Preview
FILED: NEW YORK COUNTY CLERK 07/12/2018 09:25 AM INDEX NO. 652670/2018
NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 07/12/2018
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF NEW YORK
_______________________________________________________
LIBERTY MUTUAL INSURANCE COMPANY AND
LIBERTY MUTUAL FIRE INSURANCE COMPANY.
PLAINTIFF,
INDEX NO.: 652670/18
-AGAINST- FILE NO.: GS- 723583
MICHELLE CARTER
And
DEFENDANT's
ARON ROVNER MD PLLC
FIRST SET OF DEMAND FOR
BROOK CHIROPRACTIC OF NY PC
CITMEDICAL PLLC VERIFIED WRITTEN
I,
DIGNITY PT, PC, INTERROGATORIES
FRANK SAUCHELLI MD,
GENTLE CARE ACUPUNCTURE, PC
JULES PARISEN,
JULY PT, PC
LEFFERTS GARDENS CHIROPRACTIC PC
LIFE REHAB PT PC
LONGEVITY MEDICAL SUPPLY, INC,
NYC COMMUNITY MEDICAL CARE PC,
QUANTUM REHAB PHYSICAL THERAPY PC,
YJR ACUPUNCTURE PC
DEFENDANTS.
_______________-________________________________________
PLEASE TAKE NOTICE that the Defendant YJR ACUPUNCTURE PC hereby
demands that the Plaintiff serve upon the undersigned within twenty (20) days from the date of
service herein, a copy of answers to each interrogatory pursuant to §3101, §3130, §3131, and
RULE 3133 of the Civil Practice Laws and Rules of the State of New York.
GENERAL INSTRUCTIONS
CPLR R. 3133 (b) provides "Interrogatories shall be answered in writing, under oath by
the party served, if an individual, or, ifthe party served is a corporation, a partnership or a sole
proprietorship, by an officer, director, member, agent or employee having the information. Each
question shall be answered separately and fully, and each answer shall be preceded by the
responds."
question to which it
PLEASE TAKE NOTICE that any documents provided in response to this demand must
be separately identified by an Exhibit Number or Question number, and must be annexed to the
PlaintifF s response.
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DEFINITIONS
1) Assignor(s): shall refer to MICHELLE CARTER and at time referred as Plaintiff's
insured.
2) "Defendant": shall refer to YJR ACUPUNCTURE PC and shall at times be referred
to as assignee.
"Plaintiff"
3) shall mean LIBERTY MUTUAL INSURANCE COMPANY AND
LIBERTY MUTUAL FIRE INSURANCE COMPANY and its parents, subsidiaries, affiliates,
owners, directors, trustees, offices, employees, agents and counsel or third party administrators.
Plaintiff"
4) shall mean LIBERTY MUTUAL INSURANCE COMPANY AND
LIBERTY MUTUAL FIRE INSURANCE COMPANY and any of itsagents or representatives.
5) "Received": shall mean to come into possession and/or control, or to take custody of.
"Bill"
6) or "Bills": shall mean any document requesting payment for dates of service
and services rendered; or shall also mean any document otherwise known as "NF-3", Health
Insurance Claim Form (HICF).
"Document"
7) shall mean writings, exhibits, NF-3(s), Assignment of benefit(s),
medical bills, reports, Health Insurance Claim Form(s) (HICF), emails, drawings, graphs, charts,
photographs, phone records, and other date compilations, including electronic or computerized
data compilations, from which information can be obtained, translated, if necessary, through
detection devices into reasonable usable form.
"Copy"
8) or "Copies": shall mean a reproduction, replication, duplicate, or imitation
of a document; or shall mean a document that looks like, and/or appears similar to the documents
annexed hereto.
like"
9) "Looks and "appears similar": shall mean with respect to bill(s) that the
document has the same assignor's name, same date of services, same procedure codes and the
same amount of money demanded.
10) "Paid": shall mean any satisfaction, remuneration and/or compensation in monetary
form.
11) "Assignment of Benefits": shall mean any document that appears to transfer to
another allor part of one's property, interest, or rights.
12) "Verification": shall mean any document sent by Plaintiff to plaintiff seeking
additional information from plaintiff, including, but not limited to any requests for verification in
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the form of a request for an examination under oath of the assignor(s) and/or assignee, requests for
further information pertaining to assignee's proofs of claims, including NF-3 bill, assignment of
benefits, letters of medical necessity, reports, signatures, etc.
13) "NF-10 and/or Denial of Claim Form": shall mean any document that has been
prescribed and/or approved by the Department of Insurance, pursuant to 11 NYCRR 65, that is
designed and/or intended to be used by Plaintiff to inform plaintiff that the bills submitted in the
above-captioned claimed have been denied.
