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  • Government Employees Insurance Co., Geico Indemnity Co., Geico General Insurance Company, Geico Casualty Co. v. Altai Corp. d/b/a Get Ready Medical SupplyCommercial - Insurance document preview
  • Government Employees Insurance Co., Geico Indemnity Co., Geico General Insurance Company, Geico Casualty Co. v. Altai Corp. d/b/a Get Ready Medical SupplyCommercial - Insurance document preview
  • Government Employees Insurance Co., Geico Indemnity Co., Geico General Insurance Company, Geico Casualty Co. v. Altai Corp. d/b/a Get Ready Medical SupplyCommercial - Insurance document preview
  • Government Employees Insurance Co., Geico Indemnity Co., Geico General Insurance Company, Geico Casualty Co. v. Altai Corp. d/b/a Get Ready Medical SupplyCommercial - Insurance document preview
  • Government Employees Insurance Co., Geico Indemnity Co., Geico General Insurance Company, Geico Casualty Co. v. Altai Corp. d/b/a Get Ready Medical SupplyCommercial - Insurance document preview
  • Government Employees Insurance Co., Geico Indemnity Co., Geico General Insurance Company, Geico Casualty Co. v. Altai Corp. d/b/a Get Ready Medical SupplyCommercial - Insurance document preview
  • Government Employees Insurance Co., Geico Indemnity Co., Geico General Insurance Company, Geico Casualty Co. v. Altai Corp. d/b/a Get Ready Medical SupplyCommercial - Insurance document preview
  • Government Employees Insurance Co., Geico Indemnity Co., Geico General Insurance Company, Geico Casualty Co. v. Altai Corp. d/b/a Get Ready Medical SupplyCommercial - Insurance document preview
						
                                

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FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF NASSAU ---------------------------------------------------------------------X Index Number: Government Employees Insurance Co., GEICO Indemnity Co., Date Purchased: GEICO General Insurance Company and GEICO Casualty Co. (collectively “GEICO”), Plaintiff, SUMMONS -against- Plaintiff designates Nassau County as the place of trial. Altai Corp. d/b/a Get Ready Medical Supply, The basis of the venue designated is: Plaintiff’s and Defendant’s place of business and residence CPLR §§ 503(A) and (C) Defendant. ---------------------------------------------------------------------X SUMMONS TO THE ABOVE NAMED DEFENDANT(S): YOU ARE HEREBY SUMMONED to answer the Complaint in this action and to serve a copy of your Answer, or, if the Complaint is not served with this Summons, to serve a Notice of Appearance, on the plaintiff’s attorney(s) within 20 days after the service of this Summons, exclusive of the day of service; or within 30 days after the service is complete if this Summons is not personally delivered to you within the State of New York; and in case of your failure to appear or answer, judgment will be taken against you by default for the relief demanded in the complaint. Dated: Melville, New York August 25, 2023 Respectfully, Law Office of Goldstein & Hopkins GEICO Staff Counsel By: ______________________________ Rachel S. Hochhauser, Esq. Attorneys for Plaintiff 2 Huntington Quadrangle Suite 1N01 Melville, New York 11747 (516) 714-7404 1 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 To: Altai Corp. d/b/a Get Ready Medical Supply Defendant 7122 Bay Parkway, Floor 2 Brooklyn, New York 11204 2 2 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF NASSAU ---------------------------------------------------------------------X Government Employees Insurance Co., GEICO Indemnity Co., GEICO General Insurance Company and GEICO Casualty Co. Index Number: (collectively “GEICO”), Plaintiffs, -against- Altai Corp. d/b/a Get Ready Medical Supply, Defendant. ---------------------------------------------------------------------X VERIFIED COMPLAINT Plaintiffs GEICO (collectively, “Plaintiffs”), by and through its counsel, Law Office of Goldstein & Hopkins, as and for its Verified Complaint against Defendant, hereby allege as follows: PRELIMINARY STATEMENT 1. This is an action for a declaratory judgment pursuant to