• 347-746-6001
  • contact@beynensonlaw.com
Beynenson Law
Beynenson Law
    • Search
    • No-Fault AI
    • New Decisions
    • Legal Questions
    • No-Fault Regulations
    • Arbitrator Scorecard
    • Award Volume
    • Arbitrator / Carrier Data
    • Provider / Carrier Data
    • Provider / Attorney Data
    • Arbitration Pro Extension
  • About Us
  • Contact
  • East Hampton, New York

  • 347-746-6001
  • contact@beynensonlaw.com
    • Search
    • No-Fault AI
    • New Decisions
    • Legal Questions
    • No-Fault Regulations
    • Arbitrator Scorecard
    • Award Volume
    • Arbitrator / Carrier Data
    • Provider / Carrier Data
    • Provider / Attorney Data
    • Arbitration Pro Extension
  • About Us
  • Contact
June 12, 2020

Monroe v Omni Indem. Co. (2020 NY Slip Op 50730(U))

https://www.beynensonlaw.com/case-law/monroe-v-omni-indem-co-2020-ny-slip-op-50730u/

Court
Appellate Term, Second Department
Decided
June 12, 2020
Citation
2020 NY Slip Op 50730(U) · 67 Misc 3d 141(A)
Posture
Summary judgment
Outcome
Split result
Earlier history
Appeal from Monroe v Omni Indem. Co. (2018 NY Slip Op 51258(U)) (Modified)
Issues
Policy issues Provider's prima facie case Timeliness and preclusion
Legal questions
Claimant's prima facie case on motions (see the maps)
Cite as
Monroe v Omni Indem. Co., 67 Misc 3d 141(A), 2020 NY Slip Op 50730(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2020)

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 failed to establish its rescission defense in either action, and the provider failed to prove that the denials were untimely. In two assigned no-fault actions, Pennsylvania law's applicability was uncontested. Under 40 Pa Cons Stat §§ 991.2002, 991.2004 and Erie Ins. Exch. v Lake, retroactive rescission does not defeat the rights of innocent third parties injured through no fault of their own. The insurer did not establish that the assignor lacked that protection. Under Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co., the provider also failed to establish its prima facie case because it did not prove untimely denials. The Appellate Term, Second Department, consolidated the appeals and modified each order to deny the insurer's cross motion, otherwise affirming the denial of the provider's motions.

Reported in New York Official Reports at Monroe v Omni Indem. Co. (2020 NY Slip Op 50730(U))

[*1]
Monroe v Omni Indem. Co.
2020 NY Slip Op 50730(U) [67 Misc 3d 141(A)]
Decided on June 12, 2020
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 June 12, 2020
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : THOMAS P. ALIOTTA, P.J., MICHELLE WESTON, BERNICE D. SIEGAL, JJ
2018-1759 K C

Harry Keith Monroe, M.D., as Assignee of Olaverria, Eduardo, Appellant,

against

Omni Indemnity Company, Respondent.

 Harry Keith Monroe, M.D., as Assignee of Olaverria, Eduardo, Appellant,

against

Omni Indemnity Company, Respondent.


The Rybak Firm, PLLC (Damin J. Toell and Karina Barska of counsel), for appellant. Freiberg, Peck & Kang, LLP (Yilo J. Kang of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Odessa Kennedy, J.; op 60 Misc 3d 1229[A], 2018 NY Slip Op 51258[U] [2018] [appeal No. 2018-1759 K C]), entered May 23, 2018, and separate appeal from an order of that court entered May 23, 2018 (appeal No. 2018-2220 K C). The order in each action granted defendant’s cross motion for summary judgment dismissing the respective complaint and, in effect, denied plaintiff’s motion for summary judgment.

ORDERED that, on the court’s own motion, the appeals are consolidated for purposes of disposition; and it is further,

ORDERED that the order in each action is modified by providing that defendant’s cross motion for summary judgment dismissing the respective complaint is denied; as so modified, the order in each action is affirmed, without costs.

