| VIT Acupuncture, P.C. v State Farm Auto. Ins. Co. |
| 2010 NY Slip Op 51560(U) [28 Misc 3d 1230(A)] |
| Decided on August 25, 2010 |
| Civil Court Of The City Of New York, Kings County |
| Cohen, J. |
| Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431. |
| As corrected in part through September 8, 2010; it will not be published in the printed Official Reports. |
VIT Acupuncture P.C.,
aao Mona Samedy, Plaintiff,
against State Farm Automobile Ins. Co., Defendant. |
Upon review of the foregoing papers, and after oral argument, the defendant's motion to dismiss is denied.
In this action to recover assigned first-party no-fault benefits, defendant insurance provider
moves pursuant to CPLR 3211(a)(1) and (7) to dismiss all causes of action in the complaint
based on plaintiff's alleged failure to attend two duly requested Examinations Under Oath
(EUOs).
CPLR 3211(a)(1)
To obtain pre-answer dismissal pursuant to CPLR 3211(a)(1), defendant must allege
that its defense is fully founded upon documentary evidence. Moreover, the documentary
evidence offered in that defense "must resolve all factual issues as a matter of law, and
conclusively dispose of the plaintiff's claim" (Teitler v Max J. Pollack & Sons, 288
AD2d 302 [2d Dept 2001]). "Documentary evidence" within the meaning of CPLR 3211(a)(1),
must be "unambiguous and of undisputed authenticity" (Fontanetta v Doe, 73 AD3d 78 [2d Dept 2010] citing Siegel,
Practice Commentaries, McKinney's Cons. Laws of NY, Book 7B, CPLR C3211:10, at 21-22).
CPLR 3211(a)(1) does not anticipate or intend the use of affidavits submitted as testimony
substitutes (see e.g. Berger v Temple Beth-El of Great Neck, 303 AD2d 346 [2d Dept
2003]).
Affidavits submitted by a defendant "will almost never warrant dismissal under
CPLR 3211" (Lawrence v Miller,
11 NY3d 588, 595 [2008]). In the context of CPLR 3211(a)(1), the narrow exception to this
general rule might be affidavits used solely to establish the bona fides of other, genuinely
documentary evidence. For instance, a certifying affidavit establishing a true and accurate copy
of a filed deed might support a motion for dismissal under CPLR 3211(a)(1).
By its nature, the pre-answer motion to dismiss deprives the parties of the
opportunity and obligation to have a trial, to exchange discovery, or for the non-moving party to
have even a responsive pleading in the action. This is a drastic remedy, and should be reserved to
cases which turn on an undisputed and undisputable document (e.g. a dishonored check, a deed,
etc.). CPLR [*2]3211(a)(1) should not be used as a pre-answer
alternative for what is more properly a request for summary judgment pursuant to CPLR 3212.
Defendant relies upon two affidavits to support the instant motion. The affidavit of
Jackie Hackett describes the standard office procedure for generating and mailing verification
requests, including EUO notices, as well as denials. The affidavit of calendar clerk Toyla Hogan
alleges that the plaintiff failed to appear for the EUOs purportedly scheduled by the defendant.
Presumably, this is the "documentary evidence" to which defendant's motion refers.
Defendant's affidavits are not the type of evidence required in order to succeed on a
pre-answer motion to dismiss pursuant to CPLR 3211(a)(1). Rather, defendant's proffered
affidavits are testimonial in nature. They are essentially offered as substitutes for testimony
which would otherwise be offered later at trial. These testimonial affidavits are, by their nature,
neither unambiguous nor of undisputed authenticity. They depend heavily on the credibility
attached to them as recitations of the facts of the case. They offer only one view (or two views)
of the factual narrative which underlies the claim in question.
CPLR 3211(a)(7)
Defendant further asserts that the claim should be dismissed because plaintiff's pleading fails to state a cause of action (CPLR 3211[a][7]). Under CPLR 3211(a)(7), the applicable test is whether the pleading states a cause of action, not whether the proponent of the pleading, in fact, has a meritorious cause of action (see Sokol v Leader, 74 AD3d 1180 [2d Dept, 2010]). "Whether a plaintiff can ultimately establish its allegations is not part of the calculus" (EBC I, Inc. v Goldman, Sachs & Co., 5 NY3d 11 [2005]). "[O]n a motion to dismiss pursuant to CPLR 3211(a)(7), the court must determine whether, accepting as true the factual averments of the complaint and according the plaintiff the benefits of all favorable inferences which may be drawn therefrom, the plaintiff can succeed upon any reasonable view of the facts stated" (Board of Educ. of City School Dist. of City of New Rochelle v County of Westchester, 282 AD2d 561, 562 [2d Dept 2001]).
As previously established, the testimonial affidavits of Ms. Hogan and Ms. Hackett are not
documentary evidence as required under CPLR 3211(a)(1). More germane to a CPLR 3211(a)(7)
analysis, while these affidavits, if taken as true, might bear on the merits of plaintiff's action,
they do not affect whether or not the complaint itself states a cause of action. Here, plaintiff's
complaint states a cause of action in that plaintiff claims to have properly submitted bills to
defendant for acupuncture services rendered to its assignor which have not been paid. Thus,
dismissal is not appropriate under CPLR 3211(a)(7).
Ripeness
Defendant seems to suggest that this action should be dismissed as premature because plaintiff has failed to comply with defendant's verification requests scheduling the EUOs, and that the failure to comply tolls the defendant's time to deny the claim. Pursuant to NYCRR § 65.15(h), an outstanding verification request tolls the 30 day statutory period during which defendant must pay or deny a claim. Since an insurer is not obligated to pay or deny a claim while verification requests for that claim are outstanding, any lawsuit filed during such period is deemed premature (see Vista Surgical Supplies v General Assur. Co., 12 Misc 3d 129(A) [App Term, 2d Dept 2005]; Ocean Diagnostic Imaging, P.C. v Nationwide Mutual Ins. Co., 11 Misc 3d 135(A) [App Term, 2d Dept 2006]). However, in this case, defendant admits that it issued a denial for this claim on January 28, 2008, citing plaintiff's alleged failure to appear for the scheduled EUOs. Having denied the claim, [*3]defendant essentially invited the plaintiff's subsequent proceedings to challenge the denials.
For the reasons stated, defendant's motion is denied. The plaintiff shall serve a copy of this
decision and order on defendant's counsel, with notice of entry. Defendant shall serve and file an
answer in this matter within 30 days of plaintiff's service of this order. This constitutes the
decision and order of this court.