Carothers v. Insurance Companies

26 Misc. 3d 448
Civil Court of the City of New York·Decided October 14, 2009·Published·Cited by 6 cases

Opinion

OPINION OF THE COURT

Peter P. Sweeney, J.

Following a jury verdict for defendants on their defense that plaintiff, Andrew Carothers, M.D., P.C., was fraudulently incorporated within the meaning of State Farm Mut. Auto. Ins. Co. v Mallela (4 NY3d 313 [2005]), plaintiff moves pursuant to CPLR 4404 (a), and in the interests of justice, to set aside the verdict, to enter a verdict in its favor and/or for a new trial on the grounds that: (a) the court improperly instructed the jury on fraudulent incorporation; (b) the court’s decision to charge the jury, and the specific contents of the charge concerning whether Dr. Andrew Carothers practiced medicine was erroneous; (c) the court erred in permitting the jury to consider and draw adverse inferences against the plaintiff due to Irina Vayman’s and Hillel Sher’s refusal to testify on Fifth Amendment grounds; and (d) the court made a myriad of erroneous evidentiary rulings favoring defendants.

L

Factual Background

A. Introduction

Plaintiff is a professional service corporation that was engaged in the practice of medicine. Dr. Andrew Carothers, a board certified radiologist, was listed on all the plaintiffs corporate filings as the sole shareholder, and the only officer and director. While in practice, the corporation operated several radiology facilities in the City of New York where it performed magnetic [451]*451resonance imaging scans (MRIs) for patients that were allegedly injured in automobile accidents. The vast majority of these patients were entitled to reimbursement for the cost of the MRI services from insurance companies and self-insured entities under New York’s No-Fault Law (Insurance Law § 5101 et seq.). Under the No-Fault Law, a person injured in a motor vehicle accident is entitled to recover first-party benefits, which includes reimbursement for medically necessary medical services, regardless of who was at fault in causing the accident.

Typically, when plaintiff provided MRI services for a patient, the patient assigned his or her entitlement to collect first-party benefits to the plaintiff. Plaintiff would then submit a claim for the services to the insurance company or self-insured entity that it believed was responsible for its payment. In all the actions that have been joined for trial, plaintiff is seeking to recover on claims for assigned first-party benefits.

The defendants in these actions are insurers and self-insured entities to whom plaintiff submitted claims. In many of the actions, particular defenses were asserted that applied to the particular action. In all of the joined actions, however, the defendants assert the defense that plaintiff was fraudulently incorporated within the meaning of the Court of Appeals’ landmark decision in Mallela and is therefore not entitled to reimbursement of first-party benefits under the No-Fault Law.

B. The Trial

Defendants’ contention that plaintiff was fraudulently incorporated centered on two theories. First, defendants maintained that plaintiff operated in violation of Business Corporation Law §§ 1507 and 1508 in that Hillel Sher and Irina Vayman, neither of whom was a licensed physician, actually owned and controlled the corporation. Second, the defendants maintained that Dr. Carothers was not engaged in the practice of medicine while he was associated with the plaintiff, which is also a violation of Business Corporation Law § 1507.

During the trial, defendants introduced compelling evidence supporting both theories. Defendants demonstrated, among other things, that when the corporation was formed, Dr. Carothers made absolutely no monetary investment in the corporation. Indeed, at the time, Dr. Carothers was in dire financial straits. He owed considerable back taxes and his home was under threat of foreclosure.

Defendants demonstrated that all the equipment used by the plaintiff, including the MRI machines, was leased to the plaintiff [452]*452from Forum Medical Management, Inc., a company that was owned and controlled by Sher. These leases required the plaintiff to pay exorbitant rates for the equipment. It was through these leases that the bulk of plaintiffs profits were channeled to Sher. For example, one of the MRI machines was being leased to the plaintiff for $75,000 per month. Sher, through his company, was leasing this machine from another company at a rate of only $5,950 per month. Another MRI machine, which had been purchased outright by Sher in April 2000 for $240,000, was being leased to the plaintiff four years later at an annual cost of $900,000. One expert testified that the total cost for all the equipment that the plaintiff used in its operations, including the cost of installation, would have been less than eight months of rental payments that the corporation had committed to pay to Sher’s company for a single MRI machine. Indicative of the ridiculous rental fees that plaintiff had committed to paying Sher was a $500 monthly rental fee for a fax machine.

Neither Dr. Carothers nor the plaintiff corporation was a named tenant on any of the leases for the various premises where plaintiff did business. The named tenant on all the leases was MRI Global, another company controlled by Sher. It was Sher who signed the leases on MRI Global’s behalf.

Plaintiffs day-to-day operations were run by Irina Vayman, with minimal to no input from Dr. Carothers. Even though her salary was supposed to be only $120,000 per year, the evidence indicated that she was actually paid $575,000. Other than Vayman, Dr. Carothers had no real dealings with the employees of the corporation. Everyone who worked at plaintiff’s facilities was already working at them before plaintiff was incorporated. These employees worked for a radiologist that ran a similar type of practice at the same locations. This radiologist also had close associations with Sher and Vayman.

Dr. Carothers openly credited Vayman as being the source of all of plaintiffs referrals. He never spoke with Vayman about how to market the practice nor did he know which doctors she had targeted as a referral base. In January 2005, he believed that the practice had 125 referring physicians but admitted to meeting only one of them. Curiously, while Dr. Carothers had no referral base of his own, in May and June of 2006, more than 2,500 scans were done per month. Plaintiffs counsel proffered the absurd argument that this was due to the location of the facilities.

That Dr. Carothers did not own or control the corporation was further demonstrated by how money flowed into and out of [453]*453the corporate bank accounts. Only Vayman wrote checks on behalf of the corporation. On many occasions she transferred money from the corporate account into her personal account without Dr. Carothers’ knowledge. On one such occasion, she withdrew $500,000 from the corporate account and transferred it to her personal account. Dr. Carothers did not become aware of this until several months later. Vayman also used corporate checks to pay a multitude of noncorporate expenses, including a payment to the Las Vegas Valley Water District for a home owned by Sher, payments on a Chase auto lease for a Mitsubishi, that Dr. Carothers believed belonged to Sher, and payments to Pureless Pool Services, GMAC, Chase Chemical MasterCard account, Verizon Wireless, AT&T Residential Long Distance, Nissan Motor Acceptance Corp. and an $18,000 transfer to Countrywide Home Loan, all of which were for non-corporate purposes.

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Carothers v. Insurance Companies, 26 Misc. 3d 448 (N.Y. Super. Ct. 2009).

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