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August 19, 2022

Laga v Unitrin Auto & Home Ins. Co. (2022 NY Slip Op 50906(U))

https://www.beynensonlaw.com/case-law/laga-v-unitrin-auto-home-ins-co-2022-ny-slip-op-50906u/

Court
Appellate Term, Second Department
Decided
August 19, 2022
Citation
2022 NY Slip Op 50906(U)
Posture
Motion to dismiss (CPLR 3211)
Outcome
Insurer prevailed
Later treatment
Followed in 1 later decision (see Cited by)
Issues
Declaratory judgment, res judicata
Legal questions
Effect of insurer's declaratory judgment (see the maps)
Cite as
Laga v Unitrin Auto & Home Ins. Co., 2022 NY Slip Op 50906(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 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.

The provider's benefits action was barred by collateral estoppel because a declaratory judgment had decided its entitlement to coverage. The Civil Court entered judgment for the provider after treating privity between the named defendant and the declaratory judgment insurer as the sole trial issue. The Appellate Term, Second Department, reversed the judgment, vacated the denial of dismissal and CPLR 3212 (g) findings, granted the insurer's CPLR 3211 (a) (5) and (7) motion, and remitted for dismissal. The coverage issue was identical, and the provider had appeared and opposed the declaratory judgment motion. The defense arose after the answer; an unpleaded defense could support dismissal absent surprise or prejudice.

Reported in New York Official Reports at Laga v Unitrin Auto & Home Ins. Co. (2022 NY Slip Op 50906(U))

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

Adelaida M. Laga, P.T., as Assignee of Corriolant, Belle Au Monde, Respondent,

against

Unitrin Auto and Home Insurance Company, Appellant.

Gullo & Associates, LLP (Kristina O’Shea of counsel), for appellant. The Rybak Firm, PLLC (Damin J. Toell and Richard Rozhik of counsel), for respondent.

Appeal from a judgment of the Civil Court of the City of New York, Kings County (Odessa Kennedy, J.), entered January 27, 2020. The judgment, entered upon a decision of that court dated November 8, 2019, after a nonjury trial, awarded plaintiff the principal sum of $3,158.02. The appeal from the judgment brings up for review so much of an order of that court (Louis L. Nock, J.) dated August 16, 2017 as denied defendant’s motion to dismiss the complaint and made implicit CPLR 3212 (g) findings in plaintiff’s favor.

ORDERED that, on the court’s own motion, the notice of appeal from the decision dated November 8, 2019 is deemed a premature notice of appeal from the judgment entered January 27, 2020 (see CPLR 5520 [c]); and it is further,

ORDERED that the judgment is reversed, with $30 costs, so much of the order dated August 16, 2017 as denied defendant’s motion to dismiss the complaint and made implicit CPLR 3212 (g) findings in plaintiff’s favor is vacated, defendant’s motion to dismiss the complaint is granted, and the matter is remitted to the Civil Court for the entry of a judgment in favor of defendant dismissing the complaint.

Adelaida M. Laga, P.T. (Laga) commenced this action against Unitrin Auto and Home Insurance Company to recover first-party no-fault benefits for medical services provided to its assignor, Belle Au Monde Corriolant, as a result of injuries Corriolant allegedly sustained in an automobile accident on August 7, 2011. In its answer, dated August 21, 2015, defendant [*2]identified itself as Kemper Independence Insurance Company (Kemper). Before Laga commenced this action, a declaratory judgment action had been commenced in Supreme Court, Bronx County, by Kemper against Laga, six other providers, and the assignor herein, Corriolant, alleging that Corriolant had breached the terms of the insurance policy in question by failing to appear for duly scheduled independent medical examinations. On August 4, 2016, an order was entered in the Supreme Court declaratory judgment action declaring that Laga and five other providers were “not entitled to no-fault insurance coverage for the motor vehicle accident which occurred on August 7, 2011.”

In September 2016, defendant moved in the Civil Court to dismiss the complaint pursuant to CPLR 3211 (a) (5) and (7), contending that the instant action is barred by virtue of the order in the declaratory judgment action. Plaintiff opposed defendant’s motion, raising no procedural issues, and cross-moved for summary judgment. By order dated August 16, 2017, the Civil Court (Louis L. Nock, J.) denied defendant’s motion, implicitly denied plaintiff’s cross motion, found that plaintiff had established “its prima facie case,” and held that “the sole issue that remains for trial is the privity between Kemper and [defendant].” On the trial date, the Civil Court (Odessa Kennedy, J.), upon denying defense counsel’s request for an adjournment to allow defendant to secure a witness to testify on the issue of privity between Kemper and defendant, ordered that judgment be entered in plaintiff’s favor. A judgment in favor of plaintiff in the principal sum of $3,158.02 was entered on January 27, 2020.