In each of these two actions by a provider to recover assigned first-party no-fault benefits, plaintiff moved for summary judgment, and defendant cross-moved for summary judgment dismissing the complaint on the ground that, upon the application of Pennsylvania law, there was a lack of coverage due to the rescission ab initio of the automobile insurance policy in question. [*2]By orders entered May 23, 2018, the Civil Court granted each of defendant’s cross motions and, in effect, denied each of plaintiff’s motions. We note that no issue is raised on appeal regarding the applicability of Pennsylvania law.

Under Pennsylvania law, an insurer has a common-law right to rescind a policy of automobile insurance (see 40 Pa Cons Stat §§ 991.2002, 991.2004; Erie Ins. Exch. v Lake, 543 Pa 363, 375, 671 A2d 681, 687 [1996]; Klopp v Keystone Ins. Cos., 528 Pa 1, 595 A2d 1 [1991]; Healthway Med. Care, P.C. v Infinity Group, 54 Misc 3d 132[A], 2017 NY Slip Op 50042[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2017]). The Pennsylvania Supreme Court has held, however, that, while an automobile insurance policy may be retroactively rescinded as to an insured who has made a material misrepresentation, the policy may not be retroactively rescinded with respect to third parties “who are innocent of trickery, and injured through no fault of their own” (Erie Ins. Exch. v Lake,543 Pa at 375, 671 A2d at 687; see also Island Life Chiropractic, P.C. v Infinity Group, 55 Misc 3d 42, 43 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2017]). The papers defendant submitted in support of its cross motions fail to set forth facts establishing, as a matter of law, that the assignor was not an innocent third party (see Island Life Chiropractic, P.C. v Infinity Group, 55 Misc 3d at 43; cf. Optimal Well-Being Chiropractic, P.C. v Infinity Ins. Corp., 46 Misc 3d 27 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2014]). Consequently, defendant failed to establish its entitlement in each action to summary judgment dismissing the respective complaint.

However, contrary to plaintiff’s contention, it failed to establish, as a matter of law, that defendant did not deny plaintiff’s claims in each action within the requisite period (see Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co., 25 NY3d 498 [2015]). Consequently, plaintiff failed to establish its prima facie case in either action and, thus, its motions for summary judgment were properly denied.

Accordingly, the order in each action is modified by providing that defendant’s cross motion for summary judgment dismissing the respective complaint is denied.

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


ENTER:
Paul Kenny
Chief Clerk
Decision Date: June 12, 2020

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.

Claimant's prima facie case on motions

Open the full map

On summary judgment or another pretrial motion, what must a no-fault claimant show to establish its prima facie case?

This decision: Insufficient: claimant did not prove the claim was overdue (not paid or timely denied)

Held the claimant failed to establish as a matter of law that the insurer did not deny its claims in either action within the required period, so it did not make out its prima facie case.

