Reported in New York Official Reports at Medical Arts Radiological Group, P.C. v NY Cent. Mut. Fire Ins. Co. (2015 NY Slip Op 51035(U))
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
against
NY Central Mutual Fire Insurance Co., Appellant.
Appeal from an order of the Civil Court of the City of New York, Queens County (Barry A. Schwartz, J.), entered February 8, 2013. The order, insofar as appealed from, granted the branch of plaintiff’s motion seeking to compel disclosure.
ORDERED that the order, insofar as appealed from, is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint on the ground of lack of medical necessity, based upon a peer review, and served its motion upon plaintiff’s counsel on August 20, 2012. While defendant’s motion was pending, plaintiff moved, pursuant to CPLR 3124, to compel disclosure, or for alternative relief. By order entered February 8, 2013, the Civil Court granted plaintiff’s motion to the extent that defendant was directed to provide verified written discovery responses within 45 days of the date of the order or be precluded from offering the evidence at issue. Defendant appeals from this order. The Civil Court subsequently denied defendant’s motion for summary judgment with leave to renew upon determination of the present appeal.
Service of a notice of motion pursuant to CPLR 3212 automatically stays disclosure until determination of the motion, unless the court orders otherwise (CPLR 3214 [b]; see John Eric Jacoby, M.D., P.C. v Loper Assoc., 249 AD2d 277 [1998]). A court may direct otherwise if there is a legitimate need for discovery (see Reilly v Oakwood Hgts. Community Church, 269 AD2d 582 [2000]). Thus, when defendant moved for summary judgment dismissing the complaint, an automatic stay of disclosure went into effect pursuant to CPLR 3214 (b) (see Arts4All, Ltd. v Hancock, 54 AD3d 286 [2008]), and remained in effect (see Rockaway Med. & Diagnostic, P.C. v Utica Mut. Ins. Co., 19 Misc 3d 142[A], 2008 NY Slip Op 51033[U] [App Term, 2d & 11th Jud Dists 2008]) until February 8, 2013, when the Civil Court directed defendant to provide verified responses to plaintiff’s demands for discovery. Plaintiff demonstrated that there was a legitimate need for discovery with respect to defendant’s defense of lack of medical necessity (see Reilly, 269 AD2d at 582; Metropolitan Diagnostic Med. Care, P.C. v A. Cent. Ins. Co., 42 Misc 3d 133[A], 2013 NY Slip Op 52246[U] [App Term, 2d, 11th & 13th Jud Dists 2011]). “Therefore, the court properly considered [plaintiff’s motion] during the pendency of [defendant’s] motion for summary judgment” (Reilly, 269 AD2d at 582).
Defendant does not deny that it received plaintiff’s demand for verified written interrogatories and notice for discovery and inspection, and defendant does not deny that it failed to respond to the demands. CPLR 3101 (a) directs “full disclosure of all matter material and necessary in the prosecution or defense of an action, regardless of the burden of proof.” Upon a review of the record, we find that the Civil Court did not improvidently exercise its discretion in finding that there was a legitimate need for discovery to respond to defendant’s summary judgment motion (see e.g. CPLR 3212 [f]) and directing defendant to respond to plaintiff’s written demands for discovery (see Metropolitan Diagnostic Med. Care, P.C., 42 Misc 3d 133[A], 2013 NY Slip Op 52246[U]). Consequently, under the circumstances, the court properly granted plaintiff’s motion to compel disclosure.Accordingly, the order, insofar as appealed from, is affirmed.
Aliotta, J.P., Solomon and Elliot, JJ., concur.
Decision Date: July 07, 2015
Reported in New York Official Reports at Delta Diagnostic Radiology, P.C. v Auto One Ins. Co. (2015 NY Slip Op 51032(U))
| Delta Diagnostic Radiology, P.C. v Auto One Ins. Co. |
| 2015 NY Slip Op 51032(U) |
| Decided on July 7, 2015 |
| 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 July 7, 2015
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2012-2107 Q C
against
Auto One Ins. Co., Respondent.
Appeal from an order of the Civil Court of the City of New York, Queens County (Carmen R. Velasquez, J.), entered July 27, 2012. The order granted defendant’s motion for summary judgment dismissing the complaint and denied plaintiff’s cross motion for summary judgment.
