Reported in New York Official Reports at Rockaway Med. & Diagnostic, P.C. v Chubb Ins. Co. (2023 NY Slip Op 51241(U))
[*1]Rockaway Med. & Diagnostic, P.C. v Chubb Ins. Co. |
2023 NY Slip Op 51241(U) |
Decided on October 6, 2023 |
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This opinion is uncorrected and will not be published in the printed Official Reports.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 October 6, 2023
PRESENT: : WAVNY TOUSSAINT, P.J., MARINA CORA MUNDY, LISA S. OTTLEY, JJ
2020-974 Q C
against
Chubb Insurance Co., Respondent.
The Law Offices of “Shay” Shailesh Deshpande, LLC (David O’Connor, Esq.), for appellant. McDonnell, Adels & Klestzick, PLLC (Jannine A. Gordineer of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Queens County (Rachel Freier, J.), dated April 29, 2020. The order granted defendant’s motion to dismiss the complaint.
ORDERED that the order is affirmed, with $25 costs.
In 2004, plaintiff commenced this action to recover assigned first-party no-fault benefits. By a so-ordered stipulation dated May 25, 2006, plaintiff was required to provide “complete” responses to defendant’s discovery demands by July 24, 2006 or the complaint would be dismissed. Insofar as relevant to this appeal, defendant moved, in January 2020, in effect pursuant to CPLR 3126, to dismiss the complaint on the ground that plaintiff had failed to comply with the stipulation. By order dated April 29, 2020, the Civil Court (Rachel Freier, J.) granted defendant’s motion.
A conditional so-ordered stipulation becomes absolute upon a party’s failure to sufficiently and timely comply (see e.g. Okumus v Living Room Steak House, Inc., 112 AD3d 799, 799 [2013]; Panagiotou v Samaritan Vil., Inc., 66 AD3d 979, 980 [2009]; State Farm Mut. Auto. Ins. Co. v Hertz Corp., 43 AD3d 907, 908 [2007]; Velocity Chiropractic, P.C. v Chubb Indem. Ins. Co., 47 Misc 3d 142[A], 2015 NY Slip Op 50673[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2015]). To avoid the adverse impact of a conditional so-ordered stipulation, [*2]the defaulting party must demonstrate a reasonable excuse for its failure to comply with the stipulation and the existence of a meritorious cause of action or defense (see Okumus v Living Room Steak House, Inc., 112 AD3d at 799; Panagiotou v Samaritan Vil., Inc., 66 AD3d at 980; State Farm Mut. Auto. Ins. Co. v Hertz Corp., 43 AD3d at 908).
Here, as the Civil Court properly found, plaintiff failed to comply with the stipulation. Defendant demanded verified responses to defendant’s interrogatories, but the record shows that plaintiff’s written interrogatory responses were not properly verified. While plaintiff’s responses to defendant’s discovery demands indicated that plaintiff would provide defendant with certain information concerning plaintiff’s expert witnesses to be called at trial, the record is bereft of any indication that the information was ever provided. In opposition to defendant’s motion, plaintiff objected to many of defendant’s discovery demands. However, since the demands for discovery were served on plaintiff in 2004 and plaintiff did not challenge the propriety of the demands within the time prescribed by CPLR 3122 (a) and 3133 (a), plaintiff was obligated to produce the information sought by defendant except as to matters which are palpably improper or privileged (see Recine v City of New York, 156 AD3d 836 [2017]; Fausto v City of New York, 17 AD3d 520, 522 [2005]; Maiga Prods. Corp. v United Servs. Auto. Assn., 57 Misc 3d 127[A], 2017 NY Slip Op 51148[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2017]). As plaintiff has failed to assert that the discovery demands it objected to sought information which is privileged or establish that the demands are palpably improper, plaintiff was obligated to provide defendant with that information, and its failure to do so rendered its responses incomplete.