Collateral estoppel, or issue preclusion, precludes a party from relitigating an issue where “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” (Parker v Blauvelt Volunteer Fire Co., 93 NY2d 343, 349 [1999]; see D’Arata v New York Cent. Mut. Fire Ins. Co., 76 NY2d 659 [1990]; Manko v Gabay, 175 AD3d 484 [2019]). The party seeking to rely on collateral estoppel has the burden of establishing that the issue actually litigated and determined in the prior action is identical to the issue on which preclusion is sought (see Forcino v Miele, 122 AD2d 191, 193 [1986]; Triboro Quality Med. Supply, Inc. v State Farm Mut. Auto. Ins. Co., 36 Misc 3d 131[A], 2012 NY Slip Op 51289[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2012]). The party attempting to defeat the application of collateral estoppel has the burden of establishing the absence of a full and fair opportunity to litigate (see D’Arata, 76 NY2d at 664; Uptodate Med. Servs., P.C. v State Farm Mut. Auto. Ins. Co., 23 Misc 3d 42, 44 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2009]).

Here, defendant established that the issue of whether plaintiff was entitled to receive no-fault benefits in connection with the August 7, 2011 accident involving Corriolant was identical to the issue previously decided in the declaratory judgment action and plaintiff failed to establish that it had not received a full and fair opportunity to litigate in the declaratory judgment action. Indeed, plaintiff appeared in that action and the order in that action even indicates that plaintiff submitted opposition to the motion giving rise to the order (see Reid v Reid, 198 AD3d 993, 994 [2021]; Miller v Falco, 170 AD3d 707, 709 [2019]; David v State, 157 AD3d 764, 765-766 [2018]; Matter of Abady, 22 AD3d 71, 85 [2005]). Thus, defendant was entitled to dismissal of the complaint on the ground of collateral estoppel.

We note that, while defendant failed to raise the affirmative defense of collateral estoppel in its August 21, 2015 answer, defendant had no basis to assert that defense before August 4, [*3]2016, when the order in the declaratory judgment action was entered (see Metro Health Prods., Inc. v Nationwide Ins., 52 Misc 3d 138[A], 2016 NY Slip Op 51122[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2016]; Renelique v State-Wide Ins. Co., 50 Misc 3d 137[A], 2016 NY Slip Op 50095[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2016]). Furthermore, an unpleaded defense may serve as the basis for the dismissal of a complaint in the absence of surprise or prejudice to the opposing party (see Sullivan v American Airlines, Inc., 80 AD3d 600, 602 [2011]; Vixan Cab Corp. v Chelsea Rental Corp., 72 Misc 3d 128[A], 2021 NY Slip Op 50594[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2021]).

Accordingly, the judgment is reversed, so much of the order dated August 16, 2017 as denied defendant’s motion to dismiss the complaint and made implicit CPLR 3212 (g) findings in plaintiff’s favor is vacated, defendant’s motion to dismiss the complaint is granted, and the matter is remitted to the Civil Court for the entry of a judgment in favor of defendant dismissing the complaint.

ALIOTTA, P.J., WESTON and TOUSSAINT, JJ., concur.

ENTER:
Paul Kenny
Chief Clerk
Decision Date: August 19, 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.

Effect of insurer's declaratory judgment

Open the full map

Does an insurer’s no-coverage declaratory judgment, or pending declaratory action, bar or stay a no-fault claimant’s action?

This decision: The DJ is given preclusive effect and bars every claim in the action that the court considered

Held the action barred by collateral estoppel because the declaratory judgment decided the identical entitlement issue for the same accident and the provider, which appeared and opposed there, had a full and fair opportunity to litigate.