"Claim"
14) shall mean any documents that Plaintiff received from Defendant
concerning No-Fault benefits which are the subject matter of this lawsuit.
15) The use of the singular form of any word includes the plural and vice versa.
INTERROGATORIES
1) INTERROGATORY (1): For Each Claim:
a) Set forth the full name, title, and relationship to the Plaintiff of the person
answering these interrogatories.
b) Set forth whether the person answering these interrogatories is the Plaintiff's
claim representative assigned to the bill(s) that are the subject of this lawsuit.
c) If the answer to subdivision (b) of this interrogatory is in the negative, set forth
the name of the Plaintiff's claim representative assigned to the bill(s) which are the subject of this
lawsuit.
d) Set forth whether the Plaintiff's claim representative assigned to the bill(s)
which are the subject of this lawsuit is currently employed by the Plaintiff.
e) Provide any notes, logs, or memoranda prepared or kept by the Plaintiff's claim
representative assigned to the bill(s) which are the subject of this lawsuit.
2) INTERROGATORY (2): For Each Claim:
a) Set forth whether at the time of the motor vehicle accident, which is the subject
of this lawsuit, there existed a valid New York Automobile Liability policy issued by the Plaintiff
providing No-Fault benefits for the assignor(s) and/or policy holder and/or policy holder herein.
b) Set forth the policy number and the dates the policy was in effect.
3) INTERROGATORY 3: For Each Claim:
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a) Set forth whether the Plaintiff received an assignment of benefits from the
Plaintiff assignee for services provided to the above-captioned assignor(s), who are the subject of
this lawsuit herein.
b) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth a true and accurate copy of the assignment of benefits.
4) INTERROGATORY (4): For Each Claim:
a) Set forth whether the Plaintiff received the bill(s) which are the subject of this
lawsuit concerning the assignors in this matter.
b) Set forth the date that the bill(s)were received by the Plaintiff.
c) Please set forth copies of all billsreceived by the Plaintiff ifthe response in this
inquiry is in the affirmative.
5) INTERROGATORY (5): For Each Claim:
a) Set forth whether the Plaintiff made any request for additional verification
(including any requests for verification in the form of a request for an examination under oath), of
either the assignee and/or assignor(s), concerning any of the bill(s) that are the subject of the
lawsuit.
b) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the date such request was mailed.
c) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the reason(s) why the requested verification was necessary to process the claim.
d) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth a true and accurate copy of such request.
e) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth whether the Plaintiff received any response to its request for additional verification.
f) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the date the response was received by the Plaintiff.
g) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth a true and accurate copy of the response received by the Plaintiff.
h) If the Plaintiff has issued a Denial of Claim form (N-F-10) to the plaintiff for
the bill(s) that are the subject of this lawsuit, set forth whether the Plaintiff had received allrelevant
verification requested prior to the issuance of the N-F-10.
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6) INTERROGATORY (6): For Each Claim:
a) Set forth whether the Plaintiff requested that the assignor(s) and/or the
Defendant assignee herein submit to an Examination Under Oath (EUO).
b) Ifthe answer to subdivision (a) of this interrogatory is in the affirmative, set
forth true and accurate copies of such requests.
c) If the answer to any of the above subdivisions of this interrogatory is in the
affirmative, set forth the date any and all examinations were to take place.
d) If the answer to any of above subdivisions of this interrogatory is in the
affirmative, set forth whether any assignors and/or Defendant assignee herein were represented by
legal counsel.
e) If the answer to any of the above subdivisions of this interrogatory is in the
affirmative, set forth whether Plaintiff, Plaintiff's claims representatives, and or Plaintiff's legal
counsel had any conversation with the any assigners and/or Defendant assignee and/or its legal
representatives.
1) Ifthe answer to any of the above subdivisions of this interrogatory is inthe
affirmative, set forth the dates, names of Plaintiff's employees or representatives that had said
communications.
2) If theanswer to any of the above subdivisions of this interrogatory is inthe
affirmative, set forth true and accurate copies of any letters,emails or correspondences.
f) If the answer to any of the above subdivisions of this interrogatory is in the
affirmative, set forth whether Plaintiff had any knowledge as to whether the assignors or Defendant
assignee had legal representations.
g) If the answer to any of the above subdivisions of this interrogatory is in the
affirmative, set forth whether any of the examinations were rescheduled.
h) If the answer to any of the above subdivisions of this interrogatory is in the
affirmative, set forth true and accurate copies of any and all communication between.
i) If the answer to any of the above subdivisions of this interrogatory is in the
affirmative, set forth whether the examination took place and the date the examination took place.
j) If the answer to any of the above subdivisions of this interrogatory is in the
affirmative, set forth provide a true and accurate copy of the report and/or transcript from said
examination.
