Key Takeaway
Court incorrectly applies res judicata in no-fault case where different treatment periods and lack of specific findings should prevent collateral estoppel application.
Huntington Med. Plaza, P.C. v Travelers Indem. Company, 2014 NY Slip Op 50527(U)(App. Term 2d Dept. 2014)
What is going on at the Appellate Term? Is anyone researching these issues before their opine? I just feel like this Court has been shooting from the hip lately.
“The two prior cases, involving treatments rendered from July 2008 to February 2009, went to a joint trial, at which defendant’s IME doctors testified as to their conclusions that the assignor’s injuries had resolved and that the assignor needed no further treatment. Plaintiffs put on no rebuttal witnesses in that case. After the trial, according to a decision on the record submitted by defendant in support of its motion, the court found in favor of defendant, but made no specific factual findings.”
“Based on the foregoing, defendant argued, plaintiffs were collaterally estopped from contending that the September 2009 to December 2009 treatments at issue in this case were medically necessary.”
“The decision in the prior actions was presumably based on a finding that the treatments at issue in those cases were not medically necessary. However, the court in those cases did not find that no post-IME complaints or disability could be attributable to the accident in question (compare Barnett v Ives, 265 AD2d 865 ), or that the assignor’s condition could not have worsened either after the IME or after the treatments at issue therein, nor were such findings necessary to the court’s decision.”
If you read the Trial Court decision in Martin v. Geico, a case where Plaintiff sought further medical benefits following a loss in arbitration, the Court said: “After a hearing, the arbitrator affirmed the denial by Geico for no-fault benefits on the basis that plaintiff had failed to sustain her burden of proof.” (Martin v. Geico, 2005 WL 6052968 , affd, 31 AD3d 505 ).
So, if the plaintiff failed to meet its burden, it may never come back to court. Yet, our Appellate Term sees it either otherwise.
Related Articles
- How the Huntington/Travelers case can play out in practice
- Understanding declaratory judgment actions and res judicata in New York no-fault cases
- Using first-party no-fault IME evidence to support third-party summary judgment motions
- Collateral estoppel issues when co-defendants default in coverage disputes
- Notice of entry requirements and res judicata implications