ORDERED that the order is modified by providing that defendant’s motion for summary judgment dismissing the complaint is denied; as so modified, the order is affirmed, without costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which granted defendant’s motion for summary judgment dismissing the complaint on the ground that plaintiff’s assignor had failed to appear for duly scheduled independent medical examinations (IMEs), and denied plaintiff’s cross motion for summary judgment.
Plaintiff’s cross motion failed to establish either that defendant had failed to deny the claim within the requisite 30-day period or that defendant had issued a timely denial of claim that was conclusory, vague or without merit as a matter of law (see Insurance Law § 5106 [a]; Westchester Med. Ctr. v Nationwide Mut. Ins. Co., 78 AD3d 1168 [2010]; Ave T MPC Corp. v Auto One Ins. Co., 32 Misc 3d 128[A], 2011 NY Slip Op 51292[U] [App Term, 2d, 11th & 13th Jud Dists 2011]). Thus, plaintiff’s cross motion for summary judgment was properly denied.
However, defendant’s motion for summary judgment dismissing the complaint should also have been denied. While defendant submitted properly sworn statements by the acupuncturist and doctor who had been scheduled to perform the IMEs, neither health care professional demonstrated personal knowledge of the nonappearance of plaintiff’s assignor for the examinations, and therefore defendant failed to establish its entitlement as a matter of law to the dismissal of the complaint (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 [2006]; Bright Med. Supply Co. v IDS Prop. & Cas. Ins. Co., 40 Misc 3d 130[A], 2013 NY Slip Op 51123[U] [App Term, 2d, 11th & 13th Jud Dists 2013]; Quality Health Prods. v Hertz Claim Mgt. Corp., 36 Misc 3d 154[A], 2012 NY Slip Op 51722[U] [App Term, 2d, 11th & 13th Jud Dists 2012]).
Accordingly, the order is modified by providing that defendant’s motion for summary [*2]judgment dismissing the complaint is denied.
Pesce, P.J., Aliotta and Solomon, JJ., concur.
Decision Date: July 07, 2015
Reported in New York Official Reports at S.A. Med., P.C. v Praetorian Ins. Co. (2015 NY Slip Op 50953(U))
| S.A. Med., P.C. v Praetorian Ins. Co. |
| 2015 NY Slip Op 50953(U) [48 Misc 3d 128(A)] |
| Decided on June 25, 2015 |
| Appellate Term, First 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 25, 2015
PRESENT: Lowe, III, P.J., Shulman, Hunter, Jr., JJ.
570403/15
against
Praetorian Insurance Company, Defendant-Appellant.
Defendant appeals from an order the Civil Court of the City of New York, Bronx County (Elizabeth A. Taylor, J.), entered October 15, 2013, which denied its motion for summary judgment dismissing the complaint.
Per Curiam.
Order (Elizabeth A. Taylor, J.), entered October 15, 2013, reversed, with $10 costs, and defendant’s motion for summary judgment dismissing the complaint is granted. The Clerk is directed to enter judgment accordingly.
The defendant-insurer made a prima facie showing of entitlement to summary judgment dismissing the action for first-party no-fault benefits by establishing that it timely and properly mailed the notices for independent medical examinations (IMEs) to plaintiffs’ assignor, and that the assignor failed to appear (see American Tr. Ins. Co. v Lucas, 111 AD3d 423 [2013]; American Tr. Ins. Co. v Solorzano, 108 AD3d 449 [2013]). Contrary to the motion court’s conclusion, defendant submitted competent evidence of the assignor’s nonappearance, including the sworn affidavits of the scheduled examining physician and chiropractor/acupuncturist, attesting to the affiants’ personal knowledge of their office practices and policies when an assignor fails to appear for a scheduled IME (see American Tr. Ins. Co. v Lucas, 111 AD3d at 424; Harmonic Physical Therapy v Encompass Home & Auto Ins. Co., 47 Misc 3d 146[A], 2015 NY Slip Op 50733[U] [App Term, 1st Dept 2015]).
In opposition to defendant’s prima facie showing, plaintiffs did not specifically deny the assignor’s nonappearance or otherwise raise a triable issue with respect thereto, or as to the mailing or reasonableness of the underlying notices (see Unitrin Advantage Ins. Co. v Bayshore Physical Therapy, PLLC, 82 AD3d 559, 560 [2011], lv denied 17 NY3d 705 [2011]).
