February 27, 2008
Medical Care G.M., P.C. v GEICO Ins. (2008 NY Slip Op 50379(U))
https://www.beynensonlaw.com/case-law/medical-care-g-m-p-c-v-geico-ins-2008-ny-slip-op-50379u/
- Decided
- February 27, 2008
- Citation
- 2008 NY Slip Op 50379(U) · 18 Misc 3d 140(A)
- Posture
- Summary judgment
- Outcome
- Provider prevailed
- Legal questions
- No covered accident (founded belief) (see the maps)
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.
Reported in New York Official Reports at Medical Care G.M., P.C. v GEICO Ins. (2008 NY Slip Op 50379(U))
| Medical Care G.M., P.C. v GEICO Ins. |
| 2008 NY Slip Op 50379(U) [18 Misc 3d 140(A)] |
| Decided on February 27, 2008 |
| 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| This opinion is uncorrected and will not be published in the printed Official Reports. |
SUPREME COURT OF THE STATE OF NEW YORK
APPELLATE TERM: 9th and 10th JUDICIAL DISTRICTS
PRESENT: : RUDOLPH, P.J., McCABE and SCHEINKMAN, JJ
2005-1827 N C.
against
GEICO Insurance, Respondent.
Appeal from an order of the District Court of Nassau County, Third District (Randy Sue Marber, J.), dated August 30, 2005. The order, insofar as appealed from, denied plaintiffs’ motion for summary judgment.
Order, insofar as appealed from, reversed without costs, plaintiffs’ motion for summary judgment granted and matter remanded to the court below for a calculation of statutory interest and an assessment of attorney’s fees.
In this action by two providers to recover assigned first-party no-fault benefits, the sole issue raised on appeal is whether defendant proffered sufficient evidence to demonstrate that there was an issue of fact as to whether the injuries plaintiffs’ assignor allegedly sustained, arose from an insured incident (see Central Gen. Hosp. v Chubb Group of Ins. Cos., 90 NY2d 195, 199 [1997]). Upon a review of the record, we find that defendant failed to proffer sufficient evidence in admissible form to demonstrate that it possessed a “founded belief that the alleged injur[ies] do not arise out of an insured incident” (id. at 199; Comprehensive Mental v Allstate Ins. Co., 14 Misc 3d 130[A], 2007 NY Slip Op 50017[U] [App Term, 9th & 10th Jud Dists 2007]; A.B. Med. Servs. PLLC v State Farm Auto Ins. Co., 12 Misc 3d 129[A], 2006 NY Slip Op 51033[U] [App Term, 2d & 11th Jud Dists 2006]; Ocean Diagnostic Imaging P.C. v Travelers Indem. Co., 7 Misc 3d 133[A], 2005 NY Slip Op 50644[U] [App Term, 2d & 11th Jud Dists 2005]).
Accordingly, plaintiffs’ motion for summary judgment is granted and the matter is remanded to the court below for a calculation of statutory interest and an assessment of attorney’s fees pursuant to Insurance Law § 5106 (a) and the regulations promulgated thereunder.
Rudolph, P.J., McCabe and Scheinkman, JJ., concur.
[*2]
Decision Date: February 27, 2008
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.
Did the insurer show the claimed injuries did not arise from a covered accident (staged, intentional, or unrelated)?
This decision: Insurer's proof did not raise an issue or failed at trial; provider prevails on it
Held the insurer failed to proffer sufficient evidence in admissible form showing a founded belief that the injuries did not arise from an insured incident, so the providers' summary judgment motion was granted.
Of the 234 decisions on this question in the Second Department courts and the Court of Appeals, 80 (this one included) are in the same category.
Cited in this decision
A label shows how this decision treated the case it cites.
- Comprehensive Mental v Allstate Ins. Co. (2007 NY Slip Op 50017(U)) FollowedThe provider's summary judgment motion was granted because the insurer's affidavit did not raise a triable staged-accident coverage issue.
- A.B. Med. Servs. PLLC v State Farm Mut. Auto. Ins. Co. (2006 NY Slip Op 51033(U)) FollowedThe insurer's EUO evidence did not establish a founded belief that the claimed injuries arose from a noncovered event.
- Ocean Diagnostic Imaging P.C. v Travelers Indem. Co. (2005 NY Slip Op 50644(U)) FollowedThe insurer's proof failed to establish a founded belief that the collision was part of an insurance fraud scheme.
Similar decisions
- New York Diagnostic Med. Care, P.C. v GEICO Gen. Ins. Co. (2013 NY Slip Op 51036(U))The provider's motion for summary judgment on its assigned no-fault claims was granted on appeal.
- New York Diagnostic Med. Care, P.C. v GEICO Cas. Ins. Co. (2012 NY Slip Op 52409(U))The provider's billing affidavit failed to establish overdue claims or timely denials that were legally deficient.
- Lynbrook Med., P.C. v GEICO Gen. Ins. Co. (2011 NY Slip Op 51841(U))The providers failed to establish entitlement to summary judgment because they did not show that the insurer's timely denials lacked merit.
- Ocean Diagnostic Imaging, P.C. v Geico Ins. (2004 NY Slip Op 51038(U))The insurer's attorney affidavit lacked personal knowledge and offered only conclusory fraud allegations, failing to raise a coverage issue.
- A.B. Med., PLLC v GEICO (2013 NY Slip Op 50203(U))The provider failed to establish that the insurer's denials were untimely or without merit as a matter of law.