabrina B. Kraus, J.

BACKGROUND

Plaintiff commenced this action to recover assigned first-party no fault benefits, pursuant to a summons and complaint dated July 12, 2017, seeking entry of judgment in the amount of $1509.28, plus costs and attorneys’ fees.

Defendant appeared by counsel and filed an answer on September 28, 2017, asserting eight affirmative defenses, including that the amounts sought exceed the amounts permitted by statute, and that the medical services were not necessary.

A notice of trial was filed on January 31, 2018.

On March 6, 2019, defendant moved for summary judgment and related relief. The motion was granted in part by the court (Samuels, J), pursuant to a decision and order May 8, 2019 which held “… certain codes were paid properly, but defendant failed to establish proof of 8 units / concuurent care for the rest. Thus, the case shall proceed to trial for $792.86 with the sole issue fee schedule.”

On December 18, 2019, the parties appeared before this Court, stipulated to the facts on the record, and asked that this court issue a decision. Essentially the parties agreed that the sole issue before the court is whether defendant’s reductions based on the 8 Unit Rule of the Chiropractic Workers’ Compensation Fee schedule were properly applied to the cupping services performed by a licensed acupuncturist.

Ground Rule 3, also known as the 8-Unit Rule is found within the Physical Medicine section of the Chiropractic Fee Schedule, entitled “Multiple Physical Medicine Procedures and Modalities” and provides that when multiple physical medicine procedures and/or modalities are performed on the same day, reimbursement is limited to eight units or the amount billed, whichever is less.

The parties stipulated that the amount at issue for the fifteen (15) remaining bills is $77.10, which is the total amount of the differences between the maximum chiropractic rate allowable ($16.70) and the rate actually paid by MVIAC ($11.56) after applying Ground Rule 3, the 8-unit maximum per day rule.

While carriers are permitted to refer to the chiropractic fee schedule for the rates of reimbursement for licensed acupuncturists (Great Wall Acupuncture v GEICO General Insurance Company 16 Misc 3d 23), the Appellate Division, First Department has held that ” …. such holdings do not foreclose the use of the physician fee schedule in all cases (Global Liberty Insurance Co. Of New York v North Shore Family Chiropractic, PC, 2019 NY Slip Op. 08942).

There is no authority or case law that authorizes carriers to apply the ground rules of the Chiropractic Fee Schedule to licensed acupuncturists.

The purpose of the Ground Rule would appear to be to limit the number of the same type of procedures that are reimbursable to a patient on the same day. This rationale would not therefore limit the patient’s rights to receive acupuncture treatment on the same day the patient receives chiropractic treatment. Acupuncture has been recognized as a separate and distinct modality from chiropractic treatment (Universal Acupuncture Pain Services, P.C. v Lumbermens Mutual Casualty Co. 195 Misc 2d 352).

The authority allowing for the chiropractic fee schedule to be used exists because the superintendent has not adopted a fee schedule applicable to licensed acupuncturists, not because the services performed by the professional is the same or overlap.

Based on the forgoing the court finds that plaintiff is entitled to a judgment in the amount of $77.10 plus costs and interest from July 13, 2017.

This constitutes the decision and order of the court.



Dated: January 7, 2020

New York, New York

_________________________

Hon. Sabrina B. Kraus, JCCMatter of Metro Pain Specialist P.C. v Country-Wide Ins. Co. (2020 NY Slip Op 50014(U))

Reported in New York Official Reports at Matter of Metro Pain Specialist P.C. v Country-Wide Ins. Co. (2020 NY Slip Op 50014(U))

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 9th and 10th JUDICIAL DISTRICTS

In the Matter of Metro Pain Specialist, P.C., as Assignee of Ramiro Loaiza-Hurtado, Respondent,

against

Country-Wide Insurance Company, Appellant.

Jaffe & Velazquez, LLP (Jean H. Kang of counsel), for appellant. Gabriel & Shapiro, LLC (Lenard Brumfield, Esq.), for respondent (no brief filed).

Appeal from an order of the District Court of Suffolk County, Third District (James F. Matthews, J.), dated November 2, 2017. The order granted the petition in a CPLR 7511 proceeding to vacate a master arbitrator’s award dated December 19, 2016, and, upon such vacatur, in effect, confirmed the arbitrator’s award and awarded attorney’s fees to petitioner.

