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March 1, 2016

New Millennium Med. Imaging, P.C. v American Tr. Ins. Co. (2016 NY Slip Op 50259(U))

https://www.beynensonlaw.com/case-law/new-millennium-med-imaging-p-c-v-american-tr-ins-co-2016-ny-slipop-50259u/

Court
Appellate Term, Second Department
Decided
March 1, 2016
Citation
2016 NY Slip Op 50259(U)
Posture
Summary judgment
Outcome
Provider prevailed
Later treatment
Followed in 1 later decision (see Cited by)
Issues
Declaratory judgment, res judicata Discovery and procedure
Legal questions
Effect of insurer's declaratory judgment (see the maps)
Cite as
New Millennium Med. Imaging, P.C. v American Tr. Ins. Co., 2016 NY Slip Op 50259(U) (App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2016)

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 conflicting accident dates raised a factual issue as to whether a default declaratory judgment barred the provider's claim. The provider's complaint concerned a March 17, 2012 accident, while the Supreme Court judgment declared no duty to pay claims arising from an April 2, 2012 collision because of IME nonappearance. The insurer's own moving papers referred to both dates. On its CPLR 3212 motion, it therefore failed to establish that the no-fault claim arose from the same transaction addressed in the declaratory judgment, as required for res judicata. An assignment form first submitted in reply was not considered. The Appellate Term, Second Department, affirmed the order denying the insurer summary judgment dismissing the complaint.

Reported in New York Official Reports at New Millennium Med. Imaging, P.C. v American Tr. Ins. Co. (2016 NY Slip Op 50259(U))

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

New Millennium Medical Imaging, P.C., as Assignee of NICHOLAS TOC, Respondent,

against

American Transit Ins. Co., Appellant.

Appeal from an order of the Civil Court of the City of New York, Kings County (Carol Ruth Feinman, J.), entered August 1, 2014. The order denied defendant’s motion for summary judgment dismissing the complaint.

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

New Millennium Medical Imaging, P.C. (New Millennium) commenced this action against American Transit Ins. Co. (American Transit) to recover first-party no-fault benefits for medical services that had been provided to plaintiff’s assignor as a result of injuries, which, the complaint stated, had been sustained in an automobile accident that had occurred on March 17, 2012. Before New Millennium commenced this action, the insurer, American Transit, had commenced a declaratory judgment action in Supreme Court, New York County, against New Millennium and its assignor, Nicholas Toc, among others, alleging that the providers’ claims had been timely and properly denied on the ground that their assignor had failed to attend duly scheduled independent medical examinations (IMEs). After the providers had failed to appear in the Supreme Court action, American Transit moved in the Supreme Court for an order granting it leave to enter a default declaratory judgment, declaring that, because of the assignor’s nonappearances at the scheduled IMEs, New Millennium and the other providers were not entitled to no-fault coverage “for the motor vehicle accident that occurred on 4/2/2012.” The Supreme Court issued a declaratory judgment, dated September 11, 2013, declaring that American Transit had no duty to pay no-fault claims “with respect to the April 02, 2012 collision.”

Thereafter, American Transit moved in the Civil Court, pursuant to CPLR 3212, for summary judgment dismissing New Millennium’s complaint, contending that the action is barred by virtue of the declaratory judgment. New Millennium opposed the motion. The affirmation of American Transit’s counsel, and a letter submitted by the insurer as an exhibit to the motion, both referred to an accident that had occurred on March 17, 2012. By order entered August 1, 2014, the Civil Court denied American transit’s motion, finding that an issue of fact exists as to whether the Supreme Court judgment applies to the present litigation.

“The proponent of a summary judgment motion must make a prima facie showing of entitlement to judgment as a matter of law, tendering sufficient evidence to eliminate any [*2]material issues of fact from the case” (Winegrad v New York Univ. Med. Ctr., 64 NY2d 851, 853 [1985]). Res judicata, or claim preclusion, may be invoked where a party seeks to relitigate a disposition on the merits of claims or causes of action arising out of the same transaction which had been raised or could have been raised in the prior litigation (see Schuylkill Fuel Corp. v Nieberg Realty Corp., 250 NY 304, 306-307 [1929]; Albanez v Charles, 134 AD3d 657 [2015]; Eagle Surgical Supply, Inc. v AIG Indem. Ins. Co., 40 Misc 3d 139[A], 2013 NY Slip Op 51441[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2013]). Here, American Transit failed to establish its entitlement to summary judgment, because its own papers presented two different accident dates, March 17, 2012 and April 2, 2012. Thus, a question of fact exists as to whether plaintiff’s claim arose out of the same transaction as was in controversy in the Supreme Court litigation (see Schuylkill Fuel Corp., 250 NY at 306-307; Albanez, 134 AD3d 657; Eagle Surgical Supply, Inc., 40 Misc 3d 139[A], 2013 NY Slip Op 51441[U]). We decline to consider the assignment of benefits form which American Transit proffered to show the date of the accident at issue, as the assignment of benefits form was submitted for the first time in American Transit’s reply papers (see L’Aquila Realty, LLC v Jalyng Food Corp., 103 AD3d 692 [2013]; GJF Constr. Corp. v Cosmopolitan Decorating Co., Inc., 35 AD3d 535 [2006]).

Accordingly, the order is affirmed.

Pesce, P.J., Weston and Solomon, JJ., concur.


Decision Date: March 01, 2016

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: No preclusion because the DJ does not conclusively decide these claims or cannot operate on them

Denied the insurer summary judgment on res judicata because its own papers gave two different accident dates, leaving a fact issue whether the claim arose from the accident covered by the declaratory judgment.

  • Appellate DivisionApp Div 4
  • Appellate TermApp Term 132
  • Trial courtsTrial 28
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: 5 decisions (4 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 164 decisions on this question in the Second Department courts and the Court of Appeals, 27 (this one included) are in the same category.

Cited in this decision

  • Eagle Surgical Supply, Inc. v AIG Indem. Ins. Co. (2013 NY Slip Op 51441(U))A discovery order precluding an insurer from offering trial evidence does not bar res judicata effect for a default declaratory judgment.

Cited by

A label shows how the later decision treated this one.

  • RX Warehouse Pharm., Inc. v 21st Century Ins. Co. (2022 NY Slip Op 50375(U)) FollowedThe insurer failed to support forum non conveniens dismissal with admissible accident-location evidence or proof of hardship.
  • First Care Med. Equip., LLC v Encompass Ins. (2021 NY Slip Op 50326(U))The insurer failed to show that a declaratory judgment based on EUO nonappearance barred the provider's claims by res judicata.

Similar decisions

  • Vital Meridian Acupuncture, P.C. v American Tr. Ins. Co. (2016 NY Slip Op 51007(U))An unvacated default order declaring noncoverage is a conclusive final determination that can bar a provider's action under res judicata.
  • Best Touch PT, P.C. v American Tr. Ins. Co. (2015 NY Slip Op 51789(U))A default declaratory judgment barring no-fault payment is a conclusive final determination for res judicata purposes.
  • Greenway Med. Supply Corp. v American Tr. Ins. Co. (2018 NY Slip Op 50039(U))A default declaratory order that has not been vacated may bar a provider's no-fault action under res judicata.
  • Healthway Med. Care, P.C. v American Tr. Ins. Co. (2016 NY Slip Op 51786(U))The provider's claims were barred by res judicata because a prior declaration resolved coverage for the same accident between the same parties.
  • New Millennium Med. Imaging, P.C. v Repwest Ins. Co. (2021 NY Slip Op 50577(U))The insurer established that res judicata barred the provider's claims despite a one-day discrepancy in the alleged accident date.
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