Source: http://masscases.com/cases/distapp/2009/2009massappdiv223.html
Timestamp: 2019-04-24 22:26:43+00:00

Document:
Present: Williams, P.J., Hand and Singh, JJ.
Jodi L. Conners for the defendant.
HAND, J. The plaintiff, N.E. Physical Therapy Plus, Inc. ("NEPT" ), appeals the trial court's allowance of defendant Commerce Insurance Company's ("Commerce") motion for summary judgment on NEPT's claims under G.Lc. 93A, s.11. [Note 1] For the reasons set forth below, we vacate the summary judgment on count 1 of NEPT's complaint, within which those claims are set forth.
is on the moving party to establish both the absence of any triable issue and the movant's entitlement to judgment in his favor. See Kourouvacilis v. General Motors Corp., 410 Mass. 706 , 714 (1991); Pederson v. Time, Inc., 404 Mass. 14 , 17 (1989). This affirmative burden may be met by the submission of pleadings, depositions, answers to interrogatories, admissions on file, affidavits, or other competent documentary evidence that satisfies the requirements of Rule 56(e). Where, as here, the moving party would not bear the burden of proof at trial, the movant may satisfy its summary judgment burden by submitting evidence that negates an essential element of the opposing party's claim, or by demonstrating that "proof of that element is unlikely to be forthcoming at trial." Flesner v. Technical Communications Corp., 410 Mass. 805 , 809 (1991).
The court must view the parties' evidentiary materials "in the light most favorable to the nonmoving party," Gray v. Giroux, 49 Mass. App. Ct. 436 , 438 (2000), quoting Mass. R. Civ. P., Rule 56(c), and must resolve in the nonmovant's favor any doubt as to the existence of factual issues. Foley v. Matulewicz, 17 Mass. App. Ct. 1004 , 1005 (1984); Knight v. CNA Ins. Cos., 2002 Mass. App. Div. 3 , 5. The court may not assess the credibility of the evidence presented, consider the weight of that evidence, or make any findings of fact. Riley v. Presnell, 409 Mass. 239 , 244 (1991).
paid the disputed $1,203.39 balance of the insured's PIP submissions. [Note 4] The record includes no more detail than recited here concerning the timing of, procedure followed during, or rationale for Commerce's handling of NEPT's billings.
As an initial matter, we note that Commerce's burden in moving for summary judgment on a claim under G.L.c. 93A, s.11 is not easily met. "Whether a given practice is unfair or deceptive under G.L.c. 93A must be determined from the circumstances of each case." Noyes v. Quincy Mut. Fire Ins. Co., 7 Mass. App. Ct. 723 , 726 (1979). See Schwanbeck v. Federal Mogul Corp., 31 Mass. App. Ct. 390 , 414 (1991), S.C., 412 Mass. 703 (1992), citing Spence v. Boston Edison Co., 390 Mass. 604 , 616 (1983) (ordinarily, "whether a particular set of acts, in their factual setting, is unfair or deceptive [under G.L.c. 93A] is a question of fact"). See also Chervin v. Travelers Ins. Co., 448 Mass. 95 , 112 (2006) (same); Brewster Wallcovering Co. v. Blue Mountain Wallcoverings, Inc., 68 Mass. App. Ct. 582 , 604 n.52 (2007) (same). In the context of these claims, "[r]esolution of the basic dispute under the circumstances of [a] case depends upon a factual determination of [the insurer's] knowledge and intent." Noyes, supra at 726. Intent is, of necessity, a question of fact, and so is rarely amenable to determination on summary judgment. See, e.g., Madden v. Estin, 28 Mass. App. Ct. 392 , 395 (1990), citing Quincy Mut. Fire Ins. Co. v. Abernathy, 393 Mass. 81 , 86 (1984) ("When intent is at the core of a controversy, summary judgment seldom lies.").
Accordingly, we vacate the summary judgment in Commerce's favor on count 1 of NEPT's complaint. The case is returned to the Quincy District Court for trial on that count.
[Note 1] Commerce was granted summary judgment on each of the plaintiff's five claims against it; the plaintiff appeals only the court's ruling on the G.L.c. 93A claim.
[Note 2] This fact gives NEPT standing to bring the instant action. See Provenzano v. Plymouth Rock Assur. Corp., 2008 Mass. App. Div. 68 , 69, quoting G.L.c. 90, s.34M (if PIP payments for medical bills are not made by insurer within thirty days, treating practitioner "shall be deemed a party to a contract with the insurer responsible for payment and shall therefore have a right to commence an action in contract for payment").
[Note 3] There is no evidence in the record indicating which bills or records were submitted to Coventry Healthcare Worker's Compensation, Inc., which to Boeglin, and which to Dodes; about the timing of the bills' or records' review; or about the specific details of any reviewer's conclusions.
[Note 4] This payment extinguished NEPT's claims under G.L.c. 90, s.34M, Provenzano, supra at 69, citing Fascione v. CNA Ins. Cos., 435 Mass. 88 , 94 (2001), but is not necessarily fatal to NEPT's claims under G.L.c. 93A. Id., citing Amart v. Plymouth Rock Assur Corp., 2004 Mass. App. Div. 131 , 132.
[Note 5] For example, whether Commerce ensured that any medical review of NEPT's bills was conducted by a practitioner registered or licensed in the same specialty as that practiced by those for whose services NEPT billed. See G.L.c. 90, s.34M.
[Note 6] On appeal, NEPT argues that its motion to strike the Affidavit on hearsay grounds, never acted on by the trial court, should have been allowed. Because we find that even if the Affidavit were admissible in its entirety, Commerce is not entitled to summary judgment on NEPT's G.L.c. 93A claims, we do not reach the issues relating to the admissibility of the Affidavit.
[Note 7] With respect to Commerce's argument that NEPT has any burden of proof on Commerce's summary judgment claim as to the c. 93A violation, we find Commerce's showing on its motion to have been insufficient to have shifted the bur den of proof to NEPT on that claim. See, e.g., Dattoli v. Hale Hosp., 400 Mass. 175 , 178 (1987) (burden of proof shifts to party opposing summary judgment only after moving party satisfies prerequisites to summary judgment); Madsen v. Erwin, 395 Mass. 715 , 719 (1985) (same).

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