July 18, 2018
Allstate Ins. Co. v North Shore Univ. Hosp. (2018 NY Slip Op 05268)
https://www.beynensonlaw.com/case-law/allstate-ins-co-v-north-shore-univ-hosp-2018-ny-slip-op-05268/
- Decided
- July 18, 2018
- Citation
- 2018 NY Slip Op 05268 · 163 AD3d 745
- Posture
- Default or vacatur
- Outcome
- Provider prevailed
- Later treatment
- Followed in 2 later decisions (see Cited by)
- Issues
- Defaults and vacatur
- Legal questions
- Vacating a default: excuse and defense (see the maps)
Posture, outcome, issues and treatment by other decisions are Beynenson Law’s classification. Treatment labels are assigned by a language model reading the citing decision; negative and appeal-history labels are checked by a second reader.
Summary
Editorial summary by Beynenson Law, not part of the court’s decision.
Reported in New York Official Reports at Allstate Ins. Co. v North Shore Univ. Hosp. (2018 NY Slip Op 05268)
| Allstate Ins. Co. v North Shore Univ. Hosp. |
| 2018 NY Slip Op 05268 [163 AD3d 745] |
| July 18, 2018 |
| Appellate Division, Second Department |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
[*1] (July 18, 2018)
| Allstate Insurance Company, Respondent, v North Shore University Hospital, as Assignee of Jude M. Blanc, Appellant. |
Russell Friedman, Lake Success, NY (Dara C. Goodman of counsel), for appellant.
Peter C. Merani, P.C., New York, NY (Eric M. Wahrburg of counsel), for respondent.
In an action pursuant to Insurance Law § 5106 (c) for a de novo determination of claims for no-fault insurance benefits, the defendant appeals from an order of the Supreme Court, Nassau County (James P. McCormack, J.), entered October 19, 2016. The order denied the defendant’s motion pursuant to CPLR 5015 (a) (1) to vacate its default in answering the complaint and pursuant to CPLR 2004 and 3012 (d) to extend its time to answer the complaint.
Ordered that the order is reversed, on the facts and in the exercise of discretion, with costs, and the defendant’s motion pursuant to CPLR 5015 (a) (1) to vacate its default in answering the complaint and pursuant to CPLR 2004 and 3012 (d) to extend its time to answer the complaint is granted.
This action pursuant to Insurance Law § 5106 (c) for a de novo determination of claims for no-fault insurance benefits arises from a motor vehicle accident that occurred on July 28, 2013. Jude M. Blanc allegedly was injured in the accident, and he underwent hip surgery at the defendant hospital. The defendant submitted a claim to the plaintiff insurer for no-fault benefits for the surgery and related care. The plaintiff denied the claim.
The defendant submitted the matter to arbitration. The arbitrator determined that the defendant was entitled to no-fault compensation in the amount of $16,134.83, plus interest and attorney’s fees. The plaintiff appealed the award to a master arbitrator, who affirmed the award.
On January 29, 2015, the plaintiff commenced this action pursuant to Insurance Law § 5106 (c) for a de novo determination of the defendant’s claims for recovery of no-fault benefits. The plaintiff then moved for leave to enter a default judgment because the defendant failed to timely appear or answer the complaint. In an order entered April 21, 2015, the Supreme Court granted the plaintiff’s motion for leave to enter a default judgment. On June 8, 2015, the court entered a default judgment.
In July 2016, the defendant moved pursuant to CPLR 5015 (a) (1) to vacate its default, and pursuant to CPLR 2004 and 3012 (d) to extend its time to answer the complaint. In an order entered October 19, 2016, the Supreme Court denied the motion, and the defendant appeals.
