Opinion
No. 141235/2008.
2010-08-23
URBAN RADIOLOGY, P.C. a/a/o Monica Hercules, Plaintiff, v. GEICO INSURANCE CO., Defendant.
Law Offices of Teresa M. Spina, Geico Indemnity Company, Woodbury, Attorneys for Defendant. Moshe D. Fuld, P.C., New York, Attorney for Plaintiff.
Law Offices of Teresa M. Spina, Geico Indemnity Company, Woodbury, Attorneys for Defendant. Moshe D. Fuld, P.C., New York, Attorney for Plaintiff.
REGINALD A. BODDIE, J.
In this action by a provider to recover assigned first-party no-fault benefits, defendant moved by Order to Show Cause to consolidate this matter with forty-five other pending cases commenced by the same provider against the defendant, to amend its answer to include a fraudulent incorporation defense, for additional discovery, and for a stay pending resolution of this issue in all the cases. Plaintiff opposed the motion and seeks costs and sanctions.
Defendant alleged that plaintiff provider, Urban Radiology, is ineligible for reimbursement of no-fault benefits, under Insurance Law § 5102(a)(1), because at the time services were rendered plaintiff was fraudulently incorporated, in violation of Business Corporation Law §§ 1503, 1507, 1508, and Education Law §§ 6530 and 6531. Courts have previously held that fraudulent incorporation is not a precluded defense and constitutes a complete bar to recovery under the no-fault insurance regulations (State Farm Mut. Auto. Ins. Co. v. Mallela, 4 NY3d 313 [2005];AB Medical Services PLLC v. Utica Mut. Ins. Co., 11 Misc.3d 71 [2006] ).
In brief, defendant asserted that “Although Dr. Rigney is listed as the owner of Urban Radiology, P.C. according to the Office of Professions of New York State, it is possible that he may not in fact be the true' owner of Urban Radiology, P.C. The instant UCC filing demonstrates that Ocean MRI, Inc. exerts total control of the proceeds and profits of Urban Radiology, P.C.” (affirmation of Eileen Hopkins ¶ 16). Defendant further alleged that Dr. Rigney was owner of JRWB Diagnostic Imaging, P.C., which also conducts MRIs, and that in January 1999 an arbitrator determined that Ocean MRI and David Batisyan were the true owners (affidavit of Eileen Hopkins ¶ 18). Accordingly, defendant requested depositions of Dr. John T. Rigney and Mr. Aleksander Kamsan, the former billing manager, with respect to all of plaintiff's cases pending in this Court ( Id. at ¶ 27).
During oral argument of this motion, defendant conceded that the cases are at various stages of litigation, including some which are already scheduled for trial, and that the facts differ in each case, except that the services were rendered by the same provider.
Consolidation
Civil Practice Law and Rules § 602(a) provides for consolidation of actions in appropriate circumstances as follows:
When actions involving a common question of law or fact are pending before a court, the court, upon motion, may order a joint trial of any or all matters in issue, may order the actions consolidated, and may make such other orders concerning proceedings therein as may tend to avoid unnecessary costs or delay.
However, consolidation is highly disfavored by courts in no-fault insurance cases. Generally, no-fault benefit claims may not be consolidated unless the facts and circumstances arise from a common accident. ( Metro Medical Diagnostics, P.C. v. Motor Vehicle Accident Indemnity Corp., 6 Misc.3d 136[A], 2005 N.Y. Slip Op 50238[U] [2005]; Poole v. Allstate Ins. Co., 20 AD3d 158, 519 [2d Dept 2006] (holding it would be an improvident exercise of discretion not to sever forty-seven claims where a single trial of claims would prove unwieldy and confuse the trier of fact.) Here, defendant cannot establish that the no-fault cases arose from a common set of facts or accident as grounds for consolidation. Instead, defendant seeks to proceed on the basis that the claims share a common question of law.
The identical issue was presented in a case decided by the Appellate Term in 2008 ( S & B Neurocare, P.C. v. Geico, 20 Misc.3d 132[A], 2008 N.Y. Slip Op 51450[U] [2008] ). There, the defendant also sought to consolidate all pending cases between the parties and assert a fraudulent incorporation defense. The court denied the motion, holding that merely alleging a medical provider is fraudulent fails to create sufficient questions of law and fact to justify consolidation. ( id.) The court also upheld the denial of defendant's motion to compel discovery because “[d]efendant failed to submit an affidavit specifying any facts entitling it to pretrial proceedings almost a year after the notice of trial was filed” ( id.; see also New York City Civ Ct Act § 208.17[d] ).
Similarly, the facts here clearly militate against consolidation. The cases are all at unspecified stages of litigation. Although defendant failed to set forth the procedural posture of each case, defendant acknowledged that many of the cases had proceeded past discovery and were noticed for trial. Notably, plaintiff stated, “Most cases the defendant seeks to consolidate have had a Notice of Trial filed, and the defendant is precluded from demanding additional discovery therein” (affirmation of Michael Reich ¶ 16). Consequently, it would be unwieldy to join the cases and clearly prejudicial to the plaintiff. Furthermore, defendant's underlying premise for alleging fraudulent incorporation, on these facts, is speculative. For the reasons set forth herein, consolidation is inappropriate and therefore denied.
Stay
Defendant also sought a stay pursuant to CPLR 2201, pending the outcome of discovery and a hearing on the alleged fraudulent incorporation defense. Defendant averred that a stay is necessary to maintain the status quo, to promote judicial economy and in the interests of justice (affirmation of Eileen Hopkins ¶ 34).
