| State Farm Mut. Auto. Ins. Co. v Stack |
| 2008 NY Slip Op 07651 [55 AD3d 594] |
| October 7, 2008 |
| Appellate Division, Second Department |
| State Farm Mutual Automobile Insurance Company,Respondent, v James Stack, Appellant. |
—[*1] Goldberg Segalla, LLP, White Plains, N.Y. (Kevin Burns of counsel), for respondent.
In an action to determine the defendant's claims for no-fault benefits de novo, the defendantappeals, as limited by his brief, from stated portions of a judgment of the Supreme Court, OrangeCounty (Peter C. Patsalos, J.H.O.), entered June 14, 2007, which, after a nonjury trial, inter alia,dismissed his claims for medical expenses and lost earnings.
Ordered that the judgment is modified, on the law, by deleting the third, fourth, and sixth decretalparagraphs thereof, and so much of the seventh and eighth decretal paragraphs as dismissed thedefendant's claims for medical expenses related to his hospitalization from April 10, 1997 through April12, 1997; as so modified, the judgment is affirmed insofar as appealed from, without costs ordisbursements, the defendant's claims for medical expenses related to his hospitalization from April 10,1997 through April 12, 1997, are reinstated, and the matter is remitted to the Supreme Court, OrangeCounty, for further proceedings to determine the value of the defendant's medical expenses related tohis hospitalization from April 10, 1997, through April 12, 1997.
A no-fault arbitration tribunal twice concluded that the defendant James Stack was entitled tobenefits arising from an automobile accident. Subsequently, the plaintiff, State Farm AutomobileInsurance Company (hereinafter State Farm) commenced a de novo plenary action seeking adetermination that medical expenses for Stack's hospitalization were for a condition unrelated to theaccident and that Stack failed to demonstrate his entitlement to lost earnings. After a nonjury trial, theSupreme Court determined, inter alia, that State Farm properly denied Stack's claim for medicalexpenses as unrelated to the accident [*2]and that Stack failed todemonstrate his entitlement to lost earnings within the meaning of the no-fault statute. Stack contendsthat the Supreme Court's judgment in favor of State Farm was not warranted by the facts.
As this case was tried without a jury, this Court's authority is as broad as that of the trial court, andthis Court may render a judgment it finds warranted by the facts, taking into account in a close case thefact that the trial judge had the advantage of seeing the witnesses (see Northern WestchesterProfessional Park Assoc. v Town of Bedford, 60 NY2d 492, 499 [1983]). Upon our review ofthe record, we find that the evidence did not support the determination of the Supreme Court thatStack's condition was not causally related to the accident.
An insurer seeking to deny no-fault benefits on the basis that a claimant's condition is not causallyrelated to an accident "has the burden to come forward with proof in admissible form to establish the. . . evidentiary 'found[ation for its] belief' that the patient's treated condition was unrelatedto his or her automobile accident" (Mount Sinai Hosp. v Triboro Coach, 263 AD2d 11, 19-20[1999]). The testimony of State Farm's expert witness, an anesthesiologist and pain managementspecialist, that his opinion was based solely upon a hospital discharge summary and insurance claimform, rendered his opinion speculative and of little probative value (see Gorden v Tibulcio, 50 AD3d 460 [2008]).
In contrast, the testimony of Stack's expert witness, a neurologist who based his opinion upon hisexamination of Stack and his review of Stack's relevant medical records, including, inter alia, CT scansand magnetic resonance imaging, and determined that Stack's symptoms first appeared within twoweeks of the accident and progressively worsened, was sufficient to establish that Stack's conditionwas causally related to the accident (see Scudera v Mahbubur, 299 AD2d 535, 536 [2002]).
As to Stack's claim for lost earnings, the evidence supported the Supreme Court's determinationthat he failed to demonstrate that he sustained a compensable lost wage claim within the no-fault statute(see Konstantatos v County of Suffolk, 174 AD2d 653 [1991]). Although a party may recoverlost profits while self-employed (see Young v Utica Mut. Ins. Co., 86 AD2d 764 [1982]),Stack's testimony, that after the accident he was unable to maintain his real estate business and stockmarket portfolio in the manner to which he was accustomed, was insufficient in the absence of financialrecords, such as tax returns, to establish his alleged lost earnings with reasonable certainty (seeThomas v Puccio, 270 AD2d 480 [2000]). Spolzino, J.P., Ritter, Dillon and Dickerson, JJ.,concur.