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October 7, 2025

Hertz Vehs., LLC v Ace Med Supplies Inc. (2025 NY Slip Op 51959(U))

https://www.beynensonlaw.com/case-law/hertz-vehs-llc-v-ace-med-supplies-inc-2025-ny-slip-op-51959u/

Court
Supreme Court, New York County
Judge
Lebovits, J.
Decided
October 7, 2025
Citation
2025 NY Slip Op 51959(U) ยท 87 Misc 3d 1249(A)
Posture
Default or vacatur
Outcome
Insurer prevailed
Issues
Staged accidents, lack of coverage Defaults and vacatur Timeliness and preclusion
Legal questions
No covered accident (founded belief) (see the maps)
Cite as
Hertz Vehs., LLC v Ace Med Supplies Inc., 87 Misc 3d 1249(A), 2025 NY Slip Op 51959(U) (Sup Ct, New York County 2025)

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.

A staged-accident coverage defense is not precluded by untimely denial. The Supreme Court, New York County, granted the insurer's CPLR 3215 motion for default judgment against nonanswering defendants. Adjuster evidence, EUOs and other documents established a well-founded belief that the claims arose from a staged accident. An unsigned EUO transcript showed discrepancies supporting that belief, rather than the truth of its statements. EUO-request timing was irrelevant because nonappearance was not asserted. A related arbitration supported the showing but lacked preclusive effect absent privity, except possibly against one assignor defendant. The court denied a provider's CPLR 3012 (d) cross-motion to compel acceptance of a late answer, particularly in view of the potential merits of any defense.

Reported in New York Official Reports at Hertz Vehs., LLC v Ace Med Supplies Inc. (2025 NY Slip Op 51959(U))

[*1]
Hertz Vehs., LLC v Ace Med Supplies Inc.
2025 NY Slip Op 51959(U) [87 Misc 3d 1249(A)]
Decided on October 7, 2025
Supreme Court, New York County
Lebovits, J.
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This opinion is uncorrected and will not be published in the printed Official Reports.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 7, 2025
Supreme Court, New York County


Hertz Vehicles, LLC, Plaintiff,

against

Ace Med Supplies Inc., Anan Chiropractic, P.C., Anjani Sinha Medical, P.C., Argyle Pharmacy, Inc., Atlantic Medical & Diagnostic, P.C., Centurion Midtown Anesthesia, PLLC, Citimed Complete Medical Care, P.C., Emed Pharmacy Corporation, Esraa Habiba, Fifth Avenue Surgery Center, LLC, Gamal Rehab PT, P.C., Metropolitan Medical & Surgical, P.C., Remodel Net Services, Inc., Right Choice Supply, Inc., SCOB, LLC, Sedation Vacation Perioperative Medicine, PLLC, Jorge Diaz, Rosalee Diaz, Mauro Herrera Dominguez, and Wilbert Garcia Dominguez, Defendant.




Index No. 160580/2024


Gallo Vitucci Klar LLP, New York, NY (David Boucher of counsel), for plaintiff.

Baker Law Offices, P.C., Queens, NY (Alex A. Samaroo of counsel), for defendants SCOB LLC, and Emed Pharmacy Corporation.

Rybak Firm, PLLC, Brooklyn, NY (Oleg Rybak of counsel), for defendant Gamal Rehab PT, P.C.
Gerald Lebovits, J.

The following e-filed documents, listed by NYSCEF document number (Motion 001) 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 65, 66, 67, 68, 69, 70, 71, 72 were read on this motion to DEFAULT JUDGMENT.

In this no-fault-insurance-coverage action, plaintiff-insurer, Hertz Vehicles, LLC, moves under CPLR 3215 for default judgment against the non-answering defendants. The motion is granted. Plaintiff has established, through the affidavit of its claims adjuster (see NYSCEF No. 45), examinations under oath (EUOs) of defendants Jorge Diaz and Rosalee Diaz (see NYSCEF Nos. 52, 53), and other documents, that it has a well-founded belief that the no-fault-benefits [*2]claims at issue in this action arose from a staged accident for which no coverage exists.[FN1]

Defendants SCOB, LLC, and Emed Pharmacy Corporation, assert that plaintiff’s showing is insufficient because Jorge Diaz’s unsigned EUO transcript is hearsay. (See NYSCEF No. 63 at ¶¶ 27-29.) But plaintiff is not relying on that transcript for the truth of the statements it contains. Instead, plaintiff points here to discrepancies within Jorge Diaz’s testimony, and between that testimony and other evidence in plaintiff’s possession, to explain the basis for plaintiff’s belief that the underlying accident was staged. (See NYSCEF No. 45 at ¶¶ 29-32.)

There is also no merit to the argument of SCOB and Emed (see NYSCEF No. 63 at ¶¶ 15-18, and the similar argument by defendant Gamal Rehab, PT, P.C. (see NYSCEF No. 66 at ¶¶ 37-38), that plaintiff’s motion must be denied for failure to establish that it timely mailed verification requests to defendants and timely denied their claims. The precise timing of plaintiff’s EUO requests is not relevant here, because plaintiff is not asserting an EUO-nonappearance argument. And because “an intentional and staged collision caused in the furtherance of an insurance fraud scheme is not a covered accident under a policy of insurance” (Liberty Mut. Ins. Co. v Goddard, 29 AD3d 698, 699 [2d Dept 2006]), a no-coverage defense on that ground is not subject to preclusion as untimely. (See Fair Price Med. Supply Co. v Travelers Indem. Co., 42 AD3d 277, 284-285 [2d Dept 2007] [distinguishing between a defense based on a failure to deliver billed-for medical supplies prescribed for genuine injuries (subject to preclusion) and a staged-accident defense (not subject to preclusion]), aff’d 10 NY3d 556 [2008].)

