October 31, 2008

Greater Health Through Chiropractic, P.C. v MVAIC (2008 NY Slip Op 52178(U))

https://www.beynensonlaw.com/case-law/greater-health-through-chiropractic-p-c-v-mvaic-2008-ny-slip-op-52178u/

Court: Appellate Term, Second Department
Decided: October 31, 2008
Citation: 2008 NY Slip Op 52178(U) · 21 Misc 3d 133(A)
Posture: Summary judgment
Outcome: Provider prevailed
Issues: Policy issues MVAIC
Legal questions: MVAIC eligibility: qualified covered person (see the maps)

Cite as

Greater Health Through Chiropractic, P.C. v MVAIC, 21 Misc 3d 133(A), 2008 NY Slip Op 52178(U) (App Term, 2d Dept, 2d & 11th Jud Dists 2008)

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 failed to establish that the vehicle the assignor was using or operating when injured was a motorcycle. It sought summary judgment on the ground that the assignor was ineligible for no-fault benefits, asserting that the injuries occurred while using or operating an owned motorcycle. Although motorcycle use or operation would make the assignor ineligible under Insurance Law § 5103 (a) and 11 NYCRR 65-1.1 (e), MVAIC's proof did not establish that the vehicle was a motorcycle under Vehicle and Traffic Law § 123. The Appellate Term, Second Department, affirmed denial of MVAIC's motion on that ground rather than the lower court's late-denial rationale.

Reported in New York Official Reports at Greater Health Through Chiropractic, P.C. v MVAIC (2008 NY Slip Op 52178(U))

[*1]

Greater Health Through Chiropractic, P.C. v MVAIC

2008 NY Slip Op 52178(U) [21 Misc 3d 133(A)]

Decided on October 31, 2008

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This opinion is uncorrected and will not be published in the printed Official Reports.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 October 31, 2008

SUPREME COURT OF THE STATE OF NEW YORK

APPELLATE TERM: 2nd and 11th JUDICIAL DISTRICTS

PRESENT: : PESCE, P.J., WESTON PATTERSON and RIOS, JJ
2007-1709 K C.

Greater Health Through Chiropractic, P.C., a/a/o VICTORIA CRUZ, Respondent,

against

MVAIC, Appellant.

Appeal from an order of the Civil Court of the City of New York, Kings County (Kathy J. King, J.), entered September 11, 2007. The order denied defendant’s motion for summary judgment.

Order affirmed without costs.

In this action by a provider to recover assigned first-party no-fault benefits, defendant Motor Vehicle Accident Indemnification Corporation (sued herein as MVAIC)
moved for summary judgment dismissing the complaint, arguing, inter alia, that plaintiff’s assignor was not eligible to recover first-party no-fault benefits since she could not be a “qualified person” as defined in Insurance Law § 5202 (b) due to the fact that she was allegedly injured while using or operating a motorcycle which she owned. The court denied MVAIC’s motion on the ground that MVAIC failed to deny plaintiff’s claims within the 30-day claim determination period. This appeal by MVAIC ensued.

Although plaintiff’s assignor would be ineligible to receive first-party no-fault benefits if her injuries were sustained as a result of her use or operation of a motorcycle (see Insurance Law § 5103 [a]; see also Insurance Department Regulations [11 NYCRR] § 65-1.1 [e]), MVAIC failed to submit sufficient evidence establishing that the vehicle she was using or operating at the [*2]time of the accident was a motorcycle (see Vehicle and Traffic Law § 123). As a result, MVAIC’s motion for summary judgment was properly denied, albeit on other grounds (Zuckerman v City of New York, 49 NY2d 557 [1980]).

Pesce, P.J., Weston Patterson and Rios, JJ., concur.
Decision Date: October 31, 2008

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: MVAIC bore the burden on its eligibility / lack-of-coverage defense and did not meet it; claimant prevails on this point

Held MVAIC's motion properly denied because it submitted insufficient evidence that the vehicle the assignor was using or operating was a motorcycle, which would have made her ineligible.

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

Of the 223 decisions on this question in the Second Department courts and the Court of Appeals, 23 (this one included) are in the same category.

Cited by

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.

Similar decisions

New Millennium Med. Imaging, P.C. v MVAIC (2018 NY Slip Op 51684(U))The provider failed to establish its motorcycle-riding assignor's eligibility for MVAIC benefits because it did not prove a class C motorcycle.
Advanced Chiropractic of NY, P.C. v MVAIC (2015 NY Slip Op 50386(U))A provider aware of the vehicle owner's identity must exhaust remedies against that owner before seeking no-fault benefits from MVAIC. The provider and its assignor knew the identity of the owner of the vehicle in which the assignor had been a passenger at the time of the accident.
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.
Island Life Chiropractic Pain Care, PLLC v MVAIC (2019 NY Slip Op 50226(U))The assignor failed to establish qualification for MVAIC benefits because the assignor admitted purchasing the car driven in the accident.
Optimal Well-Being Chiropractic, P.C v MVAIC (2013 NY Slip Op 51751(U))The provider failed to show that its assignor reported the alleged hit-and-run within 24 hours or had an excuse for failing to report it.