7) INTERROGATORY 7: For Each Claim:
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a) Set forth the reason(s) and justification as to why said additional verification
requests (including any requests for verification in the form of a request for an examination under
oath) were demanded from plaintiff.
8) INTERROGATORY (8): For Each Claim:
a) Set forth the name of the individual that made the determination of demanding
said requests.
9) INTERROGATORY (9): For Each Claim:
a) Set forth the procedures for the generation/creation of the verification requests
(Specifically, how are verification requests generated and created, where are the requests
generated, what is done with them after they are generated.)
b) Set forth the procedures by which the verification requests are mailed to the
provider and/or Plaintiff's assignor.
c) Set forth the specific objective standard applied by the Plaintiff if an
examination under oath was requested of plaintiff and/or plaintiff's assignor (When an insurer
requires an examination under oath of an applicant to establish proof of claim, such requirement
must be based upon the application of objective standards so that there is specific objective
justification supporting the use of such examination. Insurer standards shall be available for review
by Department examiners).
d) Set forth a true and accurate copy of said objective standards available for
review by Department examiners. (65-3.5 (e).
e) Set forth whether the Plaintiff writes or has written 1000 insurance policies in
the State of New York.
f) If the answer to (d) is in the affirmative, please set forth the procedures
established by the Plaintiff for handling claims, notices, and verification. (65-3.5 (k).
g) If the answer to (d) is in the affirmative, please set forth a written copy of the
established procedures for processing claims, notices and verification (65-3.5 (k).
10) INTERROGATORY (10): For Each Claim:
a) Set forth whether the Plaintiff made any payment for the bill(s) that are the
subject of this lawsuit,
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b) Ifthe answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the amount of payment and the date such payment was mailed.
c) Ifthe answer to subdivision (a) of this interrogatory is in the affirmative, set
forth copies of any cancelled checks, computer notes, or any other manner that reflects all or partial
payments of the bills that are the subject of this lawsuit.
I1) INTERROGATORY (11): For Each Claim:
Set forth whether the Plaintiff received an Application for Benefits form (N-F-
a)
2) from the assignor(s) herein.
b) Set forth the date Application for Benefits form (N-F-2) was received by the
Plaintiff.
c) Set forth a true and accurate copy of the same.
d) Set forth whether the Plaintiff's defense to this matter is based upon the
allegation that the assignor(s) herein failed to provide written notice to the Plaintiff within the time
requirements set forth in 11 NYCRR 65.
e) If Plaintiff's defense to this matter is based upon the allegation that the
assignor(s) herein failed to provide written notice to the Plaintiff within the time requirements set
forth in 11 NYCRR 65, set forth the dates the Plaintiff mailed the Application for Benefits form
(N-F-2) to the assignor(s) herein.
f) If Plaintiff's defense to this matter is based upon the allegation that the
assignors(s) herein failed to provide written notice to the Plaintiff within the time requirements set
forth in 11 NYCRR 65, set forth in the address to which the Plaintiff mailed the Application for
Benefits form (N-F-2).
g) If Plaintiff's defense to this matter is based upon the allegation that the
assignor(s) herein failed to provide written notice to the Plaintiff within the time requirements set
forth in 11 NYCRR 65, set forth copies of the forms that were mailed to the assignor(s) herein.
12) INTERROGATORY (12): For Each Claim:
a) Set forth whether the Plaintiff issued a Denial of Claim form (N-F-10) to the
plaintiff for the bill(s) that are the subject of this lawsuit.
b) If the answer to subdivision (a) for this interrogatory is in the affirmative, set
forth the date the N-F-10 was generated.
c) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the date the N-F-10 was mailed,
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d) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the specific address the N-F-10 was mailed from.
e) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth with specificity Plaintiff's general business practices pertaining to the mailing procedures of
the N-F-10.
f) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth a true and accurate copy of the N-F-10.
g) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth any proof of mailing, certified receipts or documentation establishing the date the NF-10(s)
was/were mailed.
h) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the reason(s) that the Plaintiff denied the plaintiff's claim.
