March 22, 2023

Integrated Pain Mgt., PLLC v Empire Fire & Mar. Ins. Co. (2023 NY Slip Op 50219(U))

Headnote

The relevant facts included Integrated Pain Management, PLLC seeking no-fault insurance benefits for medical services it rendered to an assignor, Mikwam Murphy, due to an automobile accident. Defendant Empire Fire & Marine Insurance Company moved for summary judgment dismissing the complaint, arguing that the plaintiff was barred from relitigating the issue of coverage due to the doctrines of res judicata, collateral estoppel, and law of the case. In 2019, Empire Fire had commenced a declaratory judgment action in Kings County Supreme Court against Integrated Pain Management and Murphy, among others. The main issue the court decided was whether the plaintiff was barred from relitigating the issue of coverage. The holding of the case went in favor of the defendant, Empire Fire, dismissing the plaintiff's complaint and ruling that the plaintiff was indeed barred from relitigating the issue of coverage due to the aforementioned legal doctrines.

Reported in New York Official Reports at Integrated Pain Mgt., PLLC v Empire Fire & Mar. Ins. Co. (2023 NY Slip Op 50219(U))



Integrated Pain Management, PLLC, as assignee of Mikwam Murphy, Plaintiff,

against

Empire Fire & Marine Insurance Company, Defendant.

Index No. CV-712234-21/BX

Law Offices of Gabriel & Moroff, P.C., by Joseph Padrucco, Esq., for Plaintiff

McDonnell Adels & Klestzick, PLLC, by Christopher Stevens, Esq., for Defendant

Ashlee Crawford, J.

Recitation as Required by CPLR §2219(a), the following papers were read on this motion:

Papers Numbered
Defendant’s Notice of Motion, Affirmation, and Exhibits in Support 1

Plaintiff Integrated Pain Management, PLLC, seeks $366.64 in no-fault insurance benefits for medical services it rendered to assignor Mikwam Murphy on August 16, 2018. The services consisted of treatment for injuries Murphy allegedly sustained in an automobile accident on July 22, 2018. Defendant Empire Fire & Marine Insurance Company moves pursuant to CPLR § 3212 for summary judgment dismissing the complaint, contending that plaintiff is barred by the doctrines of res judicata, collateral estoppel, and law of the case from relitigating the issue of coverage for this claim (Stevens Affirm. ¶ 18). Plaintiff does not oppose the motion.


Prior Action

In 2019, Empire Fire commenced a declaratory judgment action in Kings County Supreme Court against Integrated Pain Management and Murphy, among others (see Empire Fire & Marine Ins. Co. v. Adams, Index No. 512686/19 [Sup. Ct., Kings Co.] [the “Brooklyn Action”]). In that case, Empire Fire alleged that Integrated Pain Management and Murphy participated in an insurance fraud scheme in which rented vehicles would intentionally get into “accidents” with unsuspecting third-party drivers (id. at NYSCEF No. 1). The drivers and passengers in the rented vehicles would receive payments of up to $1,500, and in exchange for those payments would seek medical treatment from certain designated medical providers, who would seek reimbursement under Empire Fire’s no-fault insurance policy (id.).

Empire Fire sought a declaration that it was not obligated to pay for the medical treatments provided by Integrated Pain Management to Murphy arising out of a July 22, 2018 automobile accident, the same accident at issue in the instant case. Neither Integrated Pain Management nor Murphy appeared in the Brooklyn Action.

By decision and order dated April 8, 2021, Supreme Court granted default judgment for [*2]Empire Fire, ruling in relevant part that Empire Fire was not contractually obligated to reimburse Integrated Pain Management for the services it rendered to Murphy arising from the July 22, 2018 accident, because the alleged losses were not the result of an “accident” as contemplated by the insurance policy (id. at NYSCEF 129).


Discussion

In support of summary judgment in this action, defendant argues that plaintiff’s claim is barred as a matter of law under the doctrines of res judicata, collateral estoppel, and law of the case, given Supreme Court’s ruling that contractually there is no no-fault coverage for the July 22, 2018 “accident.” It emphasizes that plaintiff Integrated Pain Management and Murphy were both parties to the Brooklyn Action and the claim here arises out of the very same accident at issue in that case.

A party seeking summary judgment “must make a prima facie showing of entitlement to judgment as a matter of law, tendering sufficient evidence to eliminate any material issues of fact from the case” (Winegrad v New York Univ. Med. Ctr., 64 NY2d 851, 853 [1985]). Once this showing is made, the burden shifts to the opposing party to produce evidentiary proof in admissible form sufficient to establish the existence of triable issues of fact (Zuckerman v City of New York, 49 NY2d 557, 562 [1980]). “[M]ere conclusions, expressions of hope or unsubstantiated allegations or assertions are insufficient” to defeat summary judgment (id.). Summary judgment is a drastic remedy and must be denied if there is any doubt as to the existence of a triable issue of material fact (Rotuba Extruders, Inc. v Ceppos, 46 NY2d 223, 231 [1978]). The evidence must be viewed in the light most favorable to the party opposing summary judgment (Branham v Loews Orpheum Cinemas, Inc., 8 NY3d 931, 932 [2007]).

“Under res judicata, or claim preclusion, a valid final judgment bars future actions between the same parties on the same cause of action” (Parker v Blauvelt Volunteer Fire Co., 93 NY2d 343, 347 [1999]). “As a general rule, once a claim is brought to a final conclusion, all other claims arising out of the same transaction or series of transactions are barred, even if based upon different theories or if seeking a different remedy” (id. [internal quotation marks and citation omitted]). “Collateral estoppel, or issue preclusion, precludes a party from relitigating in a subsequent action or proceeding an issue clearly raised in a prior action or proceeding and decided against that party , whether or not the tribunals or causes of action are the same” (id. at 349 [internal quotation marks and citation omitted]). “The doctrine applies if the issue in the second action is identical to an issue which was raised, necessarily decided and material in the first action, and the plaintiff had a full and fair opportunity to litigate the issue in the earlier action” (id.; see also Rojas v Romanoff, 186 AD3d 103, 107-09 [1st Dept 2020][comparing claim preclusion and issue preclusion]).

The Court finds that defendant has met its prima facie burden on summary judgment under the doctrine of collateral estoppel. Plaintiff seeks in this action to relitigate the identical issue raised and decided against it in the Brooklyn Action; that is, plaintiff’s right to payment under defendant’s no-fault insurance policy for medical services it rendered to Murphy related to the July 22, 2018 “accident.” Both parties had a full and fair opportunity to litigate this question in the Brooklyn Action, and Supreme Court clearly decided it against plaintiff. Plaintiff has failed to raise an issue of fact sufficient to defeat summary judgment.

Accordingly, it is hereby

ORDERED that Defendant’s motion for summary judgment seeking dismissal of the complaint is GRANTED and the case is dismissed with prejudice.

This constitutes the decision and order of the Court.


_________________________________
HON. ASHLEE CRAWFORD, J.C.C.
Dated: Bronx, New York
March 22, 2023