November 9, 2018

Jamaica Wellness Med., P.C. v Hereford Ins. Co. (2018 NY Slip Op 51587(U))

https://www.beynensonlaw.com/case-law/jamaica-wellness-med-p-c-v-hereford-ins-co-2018-ny-slip-op51587u/

Court: Appellate Term, Second Department
Decided: November 9, 2018
Citation: 2018 NY Slip Op 51587(U) · 61 Misc 3d 138(A)
Posture: Summary judgment
Outcome: Insurer prevailed
Issues: Staged accidents, lack of coverage
Legal questions: No covered accident (founded belief) (see the maps)

Cite as

Jamaica Wellness Med., P.C. v Hereford Ins. Co., 61 Misc 3d 138(A), 2018 NY Slip Op 51587(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2018)

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.

The insurer's summary judgment based on the insured vehicle's noninvolvement in the alleged accident was affirmed. The Appellate Term, Second Department, affirmed the order granting the insurer's motion and denying the providers' cross motion for the reasons stated in the companion appeal decided the same day, Jamaica Wellness Med., P.C. v Hereford Ins. Co., No. 2015-2655 K C.

Reported in New York Official Reports at Jamaica Wellness Med., P.C. v Hereford Ins. Co. (2018 NY Slip Op 51587(U))

[*1]

Jamaica Wellness Med., P.C. v Hereford Ins. Co.

2018 NY Slip Op 51587(U) [61 Misc 3d 138(A)]

Decided on November 9, 2018

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This opinion is uncorrected and will not be published in the printed Official Reports.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 November 9, 2018

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : MICHAEL L. PESCE, P.J., THOMAS P. ALIOTTA, DAVID ELLIOT, JJ
2015-2743 K C

Jamaica Wellness Medical, P.C. and City Care Acupuncture, P.C., as Assignees of Nelson Shaquan, Appellants,
against
Hereford Insurance Company, Respondent.

Law Office of Melissa Betancourt, P.C. (Melissa Betancourt of counsel) for appellants. Law Office of Lawrence R. Miles (Thomas Wolf of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Reginald A. Boddie, J.), entered September 25, 2015. The order granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiffs’ cross motion for summary judgment.

ORDERED that the order is affirmed, with $25 costs.

In this action by providers to recover assigned first-party no-fault benefits, plaintiffs appeal from an order of the Civil Court which granted defendant’s motion for summary judgment dismissing the complaint on the ground that the insured vehicle had not been involved in the alleged accident on February 13, 2013, and denied plaintiffs’ cross motion for summary judgment.

For the reasons stated in Jamaica Wellness Med., P.C., as Assignee of Nelson Shaquan v Hereford Ins. Co. (__ Misc 3d ___, 2018 NY Slip Op _____ [appeal No. 2015-2655 K C], decided herewith), the order is affirmed.

PESCE, P.J., ALIOTTA and ELLIOT, JJ., concur.

ENTER:
Paul Kenny
Chief Clerk
Decision Date: November 09, 2018

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

Affirmed summary judgment for the insurer because the insured vehicle had not been involved in the alleged accident, for the reasons stated in the companion appeal.

Defense establishedTriable issueInsurer's motion failsDefense not shownThis decision

Of the 234 decisions on this question in the Second Department courts and the Court of Appeals, 32 (this one included) are in the same category.

Similar decisions

LVOV Acupuncture, P.C. v Hereford Ins. Co. (2018 NY Slip Op 51589(U))The insurer's summary judgment based on the insured vehicle's noninvolvement in the alleged accident was affirmed.
Jamaica Dedicated Med. Care, P.C. v State Farm Mut. Auto. Ins. Co. (2012 NY Slip Op 51493(U))The insurer's summary judgment motion on claims denied for EUO nonappearance was granted, and the provider's cross motion was denied.
Jamaica Dedicated Med. Care, P.C. v GEICO Gen. Ins. Co. (2013 NY Slip Op 50752(U))The insurer's affidavit omitted claims in the complaint and failed to substantiate its fee-schedule defense, defeating summary judgment.
Compas Med., P.C. v Hereford Ins. Co. (2017 NY Slip Op 51084(U))The insurer's cross motion for summary judgment based on lack of coverage for the vehicle on the accident date was granted and affirmed.
City Care Acupuncture, P.C. v Hereford Ins. Co. (2017 NY Slip Op 50037(U))The insurer established that the alleged injuries did not arise from an insured incident through the driver's certified EUO transcript.