January 18, 2011

B.Y., M.D., P.C. v Progressive Direct Ins. Co. (2011 NY Slip Op 50080(U))

Headnote

The relevant facts in this case involved an action by medical providers to recover first-party no-fault benefits, with the parties participating in mandatory arbitration. The arbitration resulted in a ruling in the plaintiffs' favor, but the defendant then served and filed a demand for a trial de novo. The plaintiffs argued that the defendant's limited participation in the arbitration amounted to a default, barring them from demanding a trial de novo, but the District Court denied the motion. The main issue was whether the defendant's limited participation in the arbitration constituted a default. The holding of the case was that where a party's attorney appears at the arbitration, participates in the hearing, and submits evidence that, if admissible, would have tended to rebut the plaintiff's case, there is no default within the contemplation of the rules, and therefore the District Court properly denied the motion to strike the demand for a trial de novo.

Reported in New York Official Reports at B.Y., M.D., P.C. v Progressive Direct Ins. Co. (2011 NY Slip Op 50080(U))

B.Y., M.D., P.C. v Progressive Direct Ins. Co. (2011 NY Slip Op 50080(U)) [*1]
B.Y., M.D., P.C. v Progressive Direct Ins. Co.
2011 NY Slip Op 50080(U) [30 Misc 3d 133(A)]
Decided on January 18, 2011
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This opinion is uncorrected and will not be published in the printed Official Reports.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 18, 2011

SUPREME COURT OF THE STATE OF NEW YORK

APPELLATE TERM: 9th and 10th JUDICIAL DISTRICTS


PRESENT: : NICOLAI, P.J., TANENBAUM and LaCAVA, JJ
2009-2504 N C.
B.Y., M.D., P.C., JR CHIROPRACTIC, P.C. and OASIS PHYSICAL THERAPY, P.C. as Assignees of JASON FRANCE, Appellants,

against

Progressive Direct Insurance Company, Respondent.

Appeal from an order of the District Court of Nassau County, Third District (Michael A. Ciaffa, J.), dated September 8, 2009. The order denied plaintiffs’ motion to strike defendant’s demand for a trial de novo.

ORDERED that the order is affirmed, without costs.

In this action by providers to recover assigned first-party no-fault benefits, the parties stipulated, among other matters, to plaintiffs’ prima facie case and defendant’s timely denial of the claim. The parties participated in mandatory arbitration (see Rules of the Chief Judge [22 NYCRR] part 28), which resulted in a ruling in plaintiffs’ favor, whereupon defendant served and filed a demand for a trial de novo (Rules of the Chief Judge [22 NYCRR] § 28.12 [a]). Plaintiffs moved to strike the demand, arguing that defendant’s limited participation in the arbitration, which consisted of defendant’s attorney’s appearance and the offer of peer review reports, to which the arbitrator sustained plaintiffs’ objection on hearsay grounds, amounted to a default, barring defendant from demanding a trial de novo. Defendant opposed, and the District Court denied the motion, finding that, on the facts, defendant had not defaulted. Plaintiffs appeal and we affirm.

The Rules of the Chief Judge provide that a demand for a trial de novo “may be made by any party not in default” (Rules of the Chief Judge [22 NYCRR] § 28.12 [a]). A party’s failure to appear for an arbitration hearing constitutes a default (Rules of the Chief Judge [22 NYCRR] § 28.7 [a]), as does a party’s appearance by counsel who otherwise “refus[es] to participate in the hearing” (Bitzko v Gamache, 168 AD2d 888 [1990]; see also Finamore v Huntington Rehabilitation Assn., 150 AD2d 426 [1989]). However, where, as here, a party’s attorney [*2]appears at the arbitration, participates in the hearing and submits evidence which, if admissible, would have tended to rebut the plaintiff’s case, there is no default within the contemplation of the Rules of the Chief Judge merely because the arbitrator ruled the proof inadmissible (see Tripp v Reitman Blacktop, 188 Misc 2d 317 [App Term, 9th & 10th Jud Dists 2001]; San-Dar Assoc. v Adams, 167 Misc 2d 727 [App Term, 1st Dept 1996]).

Accordingly, the District Court properly denied plaintiffs’ motion to strike defendant’s demand for a trial de novo.

Nicolai, P.J., Tanenbaum and LaCava, JJ., concur.
Decision Date: January 18, 2011