In view of our determination, we reach no other issue.
THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.
I concur I concur I concur
Decision Date: June 25, 2015
Reported in New York Official Reports at Rummel G. Mendoza, D.C., P.C. v Chubb Indem. Ins. Co. (2015 NY Slip Op 50900(U))
| Rummel G. Mendoza, D.C., P.C. v Chubb Indem. Ins. Co. |
| 2015 NY Slip Op 50900(U) [47 Misc 3d 156(A)] |
| Decided on June 17, 2015 |
| Appellate Term, First 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 17, 2015
PRESENT: Lowe, III, P.J., Shulman, J.
570100/15
against
Chubb Indemnity Insurance Company, Defendant-Appellant.
Defendant, as limited by the briefs, appeals from so much of an order of the Civil Court of the City of New York, New York County (James E. d’Auguste, J.), entered March 4, 2014, as denied its motion for summary judgment dismissing the no-fault claims of plaintiff L.N.L. Physical Therapy Rehabilitation, for services rendered September 2, 2010 through November 23, 2010 and January 3, 2011 through March 14, 2011, in the amount of $2,220.
Per Curiam.
Order (James E. d’Auguste, J.), entered March 4, 2014, insofar as appealed from, reversed, with $10 costs, motion granted and the no-fault claims of plaintiff L.N.L. Physical Therapy Rehabilitation in the amount of $2,220, dismissed.
The defendant-insurer made a prima facie showing of entitlement to summary judgment dismissing the first-party no-fault claims of plaintiff L.N.L. Physical Therapy Rehabilitation (“plaintiff”) in the aggregate sum of $2,220, by establishing that it timely denied the claims based on the independent medical examination (IME) report and follow-up report of its examining orthopedic doctor, which set forth a factual basis and medical rationale for her stated conclusion that the assignor’s injuries were resolved and that there was no need for further physical therapy treatment. In opposition, plaintiff failed to raise a triable issue. The affidavit of plaintiff’s treating physical therapist failed to meaningfully address the contrary findings made by defendant’s examining doctor, including the normal results of the range of motion testing of the assignor’s cervical and lumbar spine (see CPT Med. Servs., P.C. v New York Cent. Mut. Fire Ins. Co., 18 Misc 3d 87 [1st Dept 2007]). Defendant’s remaining arguments, raised for the first time in its reply brief, are not entitled to consideration (Mehmet v Add2Net, Inc., 66 AD3d 437 [2009]).
THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.
I concur I concur
Decision Date: June 17, 2015
Reported in New York Official Reports at Metro Health Prods., Inc. v Nationwide Ins. (2015 NY Slip Op 25203)
| Metro Health Prods., Inc. v Nationwide Ins. |
| 2015 NY Slip Op 25203 [48 Misc 3d 85] |
| Accepted for Miscellaneous Reports Publication |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
| As corrected through Wednesday, September 30, 2015 |
[*1]
| Metro Health Products, Inc., as Assignee of Malcolm George, Appellant, v Nationwide Ins., Respondent. |
Supreme Court, Appellate Term, Second Department, 2d, 11th and 13th Judicial Districts, June 16, 2015
APPEARANCES OF COUNSEL
The Rybak Firm, PLLC, Brooklyn (Damin J. Toell of counsel), for appellant.
{**48 Misc 3d at 86} OPINION OF THE COURT
Ordered that the order is modified by providing that defendant’s cross motion for summary judgment dismissing the complaint is denied; as so modified, the order is affirmed, without costs.
Plaintiff Metro Health Products, Inc. commenced this action to recover assigned first-party no-fault benefits for medical “services” (actually supplies) provided to its assignor as a result of injuries sustained in an automobile accident. Thereafter, defendant insurer commenced a declaratory judgment action in Supreme Court, Nassau County, against Metro Health Products, Inc. seeking a declaration that Nationwide Insurance was under no obligation to pay any of the outstanding claims mentioned therein. In an order dated December 5, 2012, the Supreme Court stated the following:
“[Nationwide]’s unopposed motion for a default judgment on this declaratory judgment action pursuant to CPLR § 3215 is granted, there being no opposition.
“Settle judgment on notice.”
