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August 14, 2020

Omphil Care, Inc. v Pearl Holding Group Managing Gen. Agent for Ocean Harbor Cas. Ins. Co. (2020 NY Slip Op 50946(U))

https://www.beynensonlaw.com/case-law/omphil-care-inc-v-pearl-holding-group-managing-gen-agent-for-ocean-harbor-cas-ins-co-2020-ny-slip-op-50946u/

Court
Appellate Term, Second Department
Decided
August 14, 2020
Citation
2020 NY Slip Op 50946(U)
Posture
Summary judgment
Outcome
Insurer prevailed
Later treatment
Followed in 1 later decision (see Cited by)
Issues
Policy issues
Cite as
Omphil Care, Inc. v Pearl Holding Group Managing Gen. Agent for Ocean Harbor Cas. Ins. Co., 2020 NY Slip Op 50946(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 established retroactive rescission of a Florida policy through notice and timely return or tender of all premiums. Florida law undisputedly governed the provider's assigned no-fault claims. After investigating application misrepresentations concerning residence and garaging, the insurer obtained a Florida declaratory judgment declaring the policy void and rescinded it under Florida Statutes Annotated, title 37, § 627.409. The motion papers showed a rescission notice and return or tender of all premiums within a reasonable period after discovery of the grounds for rescission, establishing that the policy was void ab initio. The provider's remaining arguments were unpreserved and were not considered. The Appellate Term, Second Department, affirmed denial of the provider's motion and summary judgment dismissing the complaint.

Reported in New York Official Reports at Omphil Care, Inc. v Pearl Holding Group Managing Gen. Agent for Ocean Harbor Cas. Ins. Co. (2020 NY Slip Op 50946(U))

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

Omphil Care, Inc., as Assignee of Moses, Edouard, Appellant,

against

Pearl Holding Group Managing General Agent for Ocean Harbor Casualty Insurance Company, Respondent.

The Rybak Firm, PLLC (Damin J. Toell and Karina Barska of counsel), for appellant. Gallo, Vitucci & Klar, LLP (Richard E. Weber and Marissa Dunderdale of counsel), for respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Odessa Kennedy, J.), entered March 18, 2019. The order denied plaintiff’s motion for summary judgment and granted defendant’s cross motion for summary judgment dismissing the complaint.

ORDERED that the order is affirmed, without costs.

In this action 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 the automobile insurance policy in question had been issued in Florida and that, pursuant to Florida law, there was a lack of coverage due to the valid rescission of the automobile insurance policy and the refund of the insured’s premiums. Plaintiff appeals from an order of the Civil Court entered March 18, 2019 which denied plaintiff’s motion and granted defendant’s cross motion.

It is undisputed that the vehicle in question was insured by defendant under a Florida automobile insurance policy. According to an affidavit submitted by an employee of defendant’s managing general agent, an investigation conducted after the accident revealed that, at the time the policyholder had applied for automobile insurance, he did not reside at the Florida address listed on his insurance application, and that the insured vehicle was not being garaged in Florida [*2]for the period stated on the application. Subsequent to defendant’s investigation, it initiated a declaratory judgment action in Florida Circuit Court in Broward County in which a final judgment was entered declaring the subject policy null and void based on the applicant’s misrepresentations in procuring the policy. Defendant then rescinded the policy ab initio, pursuant to Florida Statutes Annotated, title 37, § 627.409, which permits the retroactive rescission of an insurance policy if there has been a material misrepresentation in the application for insurance.

It is undisputed by the parties that Florida law applies. Inasmuch as defendant’s cross motion papers demonstrated that a rescission notice was sent to the insured, and that defendant had returned, or tendered, all premiums paid to the insured within a reasonable period of time after defendant’s discovery of the grounds for rescinding the policy, defendant established, prima facie, that it had voided the policy ab initio pursuant to Florida law (see W.H.O. Acupuncture, P.C. v Infinity Prop. & Cas. Co., 36 Misc 3d 4, 6-7 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2012], citing Leonardo v State Farm Fire and Cas. Co., 675 So 2d 176, 179 [Fla Dist Ct App, 4th Dist 1996]).

Plaintiff’s remaining arguments are not properly before this court as they are being raised for the first time on appeal, and we decline to consider them (see Joe v Upper Room Ministries, Inc., 88 AD3d 963 [2011]; Mind & Body Acupuncture, P.C. v Elrac, Inc., 48 Misc 3d 139[A], 2015 NY Slip Op 51219[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2015]).

Accordingly, the order is affirmed.

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



ENTER:
Paul Kenny
Chief Clerk
Decision Date: August 14, 2020

Cited in this decision

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

  • W.H.O. Acupuncture, P.C. v Infinity Prop. & Cas. Co. (2012 NY Slip Op 22142) FollowedUnder Florida law, failure to follow statutory cancellation procedures does not preclude rescission for a material application misrepresentation.
  • Mind & Body Acupuncture, P.C. v Elrac, Inc. (2015 NY Slip Op 51219(U)) FollowedThe insurer established full fee-schedule payment, and the provider's challenge to the IME letters' address was unpreserved.

Cited by

A label shows how the later decision treated this one.

  • Blackman Pelham Med., P.C. v Ocean Harbor Cas. Ins. Co. (2021 NY Slip Op 51257(U)) FollowedThe insurer proved valid retroactive rescission of the Florida policy by sending notice and timely returning all premiums.

Similar decisions

  • NR Acupuncture, P.C. v Ocean Harbor Cas. Ins. Co. (2019 NY Slip Op 51892(U))The insurer failed to establish valid Florida policy rescission or that a Florida declaratory judgment bound the provider.
  • T & S Med. Supply Corp. v Ocean Harbor Cas. Ins. Co. (2018 NY Slip Op 50665(U))The insurer failed to prove mailing of the rescission notice and premium refund needed to establish rescission of its Florida policy.
  • Parisien v Omni Indem. Co. (2020 NY Slip Op 50725(U))The insurer established retroactive rescission of the automobile policy under Pennsylvania law, defeating the provider's coverage claim.
  • Monroe v Omni Indem. Co. (2020 NY Slip Op 50731(U))The insurer established retroactive policy rescission under Pennsylvania law through proof of mailing the rescission letter and refund check.
  • Compas Med., P.C. v Infinity Group (2016 NY Slip Op 50042(U))The insurer established valid retroactive rescission under Florida law, and the provider failed to raise a triable issue.
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