The defendant’s motion was timely made (see CPLR 5015 [a] [1]; 2103 [b] [2]). A defendant seeking to vacate a default pursuant to CPLR 5015 (a) (1) on the ground of excusable default must demonstrate a reasonable excuse for the default and a potentially meritorious defense to the action (see CPLR 5015 [a] [1]; Eugene Di Lorenzo, Inc. v A.C. Dutton Lbr. Co., 67 NY2d 138, 141 [1986]; EMC Mtge. Corp. v Toussaint, 136 AD3d 861, 862 [2016]; Lane v Smith, 84 AD3d 746, 748 [2011]). Here, the defendant demonstrated a reasonable excuse for its default and a potentially meritorious defense to the action (see CPLR 5015 [a] [1]; Matter of Williams v Williams, 148 AD3d 917, 918 [2017]; Matter of Gasby v New York City Hous. Auth./Walt Whitman Houses, 142 AD3d 1018, 1019 [2016]; Youth v Grant, 126 AD3d 893, 893 [2015]). Furthermore, the plaintiff did not assert before the Supreme Court that the defendant’s delay in answering resulted in prejudice, the record does not reflect that the defendant acted willfully, and public policy favors resolution on the merits (see Matter of Gasby v New York City Hous. Auth./Walt Whitman Houses, 142 AD3d at 1019; Youth v Grant, 126 AD3d at 894; Curran v Graf, 13 AD3d 409 [2004]).
Accordingly, the Supreme Court improvidently exercised its discretion in denying the defendant’s motion pursuant to CPLR 5015 (a) (1) to vacate its default in answering the complaint and pursuant to CPLR 2004 and 3012 (d) to extend its time to answer the complaint. Chambers, J.P., Austin, Miller and Maltese, JJ., concur.
Legal questions
A question of no-fault law this decision rules on, from our Legal Questions pages. Bars count the decisions on the question by year and court, coloured by category; circles are this decision and the decisions on the question it cites or that cite it. Point at a bar or circle for details. The categories and summaries are Beynenson Law’s classification, made by a language model and checked by a second reading.
Did the defaulting party show a reasonable excuse (or lack of notice) and a potentially meritorious defense or claim?
This decision: Excuse (or lack of actual notice under CPLR 317) and potentially meritorious defense or claim shown; default vacated or late answer allowed
Held the provider's default in answering the insurer's de novo action excused, as it showed a reasonable excuse and a potentially meritorious defense, with no prejudice, no willfulness and a policy favoring the merits.
Of the 170 decisions on this question in the Second Department courts and the Court of Appeals, 67 (this one included) are in the same category.
Cited by
A label shows how the later decision treated this one.
- Global Liberty Ins. Co. v Shahid Mian, M.D., P.C. (2019 NY Slip Op 04144) FollowedThe provider's arbitration award established a potentially meritorious defense supporting vacatur of its default in the insurer's action.
- Prompt Med. Supply, Inc. v Nationwide Affinity Ins. Co. of Am. (2019 NY Slip Op 50685(U)) FollowedThe insurer's motion to vacate its default judgment was granted, and its answer was deemed timely.
- Parisien v Allstate Ins. Co. (2022 NY Slip Op 22262)The insurer established grounds to vacate its default through counsel's prompt action and an undisputed lack-of-coverage defense.
- American Tr. Ins. Co. v Bruno Med. Supply, Inc. (2026 NY Slip Op 01332)The provider's contradictory and conclusory allegations of law office failure did not reasonably excuse its default in answering.
Similar decisions
- New York Hosp. Med. Ctr. of Queens v Nationwide Mut. Ins. Co. (2014 NY Slip Op 06188)The insurer's clerical-oversight affidavit and potentially meritorious defense justified vacating its default judgment.
- Nyack Hosp. v Allstate Ins. Co. (2006 NY Slip Op 52233(U))The insurer lacked a meritorious defense to vacate its default because a completed hospital facility form replaced the requested no-fault application.
- Bayshore Chiropractic, P.C. v Allstate Ins. Co. (2017 NY Slip Op 51121(U))The insurer's explanation of law office failure during a file transfer showed attorney neglect and did not reasonably excuse its default.
- Westchester Med. Ctr. v Hartford Cas. Ins. Co. (2009 NY Slip Op 00528)The insurers showed an excusable default and a potentially meritorious defense based on partial exhaustion of policy limits.
- New York & Presbyt. Hosp. v Allstate Ins. Co. (2006 NY Slip Op 04260)The insurer obtained default vacatur under CPLR 317 by showing untimely actual notice of the summons and meritorious defenses.