Plaintiff subsequently moved, in the instant no-fault action, for summary judgment, and defendant cross-moved for summary judgment dismissing the complaint on the ground that the instant action was barred by virtue of the Supreme Court’s order. The Civil Court denied plaintiff’s motion and granted defendant’s cross motion “in light of [the] order entered [in] Supreme Court.”
Since the Supreme Court’s December 5, 2012 order in the declaratory judgment action did not make a declaration determining the rights of the parties involved (see Hirsch v Lindor Realty Corp., 63 NY2d 878, 881 [1984] [requiring the court in a declaratory judgment action to make a declaration determining the rights of the parties involved in the dispute]; Lanza v Wagner, 11 NY2d 317, 334 [1962]; Suburban Bindery Equip. Corp. v Boston Old Colony Ins. Co., 150 AD2d 767{**48 Misc 3d at 87}[1989]), but rather directed the insurer to settle the judgment on notice (which [*2]defendant did not demonstrate that it had done), the order cannot be considered a conclusive final determination. Therefore, the Supreme Court order has no preclusive effect on the instant no-fault action (cf. Vital Meridian Acupuncture, P.C. v Republic W. Ins. Co., 46 Misc 3d 147[A], 2015 NY Slip Op 50222[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2015]; EBM Med. Health Care, P.C. v Republic W. Ins., 38 Misc 3d 1 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2012]). Consequently, defendant’s cross motion for summary judgment dismissing the complaint should have been denied. We note that, in any event, the declaratory judgment action apparently only included one of the four claims at issue in the instant no-fault action. We cannot pass on the issue, raised by plaintiff on appeal, of whether the motion made before the Supreme Court in the declaratory judgment action, or for that matter the action itself, is deemed abandoned pursuant to 22 NYCRR 202.48 (a), (b) (see Skeete v Bell, 292 AD2d 371 [2002]).
Plaintiff failed to demonstrate its prima facie entitlement to summary judgment, as the affidavit submitted in support of its motion failed to establish that the claims at issue had not been timely denied or that defendant had issued timely denial of claims that were conclusory, vague or without merit as a matter of law (see EMC Health Prods., Inc. v Travelers Ins. Co., 47 Misc 3d 133[A], 2015 NY Slip Op 50475[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2015]; Ave T MPC Corp. v Auto One Ins. Co., 32 Misc 3d 128[A], 2011 NY Slip Op 51292[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2011]; see also Westchester Med. Ctr. v Nationwide Mut. Ins. Co., 78 AD3d 1168 [2010]). Consequently, plaintiff’s motion for summary judgment was properly denied.
Accordingly, the order is modified by providing that defendant’s cross motion for summary judgment dismissing the complaint is denied.
Elliot, J.P., Pesce and Solomon, JJ., concur.
Reported in New York Official Reports at SMB Med., PC v Federal Ins. Co. (2015 NY Slip Op 50895(U))
against
Federal Insurance Company, Defendant-Appellant.
Defendant, as limited by the briefs, appeals from so much of an order of the Civil Court of the City of New York, Bronx County (David B. Cohen, J.), entered October 17, 2013, as denied, in part, its motion for summary judgment dismissing the complaint.
Per Curiam.
Order (David B. Cohen, J.), entered October 17, 2013, insofar as appealed from, modified to grant defendant partial summary judgment dismissing the portion of the claims seeking reimbursement for acupuncture services rendered to the assignor; as modified, order affirmed, with $10 costs to defendant, and the matter remanded for further proceedings in accordance herewith.
Defendant-insurer made a prima facie showing of entitlement to summary judgment dismissing plaintiff’s no-fault claims for acupuncture treatment rendered to plaintiff’s assignor, by submitting the independent medical examination [IME] report of its examining acupuncturist which set forth a sufficient factual basis and medical rationale for the conclusion that no further acupuncture treatment was medically necessary (see V.S. Care Acupuncture PC v MVAIC, 47 Misc 3d 126[A], 2015 NY Slip Op 50350[U] [App Term, 1st Dept]). Plaintiff’s opposing submissions, consisting of an attorney’s affirmation and the report of its examining doctor, which, as plaintiff concedes on appeal, did not mention, much less address the medical necessity of the acupuncture services rendered, was insufficient to raise a triable issue (see Munoz v Hollingsworth, 18 AD3d 278, 279 [2005]; CPT Med. Servs., P.C. v New York Cent. Mut. Fire Ins. Co., 18 Misc 3d 87 [App Term, 1st Dept 2007]). We remand the matter to Civil Court for a determination of the amount of the claims for acupuncture services, since defendant has failed to establish such amount in its motion papers.