CPLR 2201 provides, “[e]xcept where otherwise prescribed by law, the court in which an action is pending may grant a stay of proceedings in a proper case, upon such terms as may be just.” A search revealed no cases where the Civil Court issued a stay of multiple actions, in similar circumstances, pending further discovery and the hearing of a Mallela claim. However, where relief was requested in the Supreme Court seeking a stay of Civil Court proceedings, the court treated these motions as motions for preliminary injunction. ( see St. Paul Travelers Ins. Co. v. Nandi, 15 Misc.3d 1145[A], 2007 N.Y. Slip Op 51154[U] [2007]; New York Central Mutual Ins. Co. v. McGee et al, 25 Misc.3d 1232[A], 2009 N.Y. Slip Op 52385[U] [2009].)
To prevail on an application for preliminary injunction, the moving party must demonstrate a probability of success on the merits, danger of irreparable harm in the absence of being granted relief and a balance of equities in its favor ( St. Paul Travelers at *7). Here, defendant clearly did not meet this test. Defendant has not established that it can properly assert a claim of fraudulent incorporation. Defendant also cannot establish irreparable harm since proof of fraud is an absolute defense to a claim for payment; nor can defendant demonstrate a balance of equities in its favor at this juncture in the litigation.
Nevertheless, the parties need not be held to the elevated standard of a preliminary injunction since, unlike the requests in St. Paul Travelers and New York Central Mutual, the defendant here does not seek to have this court stay proceedings pending in another court (15 Misc.3d 1145[A]; 25 Misc.3d 1232 [A] ). As such, defendant is not required to show that it would be entitled to preliminary injunction (Siegal, Practice Commentaries, McKinney's Cons Laws of NY, Book 7B, CPLR C2201:2).
As the Court of Appeals artfully noted in Mallela,
The [no fault] regulatory scheme, however, does not permit abuse of the truth seeking opportunity that 11 NYCRR 65–3.16(a)(12) authorizes. Indeed, the Superintendent's regulations themselves provide for agency oversight of carriers, and demand that carriers delay the payment of claims to pursue investigations solely for good cause ( see 11 NYCRR65–3.2 [c] ). In the licensing context, carriers will be unable to show “good cause” unless they can demonstrate behavior tantamount to fraud. Technical violations will not do. (Mallela, 4 NY3d 313 [2005].)
Here, defendant's statement that, “Although Dr. Rigney is listed as the owner of Urban Radiology, P.C. according to the Office of Professions of New York State, it is possible that he may not in fact be the true' owner of Urban Radiology, P.C.” is insufficient to show that defendant has a good faith basis to allege that Dr. Rigney is not the owner of Urban Radiology. Defendant has presented no affidavits or documents which address the issue of the alleged fraud with any certainty. Rather, defendant moved this court to stay the actions in order to explore the possibility of fraud. Consequently, this court declines to grant a discretionary stay in circumstances where, as here, the defendant's request for relief is based almost entirely on speculation rather than specific testimonial or documentary proof. ( see St. Paul Travelers at *7.) Accordingly, defendant's request for a stay is denied. Defendant may renew its request in the individual cases, as appropriate, upon presentation of additional proof consistent with this decision.
Leave to amend the answers and permit additional discovery
Finally, defendant requested leave to amend its answers and for additional discovery. CPLR 3025(b) commits the grant or denial of such leave to the trial court's discretion (Edenwald Contracting, 60 N.Y.2d at 959, citing Murray v. City of New York, 43 N.Y.2d 400, 404–05 [1977];Thomson v. Suffolk County Police Dept., 50 AD3d 1015 [2d Dept 2008] ). It provides that leave “shall be freely given upon such terms as may be just” (CPLR 3025 [b] ).
In other words, the court should freely grant leave to amend a pleading based on the facts and circumstances of each case and where there is no significant prejudice or surprise to the non-moving party (Sewkarran v. DeBillis, 11 AD3d 445 [2d Dept 2004] ). However, the evidence submitted in support of the motion must indicate that the amendment may have merit (Edenwald Contracting, 60 N.Y.2d at 959;Ingrami v. Rover, 45 AD3d 806, 808 [2007] ). Where the proposed amendment is “palpably insufficient or patently devoid of merit,” the court should deny leave to amend (Yemini v. Goldberg, 46 AD3d 806 [2d Dept 2007] (citations omitted); Beja v. Meadowbrook Ford, 48 AD3d 495 [2d Dept 2008] ).
CPLR 3101 governs disclosure and requires “full disclosure of all matter material and necessary in the prosecution or defense of an action, regardless of the burden of proof” (CPLR 3101[a] ). The court has previously held that, under appropriate circumstances, a party may move to seek additional discovery for the purpose of supporting a Mallela claim, pursuant to CPLR 3101(a) (One Beacon Ins. Group, LLC v. Midland Medical Care, P.C., 54 AD3d 738, 740 [2d Dept 2008] ). In instances where such discovery is sought, movant is not required to show “good cause,” but rather that the documents sought are “material and necessary in the prosecution” of the action (CPLR 3101[a]; One Beacon at 741 (citations omitted)).
Here, the court is unable to determine whether leave to amend and for additional discovery is appropriate, or in which cases it may be appropriate, as defendant has failed to articulate details regarding the procedural posture of each case. In any event, in as much as the court has declined to consolidate the cases, these issues need not be determined. Accordingly, the requests for leave to amend and for additional discovery are denied without prejudice to renew upon a proper showing in each case.
Other relief
Defendant's remaining requests for relief are premature, and therefore not addressed. Plaintiff's requests for costs and sanctions are denied.
This constitutes the Decision and Order of the Court.