CPLR §3001 in which GEICO seeks a determination that it is not legally obligated to pay Altai Corp. d/b/a Get Ready Medical Supply (“Provider” or “Defendant”) for claims that Defendant has submitted to GEICO seeking reimbursement for durable medical equipment (“DME”) that were allegedly rendered to individuals who were involved in automobile accidents and eligible for coverage under GEICO insurance policies (“Insureds”) in New York. GEICO seeks this judicial determination because Defendant has systemically failed and/or refused to appear for examinations under oath (“EUOs”) that have been requested by GEICO, which constitutes a failure by Defendant to meet a condition precedent to coverage and a violation of its obligations under the No-Fault Laws. The claims at issue in this declaratory judgment action are identified on Exhibit “A.” 3 3 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 2. This action seeks a declaration that Defendant is not entitled to receive No-Fault reimbursements as Defendant failed to meet a condition precedent to coverage as set forth in the No- Fault Regulation and the underlying policies of insurance. NATURE OF ACTION 3. GEICO alleges that Altai Corp. d/b/a Get Ready Medical Supply failed to meet a condition precedent to coverage by failing to appear for Examinations Under Oath (“EUOs”). 4. The EUOs of Altai Corp. d/b/a Get Ready Medical Supply were requested pursuant to the terms and conditions of the applicable policies of insurance and the No-Fault Regulations. 5. By failing to appear for EUOs, Altai Corp. d/b/a Get Ready Medical Supply breached a material condition precedent to coverage under the applicable insurance policies and the No Fault Regulations. The failure of Altai Corp. d/b/a Get Ready Medical Supply to meet the condition precedent to coverage vitiates GEICO’s obligation to honor any bills submitted by Altai Corp. d/b/a Get Ready Medical Supply for reimbursement pursuant to the Insurance Law and the No Fault Regulation for which EUOs of Altai Corp. d/b/a Get Ready Medical Supply were requested and Altai Corp. d/b/a Get Ready Medical Supply failed to appear. 6. As such, Altai Corp. d/b/a Get Ready Medical Supply is not entitled to seek, keep or receive No-Fault reimbursements from GEICO for all claims in which EUOs of Altai Corp. d/b/a Get Ready Medical Supply were requested and which Altai Corp. d/b/a Get Ready Medical Supply failed to appear. 7. Additionally, GEICO is not obligated to pay reimbursement for any No-Fault related matters pertaining to the claims in which EUOs of Altai Corp. d/b/a Get Ready Medical Supply were requested and Altai Corp. d/b/a Get Ready Medical Supply failed to appear. 4 4 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 8. GEICO seeks a declaration that as a result of the failure of Altai Corp. d/b/a Get Ready Medical Supply to appear for EUOs, Altai Corp. d/b/a Get Ready Medical Supply has no standing or legal right to seek, keep or receive No-Fault reimbursements from GEICO because Defendant has systematically failed and/or refused to appear for EUOs. 9. Accordingly, GEICO requests a judgment pursuant to CPLR §3001, declaring that Altai Corp. d/b/a Get Ready Medical Supply has no right to receive payment for the bills submitted to GEICO and listed on Exhibit “A” because it failed and/or refused to appear for an EUO requested by GEICO, and thus breached a condition of coverage and violated its obligations under the No-Fault Laws. PARTIES 10. GEICO is a New York insurer that is duly authorized to issue automobile insurance policies in the State of New York. GEICO maintains an office to conduct business relating to the administration of claims in Melville, New York. 11. 