Opinion
No. 056025/09.
2010-08-25
VIT ACUPUNCTURE P.C., aao Mona Samedy, Plaintiff, v. STATE FARM AUTOMOBILE INS. CO., Defendant.
DEVIN P. COHEN, J.
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 A.D.2d 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 A.D.2d 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 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 A.D.2d 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, 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.