  • Court of AppealsCt App 2
  • Appellate DivisionApp Div 54
  • Appellate TermApp Term 819
  • Trial courtsTrial 115
2015, Court of Appeals: 1 decision (1 Proof sufficient)2007, Court of Appeals: 1 decision (1 Proof sufficient)2022, Appellate Division: 1 decision (1 Proof sufficient)2019, Appellate Division: 1 decision (1 Proof sufficient)2014, Appellate Division: 10 decisions (9 Proof sufficient, 1 Overdue not shown)2013, Appellate Division: 2 decisions (2 Proof sufficient)2012, Appellate Division: 1 decision (1 Proof sufficient)2011, Appellate Division: 7 decisions (7 Proof sufficient)2010, Appellate Division: 2 decisions (1 Proof sufficient, 1 Overdue not shown)2009, Appellate Division: 3 decisions (2 Proof sufficient, 1 Other element missing)2008, Appellate Division: 6 decisions (4 Proof sufficient, 1 Overdue not shown, 1 Business-record foundation lacking)2007, Appellate Division: 8 decisions (5 Proof sufficient, 2 Mailing/receipt not shown, 1 Overdue not shown)2006, Appellate Division: 4 decisions (2 Proof sufficient, 1 Mailing/receipt not shown, 1 Other element missing)2005, Appellate Division: 3 decisions (3 Proof sufficient)2004, Appellate Division: 3 decisions (2 Proof sufficient, 1 Overdue not shown)2026, Appellate Division: 1 decision (1 Proof sufficient)2003, Appellate Division: 2 decisions (1 Proof sufficient, 1 Overdue not shown)2022, Appellate Term: 14 decisions (2 Mailing/receipt not shown, 12 Overdue not shown)2021, Appellate Term: 5 decisions (1 Proof sufficient, 4 Overdue not shown)2020, Appellate Term: 13 decisions (13 Overdue not shown)2019, Appellate Term: 22 decisions (22 Overdue not shown)2018, Appellate Term: 26 decisions (3 Proof sufficient, 1 Mailing/receipt not shown, 22 Overdue not shown)2017, Appellate Term: 38 decisions (3 Proof sufficient, 1 Mailing/receipt not shown, 34 Overdue not shown)2016, Appellate Term: 42 decisions (8 Proof sufficient, 34 Overdue not shown)2015, Appellate Term: 43 decisions (11 Proof sufficient, 1 Mailing/receipt not shown, 30 Overdue not shown, 1 Business-record foundation lacking)2014, Appellate Term: 21 decisions (10 Proof sufficient, 11 Overdue not shown)2013, Appellate Term: 34 decisions (17 Proof sufficient, 11 Overdue not shown, 6 Business-record foundation lacking)2012, Appellate Term: 32 decisions (3 Proof sufficient, 2 Mailing/receipt not shown, 11 Overdue not shown, 16 Business-record foundation lacking)2011, Appellate Term: 29 decisions (6 Proof sufficient, 1 Mailing/receipt not shown, 13 Overdue not shown, 9 Business-record foundation lacking)2010, Appellate Term: 34 decisions (22 Proof sufficient, 3 Mailing/receipt not shown, 9 Business-record foundation lacking)2009, Appellate Term: 51 decisions (27 Proof sufficient, 3 Mailing/receipt not shown, 21 Business-record foundation lacking)2008, Appellate Term: 49 decisions (16 Proof sufficient, 1 Mailing/receipt not shown, 32 Business-record foundation lacking)2007, Appellate Term: 103 decisions (8 Proof sufficient, 2 Mailing/receipt not shown, 93 Business-record foundation lacking)2006, Appellate Term: 106 decisions (73 Proof sufficient, 25 Mailing/receipt not shown, 1 Overdue not shown, 6 Business-record foundation lacking, 1 Other element missing)2005, Appellate Term: 90 decisions (84 Proof sufficient, 5 Mailing/receipt not shown, 1 Overdue not shown)2004, Appellate Term: 46 decisions (32 Proof sufficient, 10 Mailing/receipt not shown, 4 Other element missing)2003, Appellate Term: 7 decisions (7 Proof sufficient)2023, Appellate Term: 3 decisions (3 Overdue not shown)2024, Appellate Term: 7 decisions (1 Mailing/receipt not shown, 6 Overdue not shown)2025, Appellate Term: 2 decisions (1 Mailing/receipt not shown, 1 Overdue not shown)2026, Appellate Term: 2 decisions (2 Mailing/receipt not shown)2023, Trial courts: 2 decisions (2 Proof sufficient)2022, Trial courts: 4 decisions (2 Proof sufficient, 2 Overdue not shown)2021, Trial courts: 11 decisions (6 Proof sufficient, 2 Mailing/receipt not shown, 2 Overdue not shown, 1 Other element missing)2020, Trial courts: 3 decisions (1 Proof sufficient, 1 Overdue not shown, 1 Other element missing)2019, Trial courts: 6 decisions (5 Proof sufficient, 1 Mailing/receipt not shown)2018, Trial courts: 2 decisions (2 Overdue not shown)2017, Trial courts: 2 decisions (1 Overdue not shown, 1 Other element missing)2016, Trial courts: 4 decisions (4 Proof sufficient)2012, Trial courts: 5 decisions (4 Proof sufficient, 1 Business-record foundation lacking)2011, Trial courts: 2 decisions (1 Proof sufficient, 1 Business-record foundation lacking)2010, Trial courts: 3 decisions (2 Proof sufficient, 1 Business-record foundation lacking)2009, Trial courts: 6 decisions (6 Proof sufficient)2008, Trial courts: 10 decisions (4 Proof sufficient, 1 Mailing/receipt not shown, 1 Overdue not shown, 4 Business-record foundation lacking)2007, Trial courts: 6 decisions (4 Proof sufficient, 2 Business-record foundation lacking)2006, Trial courts: 13 decisions (10 Proof sufficient, 2 Overdue not shown, 1 Other element missing)2005, Trial courts: 18 decisions (10 Proof sufficient, 5 Mailing/receipt not shown, 3 Business-record foundation lacking)2004, Trial courts: 11 decisions (5 Proof sufficient, 2 Mailing/receipt not shown, 4 Other element missing)2026, Trial courts: 3 decisions (2 Proof sufficient, 1 Mailing/receipt not shown)2014, Trial courts: 1 decision (1 Proof sufficient)2015, Trial courts: 1 decision (1 Proof sufficient)2024, Trial courts: 1 decision (1 Proof sufficient)2025, Trial courts: 1 decision (1 Mailing/receipt not shown)This decision
20052010201520202025
Proof sufficientMailing/receipt not shownOverdue not shownBusiness-record foundation lackingOther element missingThis decisionCites it or cited by itCited or followed

