Radiology Resource Network, P.C. v Fireman’s Fund Ins. Co. (2004 NY Slip Op 07960)

Reported in New York Official Reports at Radiology Resource Network, P.C. v Fireman’s Fund Ins. Co. (2004 NY Slip Op 07960)

Radiology Resource Network, P.C. v Fireman’s Fund Ins. Co. (2004 NY Slip Op 07960)
Radiology Resource Network, P.C. v Fireman’s Fund Ins. Co.
2004 NY Slip Op 07960 [12 AD3d 185]
November 9, 2004
Appellate Division, First Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
As corrected through Wednesday, January 19, 2005
Radiology Resource Network, P.C., Appellant,
v
Fireman’s Fund Insurance Company, Respondent.

[*1]

Order, Supreme Court, Bronx County (Janice L. Bowman, J.), entered September 18, 2003, which, in an action to recover on 68 claims for no-fault insurance benefits assigned to plaintiff by 68 different assignors, granted defendant’s motion to sever the claim of each assignor into a separate action, unanimously affirmed, without costs.

The IAS court properly exercised its discretion under CPLR 603 in granting defendant’s motion to sever plaintiff’s 68 assigned claims for no-fault insurance benefits into separate actions. It is undisputed that the claims arise from 68 different accidents, and have been assigned to plaintiff, a vendor of medical services, by 68 different assignors. Even if it is assumed that the insurance policies of the 68 assignors are identical in all relevant respects—a matter addressed neither in the complaint nor in plaintiff’s papers opposing the motion—each claim will raise unique legal and factual issues. In this regard, we note that defendant’s answer places at issue, inter alia, the validity of the assignments, the necessity and reasonableness of plaintiff’s services in light of each assignor’s medical condition, defendant’s receipt of bills from plaintiff, and the sufficiency of the no-fault forms that have been submitted. The viability of these defenses will depend, in the case of each assignor’s claim, on the particular facts relating to that claim. At the same time, the claims are likely to raise few, if any, common issues of law or fact, even if the assignors’ insurance policies are identical. That all of the claims are for services provided by the same vendor, and are being asserted against the same insurance company, does not change the fact that individual issues are likely to predominate in the resolution of each claim.

Under the circumstances, to try all 68 claims together would be unwieldy and would create a substantial risk of confusing the trier of fact. Accordingly, the interests of convenience and avoidance of prejudice are best served by severing the claims (see Mount Sinai Hosp. v Motor Veh. Acc. Indem. Corp., 291 AD2d 536 [2002]; Bender v Underwood, 93 AD2d 747, 748 [1983]; Reid v Haher, 88 AD2d 873, 873-874 [1982]; Schneph v New York Times Co., 21 AD2d 599, 600-601 [1964]).

We note that our decision is consistent with a recent federal decision in a remarkably similar case (Boston Post Rd. Med. Imaging, P.C. v Allstate Ins. Co., 2004 WL 1586429, 2004 US Dist LEXIS 13243 [US Dist [*2]Ct, SD NY, July 15, 2004]). The plaintiff in Boston Post Road was a medical services provider that sued the same insurance company on no-fault claims arising from 59 different accidents, which had been assigned to the plaintiff by 59 different patients. In granting the insurance company’s motion to sever the claims, the Boston Post Road court stated, among other things, that the claims “arise out of distinct automobile accidents which led to different injuries to different individuals who underwent distinct medical services, payment for which was denied for varying reasons” (2004 WL at *1, 2004 US Dist LEXIS at *5). The court further noted that “[e]ven if the assignors’ insurance contracts are identical, the legal and factual issues involved in these claims are not,” since the defendant’s “answer pleaded different defenses that will apply to some claims and not to others,” meaning that “different provisions of the policies will be relevant to different claims” (2004 WL at *2, 2004 US Dist LEXIS at *5-6). These observations are equally applicable here.