13) INTERROGATORY (13): For Each Claim:
a) Set forth the procedure on how a Denial of Claim form(s) (N-F-10) was/were
created and/or generated by Plaintiff for the plaintiff for the bill(s), which are the subject of this
lawsuit.
b) Set forth the procedure on how any verification requests was/were created
and/or generated by Plaintiff for the plaintiff for the bill(s), which are the subject of this lawsuit.
c) Set forth the procedure on how any Notice of an Independent Medical
Examination Requests was/were created and/or generated by Plaintiff for the plaintiff for the
bill(s), which are the subject of this lawsuit.
d) Set forth the procedure on how any Notice of Examination Under Oath requests
was/were created and/or generated by Plaintiff for the plaintiff for the bill(s), which are the subject
of this lawsuit.
14) INTERROGATORY (14): For Each Claim:
a) Set forth the procedure on how any Denial of Claim form(s) (N-F-10) was/were
mailed and/or transported into the care and custody of the United States Postal Office by Plaintiff
for the plaintiff for the bill(s),which are the subject of this lawsuit.
b) Set forth the procedure on how any verification requests was/were mailed
and/or transported into the care and custody of the United States Postal Office by Plaintiff for the
plaintiff for the bill(s), which are the subject of this lawsuit.
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c) Set forth the procedure on how any Notice of Examination Under Oath requests
was/were mailed and/or transported into the care and custody of the United States Postal Office
by Plaintiff for the plaintiff for the bill(s), which are the subject of this lawsuit.
15) INTERROGATORY (15): For Each Claim:
a) Did Plaintiff use a courier service to mail and/or transport Denial of Claim
form(s) (N-F-10), verification requests, Notice of an Independent Medical Examination Requests
or Notice of Examination Under Oath requests into the care and custody of the United States Postal
Office by Plaintiff during the ordinary course of business.
b) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the specific name of said courier service.
16) INTERROGATORY (16): For Each Claim:
a) If the Plaintiff alleges the plaintiff's assignor failed to give timely notice of
claim to the Plaintiff, set forth whether the Plaintiff notified plaintiff's assignor that late notice will
be excused when the applicant can provided reasonable justification of the failure to give timely
notice.
b) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth how the Plaintiff gave such notice.
c) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth true and accurate copies of such notification.
17) INTERROGATORY (17): For Each Claim:
a) If the Plaintiff alleges that plaintiff's assignor failed to give timely proof of
claim to the Plaintiff, set forth whether the Plaintiff notified plaintiff's assignor that latenotice will
be excused when the applicant can provide reasonable justification of the failure to give timely
notice.
b) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth how the Plaintiff gave such notice.
c) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth true and accurate copies of such notification.
18) INTERROGATORY (18): For Each Claim:
a) With respect to the claim(s) sued for under the caption above, set forth whether
the Plaintiff requested that the assignor(s) and/or policy holder herein provide a written statement
of facts.
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b) With respect to the claim(s) sued for under the caption above, set forth true and
accurate copies of such requests.
c) With respect to the claim(s) sued for under the caption above, set forth when
and where the statements were taken.
d) With respect to the claim(s) sued for under the caption above, set forth a true
and accurate copy of the written statement.
19) INTERROGATORY (19): For Each Claim:
a) With respect to the claim(s) sued for under the caption above, set forth whether
the plaintiff's claim was subject to an investigation, or was assigned to a Special Investigation
Unit.
b) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the results of said investigation.
c) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth true and accurate topics of all reports, investigations, notes and memoranda concerning said
investigation, including, but not limited to, any SIU reports, EUO transcripts, and/or other
investigative reports.
20) INTERROGATORY (20): For Each Claim:
a) Set forth whether the Plaintiff received a copy of MV-104 for the motor vehicle
accident which is the subject of this lawsuit.
b) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the date the MV-104 was received.
c) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth a true and accurate copy of the MV-104.
d) Set forth whether the Plaintiff received a copy of the Police Report for the motor
vehicle accident which is the subject of the lawsuit.
e) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the date the Police Report was received.
f) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth a true and accurate copy of the Police Report.
21) INTERROGATORY 21: For Each Claim:
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a) Set forth whether Plaintiff/Insurance Company is claiming that the accident
accident."
pertaining to the above-entitled case was a "staged
b) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
accident."
forth the basis of claiming that said accident was a result of a "staged
c) Ifthe answer to subdivision (a) of this interrogatory is in the affirmative, set
forth true and accurate copies of any and all reports, notes, documents, transcripts, videotapes,
recordings and memoranda concerning said investigation of any alleged "staged accident",
including, but not limited to any SIU reports, investigative reports, and EUO Transcripts.
