Government Employees Insurance Company v. Innovation Anesthesia & Pain Services, P.C.

CourtDistrict Court, E.D. New York
DecidedMarch 25, 2025
Docket1:24-cv-02220
StatusUnknown

This text of Government Employees Insurance Company v. Innovation Anesthesia & Pain Services, P.C. (Government Employees Insurance Company v. Innovation Anesthesia & Pain Services, P.C.) is published on Counsel Stack Legal Research, covering District Court, E.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Government Employees Insurance Company v. Innovation Anesthesia & Pain Services, P.C., (E.D.N.Y. 2025).

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK --------------------------------------------------------------- GOVERNMENT EMPLOYEES INSURANCE CO., GEICO INDEMNITY CO., GEICO GENERAL INSURANCE COMPANY and GEICO CASUALTY CO., MEMORANDUM & ORDER 24-CV-2220 (MKB) Plaintiffs,

v.

INNOVATION ANESTHESIA & PAIN SERVICES, P.C., DONGHUI CHEN, M.D., JPM PHYSICAL THERAPY, P.C., SABINIANO MANGGURAY, P.T., LIBERTY PARK CHIROPRACTIC, P.C., JOSEPH CICCONE, D.C., HAO ACUPUNCTURE, P.C., and HONG ZHU WU, L.Ac.,

Defendants. --------------------------------------------------------------- MARGO K. BRODIE, United States District Judge: Plaintiffs Government Employees Insurance Co., GEICO Indemnity Co., GEICO General Insurance Company, and GEICO Casualty Co. (collectively, “GEICO” or “Plaintiffs”) commenced the above-captioned action on March 26, 2024, against Defendants Innovation Anesthesia & Pain Services, P.C. (“Innovation Anesthesia”); Donghui Chen, M.D. (“Chen”); JPM Physical Therapy, P.C. (“JPM PT”); Sabiniano Mangguray, P.T. (“Mangguray”); Liberty Park Chiropractic, P.C. (“Liberty Park Chiro”); Joseph Ciccone, D.C. (“Ciccone”); Hao Acupuncture, P.C. (“Hao Acupuncture”); and Hong Zhu Wu, L.Ac (“Wu”). (Compl., Docket Entry No. 1.) Plaintiffs allege, inter alia, that Defendants wrongfully obtained no-fault insurance reimbursements for medically unnecessary healthcare services in violation of the Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C. §§ 1962(c)–(d) (“RICO”) and are liable for common law fraud, aiding and abetting fraud, and unjust enrichment, (id. ¶¶ 1, 265–401), and seek damages against all defendants, and a declaratory judgment against Innovation Anesthesia, Liberty Park Chiro, Hao Acupuncture, and JPM PT, (id. ¶¶ 261–401). On September 24, 2024, Plaintiffs moved to (1) stay, until resolution of litigation, all pending no-fault insurance collection arbitrations and state court collections litigation

commenced against GEICO by or on behalf of Innovation Anesthesia, Chen, Liberty Park Chiro, Mangguray, Ciccone, and JPM PT; and (2) enjoin all Defendants, until resolution of litigation, from commencing any new no-fault insurance collection arbitrations or new no-fault collections litigation against GEICO.1 Defendants opposed the motion.2 For the reasons set forth below, the Court grants Plaintiffs’ motion to stay (1) all pending arbitrations, (2) all future arbitrations, (3) all pending state court proceedings, and (4) all future state court proceedings. I. Background a. New York and New Jersey’s no-fault insurance scheme Under New York’s no-fault law, automobile insurers provide mandatory coverage for certain no-fault benefits, including necessary expenses for medical treatment up to $50,000.3

N.Y. Ins. Law §§ 5102(a)(1), 5102(b), 5103; see also State Farm Mut. Auto. Ins. Co. v. Tri- Borough NY Med. Prac. P.C., 120 F.4th 59, 71 (2d Cir. 2024) (“The No-Fault Act provides compensation for ‘basic economic loss,’ which covers, as relevant here, ‘necessary’ health

1 (Pls.’ Mot. to Stay (“Pls.’ Mot.”), Docket Entry No. 28-1; Pls.’ Mem. in Supp. of Pls.’ Mot. (“Pls.’ Mem.”), Docket Entry No. 28-2; Pls.’ Reply in Supp. of Pls.’ Mot. (“Pls.’ Reply”), Docket Entry No. 28-19.)

2 (Defs.’ Response to Pls.’ Mot. (“Defs.’ Opp’n”), Docket Entry No. 28-4.)

