Key Takeaway
Central Nassau Diagnostic Imaging v GEICO case shows how providers can use admissions from notices to admit to establish prima facie cases for no-fault benefits.
Central Nassau Diagnostic Imaging, P.C. v GEICO, 2010 NY Slip Op 20244 (App.Term 1st Dept. 2010)
I am going to annotate this opinion –
Here is the synopsis of the argument:
“On appeal, defendant argues that plaintiff could not rely upon defendant’s admissions resulting from its failure to respond to the notice to admit to establish plaintiff’s prima facie case. Defendant maintains that, notwithstanding the factual admissions resulting from its failure to respond to the notice to admit, plaintiff was required to call witnesses at trial to lay a foundation for the admission into evidence of the bills. Because plaintiff did not call any trial witnesses, defendant asserts that the complaint should have been dismissed, as plaintiff failed to establish entitlement to recover the assigned no-fault benefits. We disagree, and affirm.”
Here is the holding:
“laintiff’s requests for admissions were appropriate and defendant, by failing to respond to the notice to admit or seek other appropriate relief, is deemed to have admitted the facts on which plaintiff sought admissions. Because defendant admitted that the two bills attached to the notice were “true and accurate” copies of the bills received by defendant and that defendant has not paid those bills, plaintiff established its entitlement to recover the overdue assigned first-party no-fault benefits (see Mary Immaculate Hosp. v Allstate Ins. Co., 5 AD3d 742 ).”
The final nail in the coffin from this court:
“Our conclusion that a plaintiff-provider can use admissions obtained through a notice to admit to establish its entitlement to recover overdue assigned first-party no-fault benefits is consonant with the purposes underlying the No-Fault Law, which “were to ensure prompt compensation for losses incurred by accident victims without regard to fault or negligence, to reduce the burden on the courts and to provide substantial premium savings to New York motorists” (Medical Socy. of State v Serio, 100 NY2d 854, 860 ), as well as case law [*3]allowing a plaintiff-provider to establish its entitlement to such benefits based on admissions obtained from a defendant-insurer on interrogatories (see Fair Price Med. Supply, Inc. v St. Paul Travelers Ins. Co., 16 Misc 3d 8 ).”
The Appellate Term, Second Department gets slighted:
“To the extent Bajaj v Gen. Assur. (18 Misc 3d 25 ) can be read to support a contrary result, we decline to follow it.”
My thoughts:
Why would a plaintiff stipulate to anything if an unanswered notice to admit or Interrogatory #18 of a famous law firm’s discovery package is completely answered?
Admittedly, I suppose this decision makes sense and is correct on the law as Appellate Division authority exists right now. As a practitioner, it just seems crazy that a provider can mail a piece of paper – it probably can even be a boulder that Fred Flintstone chizzled into – wave a wand and make its case through the statutorily mandated duties of an insurance carrier. Blame the Appellate Division for this result.
But, I have to laugh at how allowing a medical provider to meet its prima facie case without calling a witness or relying on an insurance carrier’s admissions: “educe the burden on the courts and to provide substantial premium savings to New York motorists”. It looks like the author of this per curiam opinion decided to hurl some of the left over salt from the stockpiles that New York City has at the conclusion of the winter season at Geico’s counsel’s open wounds.
ONE MORE THING
I was informed last night that I was actually referencing “interrogatory #8”, see supra. I said “18”. And yes, I have received many motions over the years explaining how my response to this famous interrogatory was deficient.
Related Articles
- The Fourth Department for the first time in a decade has discussed what constitutes a prima facie case
- Carothers v. Geico: The No-Fault Business Records Showdown
- Understanding Prima Facie Cases in New York No-Fault Insurance Law
- Prima Facie Case Requirements in NY No-Fault Insurance: Avoiding the Omni Chiropractic Mistake
- New York No-Fault Insurance Law
