Plaintiff v. Healthcare Provider
Plaintiff, a participant in a managed long-term-care plan (the Plan) both administered and partially funded by Sedgwick’s client, filed a complaint in New York State Supreme Court, County of Orange, asserting a single cause of action sounding in negligence against Sedgwick’s client and several other defendants. Specifically, plaintiff alleged that Sedgwick’s client acted negligently in creating plaintiff’s home healthcare treatment plan, inspecting her son’s home for safety prior to her transfer from a nursing home, and in assisting her with her activities of daily living, all of which purportedly caused her to fall and suffer physical injuries.
Sedgwick moved to dismiss plaintiff’s complaint pursuant to Rules 3211(a)(1) and (7) of New York Civil Practice Law and Rules (CPLR) on the grounds that it failed to state a cause of action upon which relief can be granted and because plaintiff’s claims are refuted by documentary evidence (i.e. the terms of the Plan).
The court agreed with Sedgwick’s argument that plaintiff’s complaint failed to state a cause of action for negligence against Sedgwick’s client because the parties’ relationship is based in contract (i.e. the Plan). The court further agreed with Sedgwick’s argument that plaintiff failed to allege how anything done or not done by Sedgwick’s client proximately caused her accident and injuries. The court also found that while plaintiff had not actually plead a negligent misrepresentation cause of action in her complaint and improperly included allegations to support such a claim in opposition to Sedgwick’s motion, the complaint still did not allege sufficient facts to support a cause of action for negligent misrepresentation. The court noted that plaintiff’s bare, conclusory allegations failed to satisfy the special pleading requirements set forth in Rule 3016(b), CPLR for negligent misrepresentation and fraud claims and that plaintiff also failed to allege facts that would support the conclusion that anything Sedgwick’s client represented to the plaintiff, or her son, proximately caused plaintiff’s injuries.