The stipulation, which functioned as a conditional order, therefore became absolute upon plaintiff’s failure to comply with the requirement that it provide complete responses to defendant’s discovery demands (see Feng Lucy Luo v Yang, 150 AD3d 726, 727 [2017]; Okumus v Living Room Steak House, Inc., 112 AD3d at 799; Alhomedi v TDS Leasing, Inc., 41 AD3d 747, 748 [2007]). As plaintiff failed to offer a reasonable excuse for its failure to comply with the stipulation and failed to demonstrate the existence of a potentially meritorious cause of action, the Civil Court properly dismissed the action pursuant to the stipulation (see Khan v Old Navy, 166 AD3d 599, 600 [2018]; Alhomedi v TDS Leasing, Inc., 41 AD3d at 748).
Accordingly, the order is affirmed.
TOUSSAINT, P.J., MUNDY and OTTLEY, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: October 6, 2023
Reported in New York Official Reports at Advanced Recovery Equip. & Supplies, LLC v Tri-State Consumer Ins. Co. (2023 NY Slip Op 51239(U))
[*1]Advanced Recovery Equip. & Supplies, LLC v Tri-State Consumer Ins. Co. |
2023 NY Slip Op 51239(U) |
Decided on October 5, 2023 |
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 October 5, 2023
PRESENT: : JERRY GARGUILO, P.J., ELIZABETH H. EMERSON, BARRY E. WARHIT, JJ
2021-249 N C
against
Tri-State Consumer Insurance Company, Appellant.
Thomas Torto, for appellant. Law Offices of Jonathan B. Seplowe, P.C. (Alan M. Elis of counsel), for respondent.
Appeal from a judgment of the District Court of Nassau County, First District (Robert E. Pipia, J.), entered January 10, 2020. The judgment was entered pursuant to an order of that court dated December 17, 2018, which granted a petition to vacate a master arbitrator’s award dated January 10, 2018 and remitted the matter to the master arbitrator for a new determination.
ORDERED that the judgment is affirmed, without costs.
Advanced Recovery Equipment & Supplies, LLC (Advanced) commenced this proceeding pursuant to CPLR 7511 to vacate a master arbitrator’s award, which upheld the award of an arbitrator, denying Advanced’s claims to recover assigned first-party no-fault benefits for services rendered on June 11, 2015. The District Court, by order entered January 10, 2020, granted the petition on the ground that the master arbitrator’s award was contrary to settled law and remitted the matter to the master arbitrator for a new determination.
Upon a review of the record, we agree with the District Court’s determination vacating the master arbitrator’s determination, as there was no rational basis to support it (see Matter of Acuhealth Acupuncture, P.C. v Country-Wide Ins. Co.,149 AD3d 828[2017]). Consequently, contrary to the insurer’s contention, the District Court properly granted the petition.
Accordingly, the judgment is affirmed.
GARGUILO, P.J., and EMERSON, J., concur.
WARHIT, J., taking no part.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: October 5, 2023
Reported in New York Official Reports at Absolute Med. Supplies, Inc. v Unitrin Advantage Ins. Co. (2023 NY Slip Op 51237(U))
[*1]Absolute Med. Supplies, Inc. v Unitrin Advantage Ins. Co. |
2023 NY Slip Op 51237(U) |
Decided on September 22, 2023 |
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 September 22, 2023
PRESENT: : WAVNY TOUSSAINT, P.J., CHEREÉ A. BUGGS, LISA S. OTTLEY, JJ
2023-149 K C
against
Unitrin Advantage Insurance Company, Respondent.
The Rybak Firm, PLLC (Damin J. Toell and Richard Rozhik of counsel), for appellant. Gullo & Associates, LLC (Cristina Carollo of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Nicholas W. Moyne, J.), dated September 20, 2022. 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 claim was submitted more than 45 days after the subject service had been rendered, and denied plaintiff’s cross-motion for summary judgment.
While defendant made a prima facie showing that plaintiff did not timely submit the claim at issue, the affidavit submitted by plaintiff in opposition to defendant’s motion was sufficient to raise a triable issue of fact as to that issue (see Longevity Med. Supply, Inc. v MVAIC, 71 Misc 3d 137[A], 2021 NY Slip Op 50440[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2021]). In light of the foregoing, defendant’s motion for summary judgment dismissing the complaint should have been denied and plaintiff’s cross-motion for summary judgment was properly denied.