Plaintiff has thus met its burden on its default-judgment motion under CPLR 3215. Gamal Rehab, PT, P.C., cross-moves under CPLR 3012 (d), though, to compel plaintiff to accept Gamal Rehab’s untimely answer. (See NYSCEF No. 65 [notice of cross-motion].) Applying the CPLR 3012 (d) factors identified in Emigrant Bank v Rosabianca (156 AD3d 468, 472 [1st Dept. 2017])—particularly the potential merits of any defense—this court is unpersuaded that compelling plaintiff to accept the untimely answer is warranted. The cross-motion is denied.

For the foregoing reasons, plaintiff’s motion is granted, and Gamal Rehab, PT, P.C.’s cross-motion is denied, as set out more fully in the appended order.

10/7/2025
Hon. Gerald Lebovits
J.S.C.
Footnotes


Footnote 1:Additionally, as plaintiff points out, a no-fault arbitrator hearing claims arising from the same collision held that the plaintiff here had established its staged-accident defense by a preponderance of the evidence. (See NYSCEF No. 58 at 4-5.) This arbitral determination is not entitled to issue-preclusive effect here due to a lack of privity, except perhaps with respect to defendant Mauro Herrera Dominguez (who was the assignor in the arbitral proceeding). But that an arbitrator considering the same issue found for plaintiff bolsters the conclusion that plaintiff has met its burden under CPLR 3215 (f).

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.

No covered accident (founded belief)

Open the full map

Did the insurer show the claimed injuries did not arise from a covered accident (staged, intentional, or unrelated)?

This decision: Insurer proved the injuries did not arise from a covered accident

Granted a default declaration of no coverage because the adjuster's affidavit, EUO testimony discrepancies and other documents established a well-founded belief that the claims arose from a staged accident, a defense not subject to preclusion.

  • Appellate DivisionApp Div 8
  • Appellate TermApp Term 7
  • Trial courtsTrial 10
2022, Appellate Division: 3 decisions (3 Defense established)2021, Appellate Division: 1 decision (1 Defense established)2020, Appellate Division: 1 decision (1 Defense established)2024, Appellate Division: 1 decision (1 Defense established)2025, Appellate Division: 1 decision (1 Defense established)2023, Appellate Division: 1 decision (1 Defense established)2017, Appellate Term: 2 decisions (2 Triable issue)2009, Appellate Term: 1 decision (1 Defense not shown)2007, Appellate Term: 3 decisions (1 Triable issue, 2 Defense not shown)2005, Appellate Term: 1 decision (1 Defense not shown)2022, Trial courts: 1 decision (1 Defense established)2021, Trial courts: 1 decision (1 Defense not shown)2020, Trial courts: 2 decisions (2 Insurer's motion fails)2018, Trial courts: 2 decisions (1 Defense established, 1 Triable issue)2009, Trial courts: 1 decision (1 Defense not shown)2008, Trial courts: 1 decision (1 Triable issue)2004, Trial courts: 1 decision (1 Defense not shown)2025, Trial courts: 1 decision (1 Defense established)This decision
20052010201520202025
Defense establishedTriable issueInsurer's motion failsDefense not shownThis decision

Of the 25 decisions on this question in the First Department courts and the Court of Appeals, 11 (this one included) are in the same category.

Cited in this decision

A label shows how this decision treated the case it cites.

  • Fair Price Med. Supply Corp. v Travelers Indem. Co. (2007 NY Slip Op 05220) FollowedAn insurer's untimely denial precludes a defense that billed medical supplies were never delivered when the defense does not concern coverage.
  • Fair Price Med. Supply Corp. v Travelers Indem. Co. (2008 NY Slip Op 04946)An insurer's defense that billed supplies were never delivered is subject to preclusion for an untimely denial.

Similar decisions

  • Pavlova v Allstate Ins. Co. (2019 NY Slip Op 50016(U))The insurer's EUO nonappearance defense was precluded by a denial issued more than 30 days after the last scheduled EUO. The Civil Court, Kings County, denied summary judgment to the insurer and granted summary judgment to the provider.
  • Country-Wide Ins. Co. v Gotham Med., P.C. (2015 NY Slip Op25387)A provider's refusal to answer relevant EUO questions is a material breach of the policy's cooperation condition and precludes recovery.
  • Hertz Vehicles, LLC v Best Touch PT, P.C. (2018 NY Slip Op 04854)The insurer failed to prove timely EUO requests for default relief against providers but established one claimant's failure to sign an EUO. The motion omitted receipt dates for the providers' verification forms and another claimant's application, preventing assessment of the 15-business-day deadline under 11 NYCRR 65-3.5 (a) and (b).
  • State Farm Mut. Auto. Ins. Co. v Surgicore of Jersey City, LLC (2021 NY Slip Op 03536)The insurer established entitlement to a default declaration of noncoverage based on a founded belief that the collision was staged.
  • Rizz Mgt. Inc. v State Farm Mut. Auto. Ins. Co. (2008 NY Slip Op 51191(U))The insurer failed to establish collateral estoppel or entitlement to summary judgment on its staged-accident defense.
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