January 24, 2012

B.Y., M.D., P.C. v Global Liberty Ins. Co. of N.Y. (2012 NY Slip Op 50156(U))

Headnote

The relevant facts considered in this case were that providers had moved for summary judgment to recover assigned no-fault benefits, but the insurance company opposed the motion, stating that the claims were denied based on the assignor's eligibility for workers' compensation benefits. The main issue was whether the accident occurred during the course of the assignor's employment. The court found that there was a question of fact regarding this issue and held the action in abeyance pending a determination by the Workers' Compensation Board. The holding of the court was that the insurance company's proof was sufficient to raise a question of fact as to whether the assignor was acting as an employee at the time of the accident, and that this issue must be resolved by the Workers' Compensation Board before determining the provider's motion for summary judgment.

Reported in New York Official Reports at B.Y., M.D., P.C. v Global Liberty Ins. Co. of N.Y. (2012 NY Slip Op 50156(U))

B.Y., M.D., P.C. v Global Liberty Ins. Co. of N.Y. (2012 NY Slip Op 50156(U)) [*1]
B.Y., M.D., P.C. v Global Liberty Ins. Co. of N.Y.
2012 NY Slip Op 50156(U) [34 Misc 3d 146(A)]
Decided on January 24, 2012
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This opinion is uncorrected and will not be published in the printed Official Reports.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 24, 2012

SUPREME COURT OF THE STATE OF NEW YORK

APPELLATE TERM: 9th and 10th JUDICIAL DISTRICTS


PRESENT: : NICOLAI, P.J., MOLIA and IANNACCI, JJ
2010-2417 S C.
B.Y., M.D., P.C., CITY CARE ACUPUNCTURE, P.C., MK CHIROPRACTIC, P.C. and OASIS PHYSICAL THERAPY, P.C., as Assignees of MOHAMMAD CHEEMA, Appellants,

against

Global Liberty Insurance Company of New York, Respondent.

Appeal from an order of the District Court of Suffolk County, First District (Dennis M. Cohen, J.), dated June 28, 2010. The order, insofar as appealed from, denied without prejudice plaintiffs’ motion for summary judgment and held the action in abeyance pending an application to the Workers’ Compensation Board for a determination of the parties’ rights under the Workers’ Compensation Law.

ORDERED that the order, insofar as appealed from, is modified by striking the provision denying without prejudice plaintiffs’ motion for summary judgment and by remitting plaintiffs’ motion to the District Court for a new determination after final resolution of a prompt application to the Workers’ Compensation Board to determine the parties’ rights under the Workers’ Compensation Law. In the event plaintiffs fail to file proof with the District Court of such application within 90 days of the date of the order entered hereon, the District Court shall deny plaintiffs’ motion and grant reverse summary judgment in favor of defendant dismissing the complaint unless plaintiffs show good cause why the complaint should not be dismissed. As so modified, the order, insofar as appealed from, is affirmed without costs.

In this action by providers to recover assigned first-party no-fault benefits, plaintiffs moved for summary judgment. Defendant opposed the motion and cross-moved for summary judgment dismissing the complaint on the ground that it had timely denied plaintiffs’ claims based upon the assignor’s eligibility for workers’ compensation benefits, and that there was an issue as to whether plaintiffs’ assignor had been injured during the course of employment, thereby requiring that the matter be submitted to the Workers’ Compensation Board (Board). The District Court denied the motion and cross motion without prejudice and held the action in abeyance pending a determination by the Board. The court found that a question of fact exists as to whether the accident occurred during the course of the assignor’s employment, which issue must be resolved by the Board. Plaintiffs appeal from so much of the order as denied without [*2]prejudice their motion for summary judgment and held the action in abeyance.

Defendant’s proof was sufficient to raise a question of fact as to whether the assignor was acting as an employee at the time of the accident (cf. Westchester Med. Ctr. v American Tr. Ins. Co., 60 AD3d 848 [2009]), which issue must be resolved by the Board (see O’Rourke v Long, 41 NY2d 219, 225 [1976]; Santigate v Linsalata, 304 AD2d 639, 640 [2003]; see also Infinity Health Prods., Ltd. v New York City Tr. Auth., 21 Misc 3d 136[A], 2008 NY Slip Op 52218[U] [App Term, 2d & 11th Jud Dists 2008]; Response Equip., Inc. v American Tr. Ins. Co., 15 Misc 3d 145[A], 2007 NY Slip Op 51176[U] [App Term, 2d & 11th Jud Dists 2007]; cf. A.B. Med. Servs. PLLC v American Tr. Ins. Co., 8 Misc 3d 127[A], 2005 NY Slip Op 50959[U] [App Term, 2d & 11th Jud Dists 2005]). Accordingly, plaintiffs’ motion should not have been denied without prejudice. Instead, the District Court should determine plaintiffs’ motion after final Board resolution. A prompt application to the Board, as set forth above, is required in order to determine the parties’ rights under the Workers’ Compensation Law.

Nicolai, P.J., Molia and Iannacci, JJ., concur.
Decision Date: January 24, 2012