Court Opinion

ID: 9954295
Source: CourtListenerOpinion
Date Created: 2024-03-25 21:10:43.355716+00
Date Added: 2024-06-11T08:12:00.663324
License: Public Domain

Country-Wide Ins. Co. v JAM Pharm. Corp.
               2024 NY Slip Op 30940(U)
                     March 20, 2024
           Supreme Court, New York County
        Docket Number: Index No. 650231/2022
                  Judge: Arlene P. Bluth
Cases posted with a "30000" identifier, i.e., 2013 NY Slip
 Op 30001(U), are republished from various New York
 State and local government sources, including the New
  York State Unified Court System's eCourts Service.
 This opinion is uncorrected and not selected for official
                       publication.
  FILED: NEW YORK COUNTY CLERK 03/20/2024 04:34 PM                                                                   INDEX NO. 650231/2022
  NYSCEF DOC. NO. 17                                                                                           RECEIVED NYSCEF: 03/20/2024

                                   SUPREME COURT OF THE STATE OF NEW YORK
                                             NEW YORK COUNTY
            PRESENT:             HON. ARLENE P. BLUTH                                            PART                              14
                                                                                      Justice
            ---------------------------------------------------------------------------------X   INDEX NO.          650231/2022
                COUNTRY-WIDE INSURANCE COMPANY
                                                                                                 MOTION DATE        02/22/20221
                                                         Petitioner,
                                                                                                 MOTION SEQ. NO.         001
                                                 -v-
                JAM PHARMACY CORP, a/a/o Martin Marlon,                                            DECISION + ORDER ON
                                                                                                         MOTION
                                                         Respondent.
            ---------------------------------------------------------------------------------X

            The following e-filed documents, listed by NYSCEF document number (Motion 001) 2, 9, 10, 11, 12, 13,
            14, 15
            were read on this motion to/for                                 VACATE - DECISION/ORDER/JUDGMENT/AWARD.

                      The petition to vacate an arbitral award is denied and, pursuant to CPLR 7511(e), the

            Court confirms the award.

            Background

                      This proceeding concerns a motor vehicle accident that took place on July 24, 2018

            involving a vehicle insured by petitioner. The driver of the vehicle, Mr. Marlon, received

            healthcare from respondent, who then submitted bills to petitioner for reimbursement. Petitioner

            contends that it contested these bills on the ground that Mr. Marlon did not qualify as an eligible

            injured person entitled to receive no-fault benefits. Petitioner alleges that Mr. Marlon suffered

            injuries as a result of his own intentional act.

            1
              The Court acknowledges that this motion has been pending for far too long. Although this proceeding was only
            transferred to this part a few days ago, the undersigned apologizes, on behalf of the court system, for the lengthy
            delay in the resolution of this petition.
                650231/2022 COUNTRY-WIDE INSURANCE COMPANY vs. JAM PHARMACY CORP                                     Page 1 of 4
                Motion No. 001

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  FILED: NEW YORK COUNTY CLERK 03/20/2024 04:34 PM                                                  INDEX NO. 650231/2022
  NYSCEF DOC. NO. 17                                                                        RECEIVED NYSCEF: 03/20/2024

                   It argues that another arbitrator agreed with petitioner’s version of events in a dispute

            with a separate medical provider seeking reimbursement for Mr. Marlon’s injuries. Petitioner

            claims that collateral estoppel therefore applies here.

                   In opposition, respondent contends that this Court should uphold the rational awards

            issued by the lower arbitrator and the master arbitrator. It contends that collateral estoppel does

            not apply because it was not a party to that other arbitration. Respondent demands legal fees.

                   In reply, petitioner argues that the doctrines of res judicata and collateral estoppel apply.

            It also argues that there is no basis upon which respondent is entitled to recover legal fees.

            Discussion

                   The lower arbitrator expressly rejected petitioner’s claim of issue preclusion in her award

            (NYSCEF Doc. No. 3 at 2). She observed that “[Petitioner’s] defense is based wholly upon the

            investigator's report and Assignor's signed statement. However, upon initial review I note that

            Assignor's handwritten statement is difficult to read. Review of the statement reveals possibl[e]

            discrepancies between what is written in the statement and what is summarized by the

            investigator” (id. at 4). The arbitrator noted that “The investigator's characterization of the

            incident is unclear in light of Assignor's statement which, albeit difficult to read, appears to

            indicate that the other vehicle chased him and rammed into him. As such, this would not be an

            intentional act by the Assignor causing his own injury” (id.).