11. Defendant Altai Corp. d/b/a Get Ready Medical Supply is a professional service corporation with its principal place of business at 7122 Bay Parkway, Floor 2, Brooklyn, New York. Altai Corp. was incorporated on or about January 23, 2017. At all relevant times, Get Ready Medical Supply has conducted business in the State of New York, including but not limited to: at 7122 Bay Parkway, Floor 2, Brooklyn, New York. JURISDICTION AND VENUE 12. This Court has jurisdiction over Defendant because it is a New York DME supplier that conducts business within New York State, the insurance policies were issued by GEICO in New York and the conduct which forms the basis for this declaratory judgment occurred in the State of 5 5 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 New York. Venue is proper in the County of Nassau pursuant to C.P.L.R. §503(a) inasmuch as GEICO conducts business in Nassau County. ALLEGATIONS COMMON TO ALL CAUSES OF ACTION I. An Overview of the No-Fault Laws and NY Licensing Laws 13. GEICO underwrites automobile insurance in the State of New York. 14. Under New York’s Comprehensive Motor Vehicle Insurance Reparations Act (N.Y. Ins. Law §§ 5101, et seq.) and the regulations promulgated pursuant thereto (11 N.Y.C.R.R. §§ 65, et seq.) (collectively referred to as the “No-Fault Laws”), automobile insurers are required to provide Personal Injury Protection Benefits (“No-Fault Benefits”) to Insureds. 15. No-Fault Benefits include up to $50,000.00 per insured for necessary expenses that are incurred for healthcare goods and services. In addition to reimbursement for healthcare goods and services, insured parties may receive up to $2,000.00 per month to cover loss of earnings from work as an element of their $50,000.00 maximum benefit. 16. Under the No-Fault Laws, Insureds can assign their right to No-Fault Benefits to professional health service providers and/or DME suppliers, as long as the providers meet applicable New York State and local licensing requirements to perform such services in New York. With a duly executed assignment, a healthcare provider may submit claims directly to an insurance company and receive payment for necessary medical services rendered, using the claim form approved by the New York State Department of Insurance (known as the “Verification of Treatment by Attending Physician or Other Provider of Health Service” or, more commonly, as an “NF-3”). Once the healthcare provider takes an assignment of an Insured’s rights, the provider cannot seek to recover payment from the Insured. 6 6 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 17. Finally, pursuant to N.Y. Ins. Law § 403, all bills submitted by a healthcare provider and/or DME supplier to GEICO and all other insurers must be verified by the healthcare provider subject to the following warning: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime … 18. Under the New York State Medicaid Program, the maximum permissible charge for DME and orthotic devices is the fee amount that is mandated to be billed and paid for the DME and orthotic devices at the time such DME and orthotic devices are provided. Specifically, in Gov’t Emples. Ins. Co. v. Li-Elle Serv., 2013 U.S. Dist. LEXIS 31628 (E.D.N.Y., Mar. 6, 2013), the Court states in relevant part that: [i]f the New York State Medicaid program has not established a fee payable for the specific item, then the fee payable shall be the lesser of the acquisition cost (i.e., the line item cost from a manufacturer or wholesaler net of any rebates, discounts or other valuable considerations, mailing, shipping, handling, insurance costs or any sales tax) to the provider plus 50%, or the usual and customary price charged to the general public. 19. Altai Corp. d/b/a Get Ready Medical Supply was billing for supplies that did not have an established fee under the New York State Medicaid Program. Based on that, GEICO sought to have the fee explained as to whether your charge is the lesser of: (i) the acquisition cost to you plus 50%, or (ii) the usual and customary price charged to the general public. Moreover, GEICO deemed it necessary to have supporting documentation for your acquisition cost, including (i) a detailed description of the equipment including the name of the manufacturer, make and model, (ii) any photographs or pictures identifying the type of supplies provided, (iii) the wholesale invoice, and (iv) proof of payment to the wholesaler. 