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The New York Hospital Medical Center of Queens As Assignee of Victor Morales v. Utica Mutual Insurance Company

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 9th and 10th JUDICIAL DISTRICTS New York Supreme and/or Appellate Courts


December 20, 2012

THE NEW YORK HOSPITAL MEDICAL CENTER OF QUEENS AS ASSIGNEE OF VICTOR MORALES,
RESPONDENT,
v.
UTICA MUTUAL INSURANCE COMPANY,
APPELLANT.

Appeal from an order of the District Court of Nassau County, First District (Michael A. Ciaffa, J.), dated June 21, 2011.

New York Hosp. Med. Ctr. of Queens v Utica Mut. Ins. Co.

Appellate Term, Second Department

Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.

This opinion is uncorrected and will not be published in the printed Official Reports.

Decided on December 20, 2012

PRESENT: MOLIA, J.P., NICOLAI and IANNACCI, JJ

The order, insofar as appealed from, denied defendant's cross motion for summary judgment dismissing the complaint.

ORDERED that the order, insofar as appealed from, is reversed, without costs, and defendant's cross motion for summary judgment dismissing the complaint is granted.

In this action by a provider to recover assigned first-party no-fault benefits, defendant appeals from so much of an order of the District Court as denied defendant's cross motion for summary judgment dismissing the complaint.

In support of its cross motion, defendant submitted an affidavit by its insured who stated that plaintiff's assignor had jumped on the hood of the insured's car, while it was parked, and got off of the car without incident or injury. The insured, according to his sworn statement, drove away without further contact with plaintiff's assignor. Consequently, defendant argued that plaintiff's assignor's alleged injuries did not arise out of an insured incident. In opposition to defendant's cross motion, plaintiff submitted a police accident report and plaintiff's assignor's hospital records. According to plaintiff, these records demonstrate that its assignor was injured when defendant's insured drove his car into plaintiff's assignor, as reported to the police and hospital personnel by plaintiff's assignor. The District Court found that the assignor's hearsay statements that are contained within the records, in conjunction with the medical information, raised a triable issue of fact as to how plaintiff's assignor was injured.

The police report offered by plaintiff did not constitute proof in admissible form, as it was not certified pursuant to CPLR 4518 (c) and no foundation establishing its authenticity and accuracy was offered (see Cheul Soo Kang v Violante, 60 AD3d 991, 991 [2009]). In any event, "the statements in the report attributed to the [plaintiff's assignor] constituted inadmissible hearsay" (id. at 991-992).

The hospital records that plaintiff submitted to the court purport to include a description of the alleged accident as reported to hospital staff by plaintiff's assignor. Such statements are considered reliable only when they are relevant to diagnosis or treatment (see Williams v Alexander, 309 NY 283, 286 [1955]). Here, the hospital records do not contain any allegations that rebut the allegations contained in defendant's insured's sworn statement. Furthermore, plaintiff failed to lay the requisite foundation for the hospital records (see CPLR 4518 [a], [c]). Thus, contrary to the finding of the District Court, even assuming the hospital records were admissible at all, and therefore could be used as proof that plaintiff's assignor was injured by a motor vehicle, they still did not raise a triable issue of fact as to whether defendant's insured was involved, thereby triggering defendant's liability.

Since defendant demonstrated that the injuries in question did not arise out of an insured incident, and plaintiff failed to raise a triable issue of fact, defendant's cross motion for summary judgment dismissing the complaint should have been granted (see St. Vincent's Hosp. & Med. Ctr. v Allstate Ins. Co., 69 AD3d 923 [2010]; Andromeda Med. Care, P.C. v NY Cent. Mut. Fire Ins. Co., 26 Misc 3d 126[A], 2009 NY Slip Op 52601[U] [App Term, 2d, 11th & 13th Jud Dists 2009]).

Molia, J.P., Nicolai and Iannacci, JJ., concur.

Decision Date: December 20, 2012

20121220

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