  • Appellate DivisionApp Div 4
  • Appellate TermApp Term 132
  • Trial courtsTrial 27
2021, Appellate Division: 1 decision (1 Stayed pending DJ)2016, Appellate Division: 1 decision (1 Stayed pending DJ)2015, Appellate Division: 1 decision (1 Stay denied)2025, Appellate Division: 1 decision (1 Barred by DJ)2023, Appellate Term: 7 decisions (5 Barred by DJ, 1 Not bound: parties, 1 DJ does not reach)2022, Appellate Term: 11 decisions (9 Barred by DJ, 1 DJ does not reach, 1 Stay denied)2021, Appellate Term: 11 decisions (8 Barred by DJ, 2 Not bound: parties, 1 DJ does not reach)2020, Appellate Term: 12 decisions (9 Barred by DJ, 1 Not bound: parties, 2 DJ does not reach)2019, Appellate Term: 15 decisions (7 Barred by DJ, 3 Not bound: parties, 1 DJ does not reach, 4 Stay denied)2018, Appellate Term: 11 decisions (7 Barred by DJ, 2 Not bound: parties, 2 DJ does not reach)2017, Appellate Term: 5 decisions (3 Barred by DJ, 2 DJ does not reach)2016, Appellate Term: 15 decisions (13 Barred by DJ, 1 Not bound: parties, 1 DJ does not reach)2015, Appellate Term: 14 decisions (11 Barred by DJ, 1 Not bound: parties, 2 DJ does not reach)2014, Appellate Term: 4 decisions (4 Barred by DJ)2013, Appellate Term: 3 decisions (1 Barred by DJ, 1 DJ does not reach, 1 Stayed pending DJ)2012, Appellate Term: 3 decisions (2 Barred by DJ, 1 Not bound: parties)2011, Appellate Term: 2 decisions (1 Barred by DJ, 1 DJ does not reach)2010, Appellate Term: 2 decisions (1 Not bound: parties, 1 Stayed pending DJ)2009, Appellate Term: 1 decision (1 Barred by DJ)2008, Appellate Term: 1 decision (1 Not bound: parties)2024, Appellate Term: 3 decisions (1 Not bound: parties, 2 DJ does not reach)2025, Appellate Term: 11 decisions (1 Barred by DJ, 1 Barred in part, 1 Not bound: parties, 8 DJ does not reach)2026, Appellate Term: 1 decision (1 Not bound: parties)2023, Trial courts: 1 decision (1 DJ does not reach)2022, Trial courts: 3 decisions (2 Barred by DJ, 1 Not bound: parties)2021, Trial courts: 4 decisions (4 Barred by DJ)2020, Trial courts: 1 decision (1 Barred by DJ)2019, Trial courts: 1 decision (1 Barred by DJ)2018, Trial courts: 1 decision (1 Barred by DJ)2013, Trial courts: 2 decisions (2 Barred by DJ)2011, Trial courts: 2 decisions (1 Barred by DJ, 1 Stayed pending DJ)2009, Trial courts: 1 decision (1 Stayed pending DJ)2008, Trial courts: 1 decision (1 Not bound: parties)2007, Trial courts: 2 decisions (1 Barred by DJ, 1 Stayed pending DJ)2006, Trial courts: 1 decision (1 Not bound: parties)2024, Trial courts: 2 decisions (1 Barred by DJ, 1 DJ does not reach)2026, Trial courts: 4 decisions (3 Barred by DJ, 1 Stay denied)2012, Trial courts: 1 decision (1 Stay denied)This decision
2010201520202025
Barred by DJBarred in partNot bound: partiesDJ does not reachStayed pending DJStay deniedThis decisionCites it or cited by itCited or followed

Of the 163 decisions on this question in the Second Department courts and the Court of Appeals, 100 (this one included) are in the same category.

Cited in this decision

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

  • Triboro Quality Med. Supply, Inc. v State Farm Mut. Auto. Ins. Co. (2012 NY Slip Op 51289(U)) FollowedThe provider's claim was barred by collateral estoppel because a prior jury verdict resolved whether the injuries arose from an insured incident.
  • Uptodate Med. Servs., P.C. v State Farm Mut. Auto. Ins. Co. (2009 NY Slip Op 29164) FollowedThe provider was collaterally estopped by a prior arbitration finding of fraudulent incorporation and ineligibility for reimbursement.
  • Metro Health Prods., Inc. v Nationwide Ins. (2016 NY Slip Op 51122(U)) FollowedAn unpleaded res judicata defense may support summary judgment when it causes no surprise or prejudice to the opposing party.
  • Renelique v State-Wide Ins. Co. (2016 NY Slip Op 50095(U)) FollowedA default declaratory judgment precludes a no-fault recovery that would impair the rights established by that judgment.

Cited by

A label shows how the later decision treated this one.

  • American Tr. Ins. Co. v U.S. Med Supply Corp. (2023 NY Slip Op 50560(U)) FollowedA provider invoking collateral estoppel from a prior no-fault award need not prove master arbitrator affirmance or judicial confirmation.

Similar decisions

  • Horizon P.T. Care, P.C. v Kemper Ins. Co. (2025 NY Slip Op 50823(U))The insurer failed to establish that a default declaratory judgment obtained by another insurer barred the provider's claims.
  • Ahava Med. Diagnostic, P.C. v Hertz Co. (2022 NY Slip Op 50298(U))A prior no-coverage declaratory judgment retains its binding effect even if notice of entry is served after a provider's default judgment.
  • Allay Med. Servs., P.C. v Nationwide Ins. (2021 NY Slip Op 50086(U))The provider's action was barred by res judicata because the prior declaratory judgment covered the same claim and accident.
  • Parisien v Kemper Ins. Co. (2022 NY Slip Op 22260)Collateral estoppel does not require privity between the insurer invoking it and a party to the prior declaratory judgment action.
  • Active Chiropractic, P.C. v Allstate Ins. (2018 NY Slip Op 50201(U))An unpleaded res judicata defense may support summary judgment absent surprise or prejudice to the opposing party.
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