7 7 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 20. According to the New York State Department of Financial Services which governs no-fault in New York State, any charges for health services submitted for reimbursement under the no-fault law are subject to the fee schedules put forth by the Workers’ Compensation Board. The workers’ compensation regulation concerning durable medical equipment (“DME”) in turn adopts the New York State Medicaid fee schedule in 12 N.Y.C.R.R. § 442.2, which provides: The maximum permissible charge for the purchase of durable medical equipment, medical/surgical supplies, and orthotic and prosthetic appliances shall be the fee payable for such equipment or supplies under the New York State Medicaid program at the time such equipment and supplies are provided… 21. The above regulations and allegations set forth the basis for this declaratory judgment action in which GEICO seeks a decision that it is not legally obligated to pay fraudulent claims submitted by Altai Corp. d/b/a Get Ready Medical Supply II. An Overview of New York’s No-Fault Regulations Pertaining to Verification of Claims 22. The No-Fault Laws obligate healthcare providers and/or DME supplies that seek payment of No-Fault Benefits to provide insurers with additional verification in order to establish proof of their claims. 23. The prescribed No-Fault policy endorsement set forth in 11 N.Y.C.R.R. § 65-1.1 includes a specific section entitled “Conditions”, which states in part, that “upon request by the Company, the eligible injured person or that person’s assignee . . . shall (b) as may reasonably be required, submit to an examination under oath by any person named by the Company, and shall subscribe to same . . . , and (d) provide any other pertinent information that may assist the Company in determining the amount that is payable.” 24. The prescribed No-Fault policy endorsement set forth in 11 N.Y.C.R.R. § 65-1.1 also states that “No action shall lie against the Company, unless, as a condition precedent thereto, there shall have been full compliance with the terms of this coverage.” 8 8 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 25. The proof of claim requirement in the No-Fault policy endorsement, 11 N.Y.C.R.R. § 65-3.5(b) states in relevant part: Subsequent to the receipt of one or more of the completed verification forms, any additional verification required by the insurer to establish proof of claim shall be requested within 15 business days of receipt of the prescribed verification forms. Any requests by an insurer for additional verification need not be made on any prescribed or particular form . . . 26. Additionally, 11 N.Y.C.R.R. § 65-3.5(c) states in relevant part: The insurer is entitled to receive all items necessary to verify the claim directly from the parties from whom such verification was requested. 27. An insurer is entitled to any information that is necessary for the insurer to determine whether the claim submitted by the healthcare provider and/or DME supplier is payable. The issues for which additional verification can be properly sought are not limited, and can include, for example: (i) whether the supplies provided by the DME provider were rendered and/or medically necessary; (ii) whether the supplies provided were billed in accordance with the New York State Medicaid Program; and (iii) whether the items billed for were actually provided to the eligible injured persons. 28. Under 11 N.Y.C.R.R. § 65-3.5(b) and 65-3.6, upon receipt of a bill, an insurer has 15 business days to issue a verification request, including a request for an EUO. Upon a party’s failure to provide such verification within 30 days, i.e., failure to appear for an EUO, an insurer within 10 calendar days, shall contact the party from whom verification has been requested and not been provided. At which time a follow-up EUO is scheduled. 