New York court: proof of insurance fraud doesn’t entitle insurance companies to summary judgment

If you wonder why insurance fraud and insurance expense are so high in New York state it’s because of opinions like AA Acupuncture Service v. State Farm Mutual Insurance Company. (The fact that the plaintiff is a quack-upuncturist immediately suggests problems, no?) Civil Court Judge Arlene P. Bluth agreed that there was “uncontradicted, overwhelming circumstantial evidence” that an accident had been faked. But State Farm was still not entitled to summary judgment on the litigation of bad-faith claims by three medical providers who insisted that State Farm was liable as the insurer of the woman who claimed to have been injured in the accident. (Plaintiffs deny fraud, though apparently wasn’t able to rebut the evidence of fraud at the motion stage.)

Judge Bluth claims she is just following New York precedent. In A.M. Medical Services v. Nationwide Mutual Insurance Co., 12 Misc.3d 143 (2006), the passenger and driver “admitted under oath that they faked the accident and withdrew their claims with prejudice.” but summary judgment was still not granted against the
medical provider who maintained its suit. (Daniel Wise, “N.Y. Judge: Summary Judgment Barred in Fake Auto Accident Case”, NYLJ/, Jun. 6).

One Comment

  • From what I read in the NYLJ article, the Judge stated that there is a per se rule prohibiting the granting of summary judgment in this type of case. I am interested in reading the opinion. I had not heard of a per se rule barring summary judgment when plaintiff failed to establish a prima facie case. But, hey, its New York.