Liberty Mutual Insurance v. Excel Imaging, P.C.

879 F. Supp. 2d 243, 2012 WL 2367076
CourtDistrict Court, E.D. New York
DecidedJune 21, 2012
DocketNo. 11-CV-5780
StatusPublished
Cited by27 cases

This text of 879 F. Supp. 2d 243 (Liberty Mutual Insurance v. Excel Imaging, 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
Liberty Mutual Insurance v. Excel Imaging, P.C., 879 F. Supp. 2d 243, 2012 WL 2367076 (E.D.N.Y. 2012).

Opinion

MEMORANDUM & ORDER

JACK B. WEINSTEIN, Senior District Judge:

I. Introduction..............................................................254

II. Facts....................................................................254

A. Parties..............................................................254

B. New York State No-Fault Law.........................................255

C. Fraudulent Scheme...................................................257

D. Prior Litigation.......................................................260

E. Investigation of Excel.................................................260

III. Procedural History........................................................260

IV. Jurisdiction..............................................................261

V. Legal Standards..........................................................261

A. Motion to Dismiss.....................................................261

B. Summary Judgment...................................................262

VI. Motion to Compel Arbitration..............................................262

A. Right to Arbitrate No-Fault Claims.....................................262

B. Waiver of Right to Arbitration..........................................263

C. Arbitration Stayed Pending Resolution of this Case .......................264

VII. Statute of Limitations.....................................................264

A. RICO Claims.........................................................264

1. Generally ........................................................264

2. Separate Accrual..................................................264

B. State Law Claims

1. Statute of Limitations for Duties Imposed by Statute..................265

2. Claims Subject to Three-Year Statute of Limitations...................268

C. Equitable Estoppel....................................................269

D. Issues of Fact as to When Plaintiffs Could Have Discovered the Fraud.....269

VIII. Failure to State a Claim...................................................271

A. State Law Causes of Action............................................272

1. Ability to Recover Fees Paid to Fraudulently Incorporated Medical Services Corporations............................................272

2. Common Law Fraud Pled with Sufficient Particularity.................273

3. Unjust Enrichment................................................273

B. RICO...............................................................273

1. General Principles.................................................273

2. Enterprise .......................................................274

3. Conduct..........................................................275

4. Racketeering Activity Requirement..................................275

5. Pattern Requirement..............................................276

C. RICO Conspiracy......................................................276

IX. Conclusion...............................................................277

[254]*254I. Introduction

New York’s no-fault insurance laws permit lawfully incorporated medical services corporations, as assignees of no-fault benefits, to collect payment from insurance companies for services provided to injured motorists. See Part 11(B), infra. As a prerequisite to reimbursement, these corporations must comply with state and local licensing requirements, such as being owned and operated by physicians who practice through the corporation. See N.Y. Comp. Code R. & Regs. tit. 11, § 65-3.16(a)(12).

Plaintiff insurance companies (“Liberty Mutual”) seek to recover payments already made to one such medical services corporation, Excel Imaging, P.C. (“Excel”), and for a declaratory judgment that Excel is not entitled to reimbursement for claims not yet paid. They do not allege that the defendants failed to provide radiology services to their insureds, or that these services were not medically necessary. Rather, they claim that Excel is not owned and operated by physicians — namely, defendants Mark Freilich, M.D., Faisal Abdus Sami, M.D., Tariq R. Kahn, M.D., Perez Iqbal Qureshi, M.D., and Naiyer Imam, M.D. (“Nominal Owner Defendants”) — as required by New York law, but by non-physicians Afzal M. Amanat and Mohammed Shakat Ilahi and their corporations, Claimnet L.L.C. and Amaar Holding, Inc. (“Management Defendants”). Plaintiffs assert that they were billed over $1.2 million in charges for radiology services that the defendants were not entitled to recover because their incorporation and operation violated New York statutes and regulations. They claim: 1) fraud and unjust enrichment under state law against all defendants; and 2) civil Racketeering Influenced Corrupt Organizations Act (“RICO”) violations under federal law against the individual defendants.

Defendant Mark Freilich, M.D. moves for summary judgment on the ground that the claims against him are time-barred. The remaining defendants (“Non-Freilieh Defendants”) move to either stay the action and compel arbitration pursuant to N.Y. Business Insurance Law § 5106, or to dismiss the complaint based on the statute of limitations. Both argue that the complaint must be dismissed for failure to state a claim on which relief can be granted. See Fed.R.CivJP. Rule 12(b)(6).

Defendants’ motions are denied. Plaintiffs may only be compelled to arbitrate unpaid claims on which defendants have taken no legal action; they may not compel arbitration for paid claims, or for unpaid claims on which they have sued the plaintiffs. Arbitration is stayed in the interest of judicial economy. A genuine issue of material fact exists as to when plaintiffs were on inquiry notice of the fraud and whether they were misled by defendants’ affirmative efforts to conceal the scheme, which would result in equitable tolling, precluding summary judgment. The facts alleged support claims for both civil RICO violations and state law fraud and unjust enrichment.

II. Facts

Defendants’ motions to dismiss on the pleadings were converted to motions for summary judgment. Order, Doc. Entry 38, Apr. 13, 2012. Further discovery before a decision on the pending motions was waived. See Stipulation, Doc. Entry 48, May 3, 2012. The facts are drawn primarily from the complaint and are deemed true for the purpose of these motions.

A. Parties

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Cite This Page — Counsel Stack

Bluebook (online)
879 F. Supp. 2d 243, 2012 WL 2367076, Counsel Stack Legal Research, https://law.counselstack.com/opinion/liberty-mutual-insurance-v-excel-imaging-pc-nyed-2012.