29. Because an EUO is a condition of coverage, an insurer may deny a healthcare provider’s or individual’s claim for No-Fault Benefits if the healthcare provider or individual claimant refuses to appear for an EUO, which constitutes a material breach of the insurance policy and violation 9 9 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 of the regulations. The New York State Department of Insurance has confirmed this conclusion by opinion letter, dated December 22, 2006 which states: As referenced above in Section 65-1.1(d), the prescribed No-Fault endorsement requires that, as a condition to coverage, an eligible injured person or that person’s assignee shall “…as may be reasonably required, submit to examinations under oath by any person named by the Company…” *** When an EUO is required and the party required to appear fails to attend a scheduled EUO, the insurer must meet its obligations under N.Y. Comp Codes R. & Regs. tit 11, §65-3.6(b) and within 10 calendar days, contact the party from whom verification (the EUO) has been requested and not provided, i.e., non-attendance at the scheduled EUO, in order to afford the party a second opportunity to attend an EUO. If the party fails to appear at the rescheduled EUO, an insurer may issue a denial of pending claims based upon the failure to meet the condition for coverage in not submitting to the requested EUO, as required under the prescribed endorsement. There is no requirement in the regulation that the denial must state the specific reason(s) why the insurer required the EUO. See N.Y. State Dep’t of Ins., Opinions of General Counsel, Op. Letter dated December 22, 2006, attached hereto as Exhibit “B.” III. GEICO’s Basis For Requesting an EUO of the Provider 30. Prior to seeking the EUO of the Provider, GEICO conducted an investigation into Defendant’s billing and treatment practices. 31. Specifically, for DME suppliers, an EUO can be requested in order to establish the medical necessity and quality of the durable medical equipment/orthotics provided to GEICO patients. In addition, GEICO sought to confirm the accuracy of the billing and coding practices that are associated with the claim submissions made to GEICO including the manner/method in which the charges have been calculated. Furthermore, GEICO is permitted under 11 N.Y.C.R.R.§ 65-3.16 to verify the items billed for were the actual items provided to the eligible injured persons and that those items billed for were actually provided to the patients. 10 10 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 32. Based upon GEICO’s investigation and the totality of the circumstances GEICO concluded that serious questions existed that warranted the Provider’s formal appearance for an EUO. Inexplicably, the Provider continues to fail and/or refuse to appear for EUOs that have been requested by GEICO. IV. Altai Corp. d/b/a Get Ready Medical Supply’s Failure to Comply with GEICO’s Requests for Additional Verification 33. Beginning on or about May 2022, GEICO elected to make formal requests for an EUO of Altai Corp. d/b/a Get Ready Medical Supply in connection with the claims listed on Exhibit “A”. These requests were made in accordance with the insurance policies under which the claims were submitted, and pursuant to the No-Fault Laws. 34. Each request was timely made and based upon the application of objective standards justifying the EUO and the information/documentation sought by GEICO. 35. Each request endeavored to select places and times for the EUO that would be convenient to GEICO but also advised that a change of time, date and location would be considered if requested by Altai Corp. d/b/a Get Ready Medical Supply Each request advised Altai Corp. d/b/a Get Ready Medical Supply that it would be reimbursed for any loss of earnings and reasonable transportation expenses incurred in complying with the request. 36. The EUO Scheduling Chart identifies each claim/bill where an EUO was requested, and which is subject to this declaratory judgment action. For each claim/bill, the respective dates of the written requests made by GEICO and the dates when Altai Corp. d/b/a Get Ready Medical Supply was scheduled to appear are listed, as well as the dates of the non-appearance by Altai Corp. d/b/a Get Ready Medical Supply and the dates that the claims were denied by GEICO. See Affidavit of Jillian Gardella, attached hereto as Exhibit “C,” and the Affidavit of Paul Clay, attached hereto as Exhibit “C.1.” 