Morell v. Vargas

83 Misc. 2d 30, 371 N.Y.S.2d 828, 1975 N.Y. Misc. LEXIS 2795
CourtCivil Court of the City of New York
DecidedJuly 29, 1975
StatusPublished
Cited by5 cases

This text of 83 Misc. 2d 30 (Morell v. Vargas) is published on Counsel Stack Legal Research, covering Civil Court of the City of New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Morell v. Vargas, 83 Misc. 2d 30, 371 N.Y.S.2d 828, 1975 N.Y. Misc. LEXIS 2795 (N.Y. Super. Ct. 1975).

Opinion

Fred T. Santucci, J.

This is a motion by plaintiff to set aside a jury verdict finding that the necessary, reasonable and customary charges for medical, hospital and x-ray services performed for the plaintiff amounted to a sum less than $500.

Plaintiff’s claim in this negligence action for damages for personal injuries arises out of an automobile accident which occurred on March 29, 1974 when plaintiff’s automobile, then being operated by him, was struck in the rear by a motor truck owned by the defendant Hertz Corp. and operated by defendant Vargas.

The summons and indorsed complaint in short form as required by 22 NYCRR 2900.5 and CPLR 3016 (subd [g]) alleges an "Action to recover the sum of $10,000 for personal injuries resulting in medical care and treatment in excess of $500.00 and resultant expenses.” The defendant’s answer contained a general denial.

Plaintiff’s bill of particulars alleges medical and related expenses as follows:

(a) Physicians’ services — $660.

(b) Medical supplies — $18

(c) Hospital expenses — $174

(d) Transportation to and from doctor — $75 All totaling $927.

At the trial of this action, before a jury, the plaintiff and his treating physician were the only witnesses to testify. No witness appeared at the trial on behalf of the defendant to controvert either the testimony of the plaintiff or his physician.

The plaintiff testified as to his pain and suffering and his physician gave his diagnosis, treatment and the reasonable value of his services, and also the reasonable value of the services of a neurologist that he had recommended.

The accident having occurred after February 1, 1974, the effective date of the Comprehensive Automobile Insurance [32]*32Reparations Act (Insurance Law, § 670 et seq.) commonly known as the "No-Fault Law”. Section 673 of the Insurance Law provides, inter alia, that a plaintiff shall have no right to recover for pain and suffering and similar nonmonetary detriment unless he has sustained a "serious injury.” "Serious injury” is defined as a personal injury (§ 671, subd 4, pars [a], [b]): "(a) which results in death; dismemberment; significant disfigurement; a compound or comminuted fracture; or permanent loss of use of a body organ, member, function, or system; or (b) if the reasonable and customary charges for medical, hospital, surgical, nursing, dental, ambulance, x-ray, prescription drug and prosthetic services necessarily performed as a result of the injury, would exceed five hundred dollars”.

The first question to be dealt with by the court is that where the complaint sufficiently alleges, as required by CPLR 3016 (subd [g]) that the plaintiff sustained personal injuries etc. requiring medical expenses in excess of $500 is a general denial in the answer sufficient to raise the trial issues as well as the issue of the threshold. This court is of the opinion that said denial is sufficient in that the "No-Fault” law provides that the plaintiff shall have no right to recovery unless he has sustained a "serious injury.” The plaintiff therefore is required to plead and prove that he has sustained the injury as defined under the act. Under denials, the defendant may offer any evidence tending to disprove anything the plaintiff would be permitted to offer as evidence or otherwise stated, anything the plaintiff would have the burden of proving the defendant would have the right to prove contra. (McKinney’s Cons Laws of NY, Book 7B, CPLR 3018:11.)

An affirmative defense would be required where the matters "if not pleaded, would be likely to take the adverse party by surprise or would raise issues of fact not appearing on the face of a prior pleading”. (CPLR 3018 subd [b].) That section does not set forth a requirement of an affirmative defense enumerated and mandated by that section. Nor does the "No-Fault” law contain any provision or requirement that an affirmative defense shall be pleaded in order to raise the threshold issue.

Assuming arguendo, if, in compliance with the CPLR, the complaint and bill of particulars have sufficiently pleaded the "serious injury” as defined and that an affirmative defense should be required stating that the plaintiff had not sustained a serious injury, under the Act, would it then be the defendants burden by reason of such pleading, to prove that the [33]*33plaintiff had not sustained a "serious injury” with the result that a failure to plead it would be a waiver. This court thinks not. The Insurance Law, CPLR and section 2900.05 of the New York City Civil Court Rules have placed the burden on the plaintiff of pleading and proving the "serious injury” as defined, and the plaintiff may not recover for pain and suffering until he proves that the threshold issue has been crossed. The failure to plead the affirmative defense does not shift the statutory burden of the plaintiff. In the absence of prejudice, it should not be held that the burden of proof shifts to the defendant merely because he unnecessarily pleads the matter affirmatively that the plaintiff has not sustained a serious injury as defined in the statute. (See 3 Weinstein-Korn-Miller, NY Civ Prac, par 3018.14.)

On the question of whether the court or the jury would be the trier of the facts as to the reasonableness and necessity of medical services and as to whether treatments were causally related, was considered by the court in Maynor v Wrenn (78 Misc 2d 193), on a motion made to dismiss the complaint for lack of jurisdiction, the court, in denying the motion, held that these questions of fact were properly for a jury after proper instructions.

In the instant case, and although only the plaintiff and his physician testified, the threshold question of fact under section 671 (subd 4 par [b]) of the Insurance Law was properly within the province of this jury and was submitted for their consideration.

Had the plaintiff sought to introduce his own testimony together with certified itimized medical bills under CPLR 4533-a for services rendered the same would have been sufficient evidence to submit a question of fact to the jury as to whether or not the $500 threshold had been reached. The question of threshold may be submitted to the jury in the following manner:

"You as jurors are to decide the reasonable and customary charges for medical treatment, which includes the doctor’s bill, the hospital bill and the cost of x-ray, and further if such treatment was necessarily performed as a result of the injuries you find plaintiff sustained and also whether the value of said treatment exceeds the sum of $500. If you do not so find you must go no further, but report back to the court. In that instance you will have a verdict for the defendant. If you find that the reasonable and necessary medical treatment exceeded [34]*34$500 then you will consider a verdict for the plaintiff. Your verdict will be a sum of money and in your verdict you will consider an award for pain and suffering from the injuries you find plaintiff sustained as a result of this accident. You will not consider reimbursement for medical expenses.”

In the within matter the jury rendered a verdict finding that the reasonable and customary charges for medical, hospital and x-ray services necessarily performed for the plaintiff did not exceed the sum of $500. An oral motion was made by plaintiff immediately after the verdict to set it aside as contrary to the weight of the evidence and contrary to law.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Herring v. Hayes
135 A.D.2d 684 (Appellate Division of the Supreme Court of New York, 1987)
Williams v. Dulaney
480 A.2d 1080 (Supreme Court of Pennsylvania, 1984)
Moren v. Greyhound Lines, Inc.
663 F. Supp. 139 (S.D. New York, 1978)
Manning v. Powell
246 S.E.2d 704 (Court of Appeals of Georgia, 1978)
Montgomery v. Daniels
340 N.E.2d 444 (New York Court of Appeals, 1975)

Cite This Page — Counsel Stack

Bluebook (online)
83 Misc. 2d 30, 371 N.Y.S.2d 828, 1975 N.Y. Misc. LEXIS 2795, Counsel Stack Legal Research, https://law.counselstack.com/opinion/morell-v-vargas-nycivct-1975.