We sustain so much of the order under review as denied defendant’s motion for summary judgment dismissing plaintiff’s remaining no-fault claims, since the conflicting medical expert opinions adduced by the parties sufficed to raise a triable issue as to the medical necessity of the medical services underlying these claims.
THIS CONSTITUTES THE DECISION AND ORDER OF THE COURT.
I concur I concur I concur
Decision Date: June 12, 2015
Reported in New York Official Reports at Ultimate Health Prods., Inc. v American Tr. Ins. Co. (2015 NY Slip Op 50906(U))
| Ultimate Health Prods., Inc. v American Tr. Ins. Co. |
| 2015 NY Slip Op 50906(U) [48 Misc 3d 126(A)] |
| Decided on June 11, 2015 |
| 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 11, 2015
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : ALIOTTA, J.P., SOLOMON and ELLIOT, JJ.
2013-2378 Q C
against
American Transit Ins. Co., Respondent.
Appeal from an order of the Civil Court of the City of New York, Queens County (Carmen R. Velasquez, J.), entered September 26, 2013. 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, with $25 costs.
In this action to recover assigned first-party no-fault benefits, plaintiff seeks to recover for supplies it provided to its assignor for injuries he had sustained in a motor
vehicle accident on November 10, 2010. After this action had been commenced in the Civil Court, defendant instituted a declaratory judgment action in the Supreme Court,
Bronx County, against plaintiff’s assignor and various medical providers, including plaintiff herein. By order dated October 26, 2012, the Supreme Court granted the motion therein for a default judgment, which order stated, among other things, that “[t]his action was brought for a declaration that defendant Hiyomailys Lachapelle, (Lachapelle), and the medical provider[s] . . . of Lachapelle are not entitled to no-fault coverage with a motor vehicle accident that occurred on November 10, 2010 . . . [American Transit’s] motion for default judgment against [Lachapelle and Ultimate Health Products, Inc.] . . . is granted.”
In January 2012, plaintiff moved for summary judgment in the instant action, and defendant cross-moved for summary judgment dismissing the complaint on the ground that the October 26, 2012 Supreme Court order in the declaratory judgment action barred the instant action pursuant to the doctrines of res judicata and collateral estoppel. By order entered September 26, 2013, the Civil Court denied plaintiff’s motion and granted defendant’s cross motion.
Contrary to plaintiff’s contention, the Civil Court correctly determined that the instant action is barred under the doctrine of res judicata by virtue of the October 26, 2012 Supreme Court order (see Ava Acupuncture, P.C. v NY Cent. Mut. Fire Ins. Co., 34 Misc 3d 149[A], 2012 NY Slip Op 50233[U] [App Term, 2d, 11th & 13th Jud Dists 2012]). To hold otherwise could result in a judgment in this action which would destroy or impair rights established by the order rendered by the Supreme Court in the declaratory judgment action (see Schuykill Fuel Corp. v Nieberg Realty Corp., 250 NY 304, 306-307 [1929]; Ava Acupuncture, P.C. v NY Cent. Mut. Fire Ins. Co., 34 Misc 3d 149[A], 2012 NY Slip Op 50233[U]). Moreover, the Supreme Court’s [*2]order is a conclusive final determination notwithstanding that it was entered on default, and res judicata applies to an order or judgment taken by default which has not been vacated (see Lazides v P & G Enters., 58 AD3d 607 [2009]; Matter of Allstate Ins. Co. v Williams, 29 AD3d 688, 690 [2000]; Matter of Eagle Ins. Co. v Facey, 272 AD2d 399 [2000]; Ava Acupuncture, P.C. v NY Cent. Mut. Fire Ins. Co., 34 Misc 3d 149[A], 2012 NY Slip Op 50233[U]). Plaintiff’s remaining contentions lack merit or are unpreserved for appellate review.
Accordingly, the order is affirmed.
Aliotta, J.P., Solomon and Elliot, JJ., concur.