                   “[Petitioner] does not submit any other corroborating evidence supporting its

            interpretation of the incident. Despite indicating he was arrested by police officers; [Petitioner]

            does not submit any evidence of Assignor's arrest and/or court hearing. Furthermore, [Petitioner]

             650231/2022 COUNTRY-WIDE INSURANCE COMPANY vs. JAM PHARMACY CORP                       Page 2 of 4
             Motion No. 001

                                                           2 of 4
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  FILED: NEW YORK COUNTY CLERK 03/20/2024 04:34 PM                                                  INDEX NO. 650231/2022
  NYSCEF DOC. NO. 17                                                                        RECEIVED NYSCEF: 03/20/2024

            does not submit any evidence establishing the injuries were caused by the punching incident and

            not the accident” (id. at 4-5).

                    The Master Arbitrator upheld this lower arbitrator award and noted that “Arbitrator

            Saxon conducted a hearing and reviewed of all of the evidence. Initially, Arbitrator Saxon

            determined that collateral estoppel and res judicata did not apply to a prior award of Arbitrator

            Galeno in AAA # 99-18-1113-4891 since there was no privity between the parties. Arbitrator

            Saxon next considered the lack of coverage defense based upon fraud. Arbitrator Saxon

            considered the Respondent’s investigator’s report and the EIP’s written statement. Arbitrator

            Saxon noted that there was no EUO submitted nor any evidence of the EIP’s arrest. Arbitrator

            Saxon determined after considering all of the evidence that Respondent had failed to prove the

            fraud defense” (NYSCEF Doc. No. 6 at 2).

                    This Court confirms the award and denies the petition. The fact is that the arbitrator

            rationally determined that the doctrine of collateral estoppel did not apply because the medical

            provider was not a party to the other arbitration. Accordingly, she was not bound by the ruling in

            that arbitration that the accident here was intentional.

                    Moreover, petitioner did not meet its burden to cite another basis upon which this Court

            should vacate the award. CPLR 7511 provides just four grounds for vacating an arbitration

            award, including that the arbitrator exceeded his power, which “occurs only where the

            arbitrator's award violates a strong public policy, is irrational or clearly exceeds a specifically

            enumerated limitation on the arbitrator's power. Mere errors of fact or law are insufficient to

            vacate an arbitral award. Courts are obligated to give deference to the decision of the arbitrator,

            even if the arbitrator misapplied the substantive law in the area of the contract” (NRT New York

            LLC v Spell, 166 AD3d 438, 438-39, 88 NYS3d 34 [1st Dept 2018]).

             650231/2022 COUNTRY-WIDE INSURANCE COMPANY vs. JAM PHARMACY CORP                        Page 3 of 4
             Motion No. 001

                                                           3 of 4
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  FILED: NEW YORK COUNTY CLERK 03/20/2024 04:34 PM                                                     INDEX NO. 650231/2022
  NYSCEF DOC. NO. 17                                                                             RECEIVED NYSCEF: 03/20/2024

                    That petitioner disagrees with the findings of the arbitration awards is not basis for this

            Court to disturb these awards.

                    Respondent seeks legal fees. Although the respondent did not properly cross-move for

            anything (it only filed opposition), the Court can overlook this technicality as petitioner had a

            chance to oppose. As the prevailing party, the Court finds that respondent is entitled to recover

            legal fees (Am. Tr. Ins. Co. v Rutland Med. PC, 2024 NY Slip Op 00855, 1 [1st Dept 2024]).

            Respondent’s request for $1,250 is an inherently reasonable amount and so the Court awards it.

                    Accordingly, it is hereby

                    ADJUDGED that the petition to vacate the subject arbitration awards is denied and,

            pursuant to CPLR 7511(e), the Court confirms the award and the Clerk is directed to enter

            judgment in favor of respondent and against petitioner in the amount of $2,475.95 plus statutory

            interest from 07/19/2019 at the rate of 2%/month pursuant to 11 NYCRR 65-3.9(a), plus

            Statutory attorney’s fees (20% of interest plus principal) pursuant to 11 NYCRR 65-4.6(b), plus

            the Arbitration filing fee of $40 pursuant to 11 NYCRR 65-4.5(s)(1); plus reasonable attorneys’

            fees of $1,250 pursuant to 11 NYCRR 65-4.10(j)(4) for opposing this Petition along with costs

            and disbursements upon presentation of proper papers therefor.

                   3/20/2024                                                             $SIG$
                      DATE                                                       ARLENE P. BLUTH, J.S.C.
             CHECK ONE:               X   CASE DISPOSED                  NON-FINAL DISPOSITION

                                                                                                     □
                                          GRANTED             DENIED     GRANTED IN PART              X     OTHER

             APPLICATION:                 SETTLE ORDER                   SUBMIT ORDER

                                                                                                     □
             CHECK IF APPROPRIATE:        INCLUDES TRANSFER/REASSIGN     FIDUCIARY APPOINTMENT              REFERENCE

             650231/2022 COUNTRY-WIDE INSURANCE COMPANY vs. JAM PHARMACY CORP                             Page 4 of 4
             Motion No. 001

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