ORDERED that the order is affirmed, with $25 costs, and the matter is remitted to the District Court for further proceedings consistent herewith.

After a provider’s claims for assigned first-party no-fault benefits had been denied based on the provider’s “failure to cooperate” at an examination under oath, and upon “improper kickbacks,” “improper fee splitting,” “improper fee scheduling” and “billing for services not rendered,” the provider submitted the claims to arbitration pursuant to Insurance Law § 5106 (b). Following a hearing, the arbitrator found that the provider had established its prima facie case which the insurer had failed to rebut, and awarded the provider the monies it sought. The insurer appealed the award to the master arbitrator who, by an award dated December 19, 2016, vacated the arbitrator’s award and remitted the matter for a hearing before a new arbitrator. The provider then commenced this proceeding to vacate the master arbitrator’s award, pursuant to CPLR 7511 (1) (b) (iii), on the ground that the master arbitrator had exceeded his power. The insurer opposed the petition and requested that the master arbitrator’s award be confirmed. The District [*2]Court, by order dated November 2, 2017, from which the insurer appeals, found that there was a rational basis for the original arbitrator’s award, that the master arbitrator had “exceeded his statutory authority,” granted the petition, vacated the master arbitrator’s award, and, upon such vacatur, “reinstated” the original arbitrator’s award, and awarded attorney’s fees to the provider.

The scope of judicial review of a master arbitrator’s award is limited to whether the master arbitrator exceeded his power (see Matter of Smith [Firemen’s Ins. Co.], 55 NY2d 224 [1982]; Matter of Petrofsky [Allstate Ins. Co.], 54 NY2d 207 [1981]). The role of a master arbitrator “is to review the arbitrator’s determination to assure that it was reached in a rational manner and that the decision was not arbitrary and capricious. It 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]; see also Matter of Petrofsky [Allstate Ins. Co.], 54 NY2d 207; Matter of Progressive Cas. Ins. Co. [Elite Med. Supply of NY, LLC], 162 AD3d 1471, 1472 [2018]). A master arbitrator exceeds his statutory power by making factual determinations, by reviewing factual and procedural errors committed at the original arbitration hearing, by weighing the evidence, or by resolving issues of credibility (see Matter of Smith [Firemen’s Ins. Co.], 55 NY2d 224; Matter of Richardson v Prudential Prop. & Cas. Ins. Co., 230 AD2d 861 [1996]; Matter of Allstate Ins. Co. v Keegan, 201 AD2d at 725).

Here, the master arbitrator vacated the arbitrator’s award based on “[t]he rational and what appears to [sic] insufficient evidence presented,” which necessarily involves a review of the facts by the master arbitrator (see e.g. Matter of Allstate Ins. Co. v Keegan, 201 AD2d at 725). Upon our review of the record, we find that there was a rational basis for the original arbitrator’s award. Consequently, the master arbitrator exceeded his authority by reviewing, de novo, factual issues already determined by the original arbitrator (see Matter of Richardson v Prudential Prop. & Cas. Ins. Co., 230 AD2d 861). We, thus, affirm the order of the Civil Court which vacated the master arbitrator’s award and, in effect, confirmed the arbitrator’s award (see CPLR 7511 [b] [1] [iii]; 7510).

Furthermore, the provider is entitled to recover reasonable attorney’s fees for this appeal (see 11 NYCRR § 65-4.10 [j] [4]; Acuhealth Acupuncture, P.C. v Country-Wide Ins. Co., 170 AD3d 1168, 1169 [2019]; Matter of GEICO Ins. Co. v AAAMG Leasing Corp., 148 AD3d 703, 705 [2017]). Therefore, the matter is remitted to the District Court to determine the provider’s reasonable attorney’s fees for this appeal (see Acuhealth Acupuncture, P.C. v Country-Wide Ins. Co., 170 AD3d at 1168).

Accordingly, the order is affirmed and the matter is remitted to the District Court for further proceedings relating to attorney’s fees.

It is noted that a proceeding to vacate or to confirm an arbitrator’s award is a special proceeding brought pursuant to CPLR article 4 and should, therefore, terminate in a judgment rather than an order (see CPLR 411).

ADAMS, P.J., TOLBERT and GARGUILO, JJ., concur.


ENTER:
Paul Kenny
Chief Clerk
Decision Date: January 02, 2020