Decision Date: June 11, 2015
Reported in New York Official Reports at New York Diagnostic Med. Care, P.C. v Country-Wide Ins. Co. (2015 NY Slip Op 50814(U))
| New York Diagnostic Med. Care, P.C. v Country-Wide Ins. Co. |
| 2015 NY Slip Op 50814(U) [47 Misc 3d 153(A)] |
| Decided on May 19, 2015 |
| 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 May 19, 2015
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
&em;
against
Country-wide Insurance Company, Respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Devin P. Cohen, J.), entered December 20, 2012. 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 modified by providing that defendant’s cross motion for summary judgment dismissing the complaint is denied; as so modified, the order is affirmed, without costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which denied plaintiff’s motion for summary judgment, and granted defendant’s cross motion for summary judgment dismissing the complaint on the ground that the action was premature because plaintiff had not provided verification as requested by defendant.
A review of the record reveals that triable issues of fact exist, including whether plaintiff adequately responded to defendant’s verification requests. Consequently, neither party is entitled to summary judgment (see Zuckerman v City of New York, 49 NY2d 557 [1980]).
Accordingly, the order is modified by providing that defendant’s cross motion for summary judgment dismissing the complaint is denied.
Pesce, P.J., Aliotta and Solomon, JJ., concur.
Decision Date: May 19, 2015
Reported in New York Official Reports at Metro Health Prods., Inc. v Allstate Ins. Co. (2015 NY Slip Op 50812(U))
| Metro Health Prods., Inc. v Allstate Ins. Co. |
| 2015 NY Slip Op 50812(U) [47 Misc 3d 153(A)] |
| Decided on May 19, 2015 |
| 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 May 19, 2015
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2013-159 K C
against
Allstate Insurance Company, Respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Reginald A. Boddie, J.), entered November 14, 2012. The order denied plaintiff’s motion for summary judgment and, upon searching the record, granted defendant reverse summary judgment dismissing the complaint.
ORDERED that the order is modified by striking the provision which, upon a search of the record, granted defendant reverse summary judgment dismissing the complaint; as so modified, the order is affirmed, without costs.
In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which denied plaintiff’s motion for summary judgment and, upon searching the record, granted defendant reverse summary judgment dismissing the complaint.
On the record before us, we find that there is a triable issue of fact as to whether the claims at issue had been submitted to defendant. Therefore, neither party was entitled to summary judgment (see Zuckerman v City of New York, 49 NY2d 557 [1980]).
Accordingly, the order is modified by striking the provision which, upon a search of the record, granted defendant reverse summary judgment dismissing the complaint.
Pesce, P.J., Aliotta and Solomon, JJ., concur.
Decision Date: May 19, 2015
Reported in New York Official Reports at New Way Med. Supply Corp. v American Tr. Ins. Co. (2015 NY Slip Op 50809(U))
| New Way Med. Supply Corp. v American Tr. Ins. Co. |
| 2015 NY Slip Op 50809(U) [47 Misc 3d 153(A)] |
| Decided on May 19, 2015 |
| 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 May 19, 2015
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2013-103 Q C
against
American Transit Ins. Co., Respondent.
Appeal from an order of the Civil Court of the City of New York, Queens County (Jodi Orlow, J.), entered November 14, 2012. 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, with $25 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 it had timely and properly denied the claims based on plaintiff’s assignor’s failure to appear for examinations under oath (EUOs). The Civil Court denied plaintiff’s motion and granted defendant’s cross motion.
Contrary to plaintiff’s contention, defendant established that EUO scheduling letters had been timely mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16 [App Term, 2d & 11th Jud Dists 2007]), and that plaintiff’s assignor had failed to appear for the duly scheduled EUOs (see Stephen Fogel Psychological, P.C. v Progressive Cas. Ins. Co., 35 AD3d 720 [2006]). Since defendant demonstrated that plaintiff’s assignor had failed to comply with a condition precedent to coverage (id. at 722) and that defendant had timely denied (see St. Vincent’s Hosp. of Richmond, 50 AD3d 1123; Delta Diagnostic Radiology, P.C. v Chubb Group of Ins., 17 Misc 3d 16) the claims on the ground that plaintiff’s assignor had failed to appear for duly scheduled EUOs, defendant was entitled to summary judgment dismissing the complaint.
Accordingly, the order is affirmed.
Pesce, P.J., Aliotta and Solomon, JJ., concur.
Decision Date: May 19, 2015