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East End Med., P.C. v. Oxford Health Ins., Inc.

Appellate Term of the Supreme Court of New York, First Department
Jun 29, 2006
2006 N.Y. Slip Op. 51229 (N.Y. App. Term 2006)

Opinion

570137/05.

Decided June 29, 2006.

In consolidated actions, plaintiff appeals from eight orders of the Small Claims Part of the Civil Court, New York County (Eileen A. Rakower, J.), each entered on or about August 12, 2004, which granted defendant's motion to dismiss the actions at the close of plaintiff's evidence.

Orders (Eileen A. Rakower, J.), entered on or about August 12, 2004, reversed, without costs, and new trial ordered.

PRESENT: McCooe, J.P., Gangel-Jacob, Schoenfeld, JJ


These consolidated small claims actions, seeking recovery of insurance benefits allegedly due in connection with medical services rendered by plaintiff to 13 of its patients/assignors, were erroneously dismissed at the close of plaintiff's case. The evidence so far presented, viewed in the light most favorable to plaintiff ( see Szczerbiak v. Pilat, 90 NY2d 553, 556; Bracco v. Puntillo Ltd. Partnership, 19 AD3d 624, 625), was sufficient to establish prima facie both the validity of the assignments of benefits underlying plaintiff's claims and plaintiff's entitlement to reimbursement under defendant's health care plan as an "out-of-network" provider. Defendant's present challenge to the assignments on the basis of plaintiff's claimed failure to comply with the written consent requirements of the governing health insurance plan, raised for the first time on appeal, is not properly before us. Thus, the peremptory dismissal of plaintiff's claims did not achieve "substantial justice" consistent with substantive law principles (CCA 1804, 1807).

With respect to the concerns over subject matter jurisdiction expressed in the dissent — an issue neither raised nor briefed by the parties — it suffices to say that jurisdiction over the assigned insurance claims was conferred pursuant to CCA § 1809-A, which authorizes "[a]ny corporation . . . and an assignee of any commercial claim" to institute a small claims action ( see Dependable Ambulette, Inc. v. Progressive Ins. Co., 4 Misc 3d 228, 229-230).


Plaintiff East End Medical, P.C. commenced these consolidated actions in the Small Claims Part, seeking recovery of insurance benefits allegedly owed to 13 of its patients/assignors in connection with medical services that it provided to those patients. The assigned causes of action do not qualify for small claims treatment since they run afoul of the express terms of CCA 1809(1), which provide that "No corporation, . . . partnership, or association and no assignee of any small claim shall institute an action or proceeding under this article". Nor can the assigned causes of action properly be considered "commercial claims" maintainable under CCA article 18-A, since each of the claims derives from an individual assignor, and not a corporation, partnership or association ( see Institute of Physical Medicine and Rehabilitation, LLP v. Country-Wide Ins. Co., 193 Misc 2d 803; Dunrite Auto Body Motors, Inc. v Liberty Mut. Ins. Co., 160 Misc 2d 168). "Jurisdiction of the subject matter cannot be conferred on the court even by stipulation of the parties. The objection may be taken at any stage of the action, and the court may, on its own motion whenever its attention is called to the facts, refuse to proceed further, and dismiss the action." (Siegel, NY Prac, § 8, at 11 [4th ed].) Since the Small Claims Part lacked jurisdiction to adjudicate plaintiff's assigned claims, I respectfully dissent and would sustain the dismissal of the actions, albeit solely on jurisdictional grounds, without prejudice to plaintiff's remedies in a proper forum.

This constitutes the decision and order of the court.


Summaries of

East End Med., P.C. v. Oxford Health Ins., Inc.

Appellate Term of the Supreme Court of New York, First Department
Jun 29, 2006
2006 N.Y. Slip Op. 51229 (N.Y. App. Term 2006)
Case details for

East End Med., P.C. v. Oxford Health Ins., Inc.

Case Details

Full title:EAST END MEDICAL, P.C., Plaintiff-Appellant, v. OXFORD HEALTH INSURANCE…

Court:Appellate Term of the Supreme Court of New York, First Department

Date published: Jun 29, 2006

Citations

2006 N.Y. Slip Op. 51229 (N.Y. App. Term 2006)