Of the 990 decisions on this question in the Second Department courts and the Court of Appeals, 246 (this one included) are in the same category.

Cited in this decision

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

  • Monroe v Omni Indem. Co. (2018 NY Slip Op 51258(U)) ModifiedThe insurer obtained summary judgment based on an unchallenged rescission of a Pennsylvania automobile policy under Pennsylvania law.
  • Healthway Med. Care, P.C. v Infinity Group (2017 NY Slip Op 50042(U))The insurer established rescission of the Pennsylvania policy from inception based on the insured assignor's application misrepresentations.
  • Island Life Chiropractic, P.C. v Infinity Group (2017 NY Slip Op 27040) FollowedThe insurer failed to show that policy rescission under Pennsylvania law defeated the assignor's claim as an innocent third party.
  • Optimal Well-Being Chiropractic, P.C. v Infinity Ins. Co. (2014 NY Slip Op 24227) Contrasted (cf., but see)Pennsylvania policy rescission defeated the provider's no-fault claim because the assignor was complicit in the insured's fraud.
  • Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co. (2015 NY Slip Op 04787) FollowedA provider establishes entitlement to summary judgment on overdue no-fault claims with admissible proof of mailing and receipt of statutory claim forms.

Similar decisions

  • Parisien v Omni Indem. Co. (2020 NY Slip Op 50729(U))The insurer failed to exclude innocent-third-party protection from rescission, and the provider failed to establish an untimely denial.
  • Island Life Chiropractic Pain Care, PLLC v Omni Indem. Co. (2019 NY Slip Op 50342(U))The defendant insurer's affidavits established that another carrier issued the policy covering the accident, warranting dismissal.
  • Monroe v Foremost Signature Ins. Co. (2019 NY Slip Op 52042(U))The insurer failed to support forum non conveniens dismissal with admissible evidence of witness hardship or grounds for another forum.
  • JCC Med., P.C. v Omni Indem. Co. (2021 NY Slip Op 51246(U))The insurer's summary judgment motion based on its nonissuance of a policy covering the accident vehicle was granted on appeal.
  • Omphil Care, Inc. v Pearl Holding Group Managing Gen. Agent for Ocean Harbor Cas. Ins. Co. (2020 NY Slip Op 50946(U))The insurer established retroactive rescission of a Florida policy through notice and timely return or tender of all premiums.
Beynenson Law

Tech-driven New York no-fault collections for healthcare providers.

About the firm

Contact

  • East Hampton, New York

  • 347-746-6001
  • contact@beynensonlaw.com
  • Contact form

Case Law

  • Search
  • No-Fault AI
  • New Decisions
  • Legal Questions
  • No-Fault Regulations

Arbitration Data

  • Arbitrator Scorecard
  • Award Volume
  • Arbitrator / Carrier Data
  • Provider / Carrier Data
  • Provider / Attorney Data
  • Arbitration Pro Extension

©2026 The Beynenson Law Firm, PC. Terms of Use Privacy Policy

Site by khrystev.dev

Attorney Advertising. Prior results do not guarantee a similar outcome. This website provides general information, not legal advice, and using it does not create an attorney-client relationship. Do not send confidential information through this site.