Accordingly, the order is modified by providing that defendant’s motion for summary judgment dismissing the complaint is denied.
TOUSSAINT, P.J., BUGGS and OTTLEY, JJ., concur.
ENTER:Paul Kenny
Chief Clerk
Decision Date: September 22, 2023
Reported in New York Official Reports at Heaven & Earth Acupuncture, P.C. v Hartford Ins. Co. of Ill. (2023 NY Slip Op 51236(U))
[*1]Heaven & Earth Acupuncture, P.C. v Hartford Ins. Co. of Ill. |
2023 NY Slip Op 51236(U) |
Decided on September 22, 2023 |
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 September 22, 2023
PRESENT: : WAVNY TOUSSAINT, P.J., CHEREÉ A. BUGGS, LISA S. OTTLEY, JJ
2023-132 K C
against
Hartford Insurance Company of Illinois, Respondent.
The Rybak Firm, PLLC (Damin J. Toell and Richard Rozhik of counsel), for appellant. Law Office of Terrence F. Kuhn (Alexa J. Rissoff of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Keisha M. Alleyne, J.), dated October 11, 2022. 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 granting defendant’s motion for summary judgment dismissing the complaint and denying plaintiff’s cross-motion for summary judgment.
To obtain summary judgment on its asserted defense of policy exhaustion, defendant had to prove that it had paid the limits of the policy in accordance with 11 NYCRR 65-3.15 (see Nyack Hosp. v General Motors Acceptance Corp., 8 NY3d 294 [2007]; Alleviation Med. Servs., P.C. v Allstate Ins. Co., 55 Misc 3d 44 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2017], affd 191 AD3d 934 [2021]). While defendant submitted an affidavit of a claim specialist who purported to rely upon a payment log to establish that the policy limits had been exhausted, no such log was annexed to defendant’s moving papers. Therefore, defendant failed to demonstrate, as a matter of law, that it had made any payments under the policy (see JPC Med., P.C. v State Farm Mut. Auto. Ins. Co.,75 Misc 3d 136[A], 2022 NY Slip Op 50562[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2022]; JPF Med. Servs., P.C. v Nationwide Ins., 69 Misc 3d 127[A], [*2]2020 NY Slip Op 51122[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2020]). Consequently, defendant failed to make a prima facie showing of its entitlement to summary judgment dismissing the complaint.
Plaintiff’s cross-motion for summary judgment was properly denied, as the affidavit submitted by plaintiff failed to establish that the claims had not been timely denied (see Viviane Etienne Med. Care, P.C. v Country-Wide Ins. Co., 25 NY3d 498 [2015]) or that defendant had issued timely denial of claim forms that were conclusory, vague, or without merit as a matter of law (see 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 Dept, 2d, 11th & 13th Jud Dists 2011]).
Accordingly, the order is modified by providing that defendant’s motion for summary judgment dismissing the complaint is denied.
TOUSSAINT, P.J., BUGGS and OTTLEY, JJ., concur.
ENTER:
Paul Kenny
Chief Clerk
Decision Date: September 22, 2023
Reported in New York Official Reports at Absolute Med. Supplies, Inc. v Unitrin Advantage Ins. Co. (2023 NY Slip Op 51237(U))
[*1]Absolute Med. Supplies, Inc. v Unitrin Advantage Ins. Co. |
2023 NY Slip Op 51237(U) [81 Misc 3d 128(A)] |
Decided on September 22, 2023 |
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 September 22, 2023
PRESENT: : WAVNY TOUSSAINT, P.J., CHEREÉ A. BUGGS, LISA S. OTTLEY, JJ
2023-149 K C
against
Unitrin Advantage Insurance Company, Respondent.
The Rybak Firm, PLLC (Damin J. Toell and Richard Rozhik of counsel), for appellant. Gullo & Associates, LLC (Cristina Carollo of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Nicholas W. Moyne, J.), dated September 20, 2022. 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 claim was submitted more than 45 days after the subject service had been rendered, and denied plaintiff’s cross-motion for summary judgment.
