Source: http://masscases.com/cases/distapp/2011/2011massappdiv72.html
Timestamp: 2019-04-23 22:19:39+00:00

Document:
METRO WEST MEDICAL ASSOCIATES, INC., d/b/a METRO MEDICAL ASSOCIATES v. PREMIER INSURANCE COMPANY. REGIONAL REHABILITATION ASSOCIATES MANAGEMENT CORP. v. PREMIER INSURANCE COMPANY.
Court Below: District Court, Haverhill Division.
Geoffrey M. Regan for the plaintiff.
GRECO, P.J. These cases all raise the same issue of whether the trial judge erred in granting summary judgment in favor of Premier Insurance Company. The same law firm represents Metro West Medical Associates (Metro West) and Regional Rehabilitation Associates Management Corporation (Regional Rehab.), which both provide chiropractic services. The same lawyer represents Premier Insurance Company (Premier), an insurer that provides to its insureds personal injury protection (PIP) benefits. The scenario in all seven cases is remarkably similar, but for some dates and dollar amounts. Consequently, we will address these cases in one opinion. As set out below, in each case, there was a motor vehicle accident as a result of which a party insured by Premier was treated by Metro West or Regional Rehab., which then, sitting in the shoes of the injured party pursuant to G.L. c. 90, § 34M, submitted a claim to Premier for payment for those services.
amount. On July 20, 2009, Metro West filed its complaint to recover the balance of the claim. On March 15, 2010, Premier sent Metro West a check for the balance sought in the original claim, which Metro West returned.
In case No. 1010043, the accident occurred on December 20, 2005. Metro West submitted a claim to Premier in the amount of $1,025.00 for services it provided from January 18, 2006 to April 3, 2006. On or before May 17, 2006, Premier paid $369.86 of that amount. On July 20, 2009, Metro West filed its complaint to recover the balance of the claim. On March 15, 2010, Premier sent Metro West a check for the balance sought in the original claim, which Metro West returned.
In case No. 1010044, the accident occurred on December 9, 2005. Metro West submitted a claim to Premier in the amount of $425.00 for services it provided on January 30, 2006. On March 23, 2006, Premier paid $262.00 of that amount. On July 20, 2009, Metro West filed its complaint to recover the balance of the claim. On March 15, 2010, Premier sent Metro West a check for the balance sought in the original claim, which Metro West returned.
In case No. 1010045, the accident occurred on January 24, 2006. Regional Rehab, submitted a claim to Premier in the amount of $1,956.00 for services it provided from January 30, 2006 to April 21, 2006. On May 24, 2006, Premier paid $1,504.16 of that amount. On July 20, 2009, Regional Rehab. filed its complaint to recover the balance of the claim. On March 15, 2010, Premier sent Regional Rehab. a check for the balance sought in the original claim, which Regional Rehab. returned.
In case No. 1010046, the accident occurred on December 20, 2005. Regional Rehab. submitted a claim to Premier in the amount of $2,944 .00 for services it provided from January 16, 2006 to February 23, 2006. On April 28, 2006, Premier paid $2,574.92 of that amount. On July 20, 2009, Regional Rehab. filed its complaint to recover the balance of the claim. On March 18, 2010, Premier sent Regional Rehab. a check for the balance sought in the original claim, which Regional Rehab. returned.
In case No. 1010047, the accident occurred on June 28, 2005. Metro West submitted a claim to Premier in the amount of $700.00 for services it provided from July 8, 2005 to August 26, 2005. On February 15, 2006, Premier paid $244.80 of that amount. On July 24, 2009, Metro West filed its complaint to recover the balance of the claim. On March 15, 2010, Premier sent Metro West a check for the balance sought in the original claim, which Metro West returned.
In response to Premier's motion for summary judgment, Metro West and Regional Rehab. filed essentially identical memoranda and affidavits of their attorney. In the affidavits, counsel simply refers to the pleadings, the settlement offer, the checks sent by Premier for the balance of the claim, the rejection of those checks, and the plaintiffs' Chapter 93A demand letters.
to negate one or more elements of the other party's claim. Kourouvacilis v. General Motors Corp., 410 Mass. 706 , 716 (1991). If such a showing is made, the nonmoving parties, here Metro West and Regional Rehab., may not rest upon the mere allegations ... of [their] pleading[s], but [their] response[s], by affidavits or as otherwise provided in [Rule 56], must set forth specific facts showing that there is a genuine issue for trial. Rule 56(e). See also LaLonde v. Eissner, 405 Mass. 207 , 209 (1989).
408 Mass. 100 , 105 (1990), quoting Castellucci v. United States Fid. & Guar. Co., 372 Mass. 288 , 289 (1977). However, the futility of the amendment sought has been recognized as a reason to deny such a motion. See Vakil v. Vakil, 450 Mass. 411 , 417 (2008). Here, the proposed new claims under Chapters 93A and 176D raise the same issues as the claims under § 34M upon which the trial judge awarded summary judgment. As noted above, neither Metro West, nor Regional Rehab., submitted affidavits in opposition to the materials filed by Premier explaining its basis not to pay, initially, the full amount of the claims. Moreover, these cases were brought several years after the Fascione decision where the Supreme Judicial Court alluded to the availability of a Chapter 93A claim as an additional method of recovery. Fascione, supra at 95 n. 6. Finally, in none of these cases has the statute of limitations run out.
Accordingly, the award of summary judgment in favor of Premier as well as the denial of the motions to amend in these seven cases are affirmed.
[Note 1] . Thus, in all seven cases, the providers did nothing to indicate any dissatisfaction with the amount Premier initially paid. Over three years elapsed before the complaints were filed (five on July 20, 2009, and two on July 24, 2009). However, when the balances of the claims were paid, the providers indicated their dissatisfaction by returning the checks.
[Note 2] . Premier's other argument for summary judgment pursuant to Fascione has been rejected by this Division in Metro West. Med. Assocs., Inc. v. Arnica Mut. Ins. Co., 2010 Mass. App. Div. 137 , where it was stated that it would not be inconsistent with the holding in Fascione to require that the insurer on the § 34M claim show more on summary judgment than simply that the bills have all been paid. It should also have to show that there is no genuine issue of fact concerning whether it had a valid reason not to pay, and that it paid an invalid claim for reasons unrelated to its merits.... Id. at 139. See also Olympic Physical Therapy v. ELCO Admin. Servs., 2010 Mass. App. Div. 171 , 173 n.1.

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