August 10, 2006

Pueblo Med. Treatment, P.C. v State Farm Mut. Ins. Co. (2006 NY Slip Op 51553(U))

Headnote

The court in this case considered a dispute between Pueblo Medical Treatment, P.C. and State Farm Mutual Automobile Insurance Company regarding the denial of no-fault benefits. The main issues decided were the dismissal of the third and fourth causes of action pertaining to an assignor, Ramon Albino, due to the claims being submitted to arbitration prior to the commencement of the action. The court also affirmed the denial of State Farm's cross-motion for summary judgment seeking dismissal of the causes of action pertaining to assignors Odilis Garcia and Gilberto Hernandez, stating that there were issues of fact regarding the defenses raised by the insurance company. The holding of the court was that the denial of State Farm's cross-motion for summary judgment was affirmed, but certain aspects of the discovery and the dismissal of certain causes of action were modified.

Reported in New York Official Reports at Pueblo Med. Treatment, P.C. v State Farm Mut. Ins. Co. (2006 NY Slip Op 51553(U))

Pueblo Med. Treatment, P.C. v State Farm Mut. Ins. Co. (2006 NY Slip Op 51553(U)) [*1]
Pueblo Med. Treatment, P.C. v State Farm Mut. Ins. Co.
2006 NY Slip Op 51553(U) [12 Misc 3d 147(A)]
Decided on August 10, 2006
Appellate Term, First Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
As corrected in part through September 1, 2015; it will not be published in the printed Official Reports.
Decided on August 10, 2006

APPELLATE TERM OF THE SUPREME COURT, FIRST DEPARTMENT


PRESENT: DAVIS, J.P., GANGEL-JACOB, SCHOENFELD, JJ
570085/06.
Pueblo Medical Treatment, P.C., a/a/o Odilis Garcia, Ramon Albino, Gilberto Hernandez, Plaintiff-Respondent,

against

State Farm Mutual Automobile Insurance Company, Defendant-Appellant.

Defendant appeals from so much of an order of the Civil Court, New York County (Eileen A. Rakower, J.), entered September 28, 2005, as denied its cross motion for summary judgment dismissing the complaint, or, in the alternative, to compel discovery.

PER CURIAM:

Order (Eileen A. Rakower, J.), entered September 28, 2005, modified (1) to dismiss the third and fourth causes of action pertaining to assignor Ramon Albino, and (2) to direct plaintiff to provide verified responses to questions 6-9, and 23 of the interrogatories, to respond to items 4-6, 8-9, 16, and 29-30 of defendant’s demand for discovery and inspection, and to comply with defendant’s notice of examination before trial requesting the deposition of Dr. Rafael; as so modified, affirmed, with $10 costs.

Defendant’s cross motion for summary judgment should have been granted to the extent of dismissing the third and fourth causes of action seeking no-fault benefits in the sum of $2,016.27 as to assignor Ramon Albino. It is undisputed on this record that the no-fault claims with respect to Albino were submitted to arbitration prior to the commencement of the action herein. By electing to arbitrate, plaintiff waived its right to commence an action to litigate any no-fault claims arising from the same accident (see Roggio v Nationwide Mut. Ins. Co., 66 NY2d 260, 263-264 [1985]; Cortez v Countrywide Ins. Co., 17 AD3d 508 [2005]).

Civil Court properly denied that branch of defendant’s cross motion which sought dismissal of the causes of action pertaining to assignors Odilis Garcia and Gilberto Hernandez. Defendant waived the affirmative defense of a “prior action pending” with regard to assignor Garcia by failing to raise the defense in its answer or in a pre-answer motion to dismiss (see CPLR 3211 (e); Charlton v United States Fire Ins. Co., 223 AD2d 404 [1996]). While defendant’s documentary submissions are sufficient to raise issues of fact with respect to its defenses that plaintiff is a fraudulently licensed corporation and that the medical services were provided by an independent contractor, they are insufficient to warrant judgment as a matter of law on these issues. [*2]

Defendant is entitled to discovery insofar as relevant to the foregoing defenses, as above indicated. This constitutes the decision and order of the court.
I concur I concur I concur
Decision Date: August 10, 2006