While defendant made a prima facie showing that plaintiff did not timely submit the claim at issue, the affidavit submitted by plaintiff in opposition to defendant’s motion was sufficient to raise a triable issue of fact as to that issue (see Longevity Med. Supply, Inc. v MVAIC, 71 Misc 3d 137[A], 2021 NY Slip Op 50440[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2021]). In light of the foregoing, defendant’s motion for summary judgment dismissing the complaint should have been denied and plaintiff’s cross-motion for summary judgment was properly denied.
Accordingly, the order is modified by providing that defendant’s motion for summary judgment dismissing the complaint is denied.
TOUSSAINT, P.J., BUGGS and OTTLEY, JJ., concur.
ENTER:Paul Kenny
Chief Clerk
Decision Date: September 22, 2023
Reported in New York Official Reports at Parisien v Avis Car Rental, LLC (2023 NY Slip Op 50891(U))
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
against
Avis Car Rental, LLC, Respondent.
The Rybak Firm, PLLC (Maksim Leyvi and Richard Rozhik of counsel), for appellant. Rubin, Fiorella, Friedman & Mercante, LLP (Michael Philippou of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Matthew P. Blum, J.), dated November 16, 2021. The order, insofar as appealed from and as limited by the brief, granted the branch of defendant’s motion seeking a permanent stay of the action.
ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and the branch of defendant’s motion seeking a permanent stay of the action is denied.
Plaintiff commenced this action in August of 2018 to recover assigned first-party no-fault benefits for medical services he had provided to his assignor in December 2017 and January 2018 as a result of injuries allegedly sustained in an automobile accident on November 14, 2017. As limited by his brief, plaintiff appeals from so much of an order of the Civil Court (Matthew P. Blum, J.) dated November 16, 2021 as granted the branch of defendant’s motion seeking a permanent stay of the instant action based on the doctrines of collateral estoppel and/or res judicata as a result of an “order and judgment” (declaratory judgment order) issued by the Supreme Court, New York County (Gerald Lebovits, J.), on February 21, 2017. In the declaratory judgment order, the Supreme Court found that no-fault actions that had been commenced by plaintiff herein as a result of an accident on November 7, 2013 were permanently [*2]barred because plaintiff herein had been operating in violation of various New York State laws and therefore was not entitled to recover no-fault payments (see 11 NYCRR 65-3.16 [a] [12]; State Farm Mut. Auto. Ins. Co. v Mallela, 4 NY3d 313 [2005]).
Plaintiff correctly argues that the Civil Court improperly applied the declaratory judgment order beyond its explicit purview so as to include this action, which was commenced more than eight months after the declaratory judgment order was issued (see Parisien v Zipcar, 77 Misc 3d 132[A], 2022 NY Slip Op 51245[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2022]; Active Care Med. Supply Corp. v Titan Ins.Co., 66 Misc 3d 144[A], 2020 NY Slip Op 50183[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2020]). Contrary to defendant’s contention that collateral estoppel effect should be given to the issue decided by the declaratory judgment order, namely that plaintiff was operating in violation of various New York State laws and not entitled to recover no-fault benefits, that issue is not identical to an issue to be decided in this case. The February 2017 declaratory judgment order could not have decided the issue of whether, in December of 2017 and January of 2018, plaintiff was continuing to operate in such a way that would preclude it from recovering any no-fault payments for the medical treatment rendered in connection with the November 14, 2017 accident. Thus, collateral estoppel does not apply here.
Accordingly, the order, insofar as appealed from, is reversed and the branch of defendant’s motion seeking a permanent stay of the action is denied.
TOUSSAINT, P.J., MUNDY and VENTURA, JJ., concur.