11 11 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 37. Since June 2022, Altai Corp. d/b/a Get Ready Medical Supply has systematically failed and/or refused to appear for an EUO. 38. For each claim/bill, Altai Corp. d/b/a Get Ready Medical Supply failed to appear for its scheduled EUO on no less than two occasions, and thus, Altai Corp. d/b/a Get Ready Medical Supply breached a material condition precedent to coverage contained in the No-Fault laws and the underlying insurance policies. 39. The systemic failure and/or refusal to appear for an EUO constitutes a material breach of GEICO’s insurance policies and the No-Fault Laws under which the claims have been made and, as such, relieves GEICO from any obligation to pay Altai Corp. d/b/a Get Ready Medical Supply on any of the claims. 40. In each instance where Altai Corp. d/b/a Get Ready Medical Supply has refused to appear for an EUO, GEICO issued a timely denial on the prescribed NF-10 form stating in relevant part that Altai Corp. d/b/a Get Ready Medical Supply failed to comply with its obligation to present a proper proof of claim by failing to provide the EUO, and that Altai Corp. d/b/a Get Ready Medical Supply’s claim was denied because it failed to satisfy a condition of coverage. 41. All of GEICO’s denials of Altai Corp. d/b/a Get Ready Medical Supply’s bills and charges were timely, proper, and consistent with the No-Fault Laws. The chart annexed hereto as Exhibit “A” identifies (i) each claim/bill where an EUO was requested by GEICO, (ii) the respective dates of the requests and appearance dates, (iii) the dates of the non-appearances, and (iv) the dates that the claims were denied by GEICO. 12 12 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 AS AND FOR A FIRST CAUSE OF ACTION Against Altai Corp. d/b/a Get Ready Medical Supply (Declaratory Relief Under CPLR §3001) 42. Plaintiffs incorporate, as though fully set forth herein, each and every allegation in the paragraphs set forth above. 43. There is an actual case in controversy between GEICO and Altai Corp. d/b/a Get Ready Medical Supply regarding more than $60,000.00 in billing for durable medical equipment that has been submitted to GEICO. The claims in dispute are listed on Exhibit “A.” 44. Altai Corp. d/b/a Get Ready Medical Supply has no right to receive payment for any of the claims listed on Exhibit “A” because it failed and/or refused to appear for EUOs requested by GEICO, and therefore, breached a condition of coverage and violated its obligations under the No- Fault Laws. 45. Accordingly, GEICO requests a judgment pursuant to CPLR §3001, declaring that Altai Corp. d/b/a Get Ready Medical Supply has no right to receive payment for the bills submitted to GEICO and listed on Exhibit “A” because it failed and/or refused to appear for an EUO requested by GEICO, and thus breached a condition of coverage and violated its obligations under the No-Fault Laws. WHEREFORE, GEICO respectfully requests that this Court enter a declaratory judgment pursuant to CPLR §3001 in its favor and against Defendant, as follows: A. On the First Cause of Action, a declaration that Altai Corp. d/b/a Get Ready Medical Supply has no right to receive payment for the bills submitted to GEICO and listed on Exhibit “A” because it failed and/or refused to appear for an EUO requested by GEICO, and thus breached a condition of coverage and violated its obligations under the No-Fault Laws; and 13 13 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 B. Reimbursement of the costs and disbursements associated with the prosecution of this action, and such other and further relief as the Court may deem just and proper. Dated: Melville, New York August 25, 2023 Yours, etc., Law Office of Goldstein & Hopkins GEICO Staff Counsel By: ______________________________ Rachel S. Hochhauser, Esq. Attorneys for Plaintiffs 2 Huntington Quadrangle Suite 1N01 Melville, New York 11747 (516)714-7404 14 14 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 Index No. SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF NASSAU