22) INTERROGATORY (22): For Each Claim:
a) Set forth whether Plaintiff insurance company is claiming that any of the
assignor(s) and/or policy holder committed fraud in this case.
b) Ifthe answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the basis and reasons as to why Plaintiff/Insurance Company believes that any of the
assignor(s) and/or policy holder committed fraud in this case.
c) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth true and accurate copies of any and all reports, notes, documents, transcripts, videotapes,
recordings and memoranda concerning said investigation of any fraud by any of the assignors(s)
and/or policy holder in this case, including, but not limited to any SIU reports, investigative
reports, and EUO Transcripts.
23) INTERROGATORY (23): For Each Claim:
a) Set forth whether Plaintiff insurance company is claiming that the provider
and/or plaintiff in this case have committed fraud in this case.
b) Ifthe answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the basis of claiming that any of the provider and/or plaintiff committed fraud in this case.
c) Ifthe answer to subdivision (a) of this interrogatory is in the affirmative, set
forth true and accurate copies of any and all reports, notes, documents, transcripts, videotapes,
recordings and memoranda concerning said investigation of any fraud by any of the provider
and/or plaintiff in this case, including, but not limited to any SIU reports, investigative reports, and
EUO Transcripts.
24) INTERROGATORY (24}: For Each Claim:
a) Set forth whether Insurance Company is claiming that there is no coverage in
this case.
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b) Ifthe answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the basis of claiming that there is no coverage in this case.
c) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth true and accurate copies of any and all reports, notes, documents, transcripts, videotapes,
recordings and memoranda concerning no coverage in this case, including, but not limited to any
SIU reports, investigative reports, and EUO Transcripts.
25) INTERROGATORY (25): For Each Claim:
a) Set forth whether the Plaintiff alleges that the instant matter is covered by
Worker's compensation and not No-Fault.
b) If the answer to subdivision (a) of this interrogatory is in the affirmative, please
set forth true and accurate copies of any and allreports, notes, documents, transcripts, videotapes,
recordings and memoranda concerning Plaintiff's allegation that the instant claim is covered by
Worker's Compensation.
26) INTERROGATORY (26): For Each Claim:
a) Set forth whether the Plaintiff alleges that the assignor(s)'s injuries occurred
during the course ofthe assignor(s)'s employment and was not involved in an automobile accident.
b) If the answer to subdivision (a) of this interrogatory is in the affirmative, please
set forth true and accurate copies of any and all reports, notes, documents, transcripts, videotapes,
recordings and memoranda.
27) INTERROGATORY (27): For Each Claim:
a) If the Plaintiff denied plaintiff's claim based on an alleged failure to appear for
any Examination Under Oath and/or Independent Medical Examination set forth:
1) Any Names of any companies, corporations or third party companies
and/or affiliates and/or third party vendors that allegedly forward notices of said appearances to
plaintiff.
28) INTERROGATORY (28): For Each Claim:
a) Set forth whether the individual answering these interrogatories received a copy
of Regulation 68 from Plaintiff at any time during the course of their employment with Plaintiff.
b) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth the date it was received.
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c) If the answer to subdivision (a) of this interrogatory is in the affirmative, set
forth whether the answering individual read and familiarized themselves with the copy of Reg. 68
provided by Plaintiff.
PLEASE TAKE NOTICE, that this demand is a continuing demand, and in the event knowledge
is acquired subsequent to the receipt of this demand, up to and including the trialof this action,
you are required to set forth in writing, and under oath, the name and address of such persons.
PLEASE TAKE NOTICE, in the event this Demand is not complied with the plaintiff will, upon
the trial of this action, move the court to preclude and forbid the testimony of any witness offered
by the Plaintiff as to what has not thereto been furnished to the plaintiff's attorneys, pursuant to
this Demand.
PLEASE TAKE NOTICE that your default will result in an application being made to the Court
for the appropriate relief, with costs.
Dated: WANTAGH NY
July 2, 2018
JOSEPH J ADR CCO ESQ
Law Offi es of G riel &
Shapiro L.L.C.
Atto ys for D fendant
YJR UPUN TURE PC
3361 ark enue, Ste 1000
Want , ew York11793
Tel.516-783-6565
To:
Burke, CONWAY & Dillon
Attomey for Plaintiffs
LIBERTY MUTUAL INSURANCE CO
10 Bank Street,Suite 1200
White Plains, NY 10606
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SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF NEW YORK
______________________________________..___________________________________________
LIBERTY MUTUAL INSURANCE COMPANY AND
LIBERTY MUTUAL FIRE INSURANCE COMPANY.
PLAINTIFF,
INDEX NO.: 652670/18
-AGAINST- FILE NO.: GS- 723583
MICHELLE CARTER
And
DEFENDANT's
ARON ROVNER MD, PLLC