Plaintiff’s reliance on the Second Department’s decision in Hempstead Gen. Hosp. v Liberty Mut. Ins. Co. (134 AD2d 569 [1987]) is unavailing. While Hempstead held that, under the particular circumstances of that case, Supreme Court had acted within its discretion in denying a motion to sever 29 assigned claims, the decision does not stand for the proposition that the granting of such a severance motion—in a case involving more than twice as many assigned claims—is an abuse of judicial discretion warranting reversal on appeal. In any event, Hempstead must be read in light of the Second Department’s much more recent decision in Mount Sinai Hosp. v Motor Veh. Acc. Indem. Corp. (supra). Mount Sinai held that Supreme Court “providently exercised its discretion” in granting a motion to sever five assigned no-fault claims that, inter alia, arose from “accidents on five different dates” and had “no relation or similarity to each other, other than the fact that the no-fault benefits were not paid” (291 AD2d at 536). Concur—Tom, J.P., Saxe, Williams, Friedman and Marlow, JJ.

Victoria Ins. Co. v Utica Mut. Ins. Co. (2004 NY Slip Op 04859)

Reported in New York Official Reports at Victoria Ins. Co. v Utica Mut. Ins. Co. (2004 NY Slip Op 04859)

Victoria Ins. Co. v Utica Mut. Ins. Co. (2004 NY Slip Op 04859)
Victoria Ins. Co. v Utica Mut. Ins. Co.
2004 NY Slip Op 04859 [8 AD3d 87]
June 10, 2004
Appellate Division, First Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
As corrected through Wednesday, August 25, 2004
Victoria Insurance Company, Respondent,
v
Utica Mutual Insurance Company, Appellant.

[*1]

Order, Supreme Court, New York County (Doris Ling-Cohan, J.), entered July 10, 2003, which denied the application of Utica Mutual Insurance Company to vacate its default in failing to answer a petition brought by Victoria Insurance Company to confirm three arbitration awards, unanimously affirmed, with costs.

Utica Mutual did not, in support of its vacatur application, make the necessary showing of merit. Contrary to its contention, the arbitrator did not commit misconduct in refusing to grant an adjournment to permit Utica’s investigator to appear, since Utica had not given notice that it would call a witness. In any event, the investigator’s testimony would have been duplicative of reports previously submitted in an attempt to establish that the claims paid by Victoria Insurance and for which it sought reimbursement from Utica were fraudulent. Furthermore, since Utica has not offered any affidavit from its insured, the owners of the truck that caused the accident, to show that, contrary to Department of Motor Vehicles records, the truck was not modified to increase its weight to more than 6,500 pounds, we perceive no basis to conclude that there is merit to Utica’s argument that this was not an instance in which reimbursement of otherwise nonreimbursable no-fault benefits was permitted pursuant to Insurance Law § 5105 (a).

Although the awards did not meet the requirements of CPLR 7507 that they be signed and affirmed by the arbitrator, and the issue is a question of law that can be raised for the first time on appeal (see Chateau D’If Corp. v City of New York, 219 AD2d 205, 209-210 [1996], lv denied 88 NY2d 811 [1996]), Utica is estopped from now raising the issue. Had it been raised as one of the affirmative defenses asserted by Utica in its proposed answer, Victoria would have been able to obtain a signed copy of the award from the arbitrator within the one-year period for bringing a proceeding to confirm an award. [*2]

We have reviewed Utica’s remaining arguments and find them unavailing. Concur—Tom, J.P., Saxe, Ellerin, Williams and Gonzalez, JJ.

Matter of State Farm Mut. Auto. Ins. Co. v Dowling (2004 NY Slip Op 02132)

Reported in New York Official Reports at Matter of State Farm Mut. Auto. Ins. Co. v Dowling (2004 NY Slip Op 02132)

Matter of State Farm Mut. Auto. Ins. Co. v Dowling (2004 NY Slip Op 02132)
Matter of State Farm Mut. Auto. Ins. Co. v Dowling
2004 NY Slip Op 02132 [5 AD3d 277]
March 23, 2004
Appellate Division, First Department
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
As corrected through Wednesday, May 26, 2004
In the Matter of State Farm Mutual Automobile Insurance Company, Appellant,
v
Colleen Dowling, Respondent.

Order, Supreme Court, New York County (Richard Braun, J.), entered May 5, 2003, which denied petitioner insurer’s application to stay arbitration of respondent’s underinsured motorist claim, unanimously affirmed, without costs.