Government Employees Insurance Co., GEICO Indemnity Co., GEICO General Insurance Company and GEICO Casualty Co. (collectively “GEICO”), Plaintiff(s) SUMMONS AND VERIFIED COMPLAINT - against - Altai Corp. d/b/a Get Ready Medical Supply Defendant(s) PURSUANT TO 22 NYCRR 130-1.1(a), I CERTIFY THAT BASED ON MY KNOWLEDGE, INFORMATION AND BELIEF, FORMED AFTER AN INQUIRY REASONABLE UNDER THE CIRCUMSTANCES, THE WITHIN SUMMONS AND VERIFIED COMPLAINT ARE NOT FRIVOLOUS. Law Office of Goldstein & Hopkins GEICO Attorneys for Plaintiff(s) 2 Huntington Quadrangle, Suite 1N01 Melville, NY 11747 516-714-7404 TO: Altai Corp. d/b/a Get Ready Medical Supply Defendant 7122 Bay Parkway, Floor 2 Brooklyn, New York 11204 Defendant(s) Due and timely service of a copy of the within ______________________________ is hereby admitted. Dated, 2023 Attorney(s) for 15 15 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 VERIFICATION STATE OF NEW YORK } COUNTY OF SUFFOLK } JILLIAN GARDELLA, being duly sworn, deposes and says: I am employed as a claims manager in the claims department of Plaintiff herein, an insurance corporation duly licensed by the State of New York. I have read the foregoing Verified Complaint and know the contents thereof, and the same is true to my own knowledge except as to the matters therein stated to be alleged upon information and belief, and that as to those matters, I believe it to be true. I further state that the grounds of my belief as to all matters therein stated on information and belief are derived from statements of the Plaintiff, Plaintiff's office records, and my review into the facts of this case. I declare under penalty of perjury that the foregoing is true and correct. RL IAN GARDELLA ACKNOWLEDGMENT STATE OF NEW YORK ) ) ss: COUNTY OF SUFFOLK ) On this day of August 2023, before me personally appeared2 b rm ¬a// /dL , to me known and known to me to be the individual described in and who executed the foregoing affidavit, and they duly acknowledged that they executed the same. NOTARY PUBLIC ANN FRANCES RAGONE Notary Public, State of New York No. 01RA0000009 Qualified in Suffolk County Commission Expires February 1, 2027 16 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 Exhibit “A” 17 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 Claim No. IP's Name Bill Recvd. DOS From DOS To Billed Amnt. 1st EUO Ltr. 1st EUO Dt. 2nd EUO Ltr. 2nd EUO Dt. 3rd EUO Ltr. 3rd EUO Dt. 4th EUO Ltr. 4th EUO Dt. 5th EUO Ltr. 5th EUO Dt. 6th EUO Ltr. 6th EUO Dt. 7th EUO Ltr. 7th EUO Dt. Denial Dt. Batch No. 20220531-0025 0666329500000001 ARLENE CUNNINGHAM 05/02/2022 03/29/2022 04/25/2022 $3,076.04 05/31/2022 06/21/2022 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/18/2022 12/01/2022 11/07/2022 12/01/2022 12/08/2022 01/06/2023 01/27/2023 0682431770000001 LATACIA HEPBURN 05/02/2022 03/29/2022 04/25/2022 $3,076.04 05/31/2022 06/21/2022 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/18/2022 12/01/2022 11/07/2022 12/01/2022 12/08/2022 01/06/2023 01/27/2023 8707478840000002 MICHAEL GLOVER 05/02/2022 03/29/2022 04/25/2022 $3,076.04 05/31/2022 06/21/2022 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/18/2022 12/01/2022 11/07/2022 12/01/2022 12/08/2022 01/06/2023 01/27/2023 Batch No. 20220701-0008 0294271040101252 SATIN NEWLAND 06/09/2022 04/30/2022 04/30/2022 $3,076.04 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/2022 11/07/2022 12/01/2022 12/07/2022 01/06/2023 01/25/2023 02/21/2023 02/16/2023 03/02/2023 03/20/2023 8718421270000003 MILLICENT WRIGHT 06/09/2022 05/01/2022 05/01/2022 $3,076.04 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/2022 11/07/2022 12/01/2022 12/07/2022 01/06/2023 01/25/2023 02/21/2023 02/16/2023 03/02/2023 03/20/2023 8742636580000001 CORY WILLIAMS 06/09/2022 04/29/2022 05/26/2022 $3,076.04 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/2022 11/07/2022 12/01/2022 12/07/2022 01/06/2023 01/25/2023 02/21/2023 02/16/2023 03/02/2023 03/20/2023 8748142910000001 QITUWRA MUHAMMAD 06/13/2022 04/29/2022 05/26/2022 $3,076.04 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/2022 11/07/2022 12/01/2022 12/07/2022 