| Mason v First Cent. Natl. Life Ins. Co. of N.Y. |
| 2011 NY Slip Op 06010 [86 AD3d 854] |
| July 21, 2011 |
| Appellate Division, Third Department |
| Michele Mason, as Administrator of the Estate of Kevin DaleMason, Deceased, Appellant, v First Central National Life Insurance Company of New York,Respondent. |
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Phillips Lytle, L.L.P., New York City (Andrew J. Wells of counsel), for respondent.
Kavanagh, J. Appeal from an order of the Supreme Court (Reynolds Fitzgerald, J.), enteredSeptember 27, 2010 in Broome County, which granted defendant's motion to dismiss thecomplaint.
Plaintiff commenced this action against defendant alleging that it breached the terms of a lifeinsurance policy by refusing to pay benefits under the policy it issued to decedent prior to hisdeath, and also sought punitive damages. Defendant moved to dismiss the complaint claimingthat documentary evidence existed that established a defense to the claim as a matter of law(see CPLR 3211 [a] [1]) and on the ground that plaintiff failed to state a cause of action(see CPLR 3211 [a] [7]). Supreme Court granted defendant's motion, prompting thisappeal.
At the outset, plaintiff's second cause of action for punitive damages was properly dismissed,as "a demand for such damages does not constitute a separate cause of action in a complaint"(Cass v Broome County Coop. Ins. Co., 94 AD2d 822, 823 [1983]; see Rochester Linoleum & Carpet Ctr., Inc.v Cassin, 61 AD3d 1201, 1204 [2009]; Martin v Columbia Greene Humane Socy., Inc., 17 AD3d 839, 841[*2][2005]). Turning to plaintiff's breach of contract claim,defendant refused to pay benefits under this policy because it claimed that when decedent hadapplied for it, he was not truthful about his medical history and had made materialmisrepresentations regarding his medical condition. Specifically, in the written application thatdecedent completed when seeking the policy, he denied that he had ever been "diagnosed by amember of the medical profession as having (1) high blood pressure . . . [or] (7) [a]drug or alcohol related condition." In support of its motion to dismiss, defendant submittedmedical records establishing that, prior to applying for the policy, decedent had received medicaltreatment for hypertension and alleged alcoholism. Defendant argued that these recordsconstituted documentary proof that conclusively established its defense to this action as a matterof law. Supreme Court agreed and granted its motion to dismiss (see CPLR 3211 [a] [1]).
A "motion to dismiss on the ground that the action is barred by documentary evidence. . . may be appropriately granted only where the documentary evidence utterlyrefutes [the] plaintiff's factual allegations, conclusively establishing a defense as a matter of law"(Goshen v Mutual Life Ins. Co. of N.Y., 98 NY2d 314, 326 [2002]; see Leon vMartinez, 84 NY2d 83, 88 [1994]). In our view, under these circumstances, the contents ofdecedent's medical records are not so "essentially undeniable" as to qualify as documentaryevidence that conclusively refutes any claim that plaintiff might have to recover under this policy(see Siegel, Practice Commentaries, McKinney's Cons Laws of NY, Book 7B, CPLRC3211:10, at 22; Fontanetta v John Doe1, 73 AD3d 78, 83-84 [2010]). Specifically, these medical records do not establish as amatter of law that decedent knew when he applied for this insurance policy that hypertension wassynonymous with high blood pressure or that he had been diagnosed with a medical conditionthat was alcohol-related. Given the strict standard that such records must satisfy to qualify asdocumentary evidence (see Crepin vFogarty, 59 AD3d 837, 838 [2009]; Unadilla Silo Co. v Ernst & Young, 234AD2d 754, 755 [1996]; see also Fontanetta v John Doe 1, 73 AD3d at 86), defendant'smotion to dismiss plaintiff's first cause of action on this ground should have been denied.
As to defendant's argument that this claim failed to state a cause of action (see CPLR3211 [a] [7]), we disagree. The question to be resolved on such a motion is not whether plaintiff"can ultimately establish [her] allegations" and is likely to prevail, but whether, if believed, hercomplaint sets forth facts that constitute a viable cause of action (EBC I, Inc. v Goldman, Sachs & Co., 5NY3d 11, 19 [2005]; see Crepin v Fogarty, 59 AD3d at 838).[FN*] Here, the allegations in the complaint, if accepted as true and accorded the benefit of everyfavorable inference, state such a claim (see Skibinsky v State Farm Fire & Cas. Co., 6 AD3d 975, 976[2004]). Accordingly, defendant's motion to dismiss plaintiff's first cause of action on this groundmust be denied.
Mercure, J.P., Spain, Garry and Egan Jr., JJ., concur. Ordered that the order is modified, onthe law, without costs, by reversing so much thereof as granted defendant's motion to dismiss thefirst cause of action; motion denied to that extent; and, as so modified, affirmed.
Footnote *: While Supreme Court's orderreferenced CPLR 3211 (a) (7), the content of its order clearly suggests that the court based itsdismissal of the complaint on CPLR 3211 (a) (1).