3 Because it is helpful to understand the facts of the case, the Court provides a brief overview of New York’s no-fault insurance scheme before discussing the relevant facts. See generally Allstate Ins. Co. v. Elzanaty, 916 F. Supp. 2d 273, 281–83 (E.D.N.Y. 2013) (providing a detailed overview of New York’s no-fault scheme). expenses up to $50,000 per person.” (quoting N.Y. Ins. Law § 5102(a))). “The Act’s implementing regulations allow covered individuals to assign their statutory benefits to licensed health care providers in exchange for services, and the providers in turn can submit claims directly to the insurance company for medically necessary expenses.” See id. (citing N.Y. Comp. Codes R. & Regs. tit. 11, § 65-3.11(a)); United States v. Zemlyansky, 908 F.3d 1, 7 (2d

Cir. 2018) (“[I]ndividuals injured in car accidents assign their statutory benefits to licensed medical professionals, who submit claims for medically ‘necessary’ treatments directly to the injured party’s insurance carriers.” (first quoting N.Y. Ins. Law § 5102; and then citing N.Y. Comp. Codes R. & Regs. tit. 11, § 65-3.11)). The regulation also states that “[i]n the event any person making a claim for first-party benefits and the [insurance] [c]ompany do not agree regarding any matter relating to the claim, such person shall have the option of submitting such disagreement to arbitration.” N.Y. Comp. Codes R. & Regs. tit. 11, § 65-1.1(d); see State Farm, 120 F.4th at 87; Allstate Ins. Co. v. Mun, 751 F.3d 94, 87 (2d Cir. 2014) (quoting N.Y. Comp. Codes R. & Regs. tit. 11, § 65-1.1).

“New Jersey also has a comprehensive no-fault regime.” Gov’t Emps. Ins. Co. v. Mahmood, No. 23-CV-4388, 2024 WL 113958, at *2 (E.D.N.Y. Jan. 10, 2024); see, e.g., the Compulsory Insurance Law (N.J. Stat. Ann. §§ 39:6B-1–39:6B-3; Citizens United Reciprocal Exch. v. Perez, 121 A.3d 374, 379 (N.J. 2015)) and the New Jersey Automobile Reparation Reform Act (N.J. Stat. Ann. §§ 36A-1–36A-35). Claimants may “assign[]” their no-fault claims “to healthcare service providers.” Gov’t Emps. Ins. Co. v. Beynin, No. 19-CV-6118, 2021 WL 1146051, at *2 n.1 (E.D.N.Y. Mar. 25, 2021). New Jersey’s no-fault regime includes an arbitration statute which allows for arbitration of disputes concerning “medical expense benefits” including “whether the disputed medical treatment was actually performed,” the “necessity . . . of consultations by other healthcare providers,” and “whether the treatment performed is reasonable, necessary, and compatible with the protocols provided.” N.J. Stat. Ann. § 39:6A-5.1. New Jersey’s no-fault laws also include the New Jersey Insurance Fraud Prevention Act (“IFPA”) under which plaintiffs may instead bring an action relating to fraudulent insurance claims in state or federal court. See N.J. Stat Ann. §§ 17:33A-1–17:33A-34. A person violates

the IFPA if he or she “[p]resents or causes to be presented any written or oral statement as part of, or in support of or opposition to, a claim for payment or other benefit pursuant to an insurance policy . . . knowing that the statement contains any false or misleading information concerning any fact or thing material to the claim.” Id. § 17:33A-4(a)(1). “Although New Jersey generally requires arbitration for no-fault insurance claims, New Jersey courts have repeatedly found that claims under the IFPA may be heard in state or federal courts.” Gov’t Emps. Ins. Co. v. Gerling, 718 F. Supp. 3d 268, 271 (E.D.N.Y. 2024); see Gov’t Emps. Ins. Co. v. Elkholy, No. 21-16255, 2022 WL 2373917, at *9–10 (D.N.J. June 30, 2022) (“[C]ourts routinely uphold the IFPA’s absolute mandate for judicial resolution notwithstanding contractual

clauses that would otherwise require arbitration of IFPA claims.” (first citing Nationwide Mut. Fire Ins. Co. v. Fiouris, 928 A.2d 154, 157 (N.J. Super. Ct. App. Div. 2007); and then citing Fed. Ins. Co. v. von Windherburg-Cordeiro, No. 12-CV-2491, 2012 WL 6761877, at *4 (D.N.J. Dec. 31, 2012))); Citizens United Reciprocal Exch. v. Meer, 321 F. Supp. 3d 479, 492 (D.N.J. 2018) (“The [IFPA] is not preempted by [no-fault] arbitration rules.”). b.

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Government Employees Insurance Company v. Innovation Anesthesia & Pain Services, P.C., Counsel Stack Legal Research, https://law.counselstack.com/opinion/government-employees-insurance-company-v-innovation-anesthesia-pain-nyed-2025.