November 17, 2022

Central Park Physical Medicine PC v MVAIC (2022 NY Slip Op 51127(U))

https://www.beynensonlaw.com/case-law/central-park-physical-medicine-pc-v-mvaic-2022-ny-slip-op-51127u/

Court: Appellate Term, First Department
Decided: November 17, 2022
Citation: 2022 NY Slip Op 51127(U) · 77 Misc 3d 127(A)
Posture: Summary judgment
Outcome: Insurer prevailed
Later treatment: Followed in 1 later decision (see Cited by)
Issues: MVAIC Policy issues Timeliness and preclusion
Legal questions: MVAIC eligibility: qualified covered person (see the maps)

Cite as

Central Park Physical Medicine PC v MVAIC, 77 Misc 3d 127(A), 2022 NY Slip Op 51127(U) (App Term, 1st Dept 2022)

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.

MVAIC established that the assignor was ineligible for benefits because the assignor held an automobile policy in the assignor's own name. Under Insurance Law § 5202 (b) and Insurance Law § 5221 (b) (2), the assignor was an insured rather than a qualified person entitled to no-fault benefits from MVAIC. The provider failed to raise a triable issue and did not address a certified Department of Motor Vehicles record showing coverage on the accident date. MVAIC's alleged failure to establish timely mailing of verification requests did not preclude its threshold coverage defense. The Appellate Term, First Department, reversed the order, granted MVAIC's summary judgment motion, and dismissed the complaint.

Reported in New York Official Reports at Central Park Physical Medicine PC v MVAIC (2022 NY Slip Op 51127(U))

[*1]

Central Park Physical Medicine PC v MVAIC

2022 NY Slip Op 51127(U) [77 Misc 3d 127(A)]

Decided on November 17, 2022

Appellate Term, First 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This opinion is uncorrected and will not be published in the printed Official Reports.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 November 17, 2022

SUPREME COURT, APPELLATE TERM, FIRST DEPARTMENT
PRESENT: Hagler, J.P., Tisch, Michael, JJ.
570408/22

Central Park Physical Medicine PC a/a/o Ana Gutierrez, Plaintiff-Respondent,

against

MVAIC, Defendant-Appellant.

Defendant appeals from an order of the Civil Court of the City of New York, New York County (Denise M. Dominguez, J.), entered August 19, 2021, which denied its motion for summary judgment dismissing the complaint.

Per Curiam.

Order (Denise M. Dominguez, J.), entered August 19, 2021, reversed, without costs, motion granted, and the complaint dismissed. The Clerk is directed to enter judgment accordingly.

Defendant MVAIC’s submission in support of its motion for summary judgment established, prima facie, that plaintiff’s assignor was not a “qualified” person entitled to no fault benefits from MVAIC because she was an “insured” under an automobile policy in her own name (see Insurance Law §§ 5202[b], 5221[b][2]; Englington Med., P.C. v Motor Veh. Acc. Indem. Corp., 81 AD3d 223, 228 [2011]; Matter of Kenyon, 105 AD2d 530 [1984]; BNE Clinton Med., P.C. v MVAIC, 74 Misc 3d 128[A], 2022 NY Slip Op 50058[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2022]). In opposition, plaintiff failed to raise any triable issue, and did not even address defendant’s submission of the certified Department of Motor Vehicles record, which reflected that plaintiff’s assignor had an automobile insurance policy with GEICO on the day of the accident. Nor did MVAIC’s alleged failure to show that it timely mailed verification requests preclude it from asserting the threshold coverage defense (see generally Central Gen. Hosp. v Chubb Group of Ins. Cos., 90 NY2d 195, 199-200 [1997]).

All concur

THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.

Clerk of the Court
Decision Date: November 17, 2022

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.

MVAIC eligibility: qualified covered person

Open the full map

Against MVAIC, was the claimant shown to be a qualified, covered person meeting article 52’s conditions?

This decision: Court finds a qualification or article 52 condition affirmatively NOT met; claim fails on that ground

Held the assignor was not a qualified person because a certified DMV record showed she was insured under her own automobile policy on the accident date, and unproved timely verification did not preclude this threshold coverage defense.

Found not eligibleClaimant's proof lackingMVAIC failed to proveUnresolved / for trialDefense precluded/waivedThis decisionCites it or cited by itCited or followed

Of the 43 decisions on this question in the First Department courts and the Court of Appeals, 11 (this one included) are in the same category. 2 decisions in other departments that cite or are cited by this one are on the full map.

Cited in this decision

Englington Med., P.C. v Motor Veh. Acc. Indem. Corp. (2011 NY Slip Op 00176)MVAIC failed to establish that the assignor's uninsured mini-bike disqualified the assignor from receiving no-fault benefits.
BNE Clinton Med., P.C. v MVAIC (2022 NY Slip Op 50058(U))The assignor was ineligible for MVAIC benefits because the stepfather's automobile policy insured relatives residing in the same household.

Cited by

A label shows how the later decision treated this one.

Performance Life Chiropractic PC v MVAIC (2023 NY Slip Op 50105(U)) FollowedMVAIC established that the assignor was an insured under an automobile policy and therefore was not a qualified person entitled to its benefits.

Similar decisions

Medical Supply Depot Group Corp. v MVAIC (2025 NY Slip Op 50844(U))MVAIC established that the assignor was ineligible for no-fault benefits because the assignor owned the vehicle involved in the accident.
Statewide Med. Servs., P.C. v Motor Veh. Acc. Indem. Corp. (2012 NY Slip Op 52119(U))MVAIC failed to submit competent proof that the assignor was unqualified to receive no-fault benefits or otherwise raise a triable issue.
Village Med. Supply, Inc. v MVAIC (2016 NY Slip Op 51421(U))The provider failed at trial to establish the assignor's eligibility for MVAIC benefits through residency proof and a notice-of-intention affidavit.
Advanced Chiropractic of NY, P.C. v MVAIC (2017 NY Slip Op 50955(U))The provider failed to prove the assignor's New York residency and the absence of other available insurance coverage for its MVAIC claim.
Ap Orthopedic & Rehabilitation, P.C. v Mvaic (2011 NY Slip Op 51448(U))The assignor's failure to provide proof of New York residency defeated the provider's claim for no-fault benefits from MVAIC. The Appellate Term, Second Department, found that the assignor was neither a qualified person under Insurance Law § 5202 (b) nor a covered person under Insurance Law § 5221 (b) (2), leaving a condition precedent unsatisfied.