ENTER:Paul Kenny
Chief Clerk
Decision Date: August 4, 2023
Reported in New York Official Reports at Shafai Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2023 NY Slip Op 50796(U))
Shafai Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. |
2023 NY Slip Op 50796(U) [79 Misc 3d 132(A)] |
Decided on July 21, 2023 |
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 21, 2023
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : MARINA CORA MUNDY, J.P., LISA S. OTTLEY, LOURDES M. VENTURA, JJ
2023-62 K C
against
State Farm Mutual Automobile Ins. Co., Respondent.
The Rybak Firm, PLLC (Damin J. Toell and Richard Rozhik of counsel), for appellant. Rivkin Radler, LLP (Stuart M. Bodoff of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (D. Bernadette Neckles, J.), entered July 29, 2022. The order, insofar as appealed from as limited by the brief, granted the branches of defendant’s motion seeking summary judgment dismissing the first and second causes of action of the complaint and denied the branches of plaintiff’s cross-motion seeking summary judgment upon those causes of action.
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, plaintiff appeals, as limited by its brief, from so much of an order of the Civil Court as granted the branches of defendant’s motion seeking summary judgment dismissing the first and second causes of action and denied the branches of plaintiff’s cross-motion seeking summary judgment upon those causes of action.
Contrary to plaintiff’s sole contention with respect to the branches of defendant’s motion seeking summary judgment upon the first and second causes of action, the affidavit of defendant’s employee was sufficient to give rise to a presumption that the examination under oath scheduling letters and denial of claim forms as to the claims underlying those causes of action had been timely mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]; Horizon P.T. Care, P.C. v State Farm Mut. Auto. Ins. Co., 78 Misc 3d 133[A], 2023 NY Slip Op 50442[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2023]). [*2]Thus, plaintiff has not demonstrated any basis to disturb so much of the order as granted the branches of defendant’s motion seeking summary judgment dismissing the first and second causes of action, and denied the branches of plaintiff’s cross-motion seeking summary judgment upon those causes of action.
Accordingly, the order, insofar as appealed from, is affirmed.
MUNDY, J.P., OTTLEY and VENTURA, JJ., concur.
ENTER:Paul Kenny
Chief Clerk
Decision Date: July 21, 2023
Reported in New York Official Reports at Shafai Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2023 NY Slip Op 50795(U))
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
against
State Farm Mutual Automobile Ins. Co., Respondent.
The Rybak Firm, PLLC (Damin J. Toell and Richard Rozhik of counsel), for appellant. Rivkin Radler, LLP (Stuart M. Bodoff of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Ellen E. Edwards, J.), entered April 5, 2022. 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 affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits arising out of a March 9, 2015 accident, defendant moved for summary judgment dismissing the first through fifth and seventh causes of action on the ground that plaintiff had failed to appear for duly scheduled examinations under oath (EUOs), and dismissing the sixth cause of action on the ground that it was barred by an April 18, 2019 declaratory judgment issued by the Supreme Court, Nassau County, in an action commenced by defendant herein against plaintiff herein in regard to the same March 9, 2015 accident. Plaintiff opposed defendant’s motion and cross-moved for summary judgment. By order entered April 5, 2022, the Civil Court (Ellen E. Edwards, J.) granted defendant’s motion for summary judgment on the ground that plaintiff had failed to appear for duly scheduled EUOs and denied plaintiff’s cross-motion.
“Under the doctrine of res judicata, a final adjudication of a claim on the merits precludes relitigation of that claim and all claims arising out of the same transaction or series of transactions by a party or those in privity with a party” (Ciraldo v JP Morgan Chase Bank, N.A., 140 AD3d 912, 913 [2016]; see Matter of Hunter, 4 NY3d 260, 269 [2005]; Schuylkill Fuel [*2]Corp. v Nieberg Realty Corp., 250 NY 304, 306-307 [1929]).