The application to stay arbitration was properly denied on the ground that it was not made within 20 days after service of respondent’s demand (CPLR 7503 [c]). It does not avail petitioner that it timely commenced a proceeding to stay the arbitration in Queens County, which the Queens County court ordered transferred to New York County, and that it instituted the instant stay proceeding only because of ministerial difficulties it encountered in effectuating the transfer (cf. Matter of Metropolitan Prop. & Cas. Ins. Co. [Coping], 179 AD2d 499 [1992]). In any event, as the motion court also held, the petition lacks merit. Respondent notified petitioner insurer of the accident immediately after it happened, in connection with a no-fault claim. Neither at this time nor at any other time prior to the grant of summary judgment in the personal injury action respondent had brought, could she have known that the only defendant in that action with significant insurance coverage, the driver of the car in which she was a passenger and also insured by petitioner, would be absolved of liability, and that she therefore had a viable underinsurance claim against petitioner. Under such circumstances, it was the grant of summary judgment to defendant in the personal injury action that marked the commencement of respondent’s obligation to give written notice of claim “as soon as practicable” (see Matter of Allstate Ins. Co. v Sala, 226 AD2d 172 [1996], lv denied 89 NY2d 801 [1996]). Concur—Nardelli, J.P., Mazzarelli, Saxe and Friedman, JJ.

A.b. Med. Servs. Pllc v Cna Ins. Co. (2004 NY Slip Op 50061(U))

Reported in New York Official Reports at A.b. Med. Servs. Pllc v Cna Ins. Co. (2004 NY Slip Op 50061(U))

A.b. Med. Servs. Pllc v Cna Ins. Co. (2004 NY Slip Op 50061(U)) [*1]
A.B. Med. Servs. v CNA Ins. Co.
2004 NY Slip Op 50061(U)
Decided on February 11, 2004
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 Official Reports.
Decided on February 11, 2004

APPELLATE TERM OF THE SUPREME COURT, FIRST DEPARTMENT


PRESENT:
HON. LUCINDO SUAREZ, P.J.
HON. WILLIAM J. DAVIS
HON. MARTIN SCHOENFELD, Justices.
571135/02
A.B. MEDICAL SERVICES PLLC, G.A. PHYSICAL THERAPY P.C., a/s/o MIKHAIL SMOLYANSKIY, Plaintiff-Appellant,

against

CNA INSURANCE COMPANY, Defendant-Respondent.

Plaintiff appeals from an order of the Civil Court, New York County, entered January 25, 2002 (Debra A. James, J.) which denied its motion for summary judgment.

PER CURIAM:

Order entered January 25, 2002 (Debra A. James, J.) modified to grant plaintiff’s motion for summary judgment on its no-fault insurance claim relating to the April 24, 2000 medical services rendered to its assignor, Smolyanskiy, and to remit the matter to Civil Court for the assessment of appropriate attorney’s fees and interest with respect thereto; as modified, order affirmed, without costs.

The action seeks recovery of motor vehicle no-fault benefits in the form of medical expenses allegedly incurred by plaintiff’s assignors. Plaintiff demonstrated entitlement to summary judgment on its claim for neurological testing administered to its assignor, Smolyanskiy, on April 24, 2000, since the record shows that defendant received plaintiff’s no-fault claim relating to those services no later than June 23, 2000, and did not deny the claim until [*2]July 31, 2000. Having failed to “pay or deny the claim in whole or in part” (11 NYCRR 65-3.8[c]) within 30 days of receipt, defendant waived any defenses relating to the adequacy of plaintiff’s claim forms, including the alleged absence of necessary signatures (see, Mount Sinai Hosp. v Figuerdov, 263 AD2d 11, 17 [1999]) or the medical necessity of the services rendered (see, Central Gen. Hosp. v Chubb Group, 90 NY2d 195 [1997]; Country-Wide Ins. Co. v Zabloski, 257 AD2d 306, lv denied 93 NY2d 809 [1999]).

Summary judgment is unwarranted, however, on the remaining no-fault claims alleged in the complaint. Contrary to plaintiff’s contention, the peer review reports relied upon by defendant in timely denying the remaining claims were a proper vehicle to assert the defense of lack of medical necessity (11 NYCRR 65-3.8[b][4]) and set forth sufficient facts to raise a triable issue with respect to that defense (see, S+M Supply, Inc. v Allstate Ins. Co., 2003 WL 21960336, decided July 9, 2003 [App Term, 2d Dept]).

This constitutes the decision and order of the court.