November 22, 2004

Lynch v Progressive Ins. Co. (2004 NY Slip Op 08661)

https://www.beynensonlaw.com/case-law/lynch-v-progressive-ins-co-2004-ny-slip-op-08661/

Court: Appellate Division, Second Department
Decided: November 22, 2004
Citation: 2004 NY Slip Op 08661 · 12 AD3d 570
Posture: Summary judgment
Outcome: Split result
Later treatment: Followed in 3 later decisions (see Cited by)
Issues: Policy issues

Cite as

Lynch v Progressive Ins. Co., 12 AD3d 570 (2d Dept 2004)

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 intoxication defense presented factual issues concerning both intoxication and its causal connection to the accident. The Appellate Division, Second Department, modified the order by denying the insurer's cross motion for summary judgment dismissing the complaint and reinstated the injured claimant's action for unpaid no-fault benefits. It affirmed the denial of the claimant's summary judgment motion. Factual issues remained as to intoxication under Insurance Law § 5103 (b) (2) and Vehicle and Traffic Law § 1192 (2), (3), and whether intoxication proximately caused the accident.

Reported in New York Official Reports at Lynch v Progressive Ins. Co. (2004 NY Slip Op 08661)

Lynch v Progressive Ins. Co.

2004 NY Slip Op 08661 [12 AD3d 570]

November 22, 2004

Appellate Division, Second Department

Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.

As corrected through Wednesday, January 19, 2005

Michael J. Lynch, Appellant,
v
Progressive Insurance Company, Respondent.

—[*1]In an action to recover unpaid no-fault insurance benefits, the plaintiff appeals from an order of the Supreme Court, Dutchess County (Pagones, J.), dated August 7, 2003, which denied his motion for summary judgment and granted the defendant’s cross motion for summary judgment dismissing the complaint.

Ordered that the order is modified, on the law, by deleting the provision thereof granting the cross motion and substituting therefor a provision denying the cross motion; as so modified, the order is affirmed, with costs payable to the plaintiff, and the complaint is reinstated.

There are issues of fact which precluded the granting of the defendant’s cross motion for summary judgment dismissing the complaint (see Sillman v Twentieth Century-Fox Film Corp., 3 NY2d 395, 404 [1957]), including whether the plaintiff was intoxicated at the time of the accident within the meaning of the no-fault insurance law (see Insurance Law § 5103 [b] [2]; Vehicle and Traffic Law § 1192 [2], [3]), and whether his intoxication was a proximate cause of the accident (see Scahall v Unigard Ins. Co., 222 AD2d 1070 [1995]; North v Travelers Ins. Co., 218 AD2d 901, 902 [1995]; Cernik v Sentry Ins., 131 AD2d 952 [1987]).

The plaintiff’s remaining contentions are without merit. Prudenti, P.J., Ritter, H. Miller and Spolzino, JJ., concur.

Cited by

A label shows how the later decision treated this one.

Westchester Med. Ctr. v State Farm Mut. Auto. Ins. Co. (2007 NY Slip Op 07690) FollowedThe insurer failed to establish intoxication or causation as a matter of law, but raised factual issues defeating the provider's motion.
Westchester Med. Ctr. v Progressive Cas. Ins. Co. (2008 NY Slip Op 04867) FollowedAn insurer invoking the intoxication exclusion must establish that intoxication proximately caused the accident to obtain summary judgment.
Westchester Med. Ctr. v New York Cent. Mut. Fire Ins. Co. (2012 NY Slip Op 50685(U)) FollowedThe insurer failed to establish that the assignor's alleged intoxication proximately caused the accident.
Westchester Med. Ctr. v Government Empls. Ins. Co. (2010 NY Slip Op 07331)The insurer's intoxication defense failed because its evidence did not connect the assignor's alleged intoxication to the injuries.
New York & Presbyt. Hosp. v AIU Ins. Co. (2005 NY Slip Op 06014)A resubmitted no-fault claim previously and timely denied is not subject to a new 30-day payment-or-denial period.
Westchester Med. Ctr. v Progressive Cas. Ins. Co. (2007 NY Slip Op 09770)The insurer's intoxication evidence defeated the hospital's summary judgment motion but did not establish entitlement to dismissal.
Westchester Med. Ctr. v One Beacon Ins. Co. (2008 NY Slip Op 52580(U))The insurer's intoxication evidence raised factual questions but did not establish that intoxication caused the accident.

Similar decisions

Westchester Med. Ctr. v Progressive Cas. Ins. Co. (2007 NY Slip Op 06865)The provider's claim was premature because the insurer timely requested intoxication verification that it never received.
Westchester Med. Ctr. v New York Cent. Mut. Fire Ins. Co. (2011 NY Slip Op 01458)The insurer's defective denial and insufficient mailing proof precluded its intoxication exclusion defense.
Westchester Med. Ctr. v Clarendon Natl. Ins. Co. (2008 NY Slip Op 09786)The insurer raised a triable issue whether it timely and properly denied a claim based on alleged intoxication after receiving verification.
Westchester Med. Ctr. v Mapfre Ins. Co. of N.Y. (2014 NY Slip Op 05325)The insurer raised a triable issue whether its intoxication-based denial was timely and proper after receipt of additional verification.
Woo Yup Kang v Mercury Cas. Co. (2012 NY Slip Op 51821(U))The insurer failed to establish the assignor's intoxication at the time of the accident with sufficient admissible proof.