” ‘A judgment by default that has not been vacated is conclusive for res judicata purposes and encompasses the issues that were raised . . . in the prior action’ ” (Tracey v Deutsche Bank Natl. Trust Co., 187 AD3d 815, 817 [2020], quoting Eaddy v US Bank N.A., 180 AD3d 756, 758 [2020]; see North Val. Med., P.C. v Permanent Gen. Assur. Corp., 74 Misc 3d 127[A], 2022 NY Slip Op 50048[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2022]).With respect to the branch of defendant’s motion seeking summary judgment dismissing the sixth cause of action, defendant demonstrated that the assignor, accident date, and date of service in the Supreme Court declaratory judgment action were identical to those for the claim underlying the sixth cause of action in the instant case. Consequently, that cause of action was barred under the doctrine of res judicata by virtue of the April 18, 2019 declaratory judgment and, thus, the Civil Court properly granted the branch of defendant’s motion seeking summary judgment dismissing that cause of action (see ZG Chiropractic Care, P.C. v 21st Century Ins. Co., 70 Misc 3d 138[A], 2021 NY Slip Op 50079[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2021]; Valdan Acupuncture, P.C. v Nationwide Mut. Fire Ins. Co., 64 Misc 3d 134[A], 2019 NY Slip Op 51098[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2019]; EBM Med. Health Care, P.C. v Republic W. Ins., 38 Misc 3d 1 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2012]), albeit on other grounds, since a judgment in favor of plaintiff upon the sixth cause of action in this action would destroy or impair rights or interests established by the declaratory judgment (see Schuylkill Fuel Corp., 250 NY at 306-307; North Val. Med., P.C., 2022 NY Slip Op 50048[U]; ZG Chiropractic Care, P.C., 2021 NY Slip Op 50079[U]; Valdan Acupuncture, P.C., 2019 NY Slip Op 51098[U]; EBM Med. Health Care, P.C., 38 Misc 3d at 2).
Contrary to plaintiff’s sole contention on appeal with respect to so much of the order as granted the branches of defendant’s motion seeking summary judgment dismissing the first through fifth and seventh causes of action, the affidavit of defendant’s employee was sufficient to give rise to a presumption that the EUO scheduling letters and denial of claim forms as to the claims underlying those causes of action had been timely mailed (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]; Horizon P.T. Care, P.C. v State Farm Mut. Auto. Ins. Co., 78 Misc 3d 133[A], 2023 NY Slip Op 50442[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2023]). Thus, plaintiff has not demonstrated any basis to disturb so much of the order as granted the branches of defendant’s motion seeking summary judgment dismissing those causes of action.
Accordingly, the order is affirmed.
MUNDY, J.P., OTTLEY and VENTURA, JJ., concur.
ENTER:Paul Kenny
Chief Clerk
Decision Date: July 21, 2023
Reported in New York Official Reports at Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co. (2023 NY Slip Op 50794(U))
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
against
State Farm Mutual Automobile Insurance Company, Appellant.
Rivkin Radler, LLP (Stuart M. Bodoff of counsel), for appellant. The Rybak Firm, PLLC (Oleg Rybak and Richard Rozhik of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Odessa Kennedy, J.), entered December 9, 2021. The order, insofar as appealed from and as limited by the brief, denied defendant’s motion for summary judgment dismissing the complaint.
ORDERED that the order, insofar as appealed from, is reversed, with $30 costs, and defendant’s motion for summary judgment dismissing the complaint is granted.
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 that plaintiff failed to provide requested verification. Plaintiff cross-moved for summary judgment or, in the alternative, for an order pursuant to CPLR 3212 (g) deeming certain facts established for all purposes in this action. In an order entered December 9, 2021, the Civil Court (Odessa Kennedy, J.) denied defendant’s motion and, upon implicitly denying plaintiff’s cross motion for summary judgment, found, in effect pursuant to CPLR 3212 (g), that plaintiff timely submitted the bills at issue to defendant. As limited by its brief, defendant appeals from so much of the order as denied its motion for summary judgment.