01/06/2023 01/25/2023 02/21/2023 02/16/2023 03/02/2023 03/20/2023 Batch No. 20220701-0009 0460634020101020 BARRY ROWE 06/16/2022 05/15/2022 05/15/2022 $3,076.04 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/18/2022 12/01/2022 11/07/2022 12/01/2022 12/08/2022 01/06/2023 01/26/2023 02/21/2023 02/17/2023 03/02/2023 03/20/2023 0675874170000001 FERGUSON IGBINEDION 06/13/2022 04/29/2022 05/26/2022 $3,076.04 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/18/2022 12/01/2022 11/07/2022 12/01/2022 12/08/2022 01/06/2023 01/26/2023 02/21/2023 02/17/2023 03/02/2023 03/20/2023 8709786290000001 JOSE RODRIGUEZ 06/13/2022 04/30/2022 04/30/2022 $3,076.04 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/18/2022 12/01/2022 11/07/2022 12/01/2022 12/08/2022 01/06/2023 01/26/2023 02/21/2023 02/17/2023 03/02/2023 03/20/2023 8725190870000001 SABRINA GOLDING 06/16/2022 05/10/2022 06/06/2022 $3,076.04 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/18/2022 12/01/2022 11/07/2022 12/01/2022 12/08/2022 01/06/2023 01/26/2023 02/21/2023 02/17/2023 03/02/2023 03/20/2023 Batch No. 20220701-0011 0285378310101059 RAYMOND SMITH 06/16/2022 05/15/2022 06/11/2022 $3,076.04 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/2022 11/07/2022 12/01/20222 12/08/2022 01/06/2023 01/26/2023 02/21/2023 02/17/2023 03/02/2023 03/20/2023 0527436270000002 YURIY POSTERNAK 06/17/2022 07/05/2021 08/01/2021 $3,076.04 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/20222 11/07/2022 12/01/20222 12/08/2022 01/06/2023 01/26/2023 02/21/2023 02/17/2023 03/02/2023 03/20/2023 8755566900000001 SHAKERIA WILSON 06/16/2022 05/10/2022 06/06/2022 $3,076.04 07/01/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/20222 11/07/2022 12/01/20222 12/08/2022 01/06/2023 01/26/2023 02/21/2023 02/17/2023 03/02/2023 03/20/2023 Batch No. 20220722-0056 8701545140000001 DANDRE ROLLINS 06/30/2022 05/20/2022 06/09/2022 $2,446.04 07/22/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/20222 11/07/2022 12/01/20222 12/08/2022 01/06/2023 01/27/2023 02/21/2023 02/17/2023 03/02/2023 03/20/2023 Batch No. 20220722-0090 0408622500101045 DIAMOND SANDERS 07/11/2022 06/01/2022 06/28/2022 $3,076.04 07/22/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/20222 11/07/2022 12/01/20222 12/07/2022 01/06/2023 01/26/2023 02/21/2023 02/16/2023 03/02/2023 03/20/2023 0682855580000002 DELEON MCINTOSH 07/11/2022 06/01/2022 06/28/2022 $3,076.04 07/22/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/20222 11/07/2022 12/01/20222 12/07/2022 01/06/2023 01/26/2023 02/21/2023 02/16/2023 03/02/2023 03/20/2023 8737473160000002 GIANNI HEMMINGS 07/11/2022 06/01/2022 06/28/2022 $3,076.04 07/22/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/20222 11/07/2022 12/01/20222 12/07/2022 01/06/2023 01/26/2023 02/21/2023 02/16/2023 03/02/2023 03/20/2023 8737473160000002 JEANAE JORDAN 07/11/2022 06/01/2022 06/28/2022 $3,076.04 07/22/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/20222 11/07/2022 12/01/20222 12/07/2022 01/06/2023 01/26/2023 02/21/2023 02/16/2023 03/02/2023 03/20/2023 8753882210000001 CANDI LUE 07/11/2022 06/01/2022 06/28/2022 $3,076.04 07/22/2022 08/02/2022 08/09/2022 10/07/2022 10/17/2022 12/01/20222 11/07/2022 12/01/20222 12/07/2022 01/06/2023 01/26/2023 02/21/2023 02/16/2023 03/02/2023 03/20/2023 $60,890.80 # Sensitivity: Public 18 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 Exhibit “B” 19 of 56 FILED: NASSAU COUNTY CLERK 08/31/2023 03:58 PM INDEX NO. 614141/2023 No-Fault: Examination unCler Oath Page 1 of 2 NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 08/31/2023 Home About Us Consurners Banking industry insurance Industry LEGAL Reports & Publications Regulations Opinions industry Guidance Interagency Agreements & MOUs FOlLRequests Legislative Summaries The Office of General Counsel issued the following opinion on December 22, 2006, representing the position of the New York State Insurance Department. Re: No-Fault: Examination under Oath QUESTIONS PRESENTED 1) Must a No-Fault insurer's reasonable and objective standards, used in determining whether an examination under oath of an eligibl