The proof submitted by defendant in support of its motion for summary judgment established that defendant had timely mailed its initial and follow-up verification requests (see St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d 1123 [2008]) and that defendant had not received the requested verification (see American Kinetics Lab, Inc. v GEICO Gen. Ins. Co., 77 Misc 3d 135[A], 2022 NY Slip Op 51267[U], *1 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2022]). As defendant further demonstrated that it had timely denied plaintiff’s [*2]claims (see 11 NYCRR 65-3.5 [o]; St. Vincent’s Hosp. of Richmond v Government Empls. Ins. Co., 50 AD3d at 1124), defendant made a prima facie showing of its entitlement to summary judgment dismissing the complaint (see Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co., 75 Misc 3d 143[A], 2022 NY Slip Op 50623[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2022]; Chapa Prods. Corp. v MVAIC, 66 Misc 3d 16, 18-19 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2019]; CPM Med Supply, Inc. v State Farm Fire & Cas. Ins. Co., 63 Misc 3d 140[A], 2019 NY Slip Op 50576[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2019]).
Plaintiff’s owner’s statement that he had mailed the requested verification “to the extent such responses were proper and in [his] possession” does not raise a triable issue of fact, as it does not “demonstrate that [plaintiff] had provided the requested verification or had set forth a reasonable justification for the failure to comply with defendant’s verification requests” (Burke Physical Therapy, P.C. v State Farm Mut. Auto. Ins. Co., 2022 NY Slip Op 50623[U], *1-2; see 11 NYCRR 65-3.5 [o]; 65-3.8 [b] [3]; CPM Med Supply, Inc. v State Farm Fire & Cas. Ins. Co., 2019 NY Slip Op 50576[U], *1). To the extent plaintiff argues that the verification requests were improper since they were issued after plaintiff had appeared for an examination under oath (EUO), this argument lacks merit, as the EUO pertained to claims for a different assignor, and was held five months before the claims at issue were submitted.
Accordingly, the order, insofar as appealed from, is reversed and defendant’s motion for summary judgment dismissing the complaint is granted.
MUNDY, J.P., OTTLEY and VENTURA, JJ., concur.
ENTER:Paul Kenny
Chief Clerk
Decision Date: July 21, 2023
Reported in New York Official Reports at Psychmetrics Med., P.C. v Allstate Ins. Co. (2023 NY Slip Op 50690(U))
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
against
Allstate Insurance Co., Appellant.
Peter C. Merani, P.C. (Adam Waknine and Samuel A. Kamara of counsel), for appellant. The Law Offices of “Shay” Shailesh Deshpande, LLC (Damin Toell of counsel), for respondent.
Appeal from an order of the Civil Court of the City of New York, Queens County (Lance P. Evans, J.), entered February 26, 2020. The order granted plaintiff’s motion to vacate the dismissal of the action, which dismissal had been based on plaintiff’s failure to proceed at trial, and to restore the action to the trial calendar.
ORDERED that the order is affirmed, with $25 costs.
In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from an order granting plaintiff’s motion to vacate the dismissal of the action, which dismissal was based on plaintiff’s failure to proceed at trial (see Uniform Rules for NY Civ Ct [22 NYCRR] § 208.14 [b] [2]), and to restore the action to the trial calendar.
“Where an action has been dismissed because of a default by a plaintiff, to vacate the dismissal ‘it [is] incumbent upon [the] plaintiff to demonstrate a reasonable excuse for the default and a meritorious cause of action’ ” (SZ Med., P.C. v Allstate Ins. Co., 59 Misc 3d 135[A], 2018 NY Slip Op 50497[U], *1 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2018], quoting V.S. Med. Servs., P.C. v Travelers Ins. Co., 24 Misc 3d 32, 34 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2009]). Contrary to defendant’s argument on appeal, the Civil Court did not improvidently exercise its discretion in finding that plaintiff had demonstrated a reasonable excuse for its default, as plaintiff’s witness was out of the country at the time of the trial. [*2]Contrary to defendant’s further argument, plaintiff demonstrated that it has a meritorious cause of action (see Brand Med. Supply, Inc. v Infinity Ins. Co., 51 Misc 3d 145[A], 2016 NY Slip Op 50738[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2016]).
Defendant’s remaining contentions lack merit.
Accordingly, the order is affirmed.
TOUSSAINT, P.J., BUGGS and VENTURA, JJ., concur.
ENTER:Paul Kenny
Chief Clerk
Decision Date: June 23